Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law

Abstract

Although at risk of falling into the category of one of Foster's ‘turbulent priests’ (at ix), it is clear that this is an important addition to the ongoing ethical, as well as medico-legal debate regarding autonomy. Its significance may be lent further import, given the continuing discussions surrounding reproductive rights and end of life decision-making. While perhaps not a text for the established ethicist or lawyer, Foster's work provides an excellent point of departure for those new to the area, as well as a rich source of reference material for subsequent investigation. Split into 4 Parts and 14 Chapters, in Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law, Foster seeks to provide an in depth analysis of autonomy's place within medical ethics and law. Starting from first principles, autonomy's ascendancy and subsequent influence on ethical and legal decision-making is outlined. The resultant explication provides the reader with a clear insight into Foster's position and, more specifically, his unease at the dominance associated in these circles with the principle of autonomy. Laying out his stall in the first sentence of the preface, he proposes that this book is ‘an assault on the presumption that autonomy ought to be the only voice heard in medical ethics and law’ (at ix). Contrary to the established zeitgeist, Foster's assault reveals his concern not only at the subsequent hegemony of autonomy but also at the misconception held by many in medico-legal circles, that the principle of autonomy provides the only point of reference.