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In the year ended December 2015:

13,155 abortions were performed in New Zealand, similar to 2014 (13,137).

The general abortion rate was 14.2 abortions per 1,000 women aged 15-44 years, down slightly from 14.4 per 1,000 in 2014.

Women aged 20-24 years had the highest abortion rate (23 abortions per 1,000 women aged 20-24 years).

Most abortions (63 percent) were a woman's first abortion.

55 percent of abortions were performed before the 10th week of the pregnancy.

18 percent of known pregnancies (live births, stillbirths, and abortions) ended in an abortion.

See the Abortions Statistics: Year ended December 2015 commentary and tables for more information.

Carol Slappendel, Acting Government Statistician
ISSN 1178-0193
17 June 2016

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Abortion Statistics: Year ended December 2015

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In the year ended December 2015: 13,155 abortions were performed in New Zealand, similar to 2014 (13,137). The general abortion rate was 14.2 abortions per 1,000 women aged 15-44 years, down slightly from 14.4 per 1,000 in 2014. Women aged 20-24 years had the highest abortion rate (23 abortions per 1,000 women aged 20-24 years).

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Cost of abortion

Abortion care is free for most New Zealand residents. If you are not a citizen or permanent resident your care may still be free, check out this guide to free healthcare eligibility. If your care is not funded, talk to your local provider who can tell you how much your abortion care will cost.

If you are not eligible for funded healthcare, but are pregnant as a result of rape, ACC is obliged to pay for your treatment.

Medical abortion

Medical abortion uses pills rather than surgery. An early medical abortion (up to nine weeks) is more like a natural miscarriage. A later medical abortion is more like inducing a labour.

Surgical abortion

Surgical abortion by vacuum aspiration is a minor procedure taking a few minutes, usually performed with you awake.

Availability of first trimester abortion services

Most areas of New Zealand offer a local abortion service.

The method of abortion varies from region to region. Generally you will have to a resident of an area to access the services offered there.

In a few areas of the country you will need to travel to get your abortion care. If this is the case your local District Health Board will organise the referral and assist with transport costs. Areas where this happens are Rotorua, Whanganui, Palmerston North, South Canterbury and the West Coast - see information given in Where to go.

Risks of abortion

Abortion is very safe, but all methods carry some risk. The risk is dependent on the stage of pregnancy at which the abortion is carried out as well as the procedure used.

The pre-existing health of the woman also impacts upon the risk. It's important that you give full information about your past and present health when deciding on the procedure.

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Abortion care is free for most New Zealand residents. If you are not a citizen or permanent resident your care may still be free, check out this guide to free healthcare eligibility. If your care is not funded, talk to your local provider who can tell you how much your abortion care will cost.

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What is medical abortion?

Medical abortion is a way to end pregnancy without surgery, and is like having a miscarriage.

It falls into two categories. Early medical abortion performed up to 9 weeks of pregnancy induces a miscarriage. Second trimester medical abortion is performed later in pregnancy to put a woman into early labour.

The availability of medical abortion varies around the country, check you local provider for details.

Early medical abortion

Available up to nine weeks (63 days) after the beginning of the last menstrual period.

The treatment

The treatment will usually consist of one Mifegyne® tablet. This acts by blocking the effects of progesterone, a hormone which is needed for pregnancy to continue.

This will be followed zero to 48 hourrs later by the insertion into the vagina, or inside the mouth, four tablets of Cytotec® (misoprostol). This is a different type of hormone, a prostaglandin, that helps to expel the pregnancy. The timing of this medicine depends on a number of factors including the age of your pregnancy, your local clinics protocols, and your preference. In any cases this second medicine will need to be taken either later in the day or within the next two days for medical reasons.

In New Zealand the law requires that both these medications are taken in the abortion clinic. However, it is usual for the patient to go home after taking the medicine for the miscarriage to occur.

Who can use this treatment?

Most women can have the treatment. However it is not suitable:

if there is an ectopic pregnancy (where the egg has implanted in the tube rather than in the womb).

if the first day of the last normal menstrual period was more than 63 days ago. The doctor can confirm the age of the pregnancy with an ultrasound scan.

if you have ever had a bad reaction or are allergic to the drugs used in a medication abortion: mifepristone (Mifegyne®) or misoprostol (Cytotec®).

if an intrauterine contraceptive device (IUD) is in place. This must be removed before taking Mifegyne®.

In some other circumstances the treatment may also be unsuitable so the doctor must be advised:

if you have a medical condition such as a heart complaint, high blood pressure or diabetes.

if you suffer badly from asthma or are on long-term steroid treatment for any other reason.

if you are anaemic or have a bleeding disorder or are receiving anticoagulants.

The doctor will discuss whether the treatment is suitable and what your options are.

Some other precautions

The treatment is not suitable if you do not have a telephone or you live more than one hour from emergency hospital medical services. This is in case of heavy bleeding needing emergency treatment.

The treatment is not suitable if you are unsure about the decision to have an abortion because once the Mifegyne® is taken there is a risk that if the pregnancy continues the baby may be born with abnormalities. Difficulties in making a decision must be discussed with the doctor, nurse/midwife or counsellor.

If you are breast feeding you should stop for at least five hours after taking Mifegyne® and throw away the milk produced in that time.

You should not drink alcohol or smoke once the Mifegyne® has been taken and for at least two days after taking the vaginal tablets. Recreational drugs or herbal preparations, such as St John's Wort, should not be taken.

If you are taking other medicines the doctor must be advised. Some medicines may interfere with the treatment.

What are the effects of treatment?

After taking the initial Mifegyne® tablet nothing much will happen for about 12 hours.

After 12 hours you may start to bleed. Though do not worry if there is no bleeding.

After being given the second Cytotec® tablets, bleeding should start within the next few hours and you will usually get stomach pain and cramps which may be quite strong. A medical abortion is like having a miscarriage. In some cases the bleeding can be very heavy and in a very small number of cases (about 1 in 300) it may be necessary to give a blood transfusion and/or perform a surgical abortion to stop the bleeding.

The doctor will have prescribed painkillers to manage the pain. Pain can be worse if you have never been pregnant before or if you normally suffer from painful periods. Most women cope very well with the pain in their own homes.

Other effects of the second Cytotec® medicines can be diarrhoea, sickness, headache, dizziness, hot flushes and chills. Any concerns you have must be reported to the nurse/midwife or doctor.

In over 90% of cases the pregnancy will be expelled in the six hours after taking the vaginal tablets. If the medical treatment fails a surgical abortion will be necessary; this only happens in less than 5% of cases.

Many women ask if they will be able to see the embryo. The sac and the placenta surrounding the embryo can be seen clearly but the embryo at this stage is usually too small to be seen.

You should have a good supply of maxi-pads. The miscarriage will either occur into your pad, or into the toilet bowl if you decide to rest on the toilet during the heaviest part of the miscarriage.

Follow-up

Most women will pass the tissue at home. In this case arrangements will be made to have blood tests and possibly another ultrasound examination to confirm that the abortion is complete. You are recommended to see your referring doctor for a final check in 10-14 days for any problems and for ongoing contraceptive care.

If the pregnancy tissue has been passed in the clinic, you will be given an appointment with your referring doctor for a final check-up in 10-14 days to make sure that you are well and have suffered no complications.

The follow-up tests to confirm that the pregnancy has ended are most important. The clinic will make an effort to contact you if you do not attend for the tests. Bleeding and cramping are not proof that the abortion is complete.

What about contraception?

A plan for future birth control should be discussed with the clinic medical staff.

It is possible to become pregnant again immediately after the abortion is complete, so that contraception, such as oral contraceptives, should be started within five days of taking the Mifegyne®.

Contraceptive implants can be inserted before the woman takes the second medication.

An IUD can be inserted a week after the medical abortion is complete.

You are advised not to have sex for 14 days.

If the woman is Rh negative

What to expect after going home

You will be advised not to put anything into the vagina for 14 days i.e. no tampons, no sex, no bathing or swimming.

A small number of women may develop an infection. This may cause a temperature, or pain, discharge or unusual bleeding. A doctor should be consulted if this occurs so that antibiotics can be given, if needed.

You may continue to bleed for several weeks. If the bleeding is heavy (more than two maxi-pads an hour for two hours) you should ring the clinic, the referring doctor or emergency hospital medical services.

You should recover quickly from the abortion but will be advised to take things easy for a few days and avoid aerobic exercise for two weeks. You may feel emotional and extra counselling may be needed.

Menstrual period may re-establish in four to eight weeks.

Second trimester medical abortion

In the second trimester of pregnancy (after 12 weeks) a pregnancy is aborted medically by inducing labour. This process has been used for many years in NZ as an alternative to late surgical abortion.

The treatment consists of two different pills Mifegyne® (mifepristone) followed by Cytotec® (a prostaglandin). The process is similar to that with early medical abortion except that it is likely to take longer and be more painful.

The treatment

Mifegyne® (mifepristone) is the first medication.This acts by blocking the effects of progesterone, a hormone which is needed for pregnancy to continue.

This will be followed 24 to 48 hours later by a course of prostaglandin, usually Cytotec® (misoprostol). The dose, frequency and method of delivery of the drugs varies from clinic to clinic. This prostaglandin acts on the uterus in a number of ways to induce contractions that expel the pregnancy.

Who can use this treatment?

Most women can have the treatment but it is important that the doctor knows your full medical history.

How is the treatment taken?

You will be given one to three tablets of Mifegyne® to swallow with some water, which must be taken at the hospital/clinic. You will be able to go home after taking the tablet.

You need a good supply of maxi-pads for use at home.

If there is any cause for concern such as heavy bleeding, the clinic must be consulted for advice. There should be a 24 hour telephone service for any emergencies. In a few cases the abortion may occur after Mifegyne® alone.

You will be given an appointment to return to the clinic 24 to 48 hours later and (except in those women who have already aborted) the course of prostaglandin will be begun. This may be oral or vaginal tablets. The dose will be repeated every few hours until the fetus is delivered.

After a variable time contractions will start and the cervix (neck of the womb) will dilate similar to a labour. Most women find these contractions painful and are likely to need pain relief.

What are the effects of treatment?

After taking the Mifegyne® tablet nothing much will happen for about 12 hours.

After 12 hours you may start to bleed. Though do not worry if there is no bleeding.

After being given the prostaglandin, if bleeding has not already started, it will now start and most women will get stomach pain and cramps which may be quite strong. A second trimester medical abortion is like having a labour. In some cases the bleeding can be very heavy and in a very small number of cases (about 1 in 300) it may be necessary to give a blood transfusion and other drugs which contract the uterus.

If there is a lot of pain the doctor will prescribe painkillers.

The average time taken to expel the pregnancy is about eight hours after the prostaglandin pills. However, a number of women will need to have a second course of prostaglandin the next day and occasionally on the third day.

A number of women do not pass the placenta after the fetus and require a surgical procedure to assist with this (retained placenta).

Follow-up

You should be given an appointment for a follow-up check one to two weeks after the abortion either with the clinic or with her referring doctor/specialist.

If the reason for the termination is a fetal anomaly arrangements will be made to review any post-mortem findings with the parents.

What about contraception?

A plan for future birth control should be discussed with the doctor.

It is possible to become pregnant again immediately after the abortion is complete, so that contraception, such as oral contraceptives, within five days of taking the Mifegyne®.

An implant can be inserted after the first medication.

An IUD can be inserted from one week after the abortion.

You are advised not to have sex for 14 days after the abortion is complete.

If the woman is Rh negative

What to expect after going home

You will be advised not to put anything into the vagina for 14 days i.e. no tampons, no sex, no bathing or swimming.

A small number of women may develop an infection. This may cause a temperature, or pain, discharge or unusual bleeding. A doctor should be consulted if this occurs so that antibiotics can be given, if needed.

You may continue to bleed for several weeks. If the bleeding is heavy (more than two maxi-pads an hour for two hours) you should ring the clinic, the referring doctor or emergency hospital medical services.

You should recover quickly from the abortion but will be advised to take things easy for a few days. You may feel emotional and extra counselling is available if needed. You should have a regular period in four to eight weeks.

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Medical abortion is a way to end pregnancy without surgery, and is like having a miscarriage. It falls into two categories. Early medical abortion performed up to 9 weeks of pregnancy induces a miscarriage. Second trimester medical abortion is performed later in pregnancy to put a woman into early labour.

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Definition of ethical issue: A problem or situation that requires a person or organization to choose between alternatives that must be evaluated as right (ethical) or wrong (unethical).

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We are here to help with your sexual and reproductive health. We can offer you health information, clinical services, education, training and research. We work with people of any gender, age, ethnicity or sexual orientation.

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The field of ethics (or moral philosophy) involves systematizing, defending, and recommending concepts of right and wrong behavior. Philosophers today usually divide ethical theories into three general subject areas: metaethics, normative ethics, and applied ethics. Metaethics investigates where our ethical principles come from, and what they mean. Are they merely social inventions? Do they involve more than expressions of our individual emotions? Metaethical answers to these questions focus on the issues of universal truths, the will of God, the role of reason in ethical judgments, and the meaning of ethical terms themselves. Normative ethics takes on a more practical task, which is to arrive at moral standards that regulate right and wrong conduct. This may involve articulating the good habits that we should acquire, the duties that we should follow, or the consequences of our behavior on others. Finally, applied ethics involves examining specific controversial issues, such as abortion, infanticide, animal rights, environmental concerns, homosexuality, capital punishment, or nuclear war.

