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Autonomy is often said to be the dominant ethical principle in modern
bioethics, and it is also important in law. Respect for autonomy is said to
underpin the law of consent, which is theoretically designed to protect the
right of patients to make decisions based on their own values and for their own
reasons. The notion that consent underpins beneficent and lawful medical
intervention is deeply rooted in the jurisprudence of countries throughout the
world. However, Autonomy, Consent and the Law challenges the relationship
between consent rules and autonomy, arguing that the very nature of the legal
process inhibits its ability to respect autonomy, specifically in cases where
patients argue that their ability to act autonomously has been reduced or
denied as a result of the withholding of information which they would have
wanted to receive.
Sheila McLean further argues that the bioethical debate about the true nature
of autonomy – while rich and challenging – has had little if any impact on the
law. Using the alleged distinction between the individualistic and the
relational models of autonomy as a template, the author proposes that, while it
might be assumed that the version ostensibly preferred by law – roughly
equivalent to the individualistic model – would be transparently and
consistently applied, in fact courts have vacillated between the two to achieve
policy-based objectives. This is highlighted by examination of four specific
areas of the law which most readily lend themselves to consideration of the
application of the autonomy principle: namely refusal of life-sustaining
treatment and assisted dying, maternal/foetal issues, genetics and
transplantation.
This book will be of great interest to scholars of medical law and bioethics.