June 1, 1984

Medical Ethics' Assault on Medical Values

Author Affiliations

University of North Carolina School of Medicine Chapel Hill

JAMA. 1984;251(21):2791. doi:10.1001/jama.1984.03340450019007

To the —  The notion that "autonomy ethics" has emerged as a result of the "dominant school in medical ethics... subvert[ing] values intrinsic to medicine" is naive. Emphasis on individual rights and avoidance of paternalism over the weak and stress on the freedom of individuals to choose for themselves are themes that have dominated all aspects of American society for the last two decades. The expression of these themes within medicine in the form of "autonomy ethics" is but one example of the way medicine reflects the values of the larger society.After criticizing moral philosophers for seeking universal and absolute status for their principles and rejecting the alternatives to autonomy ethics as "subjective," Clements and Sider1 offer up their own moral absolutes in the form of "biological norms." Yet Clements and Sider's naturalistic, biological norms are just as assuredly "social constructs" as is the concept of autonomy. There are