Rethinking Autonomy: A Critique of Principlism in Biomedical Ethics

Rethinking Autonomy: A Critique of Principlism in Biomedical Ethics

John W. Traphagan

Language: English

Pages: 176

ISBN: 1438445520

Format: PDF / Kindle (mobi) / ePub


This groundbreaking book offers a critical examination of the concept of autonomy, one with major implications for biomedical ethics. Working from the perspectives of ethnography and medical anthropology, John W. Traphagan argues that the notion of autonomy as a foundational principle of a common morality, the view dominant in North America, is inadequate as a universal moral category because culture deeply influences how people think about autonomy and the fundamental nature of being human. Drawing from fieldwork in Japan, Traphagan reveals a notably different sensibility, demonstrating how Japanese moral concepts and actions are based upon a deep awareness of the social embeddedness of people and an aesthetic sensitivity that emphasizes context and situation over universality in making moral evaluations of behavior. Traphagan develops data from Japan into a critical examination of how scholarly research in biomedical ethics, and ethics more generally, is conducted in North America. Arguing in a vein related to the emerging area of naturalized biomedical ethics, Traphagan proposes the creation of an empirically grounded study of moral behavior.

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cultural values that influence any steps we invent to structure ethical decision making and that are shaped by how people in a given cultural context conceptualize the person. One of the central assumptions of the American biomedical establishment is a relatively unarticulated notion of the human body/self as needing to adhere to a statistical value of normalcy. Blood pressure that is outside of the range of statistical normalcy demands treatment; people who behave in ways outside of a

done by other informants into like categories.11 It should be noted that the process of completing this research proved to be considerably more complex and difficult than I initially imagined, in part because the Japanese language does not easily lend itself to thinking about the person in this way. Several terms I thought would generate responses failed to do so: these included words for person (人間 which means person or human, but which can also mean the character of a person), self (自分 a term

Five viscera (heart, liver, kidney, spleen, lungs) or 理知 Yin organs associated with Chinese medicine 半身 Half of the body (upper or lower) 知性 膝小僧 Kneecap 先祖 楽しみ 手 Hand 頭 Head 精神 脳 Brain 感情 目 Eye 気持ち 耳 Ear 意見 足 Foot, leg 嬉しい 悔しい 口 Mouth 踵 Heel 寂しい 鳥目 Night blindness 天にものぼる 細胞 Cell 開く 腹 Belly ドキドキする 血 Blood モヤモヤする 心臓 Heart 愛おしい 胸 Chest 胸がつぶれる 瞼 Eyelids 腹をたてる 大根足 Fat legs 心配 のど Throat 遠慮 こめかみ Eye corner/temple area 安心 歯 Tooth,

overall context of action, thus in the case of Orin’s neighbor the act seems wrong not simply in terms of a specific individual, but in terms of the overall context of action. The father refuses to gracefully accept his fate and the son responds by forcing his father to his death. There is not a single person culpable of wrongdoing—both (and others as well) are complicit in the wrongness of the situation. The same is true for the rightness of Orin’s situation, particularly after her son realizes

These sensory inputs are not necessarily limited to things coming from the external world; memories also can form sensory inputs that are used in the process of interpreting particular experiences or events. As humans encounter the world, they create ideas that are directly based on empirically identifiable and uninterpreted sense data (cf. Margenau 7. One could certainly argue here that the act of taking a measurement to find the temperature of a liquid is an act of interpretation. The liquid,

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