Brent Kious

One of the most widely accepted views in bioethics is that paternalistic interference in others’ self-regarding decisions is justified only if those decisions are not autonomous. Typically, a decision is autonomous if and only if it satisfies certain psychological criteria. Namely, it must be competent and also voluntary. This latter criterion means, roughly, that the agent herself decided without being controlled or unduly influenced by other persons or impersonal forces, in light her own values.The modern locus classicus of this idea is undoubtedly Beauchamp and Childress ; they claim we have a duty to respect autonomous agents.

I am grateful for the insightful comments that have been furnished by Drs. Gala, Moseley, and Perring following their reading of my paper. Happily, I find myself in the position of being able to accept many of their criticisms, which identify many of the limitations of my argument as I see them. In only a few cases do I feel that their remarks are misplaced.The first concern raised by Moseley and Gala is that the paper gives the regrettable impression that persons with anorexia nervosa generally have few cognitive deficits and primarily experience problems in valuing. But as is widely known, this is false: many persons with AN reason poorly and suffer perceptual distortions. I did not.