Article Text

Download PDFPDF
Respect for autonomy: deciding what is good for oneself
  1. Brent Michael Kious
  1. Correspondence to Dr Brent Michael Kious, Department of Psychiatry, University of Utah, 501 Chipeta Way, Salt Lake City, UT 84108, USA; brent.kious{at}


Paternalistic interference in autonomous decisions is typically impermissible. This has several explanations, among which is a view I call the agent-constitution of the good: that the autonomous agent not only knows what is best for herself, but determines what is best for herself through her desires, goals and so on (her aims). For instance, it might seem that if an autonomous person does choose not to take insulin for her diabetes, then not only is it inappropriate to force treatment upon her, it is also not in her best interest to take insulin. Here I argue that agent-constitution, though appealing, is false. In fact, autonomous agents can be mistaken about their good, even when it seems to depend only upon their aims. Agent-constitution appears true only because we typically fail to notice constraints on a person's good in private, self-regarding decisions where paternalism might be considered.

  • Autonomy
  • Paternalism
  • Philosophical Ethics
  • Clinical Ethics

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.