By using the conceptual tools of metaethics and normative ethics, discussions in applied ethics try to resolve these controversial issues. The lines of distinction between metaethics, normative ethics, and applied ethics are often blurry. For example, the issue of abortion is an applied ethical topic since it involves a specific type of controversial behavior. But it also depends on more general normative principles, such as the right of self-rule and the right to life, which are litmus tests for determining the morality of that procedure. The issue also rests on metaethical issues such as, "where do rights come from?" and "what kind of beings have rights?"

Table of Contents

1. Metaethics

The term "meta" means after or beyond, and, consequently, the notion of metaethics involves a removed, or bird's eye view of the entire project of ethics. We may define metaethics as the study of the origin and meaning of ethical concepts. When compared to normative ethics and applied ethics, the field of metaethics is the least precisely defined area of moral philosophy. It covers issues from moral semantics to moral epistemology. Two issues, though, are prominent: (1) metaphysical issues concerning whether morality exists independently of humans, and (2) psychological issues concerning the underlying mental basis of our moral judgments and conduct.

a. Metaphysical Issues: Objectivism and Relativism

Metaphysics is the study of the kinds of things that exist in the universe. Some things in the universe are made of physical stuff, such as rocks; and perhaps other things are nonphysical in nature, such as thoughts, spirits, and gods. The metaphysical component of metaethics involves discovering specifically whether moral values are eternal truths that exist in a spirit-like realm, or simply human conventions. There are two general directions that discussions of this topic take, one other-worldly and one this-worldly.

Proponents of the other-worldly view typically hold that moral values are objective in the sense that they exist in a spirit-like realm beyond subjective human conventions. They also hold that they are absolute, or eternal, in that they never change, and also that they are universal insofar as they apply to all rational creatures around the world and throughout time. The most dramatic example of this view is Plato, who was inspired by the field of mathematics. When we look at numbers and mathematical relations, such as 1+1=2, they seem to be timeless concepts that never change, and apply everywhere in the universe. Humans do not invent numbers, and humans cannot alter them. Plato explained the eternal character of mathematics by stating that they are abstract entities that exist in a spirit-like realm. He noted that moral values also are absolute truths and thus are also abstract, spirit-like entities. In this sense, for Plato, moral values are spiritual objects. Medieval philosophers commonly grouped all moral principles together under the heading of "eternal law" which were also frequently seen as spirit-like objects. 17 th century British philosopher Samuel Clarke described them as spirit-like relationships rather than spirit-like objects. In either case, though, they exist in a spirit-like realm. A different other-worldly approach to the metaphysical status of morality is divine commands issuing from God's will. Sometimes called voluntarism (or divine command theory), this view was inspired by the notion of an all-powerful God who is in control of everything. God simply wills things, and they become reality. He wills the physical world into existence, he wills human life into existence and, similarly, he wills all moral values into existence. Proponents of this view, such as medieval philosopher William of Ockham, believe that God wills moral principles, such as "murder is wrong," and these exist in God's mind as commands. God informs humans of these commands by implanting us with moral intuitions or revealing these commands in scripture.

The second and more this-worldly approach to the metaphysical status of morality follows in the skeptical philosophical tradition, such as that articulated by Greek philosopher Sextus Empiricus, and denies the objective status of moral values. Technically, skeptics did not reject moral values themselves, but only denied that values exist as spirit-like objects, or as divine commands in the mind of God. Moral values, they argued, are strictly human inventions, a position that has since been called moral relativism. There are two distinct forms of moral relativism. The first is individual relativism, which holds that individual people create their own moral standards. Friedrich Nietzsche, for example, argued that the superhuman creates his or her morality distinct from and in reaction to the slave-like value system of the masses. The second is cultural relativism which maintains that morality is grounded in the approval of one's society - and not simply in the preferences of individual people. This view was advocated by Sextus, and in more recent centuries by Michel Montaigne and William Graham Sumner. In addition to espousing skepticism and relativism, this-worldly approaches to the metaphysical status of morality deny the absolute and universal nature of morality and hold instead that moral values in fact change from society to society throughout time and throughout the world. They frequently attempt to defend their position by citing examples of values that differ dramatically from one culture to another, such as attitudes about polygamy, homosexuality and human sacrifice.

b. Psychological Issues in Metaethics

A second area of metaethics involves the psychological basis of our moral judgments and conduct, particularly understanding what motivates us to be moral. We might explore this subject by asking the simple question, "Why be moral?" Even if I am aware of basic moral standards, such as don't kill and don't steal, this does not necessarily mean that I will be psychologically compelled to act on them. Some answers to the question "Why be moral?" are to avoid punishment, to gain praise, to attain happiness, to be dignified, or to fit in with society.

i. Egoism and Altruism

One important area of moral psychology concerns the inherent selfishness of humans. 17 th century British philosopher Thomas Hobbes held that many, if not all, of our actions are prompted by selfish desires. Even if an action seems selfless, such as donating to charity, there are still selfish causes for this, such as experiencing power over other people. This view is called psychological egoism and maintains that self-oriented interests ultimately motivate all human actions. Closely related to psychological egoism is a view called psychological hedonism which is the view that pleasure is the specific driving force behind all of our actions. 18 th century British philosopher Joseph Butler agreed that instinctive selfishness and pleasure prompt much of our conduct. However, Butler argued that we also have an inherent psychological capacity to show benevolence to others. This view is called psychological altruism and maintains that at least some of our actions are motivated by instinctive benevolence.

ii. Emotion and Reason

A second area of moral psychology involves a dispute concerning the role of reason in motivating moral actions. If, for example, I make the statement "abortion is morally wrong," am I making a rational assessment or only expressing my feelings? On the one side of the dispute, 18 th century British philosopher David Hume argued that moral assessments involve our emotions, and not our reason. We can amass all the reasons we want, but that alone will not constitute a moral assessment. We need a distinctly emotional reaction in order to make a moral pronouncement. Reason might be of service in giving us the relevant data, but, in Hume's words, "reason is, and ought to be, the slave of the passions." Inspired by Hume's anti-rationalist views, some 20th century philosophers, most notably A.J. Ayer, similarly denied that moral assessments are factual descriptions. For example, although the statement "it is good to donate to charity" may on the surface look as though it is a factual description about charity, it is not. Instead, a moral utterance like this involves two things. First, I (the speaker) I am expressing my personal feelings of approval about charitable donations and I am in essence saying "Hooray for charity!" This is called the emotive element insofar as I am expressing my emotions about some specific behavior. Second, I (the speaker) am trying to get you to donate to charity and am essentially giving the command, "Donate to charity!" This is called the prescriptive element in the sense that I am prescribing some specific behavior.

From Hume's day forward, more rationally-minded philosophers have opposed these emotive theories of ethics (see non-cognitivism in ethics) and instead argued that moral assessments are indeed acts of reason. 18 th century German philosopher Immanuel Kant is a case in point. Although emotional factors often do influence our conduct, he argued, we should nevertheless resist that kind of sway. Instead, true moral action is motivated only by reason when it is free from emotions and desires. A recent rationalist approach, offered by Kurt Baier (1958), was proposed in direct opposition to the emotivist and prescriptivist theories of Ayer and others. Baier focuses more broadly on the reasoning and argumentation process that takes place when making moral choices. All of our moral choices are, or at least can be, backed by some reason or justification. If I claim that it is wrong to steal someone's car, then I should be able to justify my claim with some kind of argument. For example, I could argue that stealing Smith's car is wrong since this would upset her, violate her ownership rights, or put the thief at risk of getting caught. According to Baier, then, proper moral decision making involves giving the best reasons in support of one course of action versus another.

iii. Male and Female Morality

A third area of moral psychology focuses on whether there is a distinctly female approach to ethics that is grounded in the psychological differences between men and women. Discussions of this issue focus on two claims: (1) traditional morality is male-centered, and (2) there is a unique female perspective of the world which can be shaped into a value theory. According to many feminist philosophers, traditional morality is male-centered since it is modeled after practices that have been traditionally male-dominated, such as acquiring property, engaging in business contracts, and governing societies. The rigid systems of rules required for trade and government were then taken as models for the creation of equally rigid systems of moral rules, such as lists of rights and duties. Women, by contrast, have traditionally had a nurturing role by raising children and overseeing domestic life. These tasks require less rule following, and more spontaneous and creative action. Using the woman's experience as a model for moral theory, then, the basis of morality would be spontaneously caring for others as would be appropriate in each unique circumstance. On this model, the agent becomes part of the situation and acts caringly within that context. This stands in contrast with male-modeled morality where the agent is a mechanical actor who performs his required duty, but can remain distanced from and unaffected by the situation. A care-based approach to morality, as it is sometimes called, is offered by feminist ethicists as either a replacement for or a supplement to traditional male-modeled moral systems.

2. Normative Ethics

Normative ethics involves arriving at moral standards that regulate right and wrong conduct. In a sense, it is a search for an ideal litmus test of proper behavior. The Golden Rule is a classic example of a normative principle: We should do to others what we would want others to do to us. Since I do not want my neighbor to steal my car, then it is wrong for me to steal her car. Since I would want people to feed me if I was starving, then I should help feed starving people. Using this same reasoning, I can theoretically determine whether any possible action is right or wrong. So, based on the Golden Rule, it would also be wrong for me to lie to, harass, victimize, assault, or kill others. The Golden Rule is an example of a normative theory that establishes a single principle against which we judge all actions. Other normative theories focus on a set of foundational principles, or a set of good character traits.

The key assumption in normative ethics is that there is only one ultimate criterion of moral conduct, whether it is a single rule or a set of principles. Three strategies will be noted here: (1) virtue theories, (2) duty theories, and (3) consequentialist theories.

a. Virtue Theories

Many philosophers believe that morality consists of following precisely defined rules of conduct, such as "don't kill," or "don't steal." Presumably, I must learn these rules, and then make sure each of my actions live up to the rules. Virtue ethics, however, places less emphasis on learning rules, and instead stresses the importance of developing good habits of character, such as benevolence (see moral character). Once I've acquired benevolence, for example, I will then habitually act in a benevolent manner. Historically, virtue theory is one of the oldest normative traditions in Western philosophy, having its roots in ancient Greek civilization. Plato emphasized four virtues in particular, which were later called cardinal virtues: wisdom, courage, temperance and justice. Other important virtues are fortitude, generosity, self-respect, good temper, and sincerity. In addition to advocating good habits of character, virtue theorists hold that we should avoid acquiring bad character traits, or vices, such as cowardice, insensibility, injustice, and vanity. Virtue theory emphasizes moral education since virtuous character traits are developed in one's youth. Adults, therefore, are responsible for instilling virtues in the young.

Aristotle argued that virtues are good habits that we acquire, which regulate our emotions. For example, in response to my natural feelings of fear, I should develop the virtue of courage which allows me to be firm when facing danger. Analyzing 11 specific virtues, Aristotle argued that most virtues fall at a mean between more extreme character traits. With courage, for example, if I do not have enough courage, I develop the disposition of cowardice, which is a vice. If I have too much courage I develop the disposition of rashness which is also a vice. According to Aristotle, it is not an easy task to find the perfect mean between extreme character traits. In fact, we need assistance from our reason to do this. After Aristotle, medieval theologians supplemented Greek lists of virtues with three Christian ones, or theological virtues: faith, hope, and charity. Interest in virtue theory continued through the middle ages and declined in the 19 th century with the rise of alternative moral theories below. In the mid 20 th century virtue theory received special attention from philosophers who believed that more recent ethical theories were misguided for focusing too heavily on rules and actions, rather than on virtuous character traits. Alasdaire MacIntyre (1984) defended the central role of virtues in moral theory and argued that virtues are grounded in and emerge from within social traditions.

b. Duty Theories

Many of us feel that there are clear obligations we have as human beings, such as to care for our children, and to not commit murder. Duty theories base morality on specific, foundational principles of obligation. These theories are sometimes called deontological, from the Greek word deon, or duty, in view of the foundational nature of our duty or obligation. They are also sometimes called nonconsequentialist since these principles are obligatory, irrespective of the consequences that might follow from our actions. For example, it is wrong to not care for our children even if it results in some great benefit, such as financial savings. There are four central duty theories.

The first is that championed by 17th century German philosopher Samuel Pufendorf, who classified dozens of duties under three headings: duties to God, duties to oneself, and duties to others. Concerning our duties towards God, he argued that there are two kinds:

1. a theoretical duty to know the existence and nature of God, and

2. a practical duty to both inwardly and outwardly worship God.

Concerning our duties towards oneself, these are also of two sorts:

1. duties of the soul, which involve developing one's skills and talents, and

2. duties of the body, which involve not harming our bodies, as we might through gluttony or drunkenness, and not killing oneself.

Concerning our duties towards others, Pufendorf divides these between absolute duties, which are universally binding on people, and conditional duties, which are the result of contracts between people. Absolute duties are of three sorts:

1. avoid wronging others,

2. treat people as equals, and

3. promote the good of others.

