View source for Autonomy

{{Short description|Capacity for control, discretion or political self-governance}}
{{Other uses}}
{{Redirect|Autonomous|the novel|Autonomous (novel){{!}}''Autonomous'' (novel)}}
{{Distinguish|Autotomy}}
In [[developmental psychology]] and [[morality|moral]], [[political]], and [[bioethics|bioethical]] [[philosophy]], '''autonomy'''{{NoteTag|{{langx|grc|αὐτονομία|autonomia}}, from {{lang|grc|αὐτόνομος}}, ''autonomos'', from αὐτο- ''auto-'' "self" and νόμος ''nomos'', "law", hence when combined understood to mean "one who gives oneself one's own [[law]]"}} is the capacity to make an informed, uncoerced decision. Autonomous [[organization]]s or [[institution]]s are independent or self-governing. Autonomy can also be defined from a [[human resources]] perspective, where it denotes a (relatively high) level of discretion granted to an employee in his or her work.<ref>{{cite book |last=Dewey|first=C.R.|title=Autonomy without a self }}</ref> In such cases, autonomy is known to generally increase [[job satisfaction]]. [[Self-actualization|Self-actualized]] individuals are thought to operate autonomously of external expectations.<ref>{{Cite journal|last=Bordages|first=John Walter|date=1989-06-01|title=Self-Actualization and Personal Autonomy|journal=Psychological Reports|language=en|volume=64|issue=3_suppl|pages=1263–1266|doi=10.2466/pr0.1989.64.3c.1263|s2cid=146406002|issn=0033-2941}}</ref> In a [[Medicine|medical]] context, respect for a patient's personal autonomy is considered one of many fundamental [[Medical ethics|ethical principles in medicine]].
==Sociology==
In the [[sociology of knowledge]], a controversy over the boundaries of autonomy inhibited analysis of any concept beyond relative autonomy,<ref>[[:fr:Pierre Bourdieu|BOURDIEU, 2001]] (MARANHÃO, 2005; [http://www.encontroanpocs.org.br/2006/lista_gt.asp?atvid=26&entid=66 2006] {{webarchive|url=https://web.archive.org/web/20101008165230/http://www.encontroanpocs.org.br/2006/lista_gt.asp?atvid=26&entid=66|date=October 8, 2010}}; [https://web.archive.org/web/20070610214637/http://www.sbsociologia.com.br/congresso_v02/papers/GT3%20Ci%C3%AAncia%2C%20Tecnologia%20e%20Inova%C3%A7%C3%A3o%20Social/A%20Autonomia%20Reflexiva%20e%20o%20Fomento%20do%20CNPq%20%C3%A0%20Pesquisa%20no%20Campo%20da%20Sociologia%20%282000-2006%29.pdf 2007]; [http://www.flacsoandes.org/dspace/bitstream/10469/382/1/Íconos%20no.31%20-%20mayo%202008.pdf Sobral & Maranhão, 2008]{{dead link|date=August 2017|bot=medic}}){{cbignore|bot=medic}}</ref> until a typology of autonomy was created and developed within [[science and technology studies]]{{Citation needed|date=October 2024}}. According to it, the institution of science's existing autonomy is "[[reflexive autonomy]]": actors and structures within the [[scientific]] field are able to translate or to reflect diverse themes presented by social and political fields, as well as influence them regarding the thematic choices on research projects.
