Rethinking Autonomy , livre ebook

State University of New York Press - John W. Traphagan

Découvre YouScribe en t'inscrivant gratuitement

Je m'inscris

Obtenez un accès à la bibliothèque pour le consulter en ligne
En savoir plus

123 pages

English

Vous pourrez modifier la taille du texte de cet ouvrage

Obtenez un accès à la bibliothèque pour le consulter en ligne
En savoir plus

A propos
Informations
Extrait

Description

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.
Acknowledgments

1. Inventing Ethics

1.1 The Problem of Common Morality
1.2 Embodied Culture
1.3 Thinking About Culture
1.4 What Is Culture?
1.5 Memory, Culture, Ethics

2. Self, Autonomy, and Body

2.1 Principles and Ethics
2.2 Autonomy
2.3 What Is a Human?
2.4 Culture, Mind, and Body
2.5 Categories of a Person and Self
2.6 The Nature of Humans
2.7 Mind and Body, Inside and Outside

3. Autonomy and Japanese Self-Concepts

3.1 Self and Other
3.2 The Individual Self
3.3 Self and Childhood Development
3.4 The Processive Self
3.5 Moral Selves and Autonomy

4. Autonomies, Virtue, and Social Change

4.1 Self, Virtue, and Character
4.2 Family, Self, Society
4.3 Autonomy, Family, and Social Change

5. Mental Health, Suicide, and Self-Centered Behavior

5.1 Self and Other
5.2 Suicide as Medical and Analytical Category
5.3 Suicide and Self-Killing in Japan
5.4 Death

6. Emotion, Aesthetics, and Moral Action

6.1 Situational Ethics in Japan
6.2 The Obasuteyama Legend
6.3 Harmony and Sincerity
6.4 Japanese Ethics

7. Rethinking Autonomy

References
Index

Sujets

Philosophie

Éthique et morale

Ethique et morale

Ethics in religion

Informations

Publié par	State University of New York Press
Date de parution	13 décembre 2012
Nombre de lectures	0
EAN13	9781438445540
Langue	English
Poids de l'ouvrage	4 Mo

Informations légales : prix de location à la page 0,1598€. Cette information est donnée uniquement à titre indicatif conformément à la législation en vigueur.

Extrait

Rethinking Autonomy
A Critique of Principlism in Biomedical Ethics
JOHN W. TRAPHAGAN

Cover image courtesy of CanStock Photo/rolffimages
Published by State University of New York Press, Albany
© 2013 State University of New York
All rights reserved
Printed in the United States of America
No part of this book may be used or reproduced in any manner whatsoever without written permission. No part of this book may be stored in a retrieval system or transmitted in any form or by any means including electronic, electrostatic, magnetic tape, mechanical, photocopying, recording, or otherwise without the prior permission in writing of the publisher.
For information, contact State University of New York Press, Albany, NY www.sunypress.edu
Production by Diane Ganeles
Marketing by Kate McDonnell
Library of Congress Cataloging-in-Publication Data
Traphagan, John W.
Rethinking autonomy : a critique of principlism in biomedical ethics / by John W. Traphagan.
p. cm.
Includes bibliographical references and index.
ISBN 978-1-4384-4552-6 (pbk. : alk. paper)
ISBN 978-1-4384-4553-3 (hardcover : alk. paper)
1. Medical ethics. 2. Ethics—Cross-cultural studies. 3. Autonomy (Psychology) I. Title.
R724.T657 2013
174.2—dc23
2012011097
10 9 8 7 6 5 4 3 2 1

For my lovely daughter, Sarah
Acknowledgments
Parts of Chapters 2 and 3 are significantly revised portions of articles. “Senility as Disintegrated Person in Japan” originally appeared in the Journal of Cross-Cultural Gerontology 17:253–67 (Traphagan 2002), “The Oddness of Things: Morality Games and Interpretations of Social Change Among Elders in Rural Japan” originally appeared in The Asia Pacific Journal of Anthropology 10(4):329–47 (Traphagan 2009). These are included here with kind permission of Springer Science and Business Media and Taylor and Francis ( http://www.informaworld.com ), respectively. Chapter 4 originally appeared as “Interpretations of Elder Suicide, Stress, and Dependency Among Rural Japanese” in Ethnology (Traphagan 2004b), and I am very appreciative of that journal for allowing me to use the article here. Data for this book were collected during several trips to Japan between 1995 and 2010, funded by a variety of sources, including a Fulbright Doctoral Research Fellowship and grants from the Michigan Exploratory Center for the Demography of Aging, the Northeast Asia Council of the Association for Asian Studies, The American Philosophical Society, the Wenner-Gren Foundation for Anthropological Research, the National Institute on Aging (grant number R03 AG016111-01), and the Mitsubishi Japan Endowment at the University of Texas at Austin. The support is greatly appreciated.
There are numerous people to thank for support and comments throughout the writing of this book. First, I thank Kirsten Cather, Robert Oppenheim, and Thomas Tweed of the University of Texas at Austin and L. Keith Brown of the University of Pittsburgh for their very helpful comments on various drafts. Second, many thanks to my father, Willis Traphagan, for content and editorial comments throughout writing. The work also benefited from the help of my assistant Emiko Miyagawa Linville who gathered some of the sources used, Maeri Megumi who reviewed Japanese terms for accuracy, and Anthony Wright who reviewed the entire manuscript, provided editorial assistance, and assisted in creating the index. Peggy Bowler Lindsey raised some fascinating points from a clinical perspective that stimulated my thinking about the manuscript. I am quite appreciative of all of their help in the preparation of the manuscript. And, finally, I want to express my love and appreciation to Tomoko, Julian, and Sarah for their patience, love, and support.

