In this posting I want to examine the relationship between
autonomy and toleration. This examination will highlight the tension between
respecting autonomous decisions and autonomous persons. I will argue that the
concept of autonomy we adopt affects how tolerant we should be. Toleration will
be defined as accepting choices we believe to be wrong and have the power to
change, provided that these choices don’t harm others. John Stuart Mill famously
argued that “the only purpose for which
power can be rightfully exercised over any member of a civilized community,
against his will, is to prevent harm to others. His own good,
either physical or moral, is not a sufficient warrant.” (1) Mill was discussing
liberty but the liberty to choose can be described as a primitive form of
autonomy. Mill believed if we accept the above then we must also accept that “if all mankind minus one, were of one
opinion, and only one person were of the contrary opinion, mankind would be no
more justified in silencing that one person, than he, if he had the power,
would be justified in silencing mankind. (2) It follows that if we equate
autonomy with the liberty of Mill that toleration and autonomy are automatically
linked and that we should tolerate any behaviour, which we disapprove of and
have the power to change, provided that this behaviour doesn’t harm others.
It might be objected that it is overly
simplistic to equate autonomy with liberty and that a more nuanced account of
autonomy is needed. How then might we better define autonomy? Let us first consider
autonomous decision making. Of course the freedom to choose is a necessary
condition for autonomous decision making but it might not be a sufficient one. My
objector might suggest that the simple freedom to choose is an insufficient
condition for two reasons. Firstly
she might suggest that for someone’s decision to be an autonomous one that it
must accord with certain accepted norms in addition to the norm of not harming
others. For instance if someone made decisions about what she should to do
today based solely on her horoscope we might question if she was truly
self-governing. My objector might then argue that our concept of autonomy must
contain a substantive element and that that there is no meaningful content
neutral account of autonomy. Secondly she might suggest that for someone’s
decision to be autonomous he must accept Kant’s hypothetical imperative and
always choose means that are likely to deliver the ends he seeks. For instance
we might question whether someone was really self-governing if one of the ends he
desired was increased learning and he sought to acquire this increase by prayer.
In the light of my objector’s suggestions two arguments might now be advanced as
to why autonomy and toleration need not be linked. Firstly if we accept a
substantive account of autonomy which includes some accepted norms then we have
no reason, based on respecting autonomous decisions, to accept those decisions
which don’t concur with those norms and hence be tolerant. Secondly it might be argued we have no reason
based on respect for autonomy to respect, tolerate, those who choose means that
are unlikely to achieve the ends they seek.
I have outlined a possible more
nuanced definition of autonomous decision making. However we can respect
autonomous decisions or autonomous people. Let us now turn our examination to
respecting autonomous people. I will suggest that that respecting an autonomous
person means accepting all of her decisions including ones that
appear to have been made in a non-autonomous manner. My objector might
argue that it is possible to respect someone as an autonomous person without
respecting all of her decisions. In order to consider this objection I will
first consider what sort of person is an autonomous person and how is she connected
to autonomous decision making. It might be suggested that an autonomous person
is simply one who always make autonomous decisions. If we accept this definition
then we should have no problem in accepting all the decisions made by an
autonomous person. However if we accept this suggestion it might be argued that
it would be much simpler if we only respected autonomous decisions and ignored
the concept of an autonomous person altogether. Moreover most people don’t
always make decisions which conform to conditions outlined above for autonomous
decision making, indeed it might be suggested that they rarely do so. It
follows that if we accept the above that we are only going to respect an extremely
small set of human beings as autonomous persons. In the light of the above should
we simply respect human beings and forget about respecting autonomous people? I
would suggest we shouldn’t. A three year old and an adult in the prime of her
faculties differ in their capacities and intuitively the idea of self-control,
self-government or autonomy seems central to this difference. Perhaps a better
way to define an autonomous person would be to define her as a human being who
has the capacity to make autonomous decisions. Such a definition would satisfy
most adults because they want to be defined as the kind of creatures who can
make their own decisions rather than simply being defined as human beings. Such
a definition would also be useful because it defines a meaningful subset of
human beings in contrast our previous definition which only defined a narrow
subset. Lastly such a definition roughly concurs with Mill’s idea that liberty
is “meant to apply to human beings in the maturity of their faculties”. If we
accept this definition of an autonomous person then what does it mean to
respect such a person? I have suggested above that this means accepting all her
decisions which don’t harm others. Let us assume that we don’t respect all the
decisions of someone who has the capacity to make autonomous decisions. Which
of her decisions should we respect, only the one that are autonomous ones?