===Institutional autonomy===
[[Institutional]] autonomy is having the capacity as a [[legislator]] to be able to implant and pursue official goals. Autonomous institutions are responsible for finding sufficient resources or modifying their plans, programs, courses, responsibilities, and services accordingly.<ref>Evans, P. B., Rueschemeyer, D., & Skocpol, T. (1985). Bringing the state back in.</ref> But in doing so, they must contend with any obstacles that can occur, such as [[social pressure]] against cut-backs or socioeconomic difficulties. From a legislator's point of view, to increase institutional autonomy, conditions of [[self-managed economy|self-management]] and institutional self-governance must be put in place. An increase in leadership and a redistribution of decision-making responsibilities would be beneficial to the research of resources.<ref>Neave, G. (2012). The evaluative state, institutional autonomy and re-engineering higher education in Western Europe: The prince and his pleasure.</ref>
Institutional autonomy was often seen as a synonym for [[self-determination]], and many governments feared that it would lead institutions to an [[irredentist]] or [[secessionist]] region. But autonomy should be seen as a solution to self-determination struggles. Self-determination is a movement toward [[independence]], whereas autonomy is a way to accommodate the distinct regions/groups within a country. Institutional autonomy can diffuse conflicts regarding minorities and ethnic groups in a society. Allowing more autonomy to groups and institutions helps create diplomatic relationships between them and the central government.<ref>Weller, M., & Wolff, S. (2014). Autonomy, self-governance, and conflict resolution: Innovative approaches to institutional design in divided societies.</ref>
==Politics==
{{main|Autonomism (political doctrine)|Political freedom}}{{See also|Autonomous administrative division}}
In governmental parlance, autonomy refers to self-governance. An example of an autonomous jurisdiction was the former United States governance of the [[Philippine Islands]]. The ''Philippine Autonomy Act of 1916'' provided the framework for the creation of an autonomous government under which the [[Filipino people]] had broader domestic autonomy than previously, although it reserved certain privileges to the United States to protect its [[sovereignty|sovereign]] rights and interests.<ref name=CorpusJuris>{{Cite encyclopedia|title=Philippine Bill of 1902 (note: Philippine Autonomy Act) |encyclopedia=Corpus Juris |url=http://thecorpusjuris.com/constitutions/philippine-autonomy-act.php |url-status=live |archive-url=https://web.archive.org/web/20160525075502/http://www.thecorpusjuris.com/constitutions/philippine-autonomy-act.php |archive-date=2016-05-25 |date=July 1902 }}</ref> Other examples include [[Kosovo]] (as the [[Socialist Autonomous Province of Kosovo]]) under the former Yugoslav government of [[Josip Broz Tito|Marshal Tito]]<ref>{{Cite book |first1=Melissa Katherine |last1=Bokovoy |first2=Jill A. |last2=Irvine |first3=Carol S. |last3=Lilly |year=1997 |title=State-society relations in Yugoslavia, 1945–1992 |location=New York |publisher=St. Martin's Press |pages=[https://archive.org/details/statesocietyrela00meli/page/295 295–301] |isbn=978-0312126902 |url-access=registration |url=https://archive.org/details/statesocietyrela00meli/page/295 }}</ref> and [[Puntland]] Autonomous Region within [[Federal Republic of Somalia]].
Although often being territorially defined as self-governments, autonomous self-governing institutions may take a [[Non-territorial autonomy|non-territorial]] form. Such non-territorial solutions are, for example, cultural autonomy in [[Estonia]] and [[Hungary]], national minority councils in [[Serbia]] or Sámi parliaments in [[Nordic countries]].<ref>Coakley, John. "Introduction: Dispersed Minorities and Non-Territorial Autonomy". ''Ethnopolitics'' 15, nr 1 (2016): 1–23.</ref><ref>Prina, Federica. "Nonterritorial Autonomy and Minority (Dis)Empowerment: Past, Present, and Future". ''Nationalities Papers'' 48, nr 3 (2020): 425–434</ref>
==Philosophy==
Autonomy is a key concept that has a broad impact on different fields of [[philosophy]]. In [[metaphysical philosophy]], the concept of autonomy is referenced in discussions about [[free will]], [[fatalism]], [[determinism]], and [[Agency (philosophy)|agency]]. In [[moral philosophy]], autonomy refers to subjecting oneself to objective moral law.<ref>[http://plato.stanford.edu/entries/autonomy-moral/#BasDis Autonomy in Moral and Political Philosophy (Stanford Encyclopedia of Philosophy)] {{Webarchive|url=https://web.archive.org/web/20190802103913/https://plato.stanford.edu/entries/autonomy-moral/#BasDis |date=2019-08-02 }}. Plato.stanford.edu. Retrieved on 2013-07-12.</ref>
=== According to Kant ===
[[Immanuel Kant]] (1724–1804) defined autonomy by three themes regarding [[contemporary ethics]]. Firstly, autonomy as the right for one to make their own decisions excluding any interference from others. Secondly, autonomy as the capacity to make such decisions through one's own independence of mind and after personal reflection. Thirdly, as an ideal way of living life autonomously. In summary, autonomy is the [[Moral rights|moral right]] one possesses, or the capacity we have in order to think and make decisions for oneself providing some degree of control or power over the events that unfold within one's everyday life.<ref>{{Cite book|url=https://books.google.com/books?id=HlJ8BbjLXSAC&q=philosophy+and+autonomy+and+kant|title=Kant on Moral Autonomy|last=Sensen|first=Oliver|date=2013|publisher=Cambridge University Press|isbn=978-1107004863}}</ref>
The context in which Kant addresses autonomy is in regards to [[moral theory]], asking both foundational and abstract questions. He believed that in order for there to be [[morality]], there must be autonomy. "Autonomous" is derived from the Greek word ''autonomos'' <ref>Oxford English Dictionary</ref> where 'auto' means self and 'nomos' means to govern (''nomos'': as can be seen in its usage in ''nomárchēs'' which means chief of the province). Kantian autonomy also provides a sense of [[Rationality|rational]] autonomy, simply meaning one rationally possesses the [[motivation]] to govern their own life. Rational autonomy entails making your own decisions but it cannot be done solely in [[Social isolation|isolation]]. Cooperative rational interactions are required to both develop and exercise our [[ability]] to live in a world with others.
