Blackwell Reference Online

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Individuals have different values. They prioritize their values in different ways. Controversial choices are choices which are perceived by many to be either irrational or against a person's interests, such as engaging in harmful or excessively risky activities. When the medical profession is involved in such choices, the basic medical principle of acting in a person's best interests is challenged. Often doctors refuse to respect controversial choices on paternalistic grounds. We should all respect and facilitate the controversial choices of competent individuals, subject to resource limitations, our own and others' well-being and autonomy, and the public interest. But more importantly, sometimes such choices make for a better, more autonomous life. Sometimes, such choices reflect considerations of global well-being or altruism, or idiosyncratic attitudes to risk. Sometimes, they reflect unusual values. However, in some other cases, controversial choices are irrational and are not expressions of our autonomy. We have an obligation to make rational if controversial choices. I distinguish between Kantian and Millian conceptions of autonomy and the place of controversial choices within these. On both accounts, there is an important place for controversial choices in leading the autonomous life. Indeed, where rational, they should be encouraged as they increase the richness of the tapestry ... log in or subscribe to read full text