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Relational Autonomy and Multiculturalism
Relational Autonomy and Multiculturalism
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Dissecting Bioethics
and gradual growth toward autonomy. essary expenses? Who will care for any
The Swiss psychologist Jean Piaget, the children? Are there members who are
author of The Moral Judgment of the willing to assume more responsibility?
Child4 was a pioneer of these studies. These are relational issues, not medical
Piaget showed that children gradually ones, and during these discussions,
improve their capacity to be autono- patients become increasingly aware of
mous, shifting from moral behavior the limitations and boundaries of au-
based essentially on the authority of the tonomy. Step by step, autonomy moves
adult to more mature moral behavior from being an abstract concept to one
based on responsibility toward others that is real and concrete and finally to
and on objective moral rules. In this one that is ready to be implemented.
growth process, horizontal relationships
with other children have an extremely
important role, further to the vertical The Concept of Relational Autonomy
relationships with parents. Piaget’s stud-
in Contemporary Philosophy
ies were expanded by the American
psychologist Lawrence Kohlberg be- The concept that autonomy is relational
tween the 1950s and 1980s.5 rather than individual and could, there-
The process of becoming autono- fore, secure broader consent is a central
mous is never ending. We are not born issue in current philosophical debates,
autonomous, and we never defini- especially in the fields of moral and
tively conquer autonomy. This is why political philosophy.7 From a feminist
Kant, after describing the difference perspective that does not wholly reject
between children and adults, states the concept of autonomy, the accusa-
that even adults of his era felt an tion that the ideal of autonomy is in-
urgency to improve their capacity to herently masculinist8 or fundamentally
be autonomous. Therefore, as Kant individualistic and rationalistic9 has
pointed out, the main task of enlight- been comprehensively explored. Jenni-
enment was to help humanity in this fer Nedelsky was the first to review the
never ending process of conquering concept of autonomy, going beyond
autonomy.6 its individualistic and rationalistic un-
This process of developing autonomy derstanding, and thus challenges other
can also be found in healthcare. When feminist perspectives that regarded
patients go to a physician with a certain this concept with suspicion. Nedelsky
health problem, they are not prepared reconceptualized individual autonomy
to make a decision. They first need to as relational autonomy, recognizing the
know the exact nature of their problem extent to which people are socially
and what their options are in terms of embedded and the fact that their iden-
medical treatment and so forth. In the tities are shaped within the context of
process of understanding their situa- social relationships and social deter-
tion, and by means of discussions with minants, such as ethnicity, class, reli-
their physician, patients gradually be- gion, race, and gender.10 Other feminist
come more and more autonomous. thinkers, like Nancy Chodorow,11
However, often this relationship is not Virginia Held,12 and Evelyn Fox
enough for patients to be sufficiently Keller,13 found that this concept held
autonomous. To undergo important much promise if reconceptualized to
medical treatment, patients might need avoid being defined in opposition to
to discuss practical issues with their both femininity and relations of depen-
families: Can the family afford the nec- dence and connection.
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known not to exercise respect for the 21st Century. Baltimore, MD: Frederick
patient autonomy.’’32 Press; 1996.
2. In the Homeric Hymn to Aphrodite, Aphrodite
We can therefore conclude that cul- tells Anchises the story of Eos and Tithonos.
tures alone do not possess rights; only See Homer. Hymn to Aphrodite, verses 218–
individuals have rights, and among 240, translated by G. Nagy; available at
these rights, there is also the right to http://www.uh.edu/~cldue/texts/
renounce individual autonomy in fa- aphrodite.html (last accessed 30 June 2009).
3. ‘‘Eos syndrome’’ has been defined as the
vor of other important values such as, capability of high-technology medicine to
for example, trusting in a good physi- alter the dying process and prolong low-
cian, family relations, the authority quality life. See Zamperetti N, Bellomo R,
of medical science, and so forth. This Dan M, Ronco C. Ethical, political, and social
perspective is generally called ‘‘liberal aspects of high-technology medicine: Eos and
care. Intensive Care Medicine 2006;32:830–5.
multiculturalism’’33 and, in the view 4. Piaget J. The Moral Judgment of the Child.
presented here, is the only perspective New York: Routledge; 1999.
on multiculturalism that does not op- 5. See Kohlberg L. Stage and sequence: The
press the individual’s rights and is cognitive-developmental approach to social-
therefore the best interpretation of the ization. In: Goslin D, ed. Handbook of Socializa-
tion. Theory and Research. Chicago: Guilford
notion of ‘‘relational autonomy.’’ Press; 2006 [1969]:347–480; Kohlberg L. Essays
on Moral Development (2 vol.). San Francisco:
Harper & Row; 1981–4.
Conclusions
6. Kant I. Beantwortung der Frage: Was ist
What contributions do the above Aufklärung? [Answering the question: What
is enlightenment?]. Berlinische Monatsschrift
reflections on liberal multiculturalism
[Berlin Monthly]; December 1789.
make to current relational autonomy 7. See, for example, Sandel M. Liberalism and the
issues? One could conclude that, al- Limits of Justice. Cambridge: Cambridge Uni-
though the possibility of exercising versity Press; 1982; Kymlicka W. Contem-
autonomy should be universally of- porary Political Philosophy. Oxford: Oxford
University Press; 1990; Benhabib S. Situating
fered, it should never be universally
the Self: Gender, Community and Postmodernism
compulsory, thereby recognizing one’s in Contemporary Ethics. New York: Routledge;
right to entrust one’s life to other 1992.
people and to renounce autonomy in 8. For a radical critique of autonomy as a sex-
the name of other important values, based concept, see Christman J. Feminism
and autonomy. In: Bushnell D, ed. Nagging
such as interdependence, solidarity,
Questions: Feminist Ethics in Everyday Life.
and trust. Herein, the true meaning of Lanham, MD: Rowman & Littlefield; 1995;
relational autonomy lies in an auton- Hoagland SL. Lesbian Ethics: Toward New
omy that is not a slave to itself and in Value. California: Institute of Lesbian Studies;
which relations are not perceived as 1998.
9. See Code L. Second persons. In: Code L. What
limitations but as a means of self-re-
Can She Know? Feminist Theory and the
alization. In other words, autonomy Construction of Knowledge. Ithaca, NY:
can flourish through relations, but only Cornell University Press; 1991; Baier A.
if relations are autonomously chosen. Cartesian persons. In: Postures of the Mind:
Essays on Mind and Morals. Minneapolis:
University of Minnesota Press; 1985; Jaggar
Notes A. Feminist Politics and Human Nature.
Totowa, NY: Rowman & Allanheld; 1983.
1. See Ackerman TH. Choosing between 10. See Nedelsky J. Re-conceiving autonomy:
Nuremberg and the National Commission: Sources, thoughts and possibilities. Yale
Balancing of moral principles in clinical Journal of Law and Feminism 1989;1:7–36;
research. In: Vanderpool HY, ed. The Ethics Nedelsky J. Law, boundaries and the
of Research Involving Human Subjects: Facing bounded self. Representations 1990;30:162–89;
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