Kant argued that morality presupposes this autonomy ({{langx|de|Autonomie}}) in moral agents, since moral requirements are expressed in [[categorical imperative]]s. An imperative is categorical if it issues a valid command independent of personal desires or interests that would provide a reason for obeying the command. It is hypothetical if the validity of its command, if the reason why one can be expected to obey it, is the fact that one desires or is interested in something further that obedience to the command would entail. "Don't speed on the freeway if you don't want to be stopped by the police" is a hypothetical imperative. "It is wrong to break the law, so don't speed on the freeway" is a categorical imperative. The hypothetical command not to speed on the freeway is not valid for you if you do not care whether you are stopped by the police. The categorical command is valid for you either way. Autonomous moral agents can be expected to obey the command of a categorical imperative even if they lack a personal desire or interest in doing so. It remains an open question whether they will, however.
The Kantian concept of autonomy is often misconstrued, leaving out the important point about the autonomous agent's self-subjection to the moral law. It is thought that autonomy is fully explained as the ability to obey a categorical command independently of a personal desire or interest in doing so—or worse, that autonomy is "obeying" a categorical command independently of a natural desire or interest; and that [[heteronomy]], its opposite, is acting instead on personal motives of the kind referenced in hypothetical imperatives.
In his ''[[Groundwork of the Metaphysic of Morals]]'', Kant applied the concept of autonomy also to define the concept of personhood and human [[dignity]]. Autonomy, along with [[rationality]], are seen by Kant as the two criteria for a meaningful life. Kant would consider a life lived without these not worth living; it would be a life of value equal to that of a plant or insect.<ref name="Shafer-Landau, Russ 2010 Pp161">Shafer-Landau, Russ. "The fundamentals of ethics." (2010). p. 161</ref> According to Kant autonomy is part of the reason that we hold others morally accountable for their actions. Human actions are morally praise- or blame-worthy in virtue of our autonomy. Non- autonomous beings such as plants or animals are not blameworthy due to their actions being non-autonomous.<ref name="Shafer-Landau, Russ 2010 Pp161"/> Kant's position on crime and punishment is influenced by his views on autonomy. Brainwashing or drugging criminals into being law-abiding citizens would be immoral as it would not be respecting their autonomy. Rehabilitation must be sought in a way that respects their autonomy and dignity as human beings.<ref>Shafer-Landau, Russ. "The fundamentals of ethics." (2010). p. 163</ref>
=== According to Nietzsche ===
[[Friedrich Nietzsche]] wrote about autonomy and the moral fight.<ref>{{cite journal|journal=The Journal of Nietzsche Studies|url=https://ndpr.nd.edu/news/24779-nietzsche-on-freedom-and-autonomy/ |title=Review of ''Nietzsche on Freedom and Autonomy'' |access-date=2014-04-02 |url-status=live |archive-url=https://web.archive.org/web/20140407061713/https://ndpr.nd.edu/news/24779-nietzsche-on-freedom-and-autonomy/ |archive-date=2014-04-07 |date=2011-07-31 |last1=Reginster |first1=Bernard }}</ref> Autonomy in this sense is referred to as the free self and entails several aspects of the self, including self-respect and even self-love. This can be interpreted as influenced by [[Immanuel Kant|Kant]] ([[Self respect|self-respect]]) and [[Aristotle]] ([[self-love]]). For Nietzsche, valuing [[Ethics|ethical]] autonomy can dissolve the conflict between love (self-love) and law (self-respect) which can then translate into reality through experiences of being self-responsible. Because Nietzsche defines having a sense of freedom with being [[Personal responsibility|responsible]] for one's own life, freedom and self-responsibility can be very much linked to autonomy.<ref>{{Cite book|url=https://books.google.com/books?id=D2a9e-FarAYC&q=philosophy+and+autonomy|title=Nietzsche on Freedom and Autonomy|last1=Gemes|first1=Ken|last2=May|first2=Simon|year=2009|publisher=OUP Oxford|isbn=978-0191607882}}</ref>
=== According to Piaget ===
