Choosing Life, Choosing Death: The tyranny of autonomy in medical ethics and law

By Charles foster

Published by Hart, 2009

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Autonomy is a vital principle in medical law and ethics. It occupies a prominent place in all medico-legal and ethical debate. But there is a dangerous presumption that it should have the only vote, or at least the casting vote. This book is an assault on that presumption, and an audit of autonomy’s extraordinary status. This book surveys the main issues in medical law, noting in relation to each issue the power wielded by autonomy, asking whether that power can be justified, and suggesting how other principles can and should contribute to the law. It concludes that autonomy’s status cannot be intellectually or ethically justified, and that positive discrimination in favour of the other balancing principles is urgently needed in order to avoid some sinister results.

“Introducing the Jake La Motta of medical ethics. Foster is an academic street-fighter who has bloodied his hands in the court room. He provides a stinging, relentless, ground attack on the Goliath of medical ethics: the central place of autonomy in liberal medical ethics.”- Julian Savulescu, Uehiro Chair in Practical Ethics, University of Oxford

"a sustained attack on the hegemony of the idea of autonomy in medical ethics and law. Charles Foster is no respecter of authority, whether of university professors or of law Lords. He grabs his readers by their lapels and shakes sense into them through a combination of no-nonsense rhetoric and subtle argument that is difficult to resist."
- Tony Hope, Professor of Medical Ethics, Oxford University

"I would certainly not choose to have Foster beside me, either as an advocate or a friend, in my final illness."- Dame Mary Warnock, The Lancet

"This book is unlikely to be in pristine state by the time you have finished reading it. Whether that is because you have thrown it in the air in celebration or thrown it across the room in frustration will depend on your perspective. But this book cannot leave you cold. It is a powerful polemic on the dominance of autonomy in medical law, which demands a reaction... This will be a book which demands and will attract considerable debate..."
- Jonathan Herring, Exeter College, Oxford University

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