Individual autonomy is a prized value in modern life. The capacity for self-governance is commonly seen as a crucial component of moral and psychological maturity, while the cultivation and preservation of the conditions for individual self-determination has been a central ambition of broadly liberal political arrangements. Recent legal developments have reinforced this long-standing tradition while also applying it in novel ways. The right to autonomy (often under the heading 'the right to privacy') has come to occupy a central place in European human rights law and in landmark decisions of the US Supreme Court, while in the UK legislation such as the Mental Capacity Act of 2005 has made key legal and medical decisions turn on the question of whether a patient has 'mental capacity' -- the capacity to make a decision for him- or herself. A guiding thread in all this is a conception of what we shall call autonomous judgement: the capacity for self-determination in making decisions.



But while these ideas have become familiar at the level of moral and political rhetoric, both in theory and in practice they present fundamental difficulties. What does it mean to be autonomous in the making of decisions? To what extent must an autonomous decision be a rational one? How can or should a clinical or legal practitioner, care-giver or social worker determine whether a particular judgement (as, for instance, about the discontinuation of medical care or the disposition of property) has been undertaken autonomously? Such determinations can have dramatic real-world consequences -- in determining whether a patient should be force-fed, for instance, or whether an executor should implement a will. But the proper basis for such determinations is far from clear. Indeed, in what sense can an act of judgement be a matter of self-determination at all, given that one of the ideals of good judgement is that a judge's decision should be determined by the best evidence?

These are all questions I feel need to be answered, and I would like your help in doing so. I will integrate my ideas into the thread as it progresses because I really want to see what you think rather than making any claims to be supported or refuted.