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

个人自主在现代生活中是一种宝贵的价值。自治能力通常被视为道德和心理成熟的重要组成部分，而培养和维护个人自决的条件一直是广泛自由的政治安排的核心目标。最近的法律发展加强了这一悠久的传统，同时也以新的方式应用它。在欧洲人权法和美国最高法院具有里程碑意义的裁决中，自主权(通常以‘隐私权’为标题)占据了核心位置，而在英国，2005年的《精神能力法案》等法律和医疗决定将关键的法律和医疗决定转向病人是否具有‘精神能力’--为患者自己做决定的能力。所有这一切的一个指导主线是我们所说的自主判断的概念：在作出决定时的自决能力。但是，尽管这些想法在道德和政治修辞层面上已变得熟悉，但无论是在理论上还是在实践中，它们都存在根本困难。在决策过程中自主是什么意思？在多大程度上，自主决策必须是理性的决策？临床或法律从业人员、护理人员或社会工作者如何或应该确定某一特定判决(例如，关于终止医疗护理或财产处置)是否是自主作出的？这样的决定可能会在现实世界中产生戏剧性的后果--例如，在决定病人是否应该强制喂养，或者遗嘱执行人是否应该执行遗嘱方面。但是，这样的决定的适当基础还远不清楚。事实上，既然良好判决的理想之一是法官的决定应该由最好的证据来决定，那么在什么意义上，判决行为又能成为自决的问题呢？为自己做决定是埃塞克斯大学哲学系为期三年的跨学科研究计划。我们的基本目标是澄清判决自主的性质和价值，这既是为了它本身，也是为了为那些必须应用这一概念的人--无论是作为父母、医生、法律专业人员，还是仅仅作为公民--提供指导。我们对这些问题的处理方法在理论上、实践上和历史上都是一样的。我们方法论的一个关键要素是将致力于自治和判断理论的哲学家与从事法律、精神医学和社会政策工作的专业人员聚集在一起。哲学理论可以通过应用于现实世界的挑战来检验和加强，而实践者可以利用哲学方法找到一种方法来克服这些问题特有的一些令人烦恼的挑战。我们的历史方法反过来又为阐明理论和实践问题提供了希望。关于判决自主权的若干当代挑战，最好参照产生这些挑战的有争议的历史加以诊断和解决。这其中的一个重要因素将是让那些反对自主判断这一理想的批评者参与进来。研究将在很大程度上通过一系列跨学科研讨会、公开讲座和国际会议进行，其中许多会议将向公众开放。该项目的研究成果包括一个网站、“绿皮书”技术报告，以及用于传播成果的知识传授“大师班”的课程。此外，还将有一系列更传统的学术成果，包括一本专著、研究文章和散文集。最重要的是，我们的目标是培养一个由研究人员和从业人员组成的跨学科网络，以提高对审判自主理想所固有挑战的专门知识。

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.