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I greatly appreciate the insightful commentaries of Adrienne Martin, James Stacey Taylor and Nir Eyal.1–3 Here I will try to clarify a few points in response.
My goal is to show that prescription requirements entail a degree of paternalism that is inconsistent with the value of medical autonomy. The commentators are right to suggest that I further clarify how I understand the value of autonomy. I agree with Martin that the most compelling justification for the value of autonomy comes from Kantian ethics.
There are two kinds of Kantians—those who argue that we should (at least to some extent) promote people's autonomous capacities and those who argue that we should respect autonomous choices even when they are destructive to one's capacities. Martin seems sympathetic to the first kind when she endorses a prohibition on self-destructive acts and rigorous informational requirements. While I have not argued for it here, I …
Competing interests None.
Provenance and peer review Commissioned; internally peer reviewed.