Conditional duties involve various types of agreements, the principal one of which is the duty is to keep one's promises.

A second duty-based approach to ethics is rights theory. Most generally, a "right" is a justified claim against another person's behavior - such as my right to not be harmed by you (see also human rights). Rights and duties are related in such a way that the rights of one person implies the duties of another person. For example, if I have a right to payment of $10 by Smith, then Smith has a duty to pay me $10. This is called the correlativity of rights and duties. The most influential early account of rights theory is that of 17 th century British philosopher John Locke, who argued that the laws of nature mandate that we should not harm anyone's life, health, liberty or possessions. For Locke, these are our natural rights, given to us by God. Following Locke, the United States Declaration of Independence authored by Thomas Jefferson recognizes three foundational rights: life, liberty, and the pursuit of happiness. Jefferson and others rights theorists maintained that we deduce other more specific rights from these, including the rights of property, movement, speech, and religious expression. There are four features traditionally associated with moral rights. First, rights are natural insofar as they are not invented or created by governments. Second, they are universal insofar as they do not change from country to country. Third, they are equal in the sense that rights are the same for all people, irrespective of gender, race, or handicap. Fourth, they are inalienable which means that I cannot hand over my rights to another person, such as by selling myself into slavery.

A third duty-based theory is that by Kant, which emphasizes a single principle of duty. Influenced by Pufendorf, Kant agreed that we have moral duties to oneself and others, such as developing one's talents, and keeping our promises to others. However, Kant argued that there is a more foundational principle of duty that encompasses our particular duties. It is a single, self-evident principle of reason that he calls the "categorical imperative." A categorical imperative, he argued, is fundamentally different from hypothetical imperatives that hinge on some personal desire that we have, for example, "If you want to get a good job, then you ought to go to college." By contrast, a categorical imperative simply mandates an action, irrespective of one's personal desires, such as "You ought to do X." Kant gives at least four versions of the categorical imperative, but one is especially direct: Treat people as an end, and never as a means to an end. That is, we should always treat people with dignity, and never use them as mere instruments. For Kant, we treat people as an end whenever our actions toward someone reflect the inherent value of that person. Donating to charity, for example, is morally correct since this acknowledges the inherent value of the recipient. By contrast, we treat someone as a means to an end whenever we treat that person as a tool to achieve something else. It is wrong, for example, to steal my neighbor's car since I would be treating her as a means to my own happiness. The categorical imperative also regulates the morality of actions that affect us individually. Suicide, for example, would be wrong since I would be treating my life as a means to the alleviation of my misery. Kant believes that the morality of all actions can be determined by appealing to this single principle of duty.

A fourth and more recent duty-based theory is that by British philosopher W.D. Ross, which emphasizes prima facie duties. Like his 17th and 18th century counterparts, Ross argues that our duties are "part of the fundamental nature of the universe." However, Ross's list of duties is much shorter, which he believes reflects our actual moral convictions:

Fidelity: the duty to keep promises

Reparation: the duty to compensate others when we harm them

Gratitude: the duty to thank those who help us

Justice: the duty to recognize merit

Beneficence: the duty to improve the conditions of others

Self-improvement: the duty to improve our virtue and intelligence

Nonmaleficence: the duty to not injure others

Ross recognizes that situations will arise when we must choose between two conflicting duties. In a classic example, suppose I borrow my neighbor's gun and promise to return it when he asks for it. One day, in a fit of rage, my neighbor pounds on my door and asks for the gun so that he can take vengeance on someone. On the one hand, the duty of fidelity obligates me to return the gun; on the other hand, the duty of nonmaleficence obligates me to avoid injuring others and thus not return the gun. According to Ross, I will intuitively know which of these duties is my actual duty, and which is my apparent or prima facie duty. In this case, my duty of nonmaleficence emerges as my actual duty and I should not return the gun.

c. Consequentialist Theories

It is common for us to determine our moral responsibility by weighing the consequences of our actions. According to consequentialism, correct moral conduct is determined solely by a cost-benefit analysis of an action's consequences:

Consequentialism: An action is morally right if the consequences of that action are more favorable than unfavorable.

Consequentialist normative principles require that we first tally both the good and bad consequences of an action. Second, we then determine whether the total good consequences outweigh the total bad consequences. If the good consequences are greater, then the action is morally proper. If the bad consequences are greater, then the action is morally improper. Consequentialist theories are sometimes called teleological theories, from the Greek word telos, or end, since the end result of the action is the sole determining factor of its morality.

Consequentialist theories became popular in the 18 th century by philosophers who wanted a quick way to morally assess an action by appealing to experience, rather than by appealing to gut intuitions or long lists of questionable duties. In fact, the most attractive feature of consequentialism is that it appeals to publicly observable consequences of actions. Most versions of consequentialism are more precisely formulated than the general principle above. In particular, competing consequentialist theories specify which consequences for affected groups of people are relevant. Three subdivisions of consequentialism emerge:

Ethical Egoism: an action is morally right if the consequences of that action are more favorable than unfavorable only to the agent performing the action.

Ethical Altruism: an action is morally right if the consequences of that action are more favorable than unfavorable to everyone except the agent.

Utilitarianism: an action is morally right if the consequences of that action are more favorable than unfavorable to everyone.

All three of these theories focus on the consequences of actions for different groups of people. But, like all normative theories, the above three theories are rivals of each other. They also yield different conclusions. Consider the following example. A woman was traveling through a developing country when she witnessed a car in front of her run off the road and roll over several times. She asked the hired driver to pull over to assist, but, to her surprise, the driver accelerated nervously past the scene. A few miles down the road the driver explained that in his country if someone assists an accident victim, then the police often hold the assisting person responsible for the accident itself. If the victim dies, then the assisting person could be held responsible for the death. The driver continued explaining that road accident victims are therefore usually left unattended and often die from exposure to the country's harsh desert conditions. On the principle of ethical egoism, the woman in this illustration would only be concerned with the consequences of her attempted assistance as she would be affected. Clearly, the decision to drive on would be the morally proper choice. On the principle of ethical altruism, she would be concerned only with the consequences of her action as others are affected, particularly the accident victim. Tallying only those consequences reveals that assisting the victim would be the morally correct choice, irrespective of the negative consequences that result for her. On the principle of utilitarianism, she must consider the consequences for both herself and the victim. The outcome here is less clear, and the woman would need to precisely calculate the overall benefit versus disbenefit of her action.

i. Types of Utilitarianism

Jeremy Bentham presented one of the earliest fully developed systems of utilitarianism. Two features of his theory are noteworty. First, Bentham proposed that we tally the consequences of each action we perform and thereby determine on a case by case basis whether an action is morally right or wrong. This aspect of Bentham's theory is known as act-utilitiarianism. Second, Bentham also proposed that we tally the pleasure and pain which results from our actions. For Bentham, pleasure and pain are the only consequences that matter in determining whether our conduct is moral. This aspect of Bentham's theory is known as hedonistic utilitarianism. Critics point out limitations in both of these aspects.

First, according to act-utilitarianism, it would be morally wrong to waste time on leisure activities such as watching television, since our time could be spent in ways that produced a greater social benefit, such as charity work. But prohibiting leisure activities doesn't seem reasonable. More significantly, according to act-utilitarianism, specific acts of torture or slavery would be morally permissible if the social benefit of these actions outweighed the disbenefit. A revised version of utilitarianism called rule-utilitarianism addresses these problems. According to rule-utilitarianism, a behavioral code or rule is morally right if the consequences of adopting that rule are more favorable than unfavorable to everyone. Unlike act utilitarianism, which weighs the consequences of each particular action, rule-utilitarianism offers a litmus test only for the morality of moral rules, such as "stealing is wrong." Adopting a rule against theft clearly has more favorable consequences than unfavorable consequences for everyone. The same is true for moral rules against lying or murdering. Rule-utilitarianism, then, offers a three-tiered method for judging conduct. A particular action, such as stealing my neighbor's car, is judged wrong since it violates a moral rule against theft. In turn, the rule against theft is morally binding because adopting this rule produces favorable consequences for everyone. John Stuart Mill's version of utilitarianism is rule-oriented.

Second, according to hedonistic utilitarianism, pleasurable consequences are the only factors that matter, morally speaking. This, though, seems too restrictive since it ignores other morally significant consequences that are not necessarily pleasing or painful. For example, acts which foster loyalty and friendship are valued, yet they are not always pleasing. In response to this problem, G.E. Moore proposed ideal utilitarianism, which involves tallying any consequence that we intuitively recognize as good or bad (and not simply as pleasurable or painful). Also, R.M. Hare proposed preference utilitarianism, which involves tallying any consequence that fulfills our preferences.

ii. Ethical Egoism and Social Contract Theory

We have seen (in Section 1.b.i) that Hobbes was an advocate of the methaethical theory of psychological egoism-the view that all of our actions are selfishly motivated. Upon that foundation, Hobbes developed a normative theory known as social contract theory, which is a type of rule-ethical-egoism. According to Hobbes, for purely selfish reasons, the agent is better off living in a world with moral rules than one without moral rules. For without moral rules, we are subject to the whims of other people's selfish interests. Our property, our families, and even our lives are at continual risk. Selfishness alone will therefore motivate each agent to adopt a basic set of rules which will allow for a civilized community. Not surprisingly, these rules would include prohibitions against lying, stealing and killing. However, these rules will ensure safety for each agent only if the rules are enforced. As selfish creatures, each of us would plunder our neighbors' property once their guards were down. Each agent would then be at risk from his neighbor. Therefore, for selfish reasons alone, we devise a means of enforcing these rules: we create a policing agency which punishes us if we violate these rules.

3. Applied Ethics

Applied ethics is the branch of ethics which consists of the analysis of specific, controversial moral issues such as abortion, animal rights, or euthanasia. In recent years applied ethical issues have been subdivided into convenient groups such as medical ethics, business ethics, environmental ethics, and sexual ethics. Generally speaking, two features are necessary for an issue to be considered an "applied ethical issue." First, the issue needs to be controversial in the sense that there are significant groups of people both for and against the issue at hand. The issue of drive-by shooting, for example, is not an applied ethical issue, since everyone agrees that this practice is grossly immoral. By contrast, the issue of gun control would be an applied ethical issue since there are significant groups of people both for and against gun control.

The second requirement for an issue to be an applied ethical issue is that it must be a distinctly moral issue. On any given day, the media presents us with an array of sensitive issues such as affirmative action policies, gays in the military, involuntary commitment of the mentally impaired, capitalistic versus socialistic business practices, public versus private health care systems, or energy conservation. Although all of these issues are controversial and have an important impact on society, they are not all moral issues. Some are only issues of social policy. The aim of social policy is to help make a given society run efficiently by devising conventions, such as traffic laws, tax laws, and zoning codes. Moral issues, by contrast, concern more universally obligatory practices, such as our duty to avoid lying, and are not confined to individual societies. Frequently, issues of social policy and morality overlap, as with murder which is both socially prohibited and immoral. However, the two groups of issues are often distinct. For example, many people would argue that sexual promiscuity is immoral, but may not feel that there should be social policies regulating sexual conduct, or laws punishing us for promiscuity. Similarly, some social policies forbid residents in certain neighborhoods from having yard sales. But, so long as the neighbors are not offended, there is nothing immoral in itself about a resident having a yard sale in one of these neighborhoods. Thus, to qualify as an applied ethical issue, the issue must be more than one of mere social policy: it must be morally relevant as well.

In theory, resolving particular applied ethical issues should be easy. With the issue of abortion, for example, we would simply determine its morality by consulting our normative principle of choice, such as act-utilitarianism. If a given abortion produces greater benefit than disbenefit, then, according to act-utilitarianism, it would be morally acceptable to have the abortion. Unfortunately, there are perhaps hundreds of rival normative principles from which to choose, many of which yield opposite conclusions. Thus, the stalemate in normative ethics between conflicting theories prevents us from using a single decisive procedure for determining the morality of a specific issue. The usual solution today to this stalemate is to consult several representative normative principles on a given issue and see where the weight of the evidence lies.

a. Normative Principles in Applied Ethics

Arriving at a short list of representative normative principles is itself a challenging task. The principles selected must not be too narrowly focused, such as a version of act-egoism that might focus only on an action's short-term benefit. The principles must also be seen as having merit by people on both sides of an applied ethical issue. For this reason, principles that appeal to duty to God are not usually cited since this would have no impact on a nonbeliever engaged in the debate. The following principles are the ones most commonly appealed to in applied ethical discussions:

Personal benefit: acknowledge the extent to which an action produces beneficial consequences for the individual in question.

Social benefit: acknowledge the extent to which an action produces beneficial consequences for society.

Principle of benevolence: help those in need.

Principle of paternalism: assist others in pursuing their best interests when they cannot do so themselves.

Principle of harm: do not harm others.

Principle of honesty: do not deceive others.

Principle of lawfulness: do not violate the law.

Principle of autonomy: acknowledge a person's freedom over his/her actions or physical body.

Principle of justice: acknowledge a person's right to due process, fair compensation for harm done, and fair distribution of benefits.

Rights: acknowledge a person's rights to life, information, privacy, free expression, and safety.

