Korean Journal of Medical Ethics
The Korean Society for Medical Ethics
Article

현대 다원주의 사회에 적합한 자율성 모색: 역량 중심 접근법에 입각한 관계적 자율성과 다형적 모델을 중심으로*

목광수1,*, 류재한2
Kwangsu MOK1,*, Jaehan RYU2
1경상대학교 인문대 철학과
2경상대학교 인문대 철학과 박사수료
1Department of Philosophy, Gyeongsang National University
2Ph.D Candidate, Department of Philosophy, Gyeongsang National University
*교신저자: 목광수. 경상대학교 인문대 철학과. 055-772-1151. epistle7@gnu.ac.kr

ⓒ Copyright 2013 The Korean Society for Medical Ethics. This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: Jun 26, 2013; Revised: Aug 10, 2013; Accepted: Aug 21, 2013

Published Online: Aug 31, 2013

ABSTRACT

The purpose of this paper is to search for a justifiable concept of autonomy that feasibly applies to bioethics and, based on this inquiry, suggest a practical model in a modern pluralist society. For this purpose, we classify personal autonomy into ‘metaphysical autonomy’ as the ideal theory guiding practical theories and both ‘narrow bioethical autonomy’ and ‘wide bioethical autonomy’ as non-ideal theories. We criticize narrow bioethical autonomy theories such as those posited by Tom Beauchamp and James Childress. Not only do they fail to flesh out metaphysical autonomy theories such as Harry Frankfurt’s, but they are not feasible because they ignore patient relationships and circumstances. We argue that Amartya Sen’s capability approach compliments the feminist concept of relational autonomy. Not only can this combination overcome the weaknesses found in narrow bioethical autonomy theories, but it allows for a practical framework to remove injustice and support autonomy. We call this combination ‘relational autonomy based on the capability approach’ and classify it as a theory of ‘wide bioethical autonomy.’ Based on this inquiry, we suggest a ‘plural forms model’ in a reasonable pluralism, which can reduce many of the autonomy-related conflicts. This model is useful in medical institution reform for explaining the plurality in both physicians’ identities and cases of patients’ autonomy (such as ambivalence) while it enhances patient autonomy through institutional and non-institutional reforms.

Keywords: 합당한 다원주의; 개인적 자율성; 관계적 자율성; 역량 중심 접근법; 다형적 모델
Keywords: reasonable pluralism; personal autonomy; relational autonomy; capability approach; plural forms model