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On the Autós of Autonomous Decision Making: Intercorporeality, Temporality, and Enacted Normativities in Transplantation Medicine
Linköping University, Department of Thematic Studies, Technology and Social Change. Linköping University, Faculty of Arts and Sciences.
2018 (English)In: Existential Medicine: Essays on Health and Illness / [ed] Kevin Aho, London and New York: Rowman & Littlefield International, 2018, p. 81-100Chapter in book (Refereed)
Abstract [en]

This chapter brings phenomenological philosophy to bioethics debates about decision-making in transplantation medicine in general and parental live kidney donation in specific. It clarifies why both discussions of parental live kidney donation in terms of coercion (Kärrfelt et al 2004) and as “indicative” of parents’ autonomy (if it expresses what they want or who they want to be, see Crouch and Elliot 1999) fail to make sense of the complexity of the situation. Noting that the rich literature that explores relational aspects of subjectivity and conceptualises autonomous individuals as making decisions situated within and dependent on particular social contexts (see Freeman 2011; Donchin 2001; Mackenzie and Stoljars 2000; Christman 1998; Friedman 1997) still rarely addresses the role of the body, the chapter also addresses the role of embodiment for perception and choice. It argues for the need to think-through what may be labelled as the autós of autonomy and, more precisely, the focus on one’s own, the same/sameness, oneself or one’s self that has come to characterise much autonomy discussions, via phenomenological philosophy.

The chapter is divided into three parts. First, I make use of the phenomenological understanding of the intercorporeal self as being-in-the-world, in a discussion of how pain, fear or bodily symptoms of ESRD that unfolds in the shared space of child and parent can shape both of them in relation to each other (c.f. Käll 2013; Zeiler 2014a), feed into their bodily style of being-together, and help form parents’ perception of actions ‘within’ reach for them. Second, I shift the focus from the parent–child dyad to the larger semiotic–material context of haemodialysis and kidney transplantation in Sweden. This allows for an examination of embodied and enacted normativities, through an engagement with what Martin Gunnarson (2016: 128) has identified as a ‘dominant […] orientation towards transplantation’ in Sweden and Latvia. This second part also combines the discussion of an orientation towards transplantation with that of how norms about parenthood may be incorporated and excorporated into parents’ lived bodies,4 thereby making it possible to show why the no-choice theme in previous empirical work is understandable but more disconcerting than may first be assumed. Third, I argue that the acknowledgement of intercorporeal dimensions of bodily existence (argued for in Part I) and the role of orientation (argued for in Part II) demonstrates the need for a thinking-through of the autós of autonomous decision making, i.e. the understanding of the ‘ownness’ of this decision making, in ways other than those argued for in much of the bioethical autonomy and relational autonomy literature.

Place, publisher, year, edition, pages
London and New York: Rowman & Littlefield International, 2018. p. 81-100
Series
New Heidegger Research
Keywords [en]
Merleau-Ponty; embodiment; relationality; transplantation medicine; intercorporeality; autonomy; parenthood; kidney donation
National Category
Philosophy Medical Ethics
Identifiers
URN: urn:nbn:se:liu:diva-150908ISBN: 9781786604835 (print)OAI: oai:DiVA.org:liu-150908DiVA, id: diva2:1245264
Funder
Riksbankens JubileumsfondAvailable from: 2018-09-04 Created: 2018-09-04 Last updated: 2018-09-05Bibliographically approved

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Zeiler, Kristin

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