The above principles represent a spectrum of traditional normative principles and are derived from both consequentialist and duty-based approaches. The first two principles, personal benefit and social benefit, are consequentialist since they appeal to the consequences of an action as it affects the individual or society. The remaining principles are duty-based. The principles of benevolence, paternalism, harm, honesty, and lawfulness are based on duties we have toward others. The principles of autonomy, justice, and the various rights are based on moral rights.

An example will help illustrate the function of these principles in an applied ethical discussion. In 1982, a couple from Bloomington, Indiana gave birth to a baby with severe mental and physical disabilities. Among other complications, the infant, known as Baby Doe, had its stomach disconnected from its throat and was thus unable to receive nourishment. Although this stomach deformity was correctable through surgery, the couple did not want to raise a severely disabled child and therefore chose to deny surgery, food, and water for the infant. Local courts supported the parents' decision, and six days later Baby Doe died. Should corrective surgery have been performed for Baby Doe? Arguments in favor of corrective surgery derive from the infant's right to life and the principle of paternalism which stipulates that we should pursue the best interests of others when they are incapable of doing so themselves. Arguments against corrective surgery derive from the personal and social disbenefit which would result from such surgery. If Baby Doe survived, its quality of life would have been poor and in any case it probably would have died at an early age. Also, from the parent's perspective, Baby Doe's survival would have been a significant emotional and financial burden. When examining both sides of the issue, the parents and the courts concluded that the arguments against surgery were stronger than the arguments for surgery. First, foregoing surgery appeared to be in the best interests of the infant, given the poor quality of life it would endure. Second, the status of Baby Doe's right to life was not clear given the severity of the infant's mental impairment. For, to possess moral rights, it takes more than merely having a human body: certain cognitive functions must also be present. The issue here involves what is often referred to as moral personhood, and is central to many applied ethical discussions.

b. Issues in Applied Ethics

As noted, there are many controversial issues discussed by ethicists today, some of which will be briefly mentioned here.

Biomedical ethics focuses on a range of issues which arise in clinical settings. Health care workers are in an unusual position of continually dealing with life and death situations. It is not surprising, then, that medical ethics issues are more extreme and diverse than other areas of applied ethics. Prenatal issues arise about the morality of surrogate mothering, genetic manipulation of fetuses, the status of unused frozen embryos, and abortion. Other issues arise about patient rights and physician's responsibilities, such as the confidentiality of the patient's records and the physician's responsibility to tell the truth to dying patients. The AIDS crisis has raised the specific issues of the mandatory screening of all patients for AIDS, and whether physicians can refuse to treat AIDS patients. Additional issues concern medical experimentation on humans, the morality of involuntary commitment, and the rights of the mentally disabled. Finally, end of life issues arise about the morality of suicide, the justifiability of suicide intervention, physician assisted suicide, and euthanasia.

The field of business ethics examines moral controversies relating to the social responsibilities of capitalist business practices, the moral status of corporate entities, deceptive advertising, insider trading, basic employee rights, job discrimination, affirmative action, drug testing, and whistle blowing.

Issues in environmental ethics often overlaps with business and medical issues. These include the rights of animals, the morality of animal experimentation, preserving endangered species, pollution control, management of environmental resources, whether eco-systems are entitled to direct moral consideration, and our obligation to future generations.

Controversial issues of sexual morality include monogamy versus polygamy, sexual relations without love, homosexual relations, and extramarital affairs.

Finally, there are issues of social morality which examine capital punishment, nuclear war, gun control, the recreational use of drugs, welfare rights, and racism.

4. References and Further Reading

Anscombe,Elizabeth "Modern Moral Philosophy," Philosophy , 1958, Vol. 33, reprinted in her Ethics, Religion and Politics (Oxford: Blackwell, 1981).

Aristotle, Nichomachean Ethics, in Barnes, Jonathan, ed., The Complete Works of Aristotle (Princeton, N.J.: Princeton University Press, 1984).

Ayer, A. J., Language, Truth and Logic (New York: Dover Publications, 1946).

Baier, Kurt, The Moral Point of View: A Rational Basis of Ethics (Cornell University Press, 1958).

Bentham, Jeremy, Introduction to the Principles of Morals and Legislation (1789), in The Works of Jeremy Bentham , edited by John Bowring (London: 1838-1843).

Hare, R.M., Moral Thinking, (Oxford: Clarendon Press, 1981).

Hare, R.M., The Language of Morals (Oxford: Oxford University Press, 1952).

Hobbes, Thomas, Leviathan, ed., E. Curley, (Chicago, IL: Hackett Publishing Company, 1994).

Hume, David, A Treatise of Human Nature (1739-1740), eds. David Fate Norton, Mary J. Norton (Oxford; New York: Oxford University Press, 2000).

Kant, Immanuel, Grounding for the Metaphysics of Morals, tr, James W. Ellington (Indianapolis: Hackett Publishing Company, 1985).

Locke, John, Two Treatises, ed., Peter Laslett (Cambridge: Cambridge University Press, 1963).

MacIntyre, Alasdair, After Virtue, second edition, (Notre Dame: Notre Dame University Press, 1984).

Mackie, John L., Ethics: Inventing Right and Wrong, (New York: Penguin Books, 1977).

Mill, John Stuart, "Utilitarianism," in Collected Works of John Stuart Mill, ed., J.M. Robson (London: Routledge and Toronto, Ont.: University of Toronto Press, 1991).

Moore, G.E., Principia Ethica, (Cambridge: Cambridge University Press, 1903).

Noddings, Nel, "Ethics from the Stand Point Of Women," in Deborah L. Rhode, ed., Theoretical Perspectives on Sexual Difference (New Haven, CT: Yale University Press, 1990).

Ockham, William of, Fourth Book of the Sentences, tr. Lucan Freppert, The Basis of Morality According to William Ockham (Chicago: Franciscan Herald Press, 1988).

Plato, Republic, 6:510-511, in Cooper, John M., ed., Plato: Complete Works (Indianapolis: Hackett Publishing Company, 1997).

Samuel Pufendorf, De Jure Naturae et Gentium (1762), tr. Of the Law of Nature and Nations

Samuel Pufendorf, De officio hominis et civis juxta legem naturalem (1673), tr., The Whole Duty of Man according to the Law of Nature (London, 1691).

Sextus Empiricus, Outlines of Pyrrhonism, trs. J. Annas and J. Barnes, Outlines of Scepticism (Cambridge: Cambridge University Press, 1994).

Stevenson, Charles L., The Ethics of Language, (New Haven: Yale University Press, 1944).

Sumner, William Graham, Folkways (Boston: Guinn, 1906).

Author Information

James Fieser
Email: jfieser@utm.edu
University of Tennessee at Martin
U. S. A.

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The field of ethics (or moral philosophy) involves systematizing, defending, and recommending concepts of right and wrong behavior. Philosophers today usually divide ethical theories into three general subject areas: metaethics, normative ethics, and applied ethics. Metaethics investigates where our ethical principles come from, and what they mean. Are they merely social inventions?

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Autonomy is variously rendered as self-law, self-government, self-rule, or self-determination. The concept first came into prominence in ancient Greece (from the Greek auto-nomos), where it characterized city states that were self governing. Only later-during the European Enlightenment-did autonomy come to be widely understood as a property of persons. Today the concept is used in both senses, although most contemporary philosophers deal with autonomy primarily as a property of persons. This orientation will be maintained here.

Most people would agree that autonomy is normatively important. This agreement is reflected both in the presence of broad assent to the principle that autonomy deserves respect, and in the popular practice of arguing for the institution (or continuation, or discontinuation) of public policy based in some way on the value of self-determination. Many also believe that developing and cultivating autonomy is an important-indeed, on some accounts, an indispensable-part of living a good life. But although the claim that autonomy is normatively significant in some way is intuitively compelling, it is not obvious why autonomy has this significance, or what weight autonomy-based considerations should be given in relation to competing normative considerations. In order to answer these questions with sufficient rigor, it is necessary to have a more detailed understanding of what autonomy is.

This article will be devoted to canvassing the leading work done by philosophers on these two issues, beginning with the question of the nature of autonomy, and then moving to the question of the normative significance of autonomy. It will be seen that autonomy has been understood in several different ways, that it has been claimed to have normative significance of various kinds, and that it has been employed in a wide range of philosophical issues. Special attention will be paid to the question of justification of the principle of respect for autonomous choice.

Table of Contents

1. History of the Concept of Autonomy

2. The Normative Roles of Autonomy

1. Autonomy in Ethical Theory

2. Autonomy in Applied Ethics

3. Autonomy in Political Philosophy

4. Autonomy in Philosophy of Education

3. Warrant for the Principle of Respect for Autonomous Choice

4. References and Further Reading

1. History of the Concept of Autonomy

The concept of autonomy first came into prominence in ancient Greece, where it characterized self-governing city-states. Barring one exception (mentioned below), autonomy was not explicitly predicated of persons, although there is reason to hold that many philosophers of that time had something similar in mind when they wrote of persons being guided or ruled by reason. Plato and Aristotle, for example-as well as many of the Stoics-surely would have agreed that a person ruled by reason is a properly self-governing or self-ruling person. What one does not find, however, are ancient philosophers speaking of the ideal of autonomy as that of living according to one's unique individuality. The one exception to this appears to be found in the thinker and orator Dio of Prusa (ca. 50-ca. 120), who, in his 80th Discourse, clearly seems to predicate autonomy of individual persons in roughly the sense in which it has come to be understood in our own day (see Cooper 2003).

Medieval philosophers made no use of the concept of autonomy that is worthy of note, although once again, many medieval philosophers would have doubtless agreed that those who live in accordance with right reason and the will of God are properly self-governing. The concept of autonomy wouldn't be circulated in learned circles again until the Renaissance and early modern times, when it was employed both in the traditional political sense, and in an ecclesiastical sense, to refer to churches that were-or at least claimed to be -independent of the authority of the Roman Catholic Pope (see Pohlmann 1971).

The concept of autonomy came into philosophical prominence for the first time with the work of Immanuel Kant. Kant's work on autonomy, however, was strongly influenced by the writings of Jean-Jacques Rousseau, so a brief word on Rousseau is in order. Although Rousseau did not use the term 'autonomy' in his writings, his conception of moral freedom-defined as "obedience to the law one has prescribed to oneself"- has a clear relation to Kant's understanding of autonomy (as will be shown below). Moreover, Rousseau wrote of moral freedom as a property of persons, thus presaging Kant's predication of autonomy of persons. The connections between Rousseau and Kant cannot be taken too far, however; for Rousseau was primarily concerned with the question of how moral freedom can be achieved and sustained by individuals within society given the presence of relations of social dependency and the possibility of domination, whereas Kant was primarily concerned with the place of autonomy in accounts of the subjective conditions requisite for, and the nature of, morality. Because of the connections Kant drew between autonomy and morality, Kant's conception of autonomy is sometimes referred to as 'moral autonomy'.

In the nineteenth century, John Stuart Mill contributed to the discussion on the normative significance of autonomy in his work On Liberty. Although Mill did not use the term 'autonomy' in this work, he is widely understood as having had self-determination in mind. Mill's work continues to have considerable influence on discussions on the normative significance of autonomy in relation to paternalism of various kinds.

A tremendous amount of research on autonomy has taken place in the last several decades in both the analytic and continental traditions. Continental philosophers speak more often of authenticity than of autonomy, but there are clear connections between the two, insofar as the 'self' in 'self-determination' is plausibly understood as the authentic self. Philosophers working in the analytic tradition have gone into great detail attempting to discern necessary and sufficient conditions for the presence of autonomy, as well as to uncover the ground and implications of its normative significance.

2. Conceptions of Autonomy

There are several different conceptions of autonomy, all of which are loosely based upon the core notions of self-government or self-determination, but which differ considerably in the details.

a. Moral Autonomy

As mentioned, moral autonomy is associated with the work of Kant, and is also referred to as 'autonomy of the will' or 'Kantian autonomy.' This form of autonomy consists in the capacity of the will of a rational being to be a law to itself, independently of the influence of any property of objects of volition. More specifically, an autonomous will is said to be free in both a negative and a positive sense. The will is negatively free in that it operates entirely independently of alien influences, including all contingent empirical determinations associated with appetite, desire-satisfaction, or happiness. The will is positively free in that it can act in accordance with its own law. Kant's notion of autonomy of the will thus involves, as Andrews Reath has written, "not only a capacity for choice that is motivationally independent, but a lawgiving capacity that is independent of determination by external influence and is guided by its own internal principle-in other words, by a principle that is constitutive of lawgiving" (Reath 2006). Now, because the lawgiving of the autonomous will contains no content given by contingent empirical influences, this lawgiving must be universal; and because these laws are the product of practical reason, they are necessary. Insofar, then, as Kant understood moral laws as universal and necessary practical laws, it can be seen why Kant posited an essential connection between the possession of autonomy and morality: the products of the autonomous will are universal and necessary practical laws-that is, moral laws. It is thus by virtue of our autonomy that we are capable of morality, and we are moral to the extent that we are autonomous. It is for this reason that Kant's conception of autonomy is described as moral autonomy. Moral autonomy refers to the capacity of rational agents to impose upon themselves-to legislate for themselves-the moral law.