The [[Switzerland|Swiss]] philosopher [[Jean Piaget]] (1896–1980) believed that autonomy comes from within and results from a "free decision". It is of [[Intrinsic value (ethics)|intrinsic value]] and the morality of autonomy is not only accepted but obligatory. When an attempt at social interchange occurs, it is reciprocal, ideal and natural for there to be autonomy regardless of why the collaboration with others has taken place. For Piaget, the term autonomous can be used to explain the idea that rules are self-chosen. By choosing which rules to follow or not, we are in turn determining our own [[Behavior|behaviour]].<ref>{{Cite book|url=https://books.google.com/books?id=3zEfxTytFnIC&q=autonomy+and+piaget&pg=PA84|title=Piaget's Construction of the Child's Reality|last=Sugarman|first=Susan|year=1990|publisher=Cambridge University Press|isbn=978-0521379670}}</ref>
Piaget studied the cognitive development of children by analyzing them during their games and through interviews, establishing (among other principles) that the children's moral maturation process occurred in two phases, the first of [[heteronomy]] and the second of autonomy:
* Heteronomous reasoning: Rules are objective and unchanging. They must be literal because the authority are ordering it and do not fit exceptions or discussions. The base of the rule is the superior [[authority]] (parents, adults, the State), that it should not give reason for the rules imposed or fulfilled them in any case. Duties provided are conceived as given from oneself. Any moral motivation and sentiments are possible through what one believes to be right.
* Autonomous reasoning: Rules are the product of an agreement and, therefore, are modifiable. They can be subject to interpretation and fit exceptions and objections. The base of the rule is its own acceptance, and its meaning has to be explained. Sanctions must be proportionate to the absence, assuming that sometimes offenses can go unpunished, so that collective punishment is unacceptable if it is not the guilty. The circumstances may not punish a guilty. Duties provided are conceived as given from the outside. One follows rules mechanically as it is simply a rule, or as a way to avoid a form of punishment.
=== According to Kohlberg ===
The American psychologist [[Lawrence Kohlberg]] (1927–1987) continues the studies of Piaget. His studies collected information from different latitudes to eliminate the cultural variability, and focused on the moral reasoning, and not so much in the behavior or its consequences. Through interviews with adolescent and teenage boys, who were to try and solve "moral dilemmas", Kohlberg went on to further develop the [[Lawrence Kohlberg's stages of moral development|stages of moral development]]. The answers they provided could be one of two things. Either they choose to obey a given law, authority figure or rule of some sort or they chose to take actions that would serve a human need but in turn break this given rule or command.
The most popular moral dilemma asked involved the wife of a man approaching death due to a special type of cancer. Because the drug was too expensive to obtain on his own, and because the pharmacist who discovered and sold the drug had no compassion for him and only wanted profits, he stole it. Kohlberg asks these adolescent and teenage boys (10-, 13- and 16-year-olds) if they think that is what the husband should have done or not. Therefore, depending on their decisions, they provided answers to Kohlberg about deeper rationales and thoughts and determined what they value as important. This value then determined the "structure" of their moral reasoning.<ref>{{Cite book|url=https://books.google.com/books?id=cShtCgAAQBAJ&q=social+and+personality+development&pg=PA491|title=Social and Personality Development|last=Shaffer|first=David|date=2008|publisher=Cengage Learning|isbn=978-1111807269|access-date=2020-10-29|archive-date=2024-02-19|archive-url=https://web.archive.org/web/20240219171919/https://books.google.com/books?id=cShtCgAAQBAJ&q=social+and+personality+development&pg=PA491|url-status=live}}</ref>
Kohlberg established three stages of morality, each of which is subdivided into two levels. They are read in progressive sense, that is, higher levels indicate greater autonomy.
* '''Level 1:''' Premoral/Preconventional Morality: Standards are met (or not met) depending on the hedonistic or physical consequences.
** [Stage 0: Egocentric Judgment: There is no moral concept independent of individual wishes, including a lack of concept of rules or obligations.]
