Brain stimulation and psychiatric disorders: Autonomy, Rationality, and Contemporary Bioethics

Personal autonomy is central to many of the most important debates in practical ethics, including those surrounding euthanasia, gene-editing, so-called ‘sin taxes’, markets for human organs, genome screening, and involuntary psychiatric treatment. But what is autonomy, and why do we seem to value it so much? In this book, Jonathan Pugh outlines a rationalist conception of autonomy, and explains the role it can play in contemporary bioethical debates. Although it is often claimed that there is an important relationship between autonomy and rationality, there is also considerable disagreement about the nature of this the relationship. In particular, it is unclear whether a rationalist view of autonomy can be compatible with legal judgments that enshrine a patient's right to refuse medical treatment, regardless of whether the reasons underpinning the choice are known and rational, or indeed whether they even exist. In exploring this relationship, Pugh develops a new framework for thinking about the concept of autonomy, one that is grounded in an understanding of the different roles that rational beliefs and rational desires have to play in autonomy. The theory is applied to a wide range of bioethical questions in which concerns about autonomy are particularly important.

Dr Jonathan Pugh is Parfit-Radcliffe Richards Senior Research Fellow at the Uehiro Centre for Practical Ethics. He recently completed a Wellcome Trust funded project entitled "The Ethics of Novel Therapeutic Applications of Deep Brain Stimulation". He has written on the ethics of human embryonic stem cell research, criminal justice, neuroethics, and gene-editing. 

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