Furthermore, the capacity for autonomy, according to Kant, is "the basis of the dignity of human and of every rational nature;" and in accordance with this rational nature, is an end in itself. Furthermore, it "restricts freedom of action, and is an object of respect". Many thinkers have followed Kant in grounding the dignity of persons (and respect for persons generally) in our capacity for autonomy (although it should be noted that not all of these thinkers have accepted Kant's conception of autonomy). More will be said on this below.

Moral autonomy is said to be a bivalent property possessed by all rational beings by virtue of their rationality-although according to Kant, it is certainly possible not to live in accordance with its deliverances in practice (for more on Kant's conception of autonomy, see Hill 1989, Guyer 2003, and Reath 2006).

One of the most common objections to this conception of autonomy is that such a robust form of independence from contingent empirical influences is not possible. Kant defended the possibility of such robust independence by arguing that human agents inhabit two realms at once: the phenomenal realm of experience, in relation to which we are determined; and a noumenal or transcendental realm of the intellect, in relation to which we are free. Given the further claim that our noumenal self can exercise efficient causality in the phenomenal realm, Kant held that our autonomy is in large part constituted by our noumenal freedom. The postulation of such a form of freedom may be criticized as metaphysically extravagant, however; and if such freedom is not possible, then neither is moral autonomy in Kant's strict sense. Some thinkers have argued that Kant's theorization on the noumenal realm was not meant to have metaphysical significance. Thomas Hill has argued, for example, that Kant may have been merely elaborating on the practical conditions in which we must understand ourselves insofar as we conceive ourselves as free. Objectors have insisted, however, that Kant intended to assert the more robust form of metaphysical freedom. Indeed, it could be pressed, he must have; for without this sense of freedom being operative, actual autonomy-and hence morality, by Kant's lights-would not be possible.

b. Existentialist Autonomy

Existentialist autonomy is an extreme form of autonomy associated principally with the writings of Jean Paul Sartre. It refers to the complete freedom of subjects to determine their natures and guiding principles independently of any forms of social, anthropological or moral determination. To possess existentialist autonomy is thus to be able to choose one's nature without constraint from any principles not of one's own choosing. Sartre held this radical freedom to be entailed by the truth of atheism. According to Sartre, God's nonexistence entails two key conclusions: firstly, humans cannot have a predetermined nature; and secondly, there cannot exist a realm of values possessing independent validity. Taken together, this entails that human beings are radically free: "For if indeed existence precedes essence, one will never be able to explain one's action by reference to a given and specific human nature; in other words, there is no determinism-man is free, man is freedom. Nor, on the other hand, if God does not exist, are we provided with any values or commands that could legitimize our behavior. Thus we have neither behind us, nor before us in a luminous realm of values, any means of justification or excuse." Fettered neither by a predetermined nature nor by an independently existing order of values, "[m]an is nothing else but what he makes of himself" (Sartre 1946).

Like moral autonomy, existentialist autonomy is a bivalent property which all human persons are said to possess (although possibly without being aware of this). Unlike moral autonomy, however, existentialist autonomy has no necessary connections to morality or to rationality as traditionally conceived.

The primary objection to existentialist autonomy is that it is too radical to be plausible. Even if God does not exist, it is argued, it does not follow that humans lack a nature that determines-at least to some extent-their choices, tendencies, proclivities, and guiding principles. A thoroughly naturalistic conception of human nature, informed by an understanding of the evolutionary forces operative in human psychology, seems to militate against the notion that humans are as unbounded as existentialist autonomy suggests we are. At the very least, it could be argued that empirical evidence does not speak in favor of the existence of existentialist autonomy in any robust form.

c. Personal Autonomy

Without question, the majority of contemporary work on autonomy has centered on analyses of the nature and normativity of personal autonomy. Personal autonomy (also referred to as 'individual autonomy') refers to a psychological property, the possession of which enables agents to reflect critically on their natures, preferences and ends, to locate their most authentic commitments, and to live consistently in accordance with these in the face of various forms of internal and external interference. Personally autonomous agents are said to possess heightened capacities for self-control, introspection, independence of judgment, and critical reflection; and to this extent personal autonomy is often put forth as an ideal of character or a virtue, the opposite of which is blind conformity, or not 'being one's own person.'

As mentioned above, personal autonomy has an essential relation to authenticity: the personally autonomous agent is the agent who is effective in determining her life in accordance with her authentic self. Personal autonomy is thus constituted, on the one hand, by a cluster of related capacities (often termed 'authenticity conditions'), centered on identifying one's authentic nature or preferences and, on the other hand, by a cluster of capacities (often termed 'competency conditions') that are centered on being able effectively to live in accordance with these throughout one's life in the face of various recalcitrant foreign influences. These capacities may be possessed singly or in unison, and often require a considerable amount of life experience to assume robust forms.

One of the most intractable problems surrounding personal autonomy concerns the analysis of the authentic self (the 'self' in 'self-determination', as it were). Some philosophers have claimed that no such self exists; and indeed, some philosophers claim that no self exists at all (for an overview of these problems, see Friedman 2003 and Mackenzie & Stoljar 2000). Most philosophers accept the possibility of the authentic self at least as a working hypothesis, however, and concentrate attention on the question of how authenticity is secured by an agent. The most popular and influential account is based on the work of Harry Frankfurt and Gerald Dworkin. According to their 'hierarchical' account, agents validate the various commitments (beliefs, values, desires, and so forth) that constitute their selves as their own by a process of reflective endorsement. On this account, agents are said to possess first-order and second-order volitions. Our first-order volitions are what we want; and our second-order volitions are what we want to want. According to the hierarchical model, our first-order desires, commitments, and so on are authentic when they are validated by being in harmony with our second-order volitions: that is, when we want what we want to want. Following from this model, an agent is autonomous in relation to a given object when the agent is able to determine her first-order volitions (and corresponding behavior) by her second-order volitions. A simple example may help to illustrate the model. Say that I am a smoker. Although I enjoy lighting up, I do not reflectively endorse my smoking; I desire it, but I do not want to desire it. On the hierarchical model, smoking is not an aspect of my authentic self, because I do not reflectively endorse it; and to the extent that I am unable to change my habits, I am not autonomous in relation to smoking. Conversely, if I can bring my first-order volitions into harmony (or identity) with my second-order volition, then my desire is authentic because it is reflectively endorsed; and to the extent that I can mold my behavior in accordance with my reflective will, I am autonomous in relation to smoking. Persons who possess the requisite capacities to form authentic desires and effectively to generally live in accordance with them are autonomous agents according to this model (see Frankfurt 1971, 1999 and Dworkin 1988).

The hierarchical model remains-in outline, at least-the leading account of authenticity undergirding most contemporary accounts of personal autonomy, although it has been attacked on many fronts. The primary objection tendered against this account is 'the problem of origins.' As we have seen, authentic selfhood as reflective endorsement holds that my authentic self is the self that I reflectively ratify: the self that I endorse as expressing, in a deep sense, who I fundamentally am or wish to be. The problem of origins arises when one attempts to explain how this act of reflective endorsement actually constitutes a break from other-determination (that is, from foreign influence). For, could it not be the case that what appears to me to be an independent act of reflective endorsement is itself conditioned by other-determining factors and therefore ultimately an other-determined act? If this is the case, then it doesn't seem that the possession of autonomy or the making of autonomous choices is possible. In short, the problem is how to sustain an account of self-determination that is not threatened by the pervasive effects of other-determination (see Taylor 2005 for elaboration on the problem of origins and related sub-problems). Much work on theories of personal autonomy has been explicitly devoted to addressing precisely these sorts of difficulties.

Besides analyzing and clarifying the authenticity conditions necessary for autonomy, philosophers have also worked on providing a thorough account of the competency conditions necessary for the presence of autonomy (see Meyers 1989, Mele 1993, and Berofsky 1995). Competency conditions, as we have seen, are those capacities or conditions that need to be present in order for one to be effective in living according to one's authentic self-conception in the face of various kinds of interference to that end. Examples of competency conditions include self-control, logical aptitude, instrumental rationality, resolve, temperance, calmness, and a good memory.

In addition to authenticity and competency conditions, many theories of personal autonomy require the presence of certain external enabling conditions: that is, external or environmental (social, legal, familial, and so forth) conditions which are more than less out of the agent's control, but which must be in place in order for fully autonomous living to be possible. Such enabling conditions include, for example, a modicum of social freedom, an array of substantive options for choice, the presence of authenticity-oriented social relations, and autonomy-supporting networks of social recognition and acknowledgment (see Raz 1986 and Anderson & Honneth 2005). Without these conditions, effective autonomous living is said by some to be impossible, even where authenticity and competency conditions are robustly satisfied. Different autonomy theorists place different emphases on external enabling conditions. Some contend that external enabling is a necessary condition for autonomy (see Oshana 1998). Others hold that autonomy more properly concerns agential satisfaction of authenticity and competency conditions, regardless of whether the external environment allows for actual autonomous expression (see Christman 2007). Both views can claim some intuitive support. On the one hand, it is reasonable to hold that it is only fitting to call a person 'autonomous' if that person is in fact effective in living according to her authentic self-conception. Yet, it also makes sense to call persons 'autonomous' who have formed an authentic self-conception and possess the requisite competency conditions effectively to express that self-conception, but happen to lack the contingent socio-relational conditions that allow for the expression of that authentic self. A possible solution to this impasse may be to avoid seeking hard and fast borders to the existence of autonomy, and say that autonomy is present in both cases, but is more robust where the proper external enabling conditions are in place.

The question of normative commitments associated with personal autonomy possession has also been a matter of some dispute. Many philosophers hold that autonomy is normatively content-neutral. According to this account, one (or one's commitments) can be autonomous regardless of the values one endorses. On this account, one could commit to any kind of life-even the life of a slave-and still be autonomous (see, for example, Friedman 2003). Other philosophers hold that autonomy possession requires substantive normative constraints of some kind or other-at the very least, it is argued that one must value autonomy in order to be truly autonomous (see Oshana 2003). As with the debate just mentioned, both sides of this debate can claim some intuitive support; this can be shown through the asking of opposing but seemingly equally compelling (apparently rhetorical) questions; namely, 'Can't one autonomously choose whatever one wants?', and, 'How can we call someone autonomous who doesn't value or seek autonomous living?' One possible solution to this debate is to say that while almost any individual choice can be autonomous, persons cannot live autonomous lives as a whole without some commitment to the value of autonomy.

Unlike moral and existentialist autonomy, personal autonomy is possessed in degrees, depending on the presence and strength of the constellation of internal capacities and external enabling conditions that make it possible. While not all persons possess personal autonomy, it is commonly claimed that virtually everyone-with the exception of the irredeemably pathological and the handicapped-possesses the capacity for personal autonomy. In addition, the links between personal autonomy possession and moral agency are usually said to be thin at best. Even those who hold that personal autonomy possession requires substantive normative commitments of some kind (such as, for example, a commitment to the value of autonomy itself), they usually hold that it is quite possible to be an autonomous villain. Some philosophers have argued that personal autonomy possession requires the presence of normative competency conditions that effectively provide agents with the capacity to distinguish right from wrong (see Wolf 1990), but this strong account is in general disfavor, and even if the account is correct, few would argue that this means that personally autonomous agents must also always act morally. In the face of this, one may wonder why autonomy-based claims are said to generate demands of respect upon others. This question will be dealt with in more detail in section 4 below.

Lastly, a word should be given on the relation between personal autonomy and freedom (or liberty, which is here taken to be synonymous with freedom). Although it is not uncommon to find the terms '(personal) autonomy' and 'freedom' used essentially synonymously, there are some important differences between them.

More often than not, to claim that a person is free is to claim that she is negatively free in the sense that she is not constrained by internal or external forces that hinder making a choice and executing it in action. There is a clear distinction between autonomy and negative freedom, however, given that autonomy refers to the presence of a capacity for effective authentic living, and negative freedom refers to a lack of constraints on action. It is entirely possible for a person to be free in this negative sense but nonautonomous, or-on accounts that do not require the presence of external enabling conditions for autonomy to be present-for a person to be autonomous but not (negatively) free.

Some writers also speak of positive freedom, and here the connections with autonomy become much deeper. Speaking very generally, to be free in this sense is to possess the abilities, capacities, knowledge, entitlements or skills necessary for the achievement of a given end. For example, I am only (positively) free to win an Olympic gold medal in archery if I am extremely skilled in the sport. Here it should be clear that one can be positively free in many ways and yet not be autonomous. Some philosophers, however, following Isaiah Berlin (Berlin 1948), have described positive freedom in such a way that it becomes basically synonymous with personal autonomy. Like autonomy, the conception of freedom that is operative in a given discussion can vary considerably; but more often than not personal autonomy is distinguished from freedom by the necessary presence, in the former, of a connection to the authenticity of the agent's self-conception and life-plan-a connection that is usually not found in conceptions of freedom.

d. Autonomy as a Right

Lastly, autonomy is sometimes spoken of in a manner that is more directly normative than descriptive. In political philosophy and bioethics especially, it is common to find references to persons as autonomous, where the autonomy referred to is understood principally as a to self-determination. In these contexts, to say that a person is autonomous is largely to say that she has a right to determine her life without interference from social or political authorities or forms of paternalism. Importantly, this right to self-directed living is often said to be possessed by persons by virtue either of their potential for autonomous living or of their inherent dignity as persons, but not by virtue of the presence of a developed and active capacity for autonomy (see Hill 1989). Some have argued that political rights (Ingram 1994) and even human rights generally (Richards 1989) are fundamentally based upon respect for the entitlements that attend possessing the capacity for autonomy.

