[10-15] Caught between theory and practice: Rethinking the human dignity and housing needs of people living with severe mental illness
発表言語：英語
In 2014, a United States federal judge in New York ordered the replacement of assisted-living facilities serving persons with severe mental illnesses with opportunities for autonomous living. Loss of life as well as compromised safety and well-being followed as a result, due to the misapplication of the philosophical concept of patient autonomy.
This case study demonstrates the theoretical blind spots of principlism, the dominant approach to analyzing ethical dilemmas in biomedical and health care ethics. The principle of respecting patient autonomy is singularly the most revolutionary tenet of principlism. Yet the concept of autonomy is infamously difficult to apply to cases involving persons with diminished decision-making capacity. I will argue that those who live with severe mental illness in particular are in danger of a “backhanded” recognition of their autonomy: an individualist notion that actively isolates them from the solidarity of a community in which they should find their autonomous moral status affirmed.
Beyond showing the relevance of the health humanities’ pragmatic approach to developing guidance for the ethical treatment of persons living with mental illness, my goal in this paper will be to recommend methodological refinements to an influential research paradigm of normative philosophy and health care ethics.