Men are qualified for civil liberty in exact proportion to their disposition to put moral chains upon their own appetites . . . . It is ordained in the eternal constitution of things, that men of intemperate minds cannot be free. Their passions forge their fetters.
–Edmund Burke, Letter to a Member of the National Assembly
I have written several essays critiquing contemporary liberal values such as equality, tolerance, and diversity. This adds to the number.
Autonomy too is a poor ideal to live by. It fails in roughly the same way as “equality,” which is incoherent if it means anything other than the semi-tautological and completely unhelpful proposition that we should “treat likes alike,” as I have argued elsewhere, though it is taken to mean much more, to the confusion of our political discourse. In the same way, there is a huge gap between the proper philosophical definition of “autonomy” and its popular meaning. “Autonomy” can mean mere unconstrainedness (lawless liberty, which is the popular meaning) or conscientiousness (following the law generated by one’s own conscience, the proper philosophical definition).
A useful launching place for the discussion of autonomy will be medical ethics, where autonomy in the sense of unconstrainedness is, unfortunately, the main practical value.
Medical ethics is a messy field. As a healthcare attorney, I get a glimpse at lots of different ethical issues–from doctor-assisted suicide to sustaining brain-dead patients on life support, from abortion to legalized medicinal drugs. I learned from a co-worker of mine that there are three foundational principles of the field of medical ethics: benevolence, non-malevolence, and autonomy. When ethics committees in hospitals are faced with difficult ethical decisions, they proceed by discussing how these three principles apply.
Upon consideration, I decided this trifecta of ideals was problematic, because only one of them can be applied with any clarity–autonomy.
“Benevolence” simply means “wishing well” or “desiring the good.” Its etymology is from bene (“well)” + volantem (present participle of velle “to wish”).
“Non-Malevolence” means not wishing for the bad. (From Latin malevolentia “ill-will, dislike, hatred.”)
“Autonomy” means self-government, or, literally, self-law–being a “law unto oneself.” (From autos “self” + nomos “custom, law.”)
The principles of Benevolence and Non-Malevolence are useless as practical tools until one has already decided that something is good or bad. Since whether a particular course or action would be good or bad is the very question facing an ethics committee, any application of these principles directly to the question at issue would fundamentally involve circular reasoning. All a committee could reasonably do with these principles would be to take into account obvious and generally accepted goods and evils–health is a good, unnecessary pain is an evil, etc.
By contrast, Autonomy means something. Its application involves no dubious philosophising. People get to choose for themselves.
Since “autonomy” means something that a committee facing a complex moral dilemma can sink its teeth into, its presence among the vaguer and more important principles would tend to skew the analysis in favor of autonomy over any ethical objection to a patient’s choice. And this indeed seems to be the direction of medical ethics, as seen in the increasing sympathy towards doctor-assisted suicide, the liberties and privacy rights that now belong to pregnant children (to obtain abortions without parental knowledge, for example), and the medical field’s increasing inability to accord any deference to traditional morality.
If I could have my way (I can’t), I would reduce the fundamental principles of medical ethics to one: benevolence. This would not be very helpful as a practical tool, but it would prevent an easy escape from squarely facing the dilemmas. Autonomy should not trump goodness just because it has a clearer application. The question in every instance is “what is good to do or not to do in this situation?”
This is indeed the question in every moral situation, not only those of medical ethics.
Now, individual preference is one important thing among others to be weighed in the balance. When the situation is medical, the patient’s preference should be weighed very heavily indeed. In nine cases out of ten, the best thing to do is what the patient wants done after having the risks and benefits of the various possible courses of action explained (i.e., informed consent). For while the patient may not be particularly qualified to make such decisions, and is not freed from moral constraint merely because the decision concerns his body and his health, the patient is nonetheless the best qualified as a matter of law and policy, and in most circumstances nobody else is in a position to dictate how the relevant moral duties apply.
But there are those instances where there are other important interests that conflict with autonomy. Perhaps the patient wants antibiotics or pain medication and should not have them–or wants to die–or (in the case of a young teenager) wants a prescription for birth control without her parents knowing about it.
In situations like these, medicine (and the rest of us) are unavoidably confronted with a philosophical question: what is the value of autonomy vis a vis other competing values?