3. The Normative Roles of Autonomy

Although disagreements concerning the nature of autonomy are rife, almost no one disagrees that autonomy has normative significance of some kind; and this agreement is found both in relation to the claim that autonomy is normatively significant for the autonomous agent and to the claim that autonomy is normatively significant for the addressees of autonomy-based demands. Following from this, autonomy plays an important normative role in a variety of philosophical areas.

a. Autonomy in Ethical Theory

Autonomy is referenced or invoked in a number of key ways in ethical theory:

(i) Autonomy serves as a ground for the claims that persons have dignity and inherently deserve basic moral respect

(ii) Autonomy is said to have a value that grounds the claim that persons deserve to be told the truth

(iii) Autonomy is referenced as a fundamental principle of ethics in Kantian deontology

(iv) Autonomy is commonly viewed as a key component of human well-being (and is therefore significant for utilitarianism)

(v) Autonomy is defended as an important virtue

(vi) Autonomy is said to be necessary for moral responsibility

(vii) Autonomy is said to have a value that grounds the claim that autonomy-based demands are worthy of special respect

(i) Ever since Kant, autonomy (or the capacity for autonomy) has been referenced by some philosophers as that property of human beings by virtue of which they possess inherent dignity and therefore inherently deserve to be treated with basic moral respect. Kant's justification for the claim that autonomy grounds the inherent dignity of persons was based on the view that it is by virtue of our autonomy that we are ends-in-ourselves. Beings that lack autonomy are, precisely because of this lack, essentially at the mercy of the determinism that characterizes the phenomenal realm: they are controlled by forces that have nothing to do with their own will. Beings that possess autonomy on the other hand, are, precisely because of this possession, free from this determination; they have the capacity for freedom through the active exercise of their autonomous wills, which allows for the legislation of universal law. Autonomous agents are not passive players in life; they are active agents, determining themselves by their own will, the authors of the laws that they follow (see Guyer 2003). As such, they are not passive means towards nature's determined ends, but are ends-in-themselves, by virtue of which they possess inherent dignity and deserve basic moral respect. Many have followed Kant in referencing autonomy as the ground of human dignity and as the basis of the basic moral respect owed to persons, although not all have followed Kant in the details of his account (for a recent account that moves away from Kant's conception of noumenal freedom, see Korsgaard 1996). The most common objection leveled against this account is that it runs into problems involving exclusion. Most would argue that the mentally handicapped, for example, are owed basic moral respect, even if they do not possess (even the capacity for) autonomy. And if human dignity is indexed to the presence of autonomy, it is argued, this would entail, counter-intuitively, that those who are more autonomous have more dignity, and are more worthy of respect. It may also be argued that the capacity for autonomy is a poor ground for human dignity (and respect for persons) for other reasons-for example, because autonomy has no essential connection to morality, or because better grounds are available, or because the very project of grounding human dignity on a property of some kind is ill-conceived. Despite these worries, however, appeals to autonomy as a basis for human dignity and basic moral respect remain quite popular.

(ii) Some philosophers have argued that a proper appreciation for others as autonomous (or as possessing the capacity for autonomy) requires that one not seek to deceive them. Respect for autonomy is thus said to have an important relation to truthfulness. In Thomas Hill's words, "Lies often reflect inadequate respect for the autonomy of the person who is deceived." (Hill 1991) We saw above that autonomy's value has been used to ground the basic moral respect owed to persons; and the present injunction against deception may be viewed as a specific form that autonomy-based respect for persons may take. It is easy to see why a connection between respect for autonomy and truthfulness (or what comes to the same thing-an injunction against deception) has been attractive to some philosophers, especially those in the Kantian tradition. When we deceive others for our own purposes, we bypass their reflective abilities and make them instruments in the achievement of our own ends, and in doing this we fail to treat them as persons capable and deserving of self-determination. Proper respect for persons as autonomous thus requires a commitment to truthfulness. It has been argued, however, that one may respect and value the autonomy of another while deceiving them at the same time (Buss 2005). One may, for example, use forms of deception so that another's capacity for autonomy may flourish. The basic idea here is that one may still reason for oneself despite being deliberately influenced by the deceptive behavior of others. As Sarah Buss writes, "To put it somewhat crudely, whether an instance of practical reasoning is self-determined is a matter of whether it is really the agent herself who is doing the reasoning. And this would seem to depend on whether she determines her response to the considerations that figure in her reasoning-not on how the considerations to which she responds relate to reality, nor on how she came to be aware of these considerations." It may be argued, however, that the conception of autonomy underlying this claim is too thin to be acceptable, and that a better conception would contain the resources necessary to judge self-determining reasoning influenced by the deliberate deception of another as nonautonomous. In this vein, some have argued that a person is autonomous in relation to a given desire or choice only if that person would not feel alienated from the causal process that gave rise to that desire or choice (Christman 2007). On the assumption that persons would feel alienated from deceptive desire- or choice-forming processes, the associated desires or choices would not count as autonomous. In response to this, however, it may be argued that autonomous agents may not feel alienated from all (or many) deceptive forms of influence upon the formation of their desires and choices, depending on the circumstances (Buss 2005). If this were the case, then a commitment to the value of autonomy may not be inconsistent with certain forms of deception or manipulation. Yet, given the traditional opposition between autonomous self-determination and agential determination rooted in deceit and manipulation, it is to be expected that resistance to the notion that they are not incompatible will continue.

(iii) Autonomy plays a key role in Kant's deontological ethics. We have already seen this in the way in which Kant grounds human dignity in autonomy. But autonomy plays a further (and closely related) normative role for Kant. It is often said that Kant held that the Categorical Imperative can be expressed in three closely related formulas: the Formula of Universal Law, the Formula of Humanity, and the Formula of the Kingdom of Ends. It has also been claimed, however, that Kant defended a fourth formula, which may be called the Formula of Autonomy. Although Kant did not state this formula explicitly, it has been argued that it can be plausibly derived from his description of the Categorical Imperative as "the idea of the will of every rational being as a will that legislates universal law." The corresponding Formula of Autonomy could then be expressed as an imperative in this way: act so that the maxims you will could be the legislation of universal law. According to this formula, we should act according to principles that express the autonomy of the will. This formulation is important, firstly because it suggests that Kant conceived autonomy as a normative principle (and not merely as a condition of the will that makes morality possible), and secondly because it further reinforces Kant's claim that humans, as autonomous law-givers, are the source of the universal law that guarantees their freedom and hence marks them out as possessing inherent dignity (see Reath 2006).

(iv) Autonomy is commonly held to be a core component of well-being. This view goes back at least to Mill's On Liberty, and has been accepted by many contemporary philosophers as well (see for example Griffin 1986 and Sumner 1996). In this connection, some argue that autonomy is an intrinsic part of well-being, and others argue that being autonomous reliably leads to well-being (and hence has instrumental prudential value). Although thus far, the normative importance of autonomy has been described as being associated primarily with deontology, the claim that autonomy is a core component of well-being shows that it can play a key role in consequentialist moral theories as well. Indeed, as will be discussed in greater detail below (section 4), although most defenses of the principle of respect for autonomy are deontological in nature, it is also possible to defend the principle on consequentialist grounds. From this point of view, it can be argued that autonomy deserves respect because respecting autonomy is reliably conducive to well-being.

(v) Autonomy has been claimed to be an important virtue to possess. It is not difficult to see why this is the case. The autonomous person is a person possessing a constellation of widely desirable qualities such as self-control, self-knowledge, rationality and reflective maturity. To be autonomous is to be self-governing; to be free from domination by foreign influences over one's character and values; to 'be one's own person'. Following from this, it is claimed by some that autonomy is a great virtue to possess - one which constitutes an important part of human flourishing. It may be objected, however, that an excessive concern with autonomy can be at odds with virtue, especially if robust autonomy entails an inability to exhibit loyalty or fidelity to projects, other persons or communities. Recent work on personal autonomy, however, has tended to support the notion that autonomy possession is not incompatible with these and similar forms of attachment (Friedman 2003).

(vi) Autonomy has been seen by some thinkers as having implications for a correct account of moral responsibility. Some accounts hold that autonomy is a necessary condition for moral responsibility. The basic defense of this claim is that it makes little sense to say that someone is morally responsible for her actions if she is not the author of those actions; and since one is the author of one's actions only if one is autonomous, autonomy possession is necessary for moral responsibility. According to this account, the class of actions that are autonomous and the class of actions for which we are morally responsible are identical, or at least almost so (see Fischer and Ravizza 1998). Other accounts hold that although persons are certainly morally responsible for their autonomous actions, they are also morally responsible for a wider range of actions as well. An account of this sort is often made by those who hold a more demanding conception of autonomy; and defenders of this account argue that we still want to hold persons morally responsible for the many actions that do not satisfy robust autonomy conditions on the one hand, but are not constituted of sheer heteronomy (brainwashing, psychosis, coercion, and so forth) on the other (see Arpaly 2005).

(vi) Many thinkers believe that autonomous claims or demands are worthy of special normative uptake-special respect-by virtue of the fact that they are autonomous. It is important to see how this claim is different from the first point given above (viz., that autonomy is said to ground basic moral respect for persons). The former claim is that the fact that persons are autonomous (or have the capacity for autonomy) is what grounds their special dignity, by virtue of which they are owed basic moral respect. Now, it is possible to owe someone basic moral respect, but not to owe special respect to a subset of their choices. Imagine that someone is brainwashed, for example. Many would argue that although we owe that person basic moral respect (for example, we are obligated, say, not to harm them or to lie to them), we do not owe special respect to that person's demands (say, to promote or not interfere with those demands). The current claim holds, however, that the fact that a person's choices are autonomous generates special demands of respect for those choices over and above the basic respect owed to the chooser (whether this be conceived as being by virtue of their capacity for autonomy or not). This principle-that autonomous choice deserves special respect-may be justified in either a deontological or consequentialist manner. Because of the considerable importance of this principle, however, it deserves a more detailed discussion, which is provided in section 4 below.

b. Autonomy in Applied Ethics

The principle of respect for autonomy has had a considerable influence on applied ethics largely because of its versatility: it can be invoked in any applied ethics debate that bears (even remotely) on morally significant situations that involve the demands of self-determination, free choice, authenticity or independence. Seven of the most important of these debates-certainly not an exhaustive list-will be briefly canvassed below:

(i) Autonomy and informed consent

(ii) Autonomy and abortion

(iii) Autonomy and end-of-life decisions

(iv) Autonomy and same-sex marriage

(v) Autonomy and just war theory

(vi) Autonomy and advertising

(vii) Autonomy and environmental ethics

(i) Respect for autonomy has had a major influence on debates in medical ethics, especially those concerning the constraints that should be in place within the physician-patient relationship. Perhaps the most important such constraint is that of informed consent. According to this principle, a patient should not receive medical treatment of any sort unless she is well-informed enough as to the treatment's nature and effects to be able to make an informed decision about it. The patient must agree to the treatment on the basis of this information. Many have argued that the requirement of informed consent is necessitated as part and parcel of a more basic imperative to respect patient autonomy (Dworkin 2006). Few argue that respecting patient autonomy has no weight at all; more commonly, objectors argue that there are cases in which overriding patient autonomy is sometimes justified by the good consequences that will likely result from doing so.

(ii) Autonomy is also referenced as an important value to be taken into consideration in the abortion debate, although it is referenced in different ways. On the one hand, it is argued that some abortions are justified as an expression of a woman's reproductive autonomy (see Overall 1990 and Fischer 2003). On the other hand, it could be argued that abortion is morally unacceptable, among other reasons, because it fails to respect the potential future autonomy of the aborted (for a related argument, see Marquis 1989). Assuming that both of these autonomy-based arguments have weight, adjudicating this dispute requires-among other things-establishing and defending the relative weights of actual and potential autonomy, both in relation to particular choices and in relation to lives as wholes.

(iii) Many argue that considerations of respect for autonomy are also decisive in the debates concerning the moral acceptability of euthanasia and suicide. Respect for autonomy can be viewed as a reason for accepting voluntary euthanasia. The basic argument here is one of consistency: if respect for others' autonomy requires respecting others' self-determining life-choices (at least when these are competently made), and if end-of-life decisions are placed within the ambit of life-choices, then end-of-life decisions made by competent, autonomous persons should be respected, even if these decisions involve voluntary euthanasia (for a related argument, see Brock 1993). Some have cast doubt, however, on whether a decision to die can be an autonomous decision at all, given the likely presence of psychological factors such as fear, hopelessness, and despair-factors which would undermine careful introspection and critical thought (Hartling 2006). Respect for autonomy can also be seen as a reason for respecting the decision to end one's life, even when reasons of mercy are not in play-that is, in cases of suicide-at least where there is reason to hold that the agent is sufficiently competent and rational (Webber & Shulman 1987). Some argue, however, that autonomy-based defenses of voluntary euthanasia and suicide involve a contradiction insofar as they invoke the value of autonomy to justify an act that destroys autonomy (Safranak 1988 and Doerflinger 1989). If correct, these arguments do not show that voluntary euthanasia or suicide are unacceptable; they show rather that arguments to establish their acceptability cannot be based on respect for autonomy. It may be a cause of worry, however, that such arguments prove too much by rendering unacceptable autonomy-based respect for any decision that involves a subsequent lessening of free choice.

