Theoretical Medicine and Bioethics

, Volume 32, Issue 4, pp 217–227

Agency and authenticity: Which value grounds patient choice?


DOI: 10.1007/s11017-011-9180-2

Cite this article as:
Brudney, D. & Lantos, J. Theor Med Bioeth (2011) 32: 217. doi:10.1007/s11017-011-9180-2


In current American medical practice, autonomy is assumed to be more valuable than human life: if a patient autonomously refuses lifesaving treatment, the doctors are supposed to let him die. In this paper we discuss two values that might be at stake in such clinical contexts. Usually, we hear only of autonomy and best interests. However, here, autonomy is ambiguous between two concepts—concepts that are tied to different values and to different philosophical traditions. In some cases, the two values (that of agency and that of authenticity) entail different outcomes. We argue that the comparative value of these values needs to be assessed.


AgencyAuthenticityAutonomyBest interestsKantMill

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  1. 1.Department of PhilosophyThe University of ChicagoChicagoUSA
  2. 2.University of Missouri at Kansas City and Children’s Mercy Bioethics CenterKansas CityUSA