However doing so means respecting an autonomous person is
equivalent to respecting autonomous decisions and the concept of an autonomous person seems to do no work. Let us accept that if the concept of an autonomous
person is to be a meaningful one that respecting someone as an autonomous
person necessarily means accepting all of her decisions. This position seems to
concur with that of Mill. It follows that respecting someone as an autonomous person means
respecting, or at the very least accepting, her autonomous decisions. Acceptance
of the above and the previously outlined definition of toleration means that we
will be tolerant automatically. It means accepting choices we believe to be
wrong and have the power to change, provided these choices don’t harm others.
It might be objected that it
is difficult to ascertain whether someone has the capacity to make autonomous
decisions. She might point out that if we respect autonomous persons and this
means that we must respect non-autonomous decisions that this respect causes
difficulties for the doctrine of informed consent. My objector might proceed to
argue that because of this difficulty it would be much better to assess whether
some specific decision was an autonomous one rather than whether the person
making it had the capacity to make autonomous decisions. For this reason she
might suggest that when we respect autonomy we should only respect autonomous
decisions. She might point out that adopting her suggestion would mean that it
would be easier to act beneficently towards someone who seems to be making a
decision which runs counter to his best interests. If we accept that respecting
autonomy means respecting autonomous decisions and accept a substantive account
of autonomy then respect for autonomy and toleration aren’t automatically
linked. There are no reason based on respect for autonomy as to why we should
accept the decisions of others which conflict with our accepted norms. In a
western democracy if the wearing of the hijab goes against our accepted norms
then there is no reason to accept it based on respect for autonomy not to ban
it; similarly in an Islamic state if not wearing the hijab goes against the
accepted norms then again then there is no reason to accept not wearing it
based on respect for autonomy. It follows that there is no reason based on
respect for autonomy, as conceived above, as to why we should be tolerant,
unless of course one of our accepted norms is to be tolerant.
It would seem if we believe
respecting autonomy means respecting autonomous persons then we should be
tolerant, if we accept a substantive account of autonomy and believe respecting
autonomy means respecting autonomous decisions then we have no reason based on
autonomy to be tolerant. I will now present two arguments as to why we
shouldn’t accept that respecting autonomy means respecting substantive autonomous
decisions. Firstly I would argue if we do so then we might be accused of epistemic
arrogance. Let us accept that any autonomous decision must accord with the
hypothetical imperative. Let us assume someone makes a decision using this
imperative but that we don’t accept her decision as an autonomous one. It
follows that our rejection is based on rejecting the beliefs or norms her
decision is based upon. Let us also accept that our beliefs and desires help
define us as persons. It follows if we don’t respect someone’s decisions that
whilst we might be respecting her as a human being in a caring way but that we
aren’t respecting her as a person. Autonomy and the concept of a person are of
necessity connected. Most people don’t want to be only respected as a human being
but as a person. It follows that if we only respect autonomous decisions we
erode the concept of a person. Secondly I will argue that if we only accept a
substantive account autonomous decisions that the concept of an autonomous
decisions also loses its usefulness. If we only respect substantive autonomous
decisions we only respect what we regard as good decisions. It follows if we
only respect what we regard as good decisions the idea of autonomous making is
doing no useful work and becomes redundant. It follows that that if he concept
of autonomy is to remain a useful concept that we should reject a substantive
account of autonomous decision making.
I have argued that we
should reject a substantive account of autonomy. Most applied philosophers seem
wedded to a substantive account of autonomy perhaps, this is because of an
unconscious desire to justify their discipline for after all if something is a
primitive concept then there is less of a need for applied philosophy. If we
reject a substantive of autonomous decision making and still believe autonomy
remains important then we must accept that respecting autonomy means respecting
those people who have the capacity to make autonomous decisions. Respecting
those people who perhaps aren’t as we educated as some are and rely on their
emotions more than most people do. If we do so we must still be able to define
an autonomous decision. Clearly not all decisions are autonomous. For instance
random decisions, coerced decisions or decision made under some internal
compulsion, such as a patient refusing consent because of fear, aren’t
autonomous decisions. I have argued above that we should reject a substantive
account of autonomous decision making because it erodes the idea of a
particular person and reduces the need for autonomous decisions by equating
them with good decisions. It follows that we should adopt a content
neutral or primitive account of autonomous decision making. An
autonomous decision is one which is freely made by someone which is based on
her own beliefs and is instrumentally rational enough to serve those beliefs. Respecting
this primitive concept of autonomy entails that we will be naturally tolerant.
Respecting autonomy means accepting
choices we believe to be wrong and have the power to change provided that these
choices don’t harm others. Lastly if we accept that informed consent is based
on respect for patient autonomy then adopting a primitive account of autonomy
means a larger number of people should be competent to give consent compared to
the number if we adopt a substantive account.
- Mill J S. (1974) On Liberty and Other Essays. Oxford University Press (Oxfords Worlds Classics), introduction.
- Mill J S, chapter 2