I contest that contemporary society both grossly overvalues and misunderstands autonomy. It does this with a great many things pertaining to the “self.” Self is one of the chief idols of the day, yet what is a self? I suggest here that the two essential ingredients of a self are (1) attunements to things outside the self, and (2) the capacity of forming narratives (e.g., reasoning about one’s experiences). If so, then there is no essential substance to a self, and the “auto” (self) has no peculiar “nomos” (law).
In the absence of any peculiar law-of-the-self, what does it mean to be a law unto oneself? Usually we use this phrase (“law unto himself”) to mean that a person is lawless, ungovernable. People who are truly lawless and ungovernable usually (and rightly) end up in jail because their freedom is a threat to the welfare of everyone else. One form of autonomy is this autonomy-as-unconstrainedness, which philosopher Iris Murdoch critiques as an “inconsequential chucking of one’s weight about.” But caprice is not a meaningful or a worthwhile form of autonomy. It is not even a true form of autonomy insofar as it involves no actually coherent “nomos” (law).
One of the greatest philosophers, Immanuel Kant, wrote about the problem of free will. One of his conclusions, as summarized by my philosophy textbook (The Great Conversation), is as follows:
Freedom, Kant says, is not sheer randomness; nor is it whim or caprice; nor is it arbitrariness. Freedom is giving the law for one’s action to oneself. It is not, therefore, lawless. Freedom is in fact a kind of causality–a power of producing actions according to a rule that one legislates for oneself. But this is just autonomy, and autonomy is the principle of a rational will free from control by the inclinations. Such a will is bound only by the requirement of lawfulness itself–that is, by universality, by the categorical imperative. So “a free will and a will subject to moral laws are one and the same.”
(That paragraph is not easy to follow, admittedly, but it is much easier than the actual Kant passage quoted above it in my textbook.)
Basically it means that to the degree one is ruled by one’s passions (“inclinations”) one is not free at all. One is free only when one acts in accordance with the moral law that one’s own reason freely embraces. And therefore, “submission to conscience” is the true meaning of “freedom.”
From a legal perspective, autonomy is good for three main reasons that I can see. (In this context, autonomy means the absence of law constraining individual freedom.) First, it is good to the degree that people will indeed be ruled by conscience. (Any expression of “autonomy” that is contrary to conscience is of the bad, jailward-tending kind of empty and unmeaning unconstrainedness.) Second, it is good because the alternative (legislating and enforcing laws) is in various ways, monetary and otherwise, costly. Third, legally curtailing autonomy entails granting some entity power to constrain others, and this power may be abused. Preserving autonomy avoids this danger. These goods are, as far as I can see, the main (only?) reasons that autonomy is to an extent desirable under the law. If you can think of others, let me know in the comments.
Accordingly, from this legal perspective, it makes sense that religious liberty should be the first and most prized liberty named in the Bill of Rights, followed by freedom of political speech, since expressions of conscience and of convictions regarding what is true and what is right are the essential fruits of true autonomy. Being ruled by conscience is the mark of a good man, and the right to be so ruled is therefore properly held sacred under the best reading of the Constitution.
Similarly, from a theological perspective, I would argue that God gives us freedom/autonomy only in the hope that we will use it to choose to follow him. There is no other fundamental purpose, though his sovereignty finds means to turn to good ends the evil uses we sometimes make of our autonomy.
Autonomy is only good–and indeed, is only authentically autonomy–to the degree that we are ruled by conscience. Tolstoy says something very similar in a passage of The Kingdom of God is Within You, portions of which I quote in the very long but excellent footnote below. As he says in a part that I omitted, some will not perceive rule by conscience as self-rule at all. But it is (or so I currently think, along with Kant and Tolstoy) the only autonomy that actually exists, insofar as any choice contrary to conscience expresses not freedom but bondage to the passions. The only true freedom and the only true autonomy is found in enslaving oneself to one’s own conscience.
I began this essay stating that benevolence is more important than autonomy. But if we take “autonomy” to mean, not unconstrainedness, but following the law of one’s own conscience, it appears that benevolence is almost the same thing as autonomy.
