ON PERSONAL AUTONOMY

We owe it largely to the feminists that personal autonomy has become a live ethical issue. The feminist claim is that men have explicitly, and, tacitly, imposed upon women the status of non-autonomous objects - sexually, reproductively, domestically usable chattels. Women who have not submitted to these uses in marriage or concubinage have often either had to retreat from the world into monasticism or to make their sexual usefulness marketable by prostitution, to sell their domestic usefulness in the drudgery of 'domestic service'. They have often been cast as 'carers' with the 'living for others' ethos that this stereotyping entails. This subordinating of the female identity has led in turn to a reactive counter-tyranny exercised by women - the heavy mother, the interfering mother-in-law, the manipulative 'power behind the throne', the megalomaniac politician even. A famous remark of a populist theologian of a generation or two ago - C S Lewis - might be remembered in our reflections upon personal autonomy. He wrote, of some unidentified person of distorted femininity, "She's the sort of woman who lives for others - you can always tell the others by their hunted expression."

The feminists have a strong case for asserting that women have, usually if not always, been objects in the sense that they are not seen as human ends but as men's means to this or that male-determined end. The impact of the feminist case has been diluted, as is the impact of many a good case, by crass over-statement and runaway trivialisation but these human follies weaken only the impact, not the justice, of that case.

There is perhaps no need to labour the traditional scriptural angle on this. We all know about the legendary creation of Eve as Adam's needed helpmate, her almost immediately becoming the scapegoat for sin (the sin of trying symbolically to undertake ethical inquiry rather than simply accepting the imposed will of a male god). We are familiar with the chattel status of wives in the Decalogue - equating them with farm animals and depicting them, like animals, as objects of the neighbours' covetousness. And so on!

Of course, men can be relegated to the status of objects just as easily, if not so numerously. Slavery in its various forms is obviously a case in point. So is militarism. In much more gentle ways the subservience of priest to bishop, to archbishop, to cardinal, to pontiff is clearly a case of using the junior clergy as mere things - megaphones - for their seniors. The politician's obedience to the party whip is simply a submission to being used as an object - a rubber stamp vote.

These things are all rather obvious but there are more insidious ways of turning people into objects - ways that seem at first sight to be laudable in the extreme. Medical care is a case in point. It begins as, and indeed very largely is, a laudable effort to alleviate human suffering. The doctors and nurses are commended for their efforts to heal people and it is no retreat from this commendation to say that the patient is also an object, an entity that challenges the medical and nursing skills of those involved. A person being treated is also a problem being addressed and, so long as the patient is seen primarily as a person - only secondarily as a technical challenge - then all well and good. But some element of cool technical challenge is necessary, very often, in the patient's interest. It is easy to imagine a casualty doctor receiving the victim of some horribly sadistic assault; if the victim is seen too emotionally as a person then the doctor's human feelings may be so overpowering as to make effective clinical judgment somewhat elusive. The victim's best interest might be better served by a modicum of 'forget feelings, how can we get this problem solved?'

But, as is so often the case, the higher the technology the easier it is to downplay the human personal aspect. With advanced life-support facilities available, such that a patient can be kept almost indefinitely in the persistent vegetative state, it is very easy simply to see the challenge 'how can we keep this body ticking?' and to forget that the body was once a functioning person and never again can be one. We can now inflict life, in a narrowly physiological sense of the word 'life', upon an ex-person, a once-person, whose consciousness and faculty of choice, and the dignity that goes with these things, are no more. There is fortunately an ethos of humanist common sense emerging in respect of the persistent vegetative state and the strident fuss made by the 'pro-life' party tends to be overridden both by the courts and by public opinion. To refuse to 'switch off' is neither more nor less 'playing God' than to decide to do so. Playing God is a vacuous phrase - even supposing that there is a god to be 'played'. Matters are more serious when voluntary euthanasia is a practical issue for non-vegetative patients. In this area there is a largely unsuspected potential for manipulating people as objects a potential that is at least as disturbing as the technician's temptation to view a terminally ill person as rather like an old car that he wishes to keep on the road - just to satisfy an ambition to show that he can do it. This subtle, and largely unsuspected, potential for manipulating people as objects arises in an activity that it s often thought to be the very epitome of the moral ideal. I refer to the work of the hospices.

Anyone who argues for voluntary euthanasia must logically support the provision of hospices. The word voluntary is void unless the individual terminal patient has a right to allow death to come naturally, just as he has a right to procure death, and if the right to choose life be exercised then the patient deserves every comfort and support during the terminal stages however prolonged they may be. That is what hospices are for; they are staffed by people who derive satisfaction from performing this service for their fellows who desire it. Hospice staff, and their lay helpers, are generally moved by the highest moral concerns and we should all be glad that there are such people.

But the operative phrase is their fellows who desire it. Just as it is wrong to undermine the voluntary aspect of voluntary euthanasia so it is also wrong - an equal denial of personal autonomy, an equal objectification of the person - to use terminally ill people just to show how 'pro-life' one is. Hospice staff can fall easily into the self-indulgent error of seeing themselves as 'living for others' when in fact what they may be doing is using the terminally ill to show how caring they are. This is just like the technician seeing the terminal patient as a technical challenge - keep the old banger on the road somehow! It is not always possible to determine clearly who is living for whom; it is possible that the terminally ill are being kept alive for the technical and moral gratification of others. The concept of personal autonomy is one that should never be lost sight of in life and death situations especially. The truly freethinking person is an autonomous person neither intruding upon others nor being intruded upon by them.

Return to Home Page