Rethinking Autonomy: A Critique of Principlism in Biomedical Ethics

176 Pages·2013·1.328 MB·English

by  John W. Traphagan

J O H N W. T R A P H A G A N
Rethinking Autonomy
A CRITIQUE OF PRINCIPLISM IN BIOMEDICAL ETHICS
Rethinking Autonomy

eR thinik ng Autonomy
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JOHN . W T RA PH AGAN
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Library of Congress Cataloging-in-publication Data
Traphagan, John .W
Rethinking autonomy : a critique of principlism in biomedical ethics /
by John . WTraphagan.
p. cm.
Includes bibliographical references and index.
ISB N 978-1-4384-4552-6 (pbk. : alk. paper)
ISB N 978-1-4384-4553-3 (hardcover : alk. paper)
1. Medical ethics. 2. Ethics(cid:151)Cross-cultural studies. 3. Autonomy
( Psychology) I. Title.
R724.T657 2013
174.2(cid:151)dc23 2012011097
10 9 8 7 6 5 4 3 2 1
For my lovely daughter, Sarah

Contents
Acknowledgments ix
1. Inventing Ethics 1
1.1 The problem of Common Morality 1
1.2 Embodied Culture 9
1.3 Thinking About Culture 12
1.4 What Is Culture? 13
1.5 Memory, Culture, Ethics 23
2. Self, Autonomy, and Body 27
2.1 principles and Ethics 27
2.2 Autonomy 32
2.3 What Is a human? 36
2.4 Culture, Mind, and Body 41
2.5 Categories of person and Self 51
2.6 The nature of humans 58
2.7 Mind and Body, Inside and outside 59
3. Autonomy and Japanese Self-Concepts 63
3.1 Self and other 63
3.2 The Individual Self 70
3.3 Self and Childhood Development 72
3.4 The processive Self 74
3.5 Moral Selves and Autonomy 75
4. Autonomies, Virtue, and Social Change 79
4.1 Self, Virtue, and Character 79
4.2 Family, Self, Society 83
4.3 Autonomy, Family, and Social Change 88
viii Contents
5. Mental H ealth, Suicide, and Self-Centered Behavior 95
5.1 Self and O ther 95
5.2 Suicide as Medical and Analytical Category 98
5.3 Suicide and Self-Killing in Japan 102
5.4 Death 111
6. Emotion, Aesthetics, and Moral Action 119
6.1 Situational Ethics in Japan 119
6.2 The Obasuteyama Legend 121
6.3 H armony and Sincerity 129
6.4 Japanese Ethics 131
7. Rethinking Autonomy 135
References 147
Index 159
Akc noelw gd ments
P arts of Chapters 2 and 3 are signi(cid:31)cantly revised portions of articles.
“Senility as Disintegrated P erson in Japan” originally appeared in the
Journal of Cross-Cultural Gerontology 17:253–67 raph(T agan 2002),
“The O ddness of Things: Morality G ames and Interpretations of Social
Change Among Elders in Rural Japan” originally appeared in The Asia
Pacific Journal of Anthropology 10(4):329–47 raph(T agan 2009). These
are included here with kind permission of Springer Science and Business
Media and ayT lor and Francis (htt.ip://wwwnformaworld.com), respec-
tively. Chapter 4 originally appeared as “Interpretations of Elder Suicide,
Stress, and Dependency Among Rural Japanese” in Ethnology raph(T agan
2004b), and I am very appreciative of that journal for allowing me to use
the article here. Data for this book were collected during several trips to
Japan between 1995 and 2010, funded by a variety of sources, including
a Fulbright Doctoral Research Fellowship and grants from the Michigan
Exploratory Center for the Demography of Aging, the N ortheast Asia
Council of the Association for Asian Studies, The American P hilosophi-
cal Society, the eW nne-r G ren Foundation for Anthropological Research,
the N ational Institute on Aging (grant number R03 A G 016111-01), and
the Mitsubishi Japan Endowment at the University of eT xas at Austin.
The support is greatly appreciated.
There are numerous people to thank for support and comments
throughout the writing of this book. First, I thank Kirsten Cathe, rRobert
O ppenheim, and Thomas weT ed of the University of eT xas at Austin
and L. Keith Brown of the University of P ittsburgh for their very helpful
comments on various drafts. Second, many thanks to my fathe, r iWl-
lis raphT agan, for content and editorial comments throughout writing.
The work also bene(cid:31)ted from the help of my assistant Emiko Miya-
gawa Linville who gathered some of the sources used, Maeri Megumi
who reviewed Japanese terms for accuracy, and Anthony riWght who
ix