Thus, autonomy in the good and true sense of the word (governing one’s self by the law embraced by one’s conscience) means enslavement to conscience, while autonomy in the sense of mere unconstrainedness means enslavement to one’s passions. Either way, autonomy means enslavement. The greatest possible extent of our freedom is simply to choose which master we will serve.
 According to the existing theory so essential to support hypocrisy, man is not free and cannot change his life.
“Man cannot change his life, because he is not free. He is not free, because all his actions are conditioned by previously existing causes. And whatever the man may do there are always some causes or other through which he does these or those acts, and therefore man cannot be free and change his life,” say the champions of the metaphysics of hypocrisy. And they would be perfectly right if man were a creature without conscience and incapable of moving toward the truth; that is to say, if after recognizing a new truth, man always remained at the same stage of moral development. But man is a creature with a conscience and capable of attaining a higher and higher degree of truth. And therefore even if man is not free as regards performing these or those acts because there exists a previous cause for every act, the very causes of his acts, consisting as they do for the man of conscience of the recognition of this or that truth, are within his own control.
. . . .
[T]he recognition of truth, which is the cause of all the manifestations of human life, does not depend on external phenomena, but on certain inner spiritual characteristics of the man which escape our observation.
And therefore man, though not free in his acts, always feels himself free in what is the motive of his acts—the recognition or non-recognition of truth. And he feels himself independent not only of facts external to his own personality, but even of his own actions.
Thus a man who under the influence of passion has committed an act contrary to the truth he recognizes, remains none the less free to recognize it or not to recognize it; that is, he can by refusing to recognize the truth regard his action as necessary and justifiable, or he may recognize the truth and regard his act as wrong and censure himself for it.
Thus a gambler or a drunkard who does not resist temptation and yields to his passion is still free to recognize gambling and drunkenness as wrong or to regard them as a harmless pastime. In the first case even if he does not at once get over his passion, he gets the more free from it the more sincerely he recognizes the truth about it; in the second case he will be strengthened in his vice and will deprive himself of every possibility of shaking it off.
In the same way a man who has made his escape alone from a house on fire, not having had the courage to save his friend, remains free, recognizing the truth that a man ought to save the life of another even at the risk of his own, to regard his action as bad and to censure himself for it, or, not recognizing this truth, to regard his action as natural and necessary and to justify it to himself. In the first case, if he recognizes the truth in spite of his departure from it, he prepares for himself in the future a whole series of acts of self-sacrifice necessarily flowing from this recognition of the truth; in the second case, a whole series of egoistic acts.
Not that a man is always free to recognize or to refuse to recognize every truth. There are truths which he has recognized long before or which have been handed down to him by education and tradition and accepted by him on faith, and to follow these truths has become a habit, a second nature with him; and there are truths, only vaguely, as it were distantly, apprehended by him. The man is not free to refuse to recognize the first, nor to recognize the second class of truths. But there are truths of a third kind, which have not yet become an unconscious motive of action, but yet have been revealed so clearly to him that he cannot pass them by, and is inevitably obliged to do one thing or the other, to recognize or not to recognize them. And it is in regard to these truths that the man’s freedom manifests itself.
. . . .
The liberty of man does not consist in the power of acting independently of the progress of life and the influences arising from it, but in the capacity for recognizing and acknowledging the truth revealed to him, and becoming the free and joyful participator in the eternal and infinite work of God, the life of the world; or on the other hand for refusing to recognize the truth, and so being a miserable and reluctant slave dragged whither he has no desire to go.
. . . .
Whether this is a great or small degree of freedom in comparison with the fantastic liberty we should like to have, it is the only freedom that really exists, and in it consists the only happiness attainable by man.
2 thoughts on “Autonomy as Enslavement”
When I read “non-malevolence” in this context it comes across to me as a question of intent. Granted that unless one is a mind reader, intent is hard to measure, prove, or judge. But doesn’t it have a place in questions of medical ethics?
Jim, thanks for reading and commenting. The reason I would reduce the basic principles of medical ethics to one, benevolence, and would exclude non-malevolence, is simply that in my mind, if benevolence is the basic principle, then adding non-malevolence becomes duplicative–it adds nothing. In other words, if you only acknowledge benevolence (well-wishing) as the standard of rightness, then any malevolence will automatically be rejected under that standard.