Autonomy in medical bioethics: the response of the principialism of Beauchamp and Childress to O’Neill’s criticism of the triumph of autonomy

Abstract

The notion of autonomy attains central relevance within the field of medical bioethics. In Autonomy and Trust in Bioethics, Onora O’Neill questions the concept of individual autonomy that prevails within bioethics and identifies a supposed triumph of autonomy, which in many situations ends up being merely a synonym for informed consent. O’Neill points out theoretical and practical limits to informed consent and advocates a concept of autonomy that makes it possible to reestablish trust in the practices, activities and products of medicine. The aim of this article was to investigate whether this concept is in fact necessary, given that Beauchamp and Childress seem to answer the problem of the triumph of autonomy in biomedical practice through their theoretical proposal based on fourprima facie valid principles, namely the principle of autonomy, the principle of non-maleficence, the principle of beneficence and the principle of justice.