Autonomy and Trust in Bioethics

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Cambridge University Press, Apr 18, 2002 - Medical - 213 pages
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Why has autonomy been a leading idea in philosophical writing on bioethics, and why has trust been marginal? In this important book, Onora O'Neill suggests that the conceptions of individual autonomy so widely relied on in bioethics are philosophically and ethically inadequate, and that they undermine rather than support relations of trust. She shows how Kant's non-individualistic view of autonomy provides a stronger basis for an approach to medicine, science and biotechnology, and does not marginalize untrustworthiness, while also explaining why trustworthy individuals and institutions are often undeservingly mistrusted. Her arguments are illustrated with issues raised by practices such as the use of genetic information by the police or insurers, research using human tissues, uses of new reproductive technologies, and media practices for reporting on medicine, science and technology. Autonomy and Trust in Bioethics will appeal to a wide range of readers in ethics, bioethics and related disciplines.
  

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Contents

Gaining autonomy and losing trust?
1
12 Medical ethics and environmental ethics
4
13 Trust in the risk society
7
14 Judging reliability and placing trust
12
15 Trust and autonomy in medical ethics
16
16 Varieties of autonomy
21
Autonomy individuality and consent
28
Mill
29
52 Principled autonomy deception and trust
97
53 Genetic technologies
99
54 Genetic exceptionalism
101
uninterpreted genetic data
105
interpreted genetic information
110
57 Trust genetics and insurance
115
The quest for trustworthiness
118
62 Improving trustworthiness
123

23 The triumph of autonomy
34
24 The triumph of informed consent
37
25 Impaired capacities to consent
40
26 Consent and opacity
42
27 The consumer view of autonomy
44
Reproductive autonomy and new technologies
49
contraception
51
abortion
52
assisted reproductive technologies
57
35 Reproductive choice and parenthood
61
36 The limits of reproductive autonomy
65
37 Reprogenetics and procreative autonomy
70
Principled autonomy
73
42 Human rights as a basic framework?
74
43 Grounding human rights in the good
76
44 Grounding human rights in the human obligations
78
45 Kant and principled autonomy
83
46 Principled autonomy and human obligations
86
47 Taking principled autonomy seriously
89
48 Principled autonomy obligations and rights
95
Principled autonomy and genetic technologies
96
63 The pursuit of trustworthiness
125
64 Trustworthiness through audit
129
65 Trustworthiness through openness
134
66 Information testimony and placing trust
136
Trust and the limits of consent
141
72 Limited trust limited suspicion
142
73 Trust and suspicion about uses of human tissues
145
74 The arguments behind informed consent
149
75 Paternalism and informed consent in context
151
76 How much information is needed for informed consent?
154
77 Informed consent and risk
160
Trust and communication the media and bioethics
165
82 Individual autonomy cut down to size?
166
83 Democratic legitimation in bioethics
169
84 Bioethics and the media
174
85 Press freedom and bioethics
180
86 Press responsibilities and bioethics
184
Bibliography
193
Institutional bibliography
203
Index
207
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About the author (2002)

Onora O'Neill is Principal of Newnham College, Cambridge, and has written widely on ethics and political philosophy.

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