Deciding for Oneself: Autonomous Judgement in History, Theory, and Practice (The Essex Autonomy Project)

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Individual autonomy is a prized value in modern life. The capacity for self-governance is commonly seen as a crucial component of moral and psychological maturity, while the cultivation and preservation of the conditions for individual self-determination has been a central ambition of broadly liberal political arrangements. Recent legal developments have reinforced this long-standing tradition while also applying it in novel ways. The right to autonomy (often under the heading 'the right to privacy') has come to occupy a central place in European human rights law and in landmark decisions of the US Supreme Court, while in the UK legislation such as the Mental Capacity Act of 2005 has made key legal and medical decisions turn on the question of whether a patient has 'mental capacity' - the capacity to make a decision for him- or herself. A guiding thread in all this is a conception of what we shall call autonomous judgement: the capacity for self-determination in making decisions. But while these ideas have become familiar at the level of moral and political rhetoric, both in theory and in practice they present fundamental difficulties. What does it mean to be autonomous in the making of decisions? To what extent must an autonomous decision be a rational one? How can or should a clinical or legal practitioner, care-giver or social worker determine whether a particular judgement (as, for instance, about the discontinuation of medical care or the disposition of property) has been undertaken autonomously? Such determinations can have dramatic real-world consequences-in determining whether a patient should be force-fed, for instance, or whether an executor should implement a will. But the proper basis for such determinations is far from clear. Indeed, in what sense can an act of judgement be a matter of self-determination at all, given that one of the ideals of good judgement is that a judge's decision should be determined by the best evidence? Deciding for Oneself is a three-year interdisciplinary research initiative based in the Philosophy Department at the University of Essex. Our fundamental aim is to clarify the nature and value of judgemental autonomy, both for its own sake, and in order to provide orientation for those who must apply this notion-whether as parents, medical practitioners, legal professionals, or simply as citizens. Our approach to these issues is in equal measures theoretical, practical, and historical. A crucial element of our methodology is to bring together philosophers working on the theory of autonomy and judgement with working professionals in the law, psychiatric medicine, and social policy. Philosophical theories can be tested and strengthened by application to real-world challenges, while practitioners can make use of philosophical approaches to find a way through some of the vexing challenges endemic to these issues. Our historical approach in turn holds out promise for illuminating both the theoretical and practical issues. A number of contemporary challenges regarding judgemental autonomy are best diagnosed and addressed with reference to the contested history that produced them. One important element in this will be to engage the critics who have objected to the very ideal of autonomous judgement. Research will be conducted in large part through a series of interdisciplinary workshops, public lectures and international conferences, many of which will be open to the public. Among the research outputs for the project will be a website, 'Green Paper' technical reports, and a curriculum for a Knowledge Transfer 'Master Class' for the dissemination of results. In addition there will be a series of more conventional academic outputs, including a monograph, research articles and collections of essays. Above all, our aim is to cultivate an interdisciplinary network of researchers and practitioners will advance expertise on the challenges intrinsic to the ideal of judgemental autonomy.