Revon, Gabriel;
Reiss, Michael J;
(2025)
Principlism in Bioethics: How to Consolidate Autonomy? A Scoping Review.
Bioethics Open Research
, 3
(1)
10.12688/bioethopenres.17704.1.
Preview |
Text
Revon & Reiss 2025 BioethOpenRes Principlism in bioethics - How to consolidate autonomy. A scoping review.pdf - Published Version Download (320kB) | Preview |
Abstract
Background: The concept of autonomy in bioethics is subject to significant debate, with scholars describing it in contradictory terms—ranging from “fundamental” and “universal” to “blurry” and “flawed”. Despite its central role in safeguarding patients’ rights, informed choice, and personal integrity, the paradoxical nature of autonomy has led to conceptual fragmentation and academic disagreement. / Objectives: This study aims to reconcile autonomy with other core ethical principles—beneficence, non-maleficence, and justice—by considering it as a non-absolute principle that can be justifiably infringed upon in certain ethical circumstances. Additionally, it explores how emerging interdisciplinary approaches may refine or consolidate autonomy in bioethical discourse. / / Results: A scoping literature review identifies two innovative yet contentious approaches to autonomy: 1. Narrative Autonomy, which emerges from identity politics and philosophy, emphasises the role of personal narratives in shaping decision-making. 2. Autonomy-Enhancing Paternalism, influenced by behavioural economics and psychology, proposes interventions that subtly guide individuals towards better decisions while preserving their agency. Both approaches offer valuable perspectives but lack broad consensus. In contrast, an interdisciplinary “relational turn”, which underscores informed decision-making within a social and collective framework, appears more promising for strengthening autonomy while addressing ethical tensions in bioethics. / / Conclusions: While autonomy remains a fundamental principle in bioethics, its formulation must evolve to remain relevant in contemporary ethical debates. A relational approach to autonomy—one that integrates social responsibility and collective well-being—may enhance human flourishing and promote social justice while addressing the limitations of traditional models.
| Type: | Article |
|---|---|
| Title: | Principlism in Bioethics: How to Consolidate Autonomy? A Scoping Review |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.12688/bioethopenres.17704.1 |
| Publisher version: | https://doi.org/10.12688/bioethopenres.17704.1 |
| Language: | English |
| Additional information: | © The Author(s), 2025. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/ |
| Keywords: | Autonomy, Principlism, Relational Autonomy, Vaccination, Paternalism |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Curriculum, Pedagogy and Assessment |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10211883 |
Archive Staff Only
 |
View Item |
