Abstract

Etymologically, autonomy is the ability to give oneself rules and follow them. It is an important principle of medical ethics, which can sometimes raise some tensions in the care relationship. We propose a new definition of ethics, the ethics of heteronomy: a self-normative, discursive and responsible autonomy. Autonomy cannot be considered without the responsibility each person must have towards others. In the care relationship, autonomy would be more the ability of each person to reach out to others than the ability to decide alone. The care relationship must be seen as an accompaniment of equals where each person allows the other to be rephrased. Autonomy would then no longer be absolute but relative to each situation. Being autonomous would become an ability for adaptation of the patient-doctor pair. The accompaniment allows the birth of a relationship of trust, giving the patient and the doctor the ability to touch and let themselves be touched, thus making each one progress in this reciprocal dialectic. The care relationship becomes the possibility of considering autonomy as a collective and not as an individual notion only. Paradoxically, by promoting the autonomy of the patient-doctor pair, they both develop their own autonomy.

中文翻译：

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从对自治原则的批判到他律伦理

摘要

从词源学上讲，自主性是给自己制定规则并遵守这些规则的能力。这是医学道德的一项重要原则，有时会导致护理关系紧张。我们提出了伦理学的新定义，即他律伦理学：一种自我规范的、话语性的和负责任的自治。如果每个人都必须对他人承担责任，就不能考虑自治。在照护关系中，自主权更多地是每个人与他人接触的能力，而不是单独做决定的能力。照顾关系必须被视为平等的陪伴，每个人都允许对方重新表述。自治将不再是绝对的，而是相对于每种情况而言的。自主将成为医患对的一种适应能力。陪伴让信任关系诞生，让患者和医生有能力触摸，也让自己被触摸，从而使彼此在这种相互的辩证关系中取得进步。照料关系成为将自主视为集体而不只是个人概念的可能性。矛盾的是，通过促进医患对的自主权，他们都发展了自己的自主权。