(iv) Autonomy also carries normative weight in a number of applied ethics debates relating to public policy. Respect for autonomy can be straightforwardly referenced, for example, as an argument in favor of the acceptability of same-sex marriage: respect for others' autonomy entails respect for their autonomous decisions, and decisions regarding marriage-even same-sex marriage-fall within these parameters (when autonomous). Objectors might argue, however, that homosexual marriage is immoral, and that the right to noninterference with autonomous choice does not exist where the object of the choice is immoral. Few would argue, for example, that there exists an obligation to respect someone's autonomous decision to embezzle money, given that that act is immoral. The question then becomes whether same-sex marriage is morally acceptable.

(v) Respect for autonomy also plays a role in discussions of a just-war theory. Specifically, it has been referenced as the key principle determining the proper constraints and limitations that should be in place if we wish our prosecution of war to be just. It has been argued, for example-and in partial conjunction with what has been said above-that possession of autonomy (or the existence of a capacity for it) is the ground of human dignity, and hence the actions which appreciate that dignity must center on respect for autonomy. In relation to war, this suggests that while war may sometimes be morally permissible (in cases of self-defense, for example), wartime actions cannot involve violations of others' autonomy, especially that of noncombatants (for an extended discussion, see Zupan 2004).

(vi) In business ethics, respect for autonomy has been identified as a key reason why persuasive advertising practices are morally unacceptable (Crisp 1987). The arguments given in support of this claim largely follow those mentioned above in relation to truthfulness-viz. that respect for others' autonomy is incompatible with deception or manipulation-combined with the claim that persuasive advertising practices constitute deception or manipulation. In this vein it has also been argued that persuasive advertising undermines consumer autonomy by creating foreign desires and wants and by producing compulsive behavior in consumers. Some have argued, however, that persuasive advertising practices do not threaten consumers' autonomy, at least not necessarily or intrinsically (Arrington 1982). From this point of view, although such deception may occur, this is the exception; usually it provides consumers with the information necessary for making informed decisions. It has also been argued that, even if persuasive advertising thwarts autonomy, it is still in consumers' interests to be exposed to it, given that companies would likely only go to such trouble for products that will be market-winners, and hence that consumers would have desired and bought those products anyway, even after careful consideration (Nelson 1978). One obvious problem with this argument is that it assumes that heavy persuasive marketing is a sign of product quality, which is certainly debatable; but even if that premise is granted, it may still be argued that rhetorical device laden advertising, by attempting to bypass consumers' critical thinking abilities, violates their autonomy.

(vii) Respect for autonomy has even been referenced in relation to issues in environmental ethics. Eric Katz has argued, for example, that nature as a whole constitutes an 'autonomous subject', which therefore deserves moral respect and should not be treated as a mere means to the satisfaction of human ends (Katz 1997). Critics of this view may wonder whether the notion of an autonomous subject operative here has been stretched to breaking point, or rendered hollow. If correct, this criticism does not, of course, entail that prohibitions against using nature as a mere means to human ends cannot be provided; it simply means that an acceptable defense cannot be based on autonomy-related considerations.

It should be clear from the breadth and diversity of the employment of the principle of respect for autonomy that it is both, extremely versatile and a mainstay of applied ethics debates. The brief sketches given above concern some of the more prominent autonomy-related discussions in applied ethics, but other debates in applied ethics-relating, for example, to injunctions against discrimination (Gardner 1992 and Doyle 2007) or against domestic abuse (Friedman 2003), to name a couple-have been approached and adjudicated in reference to the importance of respecting autonomy as well.

More often than not, however, those who reference the principle of respect for autonomy in applied ethics either take its normative force for granted, or only devote passing attention to the question of its justification. Yet, given that the principle is neither self-evident nor immune to challenge, it is very important that those who reference the principle be able to provide a robust justification of its normative weight. Because of its fundamentality, this issue will be considered separately and in more detail in section 4 below.

c. Autonomy in Political Philosophy

Autonomy is considered normatively significant for issues in political philosophy, primarily in relation to discussions of social justice and rights. It is particularly important for political liberalism (see, for example, Christman and Anderson 2005); and some have argued that autonomy is the core value of liberalism (see White 1991 and Dagger 2005). Four of the most important issues in political philosophy that invoke the normative significance of autonomy include:

(i) The establishment and validation of just social and political principles

(ii) The legitimation of political power

(iii) The justification of political rights (both specific and general)

(iv) The acceptability of political paternalism

(i) A conception of the autonomous individual provides the perspective from which social and political principles are formulated, and validated as just, in several contractarian political theories. A classic example is provided in Rawls' A Theory of Justice (1971). According to Rawls, principles of social justice are best conceived and validated based on what would be acceptable to (representatives of) members of society gathering together in an 'original position' behind a 'veil of ignorance'. Rawls argued that the conditions that constrain this process will ensure that those taking part in it are acting autonomously (that is, according to Rawls, as free and rational). Of key importance is the veil of ignorance because, by preventing any detailed knowledge of one's condition or place in society, it "deprives the persons in the original position of the knowledge that would enable them to choose heteronomous principles". Rawls concludes: "[W]e can say that by acting from these principles persons are acting autonomously: they are acting from principles that they would acknowledge under conditions that best express their nature as free and equal rational beings." Given these key constraints in the contracting process, it results, according to Rawls, in valid principles of social justice. Here it can be seen that autonomy has double (and mutually supporting) normative significance: it characterizes members of society in an idealized way in order to form the normatively privileged perspective from which to establish principles of social justice; and it provides the standard that validates those principles as just (viz., by being accepted by autonomous agents). One can see the influence of Kant's conception of autonomy and its normative significance in this doctrine. Roughly put, Kant held that moral principles are those that would be accepted by persons within an idealized constraint-viz., insofar as they are autonomous. Similarly, Rawls argued that the principles of social justice are those that would be accepted by persons within an idealized constraint-viz., insofar as they are conceived as autonomous (free and rational) agents behind a veil of ignorance in the original position. Rawls explicitly acknowledged his indebtedness to Kant in this regard.

(ii) In relation, a cornerstone of political liberalism is the view that political power is legitimized by its free acceptance by a state's subjects who are conceived (at least minimally) as autonomous persons. John Locke is recognized as one of the key progenitors of this view of the legitimation of political power. In Two Treatises on Government (1689), he wrote: "Men being, as has been said, by nature all free, equal, and independent, no one can be put out of his estate, and subjected to the political power of another, without his own consent, which is done by agreeing with other men to join and unite into a community for their comfortable, safe, and peaceable living one amongst another..." That which secures the legitimacy of government on such a view is precisely the agreement to do so amongst those who are not only naturally equal in standing, but also free and independent-that is, self-directing. The tradition of placing crucial normative weight on the autonomy of the contracting parties has continued to the present. Referring to liberalism in political philosophy in general, John Christman has written (2005), "Liberal legitimacy...assumes that autonomous citizens can endorse the principles that shape the institutions of political power....In this way, political power is an outgrowth of autonomous personhood and choice." As before, autonomy is fulfilling two (mutually supporting) roles: it is being used to delimit the normatively privileged perspective from which judgment is authoritative regarding political legitimacy, and it is informing (at least partly) the standard in relation to which that judgment (viz., the acceptance of a political power) is made.

(iii) Autonomy is referenced as a core ground in the justification of political rights in a broadly liberal political framework. It is argued, for example, that a theory of autonomy has to be presupposed to achieve agreement with a theory of rights that in principle is acceptable to all. It is also argued that autonomy is absolutely central in views of rights that enshrine the idea that people have the freedom equally to conceive and enjoy widely different forms of meaningful life. Attracta Ingram (Ingram 1994) provides a clear articulation of the view that autonomy deserves a central place in the defense of a scheme of political rights: "I think that the most compelling answer is that people's most vital human interest is in living meaningful lives. This interest cannot be secured while they are at risk of slavery, social subordination, repression, persecution, and grinding poverty - conditions that history shows to be the lot of many in societies which do not recognize the value of individual freedom. So it is rational for people to want to develop the mental capacities and social environment necessary to living independent lives. Since what is at stake is the proper distribution of human freedom, we have here matters of justice and rights; the province of political morality." (112-3) Autonomy is thus said by some to be a-or the-core unifying value in a conception of rights that is liberal (and hence pluralistic) in tenor (see also Richards 1989). In addition, the value of autonomy is referenced to justify particular rights such as the right to free speech (Brison 2000) or the right to privacy (Kupfer 1987).

(iv) Autonomy is referenced by many as the core value that militates against the acceptability of political (and informal) paternalism. According to a widely-accepted conception, an act is paternalistic if it involves direct interference with another's actions and will for the purpose of advancing (what the interferer takes to be) that person's own good. Paternalism bypasses the agent's capacity to be self-directing and ignores the agent's wishes regarding the way she would like to live her own life; and it is these factors that constitute a violation of the autonomy of the one suffering paternalistic influence. It is commonly held that possession of the capacity for autonomy gives the agent a right and an authority-at least in relation to minimally voluntary, self-regarding choices (all else being equal)-to be self-determining without interference (for a detailed account of paternalism and the defense of the claims of autonomy, see VanDeVeer 1986; see also Mill's classic argument against paternalism in On Liberty). Supporters of paternalistic doctrines tend to argue that paternalism is justified based either on the highly beneficial consequences of such interference, or on the ground that a policy of paternalism could be hypothetically accepted by autonomous agents when the possible related consequences are severe enough (on the latter see Rawls 1999). It has also been argued that a certain degree of paternalism is unavoidable, but that such paternalism should be constrained by the goal of leading persons to welfare-promoting choices while not threatening freedom of choice (Sunstein and Thaler 2003).

It is worth mentioning in passing that J.S. Mill, who is often referenced as a champion of individual liberty and a firm critic of paternalistic policy, endorsed a strong version of paternalism, but only in relation to "those backward states of society in which the race itself may be considered as in its nonage." In relation to these, Mill (1971) claimed that "Despotism is a legitimate mode of government in dealing with barbarians, provided the end be their improvement and the means justified by actually effecting that end." Although these claims of Mill's would find few supporters today, it is worth adding that the standard that Mill employed to ground the distinction between unjustified and justified paternalism was the presence of a kind of maturity of thought and judgment that is not greatly dissimilar to autonomy: "[A]s soon as mankind have attained the capacity of being guided to their own improvement by conviction or persuasion...compulsion, either in the direct form or in that of pains and penalties for noncompliance, is no longer admissible as a means to their own good, and justifiable only for the security of others."

d. Autonomy in Philosophy of Education

Several philosophers have argued that autonomy development is the most important goal (or at least one of the most important goals) of a liberal education. Reasoning in support of this claim usually takes two forms. Firstly, some argue that autonomy should be the primary goal of liberal education because autonomy enhancement is the most important goal of the liberal state, and hence an education in such a state should be an education for autonomy (see White 1991, and compare with Raz 1986, ch. 14). Secondly, some argue that autonomy should be the goal of liberal education because it should be a key goal of any form of education, largely because an education for autonomy is crucial for human well-being across the board.

The latter position has been challenged by communitarians, however, who argue that there is no justification for the claim that autonomy is universally valuable, and who see autonomy as at best a parochial (Western) value (see MacIntyre 1981, White 1991, and Raz 1986). The communitarian argument has been challenged in various ways. It has been directly counter-argued, for example, that autonomy is universally intrinsic to well-being (see Norman 1994 and Ishtiyaque & Cuypers 2008). In addition, the epistemic benefits of autonomy development for forming rational judgments about one's life have been cited as reason for allowing the state to mandate education for autonomy, even over the protests of more traditionally-minded parents (MacMullen 2007). Although communitarians continue to be suspicious of the claim that autonomy should be a goal of all education, it is widely agreed that education for autonomy is central to an education in a liberal society.

4. Warrant for the Principle of Respect for Autonomous Choice

As mentioned above (in section 3a), the idea that autonomy gives rise to demands of respect can take two forms. On the one hand, it is argued that the possession of autonomy or the capacity for it grounds human dignity and the basic moral respect for persons that attends that dignity. On the other hand, it is argued that the fact that a choice or demand is autonomous is reason to give special or added normative uptake to that choice or demand. For clarity, one might refer to the former as the principle of respect for autonomy and the latter as the principle of respect for autonomous choice. The principle of respect for autonomy has already been examined in connection with Kant's moral philosophy, and it was shown that although this principle has been popular, it is also quite controversial, largely because of problems involving exclusion. The principle of respect for autonomous choice will be examined in the present section. As shown above, this principle plays a key role in a variety of normative debates, especially debates in applied ethics. As has been mentioned, however, the principle is often either invoked without supporting argument or is given thin justification at best. The principle is therefore worthy of further discussion, especially with regard to its normative warrant. What is the warrant for the claim that autonomous choices give rise to special demands of respect? Two views have emerged on this question. Unsurprisingly, these views can be delineated along deontological and consequentialist lines.