** Stage 1: Punishment-Obedience Orientation: The rule is obeyed only to avoid punishment. Physical consequences determine goodness or badness and power is deferred to unquestioningly with no respect for the human or moral value, or the meaning of these consequences. Concern is for the self.
** Stage 2: Instrumental-Relativist Orientation: Morals are individualistic and egocentric. There is an exchange of interests but always under the point of view of satisfying personal needs. Elements of fairness and reciprocity are present but these are interpreted in a pragmatic way, instead of an experience of gratitude or justice. Egocentric in nature but beginning to incorporate the ability to see things from the perspective of others.
* '''Level 2:''' Conventional Morality/Role [[Conformity]]: Rules are obeyed according to the established conventions of a society.
** Stage 3: Good Boy–Nice Girl Orientation: Morals are conceived in accordance with the stereotypical social role. Rules are obeyed to obtain the approval of the immediate group and the right actions are judged based on what would please others or give the impression that one is a good person. Actions are evaluated according to intentions.
** Stage 4: Law and Order Orientation: Morals are judged in accordance with the authority of the system, or the needs of the social order. Laws and order are prioritized.
* '''Level 3:''' Postconventional Morality/Self-Accepted Moral Principles: Standards of moral behavior are internalized. Morals are governed by rational judgment, derived from a conscious reflection on the recognition of the value of the individual inside a conventionally established society.
** Stage 5: Social Contract Orientation: There are individual rights and standards that have been lawfully established as basic universal values. Rules are agreed upon by through procedure and society comes to consensus through critical examination in order to benefit the greater good.
** Stage 6: Universal Principle Orientation: Abstract ethical principles are obeyed on a personal level in addition to societal rules and conventions. Universal principles of justice, reciprocity, equality and human dignity are internalized and if one fails to live up to these ideals, guilt or self-condemnation results.
=== According to Audi ===
[[Robert Audi]] characterizes autonomy as the self-governing power to bring reasons to bear in directing one's conduct and influencing one's propositional attitudes.<ref>{{cite book |last1=Audi |first1=Robert |title=The Architecture of Reason: The Structure and Substance of Rationality |date=2001 |publisher=Oxford University Press |url=https://philpapers.org/rec/AUDTAO-3 |access-date=2020-11-20 |archive-date=2021-06-19 |archive-url=https://web.archive.org/web/20210619215025/https://philpapers.org/rec/AUDTAO-3 |url-status=live }}</ref>{{rp|211–212}}<ref>{{cite journal |last1=Haji |first1=Ish |title=Review of The Architecture of Reason: The Structure and Substance of Rationality |url=https://ndpr.nd.edu/news/the-architecture-of-reason-the-structure-and-substance-of-rationality/ |website=Notre Dame Philosophical Reviews |date=9 March 2002 |access-date=20 November 2020 |archive-date=23 October 2020 |archive-url=https://web.archive.org/web/20201023025553/https://ndpr.nd.edu/news/the-architecture-of-reason-the-structure-and-substance-of-rationality/ |url-status=live }}</ref> Traditionally, autonomy is only concerned with practical matters. But, as Audi's definition suggests, autonomy may be applied to responding to reasons at large, not just to practical reasons. Autonomy is closely related to [[freedom]] but the two can come apart. An example would be a political prisoner who is forced to make a statement in favor of his opponents in order to ensure that his loved ones are not harmed. As Audi points out, the prisoner lacks freedom but still has autonomy since his statement, though not reflecting his political ideals, is still an expression of his commitment to his loved ones.<ref name="Audi">{{cite journal |last1=Audi |first1=Robert |title=Autonomy, Reason, and Desire |journal=Pacific Philosophical Quarterly |date=1991 |volume=72 |issue=4 |pages=247–271 |doi=10.1111/j.1468-0114.1991.tb00320.x |url=https://philpapers.org/rec/AUDARA |access-date=2020-11-20 |archive-date=2021-04-14 |archive-url=https://web.archive.org/web/20210414111939/https://philpapers.org/rec/AUDARA |url-status=live }}</ref>{{rp|249}}
Autonomy is often equated with self-legislation in the [[Kantian]] tradition.<ref>{{cite journal |last1=Kleingeld |first1=Pauline |last2=Willaschek |first2=Marcus |title=Autonomy Without Paradox: Kant, Self-Legislation and the Moral Law |journal=Philosophers' Imprint |date=2019 |volume=