Principle of Respect for Autonomy

As commonly understood today, autonomy is the capacity for self-determination. Being autonomous, however, is not the same as being respected as an autonomous agent. To respect an autonomous agent is to acknowledge that person’s right to make choices and take action based on that person’s own values and belief system. On this account, respect involves not only refraining from interfering with others’ choices, but sometimes entails providing them with the necessary conditions and opportunities for exercising autonomy. The principle of respect for autonomy implies that one should be free from coercion in deciding to act, and that others are obligated to protect confidentiality, respect privacy, and tell the truth. In the practice of health care, a person’s autonomy is exercised through the process of obtaining informed consent. The principle of respect for autonomy, however, does not imply that one must cooperate with another’s actions in order to respect that individual’s autonomy.

Autonomy is given a central place or primary status in the prevailing modern liberalism of contemporary society, as reflected in Oregon’s Measure 16 that legalized physician-assisted suicide. However, the principle of respect for autonomy implies that autonomy has only a prima facie standing, that is, it can be overridden by competing moral considerations. For example, if an individual’s choices endanger public health, potentially harm others, or require a scarce resource, that individual’s autonomy may justifiably be restricted. Within the Catholic moral tradition, autonomy is similarly limited insofar as it must be measured by the principles of stewardship, respect for persons, justice and the common good.

Respect for autonomy, then, should not be construed as an absolute and foundational value, but a "middle principle" that requires every individual to respect every other individual’s self-determination to an appropriate extent within the context of community. A health care institution is a moral community that can be properly considered as an autonomous agent in its own right. Considered as such, Catholic health care institutions should never be required to assist with suicide, euthanasia, or any action that opposes its professional integrity, values, principles, or institutional conscience.

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