Autonomy and individual responsibility

Abstract

The Universal Declaration on Bioethics and Human Rights is an extraordinarily ambitious document. It seeks to “provide a universal framework of principles and procedures to guide States in the formulation of their legislation, policies or other instruments in the field of bioethics” (Universal Declaration, Art. 2(a), 2005). Few, if any, intergovernmental instruments match its breadth in terms of subject matter covered (“ethical issues related to medicine, life sciences and associated technologies as applied to human beings, taking into account their social, legal and environmental dimensions”) (Universal Declaration, Art. 1, 2005). It is also notable for the unusually vast audience to whom it is addressed. Not only is it meant to offer advice to member states but also “to guide the actions of individuals, groups, communities, institutions and corporations, public and private” (Universal Declaration, Art. 2(b), 2005). The Declaration has received some attention from scholars and policy makers, both positive and negative. UNESCO itself has taken steps to circulate and promote it, including by publishing commentaries on its various provisions, authored by invited contributors, including the International Bioethics Committee itself. But one aspect of the Declaration has not yet received the attention it deserves, namely, its treatment of autonomy as an ethical principle. Whereas autonomy has been accorded pride of place as the dominant ethical principle in mainstream bioethics for decades, the Declaration offers a strikingly different approach. That is, it subordinates autonomy to other goods such as human dignity, solidarity, and protection of the vulnerable. In this way, the Declaration recovers and restores the original key animating good for public bioethics that gave rise to this new species of law and policy in the first instance. It marks an important return to the foundational principle of respect for persons.