PT - JOURNAL ARTICLE AU - Schwab, A P TI - Formal and effective autonomy in healthcare AID - 10.1136/jme.2005.013391 DP - 2006 Oct 01 TA - Journal of Medical Ethics PG - 575--579 VI - 32 IP - 10 4099 - http://jme.bmj.com/content/32/10/575.short 4100 - http://jme.bmj.com/content/32/10/575.full SO - J Med Ethics2006 Oct 01; 32 AB - This essay lays the groundwork for a novel conception of autonomy that may be called “effective autonomy”—a conception designed to be genuinely action guiding in bioethics. As empirical psychology research on the heuristics and biases approach shows, decision making commonly fails to correspond to people’s desires because of the biases arising from bounded cognition. People who are classified as autonomous on contemporary philosophical accounts may fail to be effectively autonomous because their decisions are uncoupled from their autonomous desires. Accordingly, continuing attempts to value patient autonomy must go beyond existing philosophical conceptions of autonomy to consider the background conditions of human decision making.