對自主的再思考：關係取向

Rethinking Autonomy: A Relational Approach

本文從教學及臨床現場的觀察與反思出發，重新思考主流醫學倫理學界所採取的自由個人主義式自主觀。援引女性主義取向的關係自主論點，本文論證自主不該被窄化為獨自做決定的個人權利，而且僅強調資訊與選擇的知情同意，亦無法使自主性獲得實質的提升。尤其在臺灣的醫療社會文化脈絡中，我們必須深化對自主與尊重自主的理解，構思一套兼容獨立與相互依賴，並敏於社會關係與權力結構的關係自主觀。

Starting from my preliminary observations and reflections on cases in teaching and clinical settings, I examine the liberal individualistic conception of autonomy employed in mainstream bioethics and medical ethics. Drawing on a feminist approach to relational autonomy, this article argues that autonomy should be characterized as more than an individual right to independent decision making and informed consent. Promoting relational autonomy in socio-cultural and medical context in Taiwan, it is argued, needs to develop a richer and more complex conception of autonomy and respect for autonomy which accommodates independence and interdependence while being sensitive to the social and power relations.