Note on Conventions
Throughout this book, I make use of Japanese words and sources. For words that are difficult to translate into English, I typically make use of Romanized Japanese accompanied by the actual Japanese written word. In many cases, I have chosen to simply include Japanese characters in parentheses following a translation. This is somewhat different from custom in writing books about Japan, where normally the trend is to Romanize all Japanese words. I am working from the assumption that those who know Japanese will be able to read the characters and that for those who do not know Japanese, the Romanized version of the word is not particularly useful.
All of the names of individuals who participated in my research mentioned in this volume are pseudonyms in order to protect their identities.
Chapter 1
Inventing Ethics
The common morality is the set of norms shared by all persons committed to morality…. The common morality is applicable to all persons in all places, and we rightly judge all human conduct by its standards … all persons committed to morality adhere to the standards we are calling the common morality.
— Beauchamp and Childress (2009:4–5)

1.1. The Problem of Common Morality
This book has been brewing in my head for more than twenty years, ever since I started graduate studies at Yale Divinity School focused on religious and social ethics. Throughout my time at Yale, I was constantly nagged by the feeling that the way in which religious and biomedical ethicists approach moral reasoning at American universities is flawed. I carried this impression with me to the University of Virginia, where I began a PhD in religious ethics, only to determine that I had no faith in the field, a realization that forced me to leave graduate school altogether for a few years. When I returned, I had concluded that what was missing in the approaches taken in much of the ethics world in general and the biomedical ethics world in particular was an awareness of, or even interest in, how ethics might be constructed in non-Western—and really non-Christian—societies. American ethicists in particular were, and are, concerned with what Aquinas wrote, or how to conceptualize the notion of supererogation in relation to Christian doctrine, or whether we can find a foundation for moral behavior in natural law as opposed to grounding ideas of right and wrong in calculations of utility. With a few important exceptions, ethicists in the United States, at least, rarely asked questions such as the following: Is the concept of natural law meaningful in all cultural contexts? Could natural law be relevant in one society, but not in another, and still be a useful basis for determining right and wrong? Can moral behavior be structured around something entirely unlike the Western emphasis on notions such as divine command or natural law? Could an ethical system be based on, say, aesthetic sensibility?
American biomedical ethicists tend to emphasize principles or fundamental features of the person that work from assumptions associated with Western liberal democracies, assumptions that structure how we think about moral decision making and the rights of individuals. It is assumed, for example, that concepts such as autonomy are features inherently related to individual selves ( Levi 1999:34 ); far less frequently do ethicists explore the possibility that self is a cultural construct, and then ask how that might influence the notion or even meaningfulness of autonomy as a category of moral reasoning. One of the more profound problems of American biomedical ethics, as Long argues convincingly (2005:107), is that American bioethicists are inclined to draw on their own upbringing and socialization when thinking about the rights of persons and the relationship of individuals to others. As a result, there is a strong tendency to see autonomy as a natural state of being for any mature and capable human, and to assume that those who are incapacitated, particularly the mentally incapacitated, have or should have decreased capacity to act autonomously.
Intertwined with this faith in autonomy is an equivalent faith in the idea of Western rationality as an acultural and objective system of reasoning that provides a foundation for identifying if a person is capable of acting autonomously or whether a person has had the capacity to act autonomously somehow interrupted or eliminated through injury, illness, or simply having been born with a lower or different intellectual capacity in comparison to statistical norms. This notion of autonomy as foundational is widespread in Western philosophy and is well summed up in Kant's claim that autonomy represents “the basis of the dignity of human nature and of every rational nature” (2005:94), a notion that has continued to appear in the work of philosophers and theologians to the present day (cf. Pellegrino and Thomasma 1993 ). Thinking about, and rethinking, the relationship between autonomy and self is the central theme of this book; a theme that will involve questioning common assumptions about the nature of right and wrong and the possibilities for identifying anything we might call a “common morality” as it would apply to biomedical ethics (or any other application of moral concepts).
Indeed, when one does ask these types of questions, claims of a common morality like the one cited at the beginning of this book quickly become problematic. If moral principles are grounded on a set of assumptions about nature, culture, the structure and composition of human selves, as well as how people should conceptualize social interactions, responsibilities, and obligations different from those often assumed to be normal and natural by American and many other ethicists, then it is inherently difficult—most likely impossible—to arrive at any empirical basis for claiming a common morality. And it is imprudent to claim a common morality that is either overtly or tacitly derived from principles of behavior associated with one particular religious or cultural tradition. Common morality becomes a wish rather than a fact, its existence grounded in questionable intuitions about the world rather than empirical evidence and observation of the worl