What is Autonomy? Why and How Recent Policies and Practices have Sought to Increase Autonomy? (Essay Sample)

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In the society, autonomy is normally held in high esteem. It serves as one of the pivotal concepts in most philosophical debates for instance, on how to conceive morality, on understanding one’s self as a person, on authentication of political norms and even on issues surrounding biomedical ethics. In all this debates, the construct of autonomy is invoked when trying to formulate a particular constitutive consequence of the subject under debate or used as a justificatory criterion. Autonomy has also been applied extensively used in the legitimisation of social care norms and practices. For many years, the concept of autonomy has been evaluated and policies formulated that are in line with it. To understand its impact in the area of social care, this paper attempts to answer these questions.
* What is autonomy?
* Why and how recent policies and practices have sought to increase autonomy?
Autonomy
Autonomy is a term with varying meanings and definitions often considered to be pertinent to the western cultures CITATION Mol12 \p 214 \m Cla12 \p 289 \l 1033 (Perkins, Ball, Whittington, & Hollingsworth, 2012, p. 214; Manzi, Regalia, Pelucchi, & Fincham, 2012, p. 289). It is a Greek term first used to describe the exertion of laws by Greek city states CITATION Küh10 \p 2 \l 1033 (Kühler & Jelinek, 2010, p. 2). One key idea that never changed since the Greek era is that one way or another the subject in question governs itself. In regards to personal autonomy, individuals govern themselves such a man would decide and act in accordance with his convictions, values, and such like without internal and external interference. CITATION Ent10 \p 741 \l 1033 (Entwistle, Carter, Cribb, & McCaffery, 2010, p. 741). Following numerous discussion and seminar materials from scholars such as Frankfurt CITATION Fra88 \n \t \l 1033 (1988) nowadays autonomy is described "by pointing to a person’s capacity to reflect and endorse or disapprove of her (first order) desires on a higher (second order) level and to form a volition in line with an approved desire which moves her to act accordingly" CITATION Küh10 \p 3 \l 1033 (Kühler & Jelinek, 2010, p. 3).
This short of description of autonomy as self-government provides adequate basic idea and also highlights the central point which is the relationship between the self and autonomy. For by describing personal autonomy as self-government, it is strongly supported by the concept of self than a simple statement that the individual governing is similar to the one being governed. Instead, self takes up the idea of values, desires, convictions, and the like being of an individual’s own. For to be autonomous, he or she has to decide, act and generally live in accordance with the motives that represent the expression of one’s self. Therefore, autonomy leads to the concept of authenticity CITATION Küh10 \p Ibid \l 1033 (Kühler & Jelinek, 2010, p. Ibid). In that if an individual’s decisions, and actions represents basically who they are can be can be considered authentic. At time this can be controversial, since it is often difficult to bring out the impression of self and the idea of who an individual is in detail CITATION Mar91 \p 224 \l 1033 (Markus & Kitayama, 1991, p. 224).
The libertarian view of freedom is that people must make a choice "between options equally open, or, at least, more or less accessible, to us on an ontological level" CITATION Küh10 \p 10 \l 1033 (Kühler & Jelinek, 2010, p. 10). This implies that the act of making a choice is important, but it is not when it comes to the range of options. Also, that person’s preference is sovereign regardless of whether this particular choice is for the best interest of the individual CITATION Bur13 \p 1 \l 1033 (Burchardt, Evans, & Holder, 2013, p. 1). This view differs with that of the determinism that does not recognise any possible continuation in one and the same situation.
On the other hand, Scholars have found that the construct of individual freedom held by people particularly the elderly lays on faith and confidence of their competence and mastery. This, in turn, result in the production of "...a definition of personal identity predicated on independence and self-reliance" CITATION Geo93 \p 8 \l 1033 (Algich, 1993, p. 8). Consequently, this cultural paragon results in a number of secondary defences such as a denial of need, an inflated self-image, contempt for weaknesses of other, hostilities towards the caregivers even by the disabled and require assistance, all against dependence. A cultural attitude that constitutes aversion for dependence is referred to as counterdependence CITATION Geo93 \p Ibid \l 1033 (Algich, 1993, p. Ibid).
