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      “Accompanied Only by My Thoughts”: A Kantian Perspective on Autonomy at the End of Life

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          Abstract

          Within bioethics, Kant’s conception of autonomy is often portrayed as excessively rationalistic, abstract, and individualistic, and, therefore, far removed from the reality of patients’ needs. Drawing on recent contributions in Kantian philosophy, we argue that specific features of Kantian autonomy remain relevant for medical ethics and for patient experience. We use contemporary end-of-life illness narratives—a resource that has not been analyzed with respect to autonomy—and show how they illustrate important Kantian themes, namely, the duty to know oneself, the interest in elaborating universalizable principles, and the emphasis on ideals as points of orientation that guide behavior without ever being fully realized. As Kant does, the patient-authors discussed here perceive the end of life as a moment to reflect on the constitutive principles which have governed that life, thereby offering a privileged moment to pursue self-knowledge. We argue that bioethical conceptions of autonomy stand to gain if they revise their conception of Kantian moral philosophy as too formal, abstract, and detached from emotions and personal relationships to be helpfully applied.

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          The Wounded Storyteller

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            What We Owe to Each Other

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              The ethics of care: Personal, political, and global.

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                Author and article information

                Contributors
                Journal
                J Med Philos
                J Med Philos
                jmp
                The Journal of Medicine and Philosophy
                Oxford University Press (US )
                0360-5310
                1744-5019
                December 2022
                23 December 2022
                23 December 2022
                : 47
                : 6
                : 688-700
                Affiliations
                University of St. Gallen , St. Gallen, Switzerland
                ETH Zurich , Zurich, Switzerland
                Author notes
                Address correspondence to: Anna Magdalena Elsner, School of Humanities and Social Sciences, University of St. Gallen, Müller-Friedberg-Strasse 6-8, 9000 St. Gallen, Switzerland. Email: anna.elsner@ 123456unisg.ch
                Article
                jhac026
                10.1093/jmp/jhac026
                9872763
                36562838
                826dd20e-e752-4407-9967-d93d66714dd9
                © The Author(s) 2022. Published by Oxford University Press on behalf of the Journal of Medicine and Philosophy Inc.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                Page count
                Pages: 13
                Categories
                Articles
                AcademicSubjects/MED00520
                AcademicSubjects/SCI01050
                AcademicSubjects/AHU02860

                autonomy,bioethics,diski,end of life,illness narratives,judt,kant,kalanithi,taylor

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