Firstly, many philosophers following Kant (often only roughly), contend that autonomous choices deserve special respect because persons, as capable of self-determination, are entitled, all else being equal, to be self-determining without interference. This may be termed the authority view of the justification for the principle of respect for autonomous choice. The authority view is most often allied to the view that respect for autonomy functions primarily as a side-constraint which forbids paternalistically-motivated interference in the self-regarding, minimally voluntary choices of others, even if such interference would be prudentially best for the choosing persons.

Secondly, some philosophers following Mill, contend that autonomous choices deserve special respect because a policy of such respect conduces to desirable prudential consequences, either for the choosing agent, or aggregately. On this view, autonomous choices are not to be respected merely because they are autonomous, or because those making them have a capacity for self-determination, but rather because doing so will lead to the most beneficial prudential results. This more consequentialist view of the normative warrant for the principle of respect for autonomous choice may be termed the benefit view.

Based on the literature, it is quite clear that the authority view is the dominant view in the field, and has been for some time. Many philosophers hold that persons have a right to have their self-determining choices respected even in cases where there is good reason to think that the fulfillment of their autonomous choices would lead to bad prudential results (see Wellman 2003 and Darwall 2006). Against this it may be argued that where the prudential results of respecting a person's autonomous choice are disastrous enough, interference may be justified, thus opening the door to the salience of consequentialist considerations bearing upon the principle (see Young 1982 and Wellman 2003). It has also been argued that the relation between the fulfillment of at least minimally robust autonomous choice and the resulting expression of authentic selfhood (conceived as highly prudentially significant) suggests that the benefit view deserves to be given closer attention (Piper 2009). Given the great popularity and wide employment of the principle of respect for autonomous choice, it is safe to say that the question of its normative warrant deserves far greater attention than it has thus far received.

5. References and Further Reading

Anderson, Joel and Axel Honneth. "Autonomy, Vulnerability, Recognition, and Justice." In Autonomy and the Challenges to Liberalism: New Essays, eds. John Christman and Joel Anderson, 127-149. Cambridge: Cambridge University Press, 2005.

Arpaly, Nomy. "Responsibility, Applied Ethics, and Complex Autonomy Theories." In Personal Autonomy: New Essays in Personal Autonomy and Its Role in Contemporary Moral Philosophy, ed. James Stacey Taylor, 162-180. Cambridge: Cambridge University Press, 2005.

Arrington, Robert L. "Advertising and Behavior Control." Journal of Business Ethics 1, no. 1 (Feb. 1982): 3-12.

Berlin, Isaiah. Two Concepts of Liberty. Oxford: Oxford University Press, 1958.

Berofsky, Bernard. Liberation from Self: A Theory of Personal Autonomy. Cambridge; Cambridge University Press, 1995.

Brison, Susan J. "Relational Autonomy and the Freedom of Expression." In Relational Autonomy: Feminist Perspectives on Autonomy, Agency, and the Social Self, eds. Catriona Mackenzie and Natalie Stoljar, 280-299. Oxford: Oxford University Press, 2000.

Brock, D. "Voluntary Active Euthanasia." The Hastings Center Report 22, no. 2 (1993): 10-22.

Buss, Sarah. "Valuing Autonomy and Respecting Persons: Manipulation, Seduction, and the Basis of Moral Constraints." Ethics 115, no. 2 (Jan 2005): 195-235.

Christman, John and Joel Anderson, eds. Autonomy and the Challenges to Liberalism: New Essays. Cambridge: Cambridge University Press, 2005.

Christman, John. "Autonomy, History, and the Subject of Justice." Social Theory and Practice 33, no. 1 (January 2007): 1-26.

Christman, J. "Autonomy, Self-Knowledge, and Liberal Legitimacy." In Autonomy and the Challenges to Liberalism: New Essays, eds. John Christman and Joel Anderson, 330-357. Cambridge: Cambridge University Press, 2005.

Cooper, John. "Stoic Autonomy." In Autonomy, eds. Ellen Frankel Paul, Fred Miller, and Jeffrey Paul: 1-29. Cambridge: University of Cambridge Press, 2003.

Crisp, Roger. "Persuasive Advertising, Autonomy, and the Creation of Desire." Journal of Business Ethics 6, no. 5 (July 1987): 413-418.

Dagger, Richard. "Autonomy, Domination, and the Republican Challenge to Liberalism." In Autonomy and the Challenges to Liberalism: New Essays, eds. John Christman and Joel Anderson, 177-203. Cambridge: Cambridge University Press, 2005.

Darwall, Stephen. "The Value of Autonomy and Autonomy of the Will." Ethics 116, no. 2 (January 2006): 263-284.

Doerflinger, Richard. "Assisted Suicide: Pro-Choice or Anti-Life?" The Hastings Center Report 19, no. 1 (Jan-Feb 1989): 16-19.

Doyle, Oran. "Direct Discrimination, Indirect Discrimination, and Autonomy." Oxford Journal of Legal Studies 27, no. 3 (2007): 537-553.

Dworkin, Gerald. The Theory and Practice of Autonomy. Cambridge: Cambridge University Press, 1988.

Dworkin, Gerald. "Autonomy and Informed Consent." In Ethical Health Care, eds. Patrician Illingworth and Wendy Parmet, 79-91.Upper Saddle River, NJ: Pearson Prentice-Hall, 2006.

Fischer, John Martin. "Abortion, Autonomy, and Control Over One's Body." Social Philosophy and Policy 20, no. 2 (2003): 286-306.

Fischer, John Martin and Mark Ravizza. Responsibility and Control: A Theory of Moral Responsibility. Cambridge: Cambridge University Press, 1998.

Frankfurt, Harry. "Freedom of the Will and the Concept of a Person." In The Importance of What We Care About by Harry Frankfurt, 11-25. Cambridge: Cambridge University Press, 1988.

Frankfurt, Harry. Necessity, Volition, and Love. Cambridge: Cambridge University Press, 1999.

Friedman, Marilyn. Autonomy, Gender, Politics. Oxford: Oxford University Press, 2003.

Gardner, John. "Private Activities and PersonalAutonomy: At the Margins of Anti-discrimination Law." In Discrimination: The Limits of the Law, eds.Bob Hepple and Erika Szyszczak, 148-171. London: Mansell, 1992.

Griffin, James. Well-Being: Its Meaning, Measurement, and Moral Importance. Oxford: Oxford University Press, 1986.

Guyer, Paul. "Kant on the Theory and Practice of Autonomy." In Autonomy, eds. Ellen Frankel Paul, Fred Miller, and Jeffrey Paul: 70-98. Cambridge: Cambridge University Press, 2003.

Hartling, O.J. "Euthanasia-the Illusion of Autonomy." Medicine and Law 25, no. 1 (2006): 189-99.

Hill, Thomas. "The Kantian Conception of Autonomy." In The Inner Citadel: Essays on Individual Autonomy, ed. John Christman, 91-105. Oxford: Oxford University Press, 1989.

Hill, Thomas. "Autonomy and Benevolent Lies." In Autonomy and Self-Respect by Thomas Hill, 25-42. Cambridge: Cambridge University Press, 1991.

Ingram, Attracta. A Political Theory of Rights. Oxford: Oxford University Press, 1994.

Ishtiyaque, Haji and Stefaan Cuypers. "Authenticity-Sensitive Preferentism and Educating for Well-Being and Autonomy." Journal of Philosophy of Education 42, no. 1 (February 2008): 85-106.

Kant, Immanuel, trans. Mary Gregor. Groundwork of the Metaphysics of Morals. Cambridge: Cambridge University Press, 1998.

Katz, Eric. Nature As Subject. New York: Rowman & Littlefield, 1997.

Korsgaard, Christine. Creating the Kingdom of Ends. New York: Cambridge University Press, 1996.

Kupfer, Joseph. "Privacy, Autonomy, and Self-Concept." American Philosophical Quarterly 24, no. 1 (January 1987): 81-9.

MacIntyre, Alasdair. After Virtue: A Study in Moral Theory. Notre Dame: University of Notre Dame Press, 1981.

Mackenzie, Catriona and Natalie Stoljar, eds. Relational Autonomy: Feminist Perspectives on Autonomy, Agency, and the Social Self. Oxford: Oxford University Press, 2000.

MacMullen, Ian. Faith in Schools? Autonomy, Citizenship and Religious Education in the Liberal State. Princeton, NJ: Princeton University Press, 2007.

Marquis, Don. "Why Abortion is Immoral." Journal of Philosophy 86 (April 1989): 183-202.

Mele, Alfred. Autonomous Agents: From Self-Control to Autonomy. Oxford: Oxford University Press, 1995.

Meyers, Diana. Self, Society, and Personal Choice. New York: Columbia University Press, 1989.

Mill, John Stuart. On Liberty. Edited by Curran V. Shields. New Jersey: Prentice-Hall Inc., 1997.

Nelson, Philip. "Advertising and Ethics." In Ethics, Free Enterprise, and Public Policy: Original Essays on Moral Issues in Business, eds. Robert T. De George and Joseph A. Pichler. New York: Oxford University Press, 1978.

Norman, Richard. "'I Did It My Way': Some Thoughts on Autonomy." Journal of Philosophy of Education 28, no. 1 (1994): 25-34.

Oshana, Marina. "Personal Autonomy and Society." Journal of Social Philosophy 29, no. 1 (Spring 1998): 81-102.

Oshana, Marina. "How Much Should We Value Autonomy?" In Autonomy, eds. Ellen Frankel Paul, Fred Miller, and Jeffrey Paul, 99-126. Cambridge: Cambridge University Press, 2003.

Overall, Christine. "Selective Termination of Pregnancy and Women's Reproductive Autonomy." The Hastings Center Report 20, no. 3 (May-June 1990): 6-11.

Piper, Mark. "On Respect for Personal Autonomy and the Value Instantiated in Autonomous Choice." Southwest Philosophy Review 25, no. 1 (January 2009): 189-198.

Pohlmann, R. "Autonomie." In Historisches Wörterbuch der Philosophie, ed. J. Ritter, 1: 701-719. Basel: Schwabe, 1971.

Rawls, John. A Theory of Justice, rev. ed. Cambridge, MA: Harvard University Press, 1999.

Raz, Joseph. The Morality of Freedom. Oxford: Oxford University Press, 1986.

Reath, Andrews. "Autonomy of the Will as the Foundation of Morality." In Agency and Autonomy in Kant's Moral Theory by Andrews Reath, 121-172. Oxford: Oxford University Press, 2006.

Richards, David A.J. "Rights and Autonomy." In The Inner Citadel: essays on Individual Autonomy, ed. John Christman, 203-220. Oxford: Oxford University Press, 1989.

Safranek, John. "Autonomy and Assisted Suicide: the Execution of Freedom." The Hastings Center Report 28, no. 4 (July-Aug. 1998): 32-36.

Sartre, Jean-Paul, trans. Bernard Frechtman. Existentialism is a Humanism. New York: Philosophical Library, 1946.

Sumner, L.W. Welfare, Happiness, and Ethics. Oxford: Oxford University Press, 1996.

Sunstein, Cass and Richard Thaler. "Libertarian Paternalism is Not an Oxymoron." The University of Chicago Law Review 70, no. 4 (Fall 2003): 1159-1202.

Taylor, James Stacey. "Introduction." In Personal Autonomy: New Essays on Personal Autonomy and Its Role in Contemporary Moral Philosophy, ed. James Stacey Taylor, 1-29. Cambridge: Cambridge University Press, 2005.

VanDeVeer, Donald. Paternalistic Intervention: The Moral Bounds of Benevolence. Princeton, NJ: Princeton University Press, 1986.

Webber, May and Ernest Shulman. "Personal Autonomy and Rational Suicide." Paper given at the Annual Convention of the American Association of Suicidology/International Association for Suicide Prevention (1987).

Wellman, Christopher Heath. "The Paradox of Group Autonomy." In Autonomy, eds. Ellen Frankel Paul, Fred Miller, and Jeffrey Paul, 265-285. Cambridge: Cambridge University Press, 2003.

White, John. Education and the Good Life: Autonomy, Altruism, and the National Curriculum. New York: Teachers College Press, 1991.

Wolf, Susan. Freedom and Reason. New York: Oxford University Press, 1990.

Young, Robert. "The Value of Autonomy." The Philosophical Quarterly 32, no. 126 (January 1982): 35-44.

Zupan, Daniel S. War, Morality, and Autonomy: An Investigation in Just War Theory. Hampshire, England: Ashgate Publishing Ltd., 2004.

Author Information

Mark Piper
Email: pipermc@jmu.edu
James Madison University
U. S. A.

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Autonomy is variously rendered as self-law, self-government, self-rule, or self-determination. The concept first came into prominence in ancient Greece (from the Greek auto-nomos), where it characterized city states that were self governing. Only later-during the European Enlightenment-did autonomy come to be widely understood as a property of persons.

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