This attitude of counterdependence equates any form of dependence to a degrading submission. The view is understandable given the fact that the notion of autonomy as a negative freedom is dominant. It is viewed that individual freedom in the life of an individual is due to non-interference by others. This overdetermination of autonomy as a negative freedom is due to a set of beliefs about a person’s freedom that incorporate self-reliance, self-assertion, and personal preference. CITATION Geo93 \m Küh10 \p 10 \l 1033 (Algich, 1993; Kühler & Jelinek, 2010, p. 10).
Self-reliance is the capability to cater for one’s own needs CITATION Geo93 \p Ibid \l 1033 (Algich, 1993, p. Ibid). As people age, their power of self-reliance diminishes as that of dependence begins. The problem does not lie with the self-reliance as such but in that it defines individual’s worth. Lack of self-reliance contributes to a diminished sense of worthiness among old people. Therefore "if identity and value are grounded in one’s ability to be self-supporting, then physical infirmity and disability can compromise one’s sense of personal worth precisely through promising self-reliance" CITATION Geo93 \p 8 \l 1033 (Algich, 1993, p. 8). This point has been considered in one of population health measures "active life expectancy”. This measure involves abilities and activities such as eating, bathing, dressing and mobility that correlate with functional wellbeing. Loss of these abilities is considered loss of independence CITATION Mar91 \p 226 \l 1033 (Markus & Kitayama, 1991, p. 226).
Self-assertion refers to one actively pursuing the fulfilment of their desires. Therefore, it is not enough for an individual to just to have the desires; it also involves active engagement in the accomplishment of these desires. Whatever inhibits the attainment of these desires is considered to be curtailing freedom. Therefore, non-interference becomes paramount. It is often considered odd when applied to children CITATION Cla12 \p 290-3 \l 1033 (Manzi, Regalia, Pelucchi, & Fincham, 2012, pp. 290-3) yet when critically evaluated the restraint of desire that is requisite for maturation seems to be perceived as somewhat wrong in the case of adults. This can be considered a fundamental mistake. Whether as a child or adult, acquisition of any form of skill or expertise involves exercising discipline of unruly desires.
Choice and Autonomy
Personal preference bases the discussion of autonomy on choice and decision. Choice is imperative in that attention to individual’s wishes desires and impulses make up an important set of concerns in the analysis of human action CITATION Dow06 \p 15 \l 1033 (Dowling, et al., 2006, p. 15). However, the dilemma lies in that it is often difficult to question whether one’s values and desires are worth having CITATION Geo93 \l 1033 (Algich, 1993). Kühler & Jelinek, (2010) attempt to correlate authentication to personal autonomy to justify the notion of choice, however, in the end, they still find the same dilemma Algich (993) highlights. For instance, choice of a specific item does not necessarily mean that that item is good for that individual. Therefore, choice is paramount but not all important. As Algich (1993) overemphasis on this choice and decision making has rendered pointless other features of autonomy.
Unlike Algich (1993), Burchardt, Evans, & Holder, (2013) view that the phenomenon of choice as concept of autonomy has been unrecognized in the development of social policies. They find choice to be pivotal in the establishment of policies related to healthcare, education and childcare, social care and pension provision among others. In their view choice as an aspect of autonomy, permit us to distinguish between instrumental motivation and intrinsic motivations. Policies have been developed that focus on choice and control. This has been encouraged by the creation of the Equality Measurement Framework (EMF) CITATION Bur13 \p 1 \l 1033 (Burchardt, Evans, & Holder, 2013, p. 1). Equality Measurement Framework as been mandated to provide to monitor and evaluate inequality in the substantive freedom in United Kingdom.
The current coalition government in United Kingdom has also emphasised on choice and control. The shift and emphasis on choice and control in United Kingdom can be attributed to successful implementation of choice in policy by various nations such as Sweden, France Germany and the Netherlands CITATION Bur13 \p 2 \l 1033 (Burchardt, Evans, & Holder, 2013, p. 2). Sweden adopted choice revolution in reforming its health care , rights for patients, education and childcare, France also has adopted the choice revolution for parents to purchase childcare CITATION Bur13 \p 2 \l 1033 (Burchardt, Evans, & Holder, 2013, p. 2). Italy has a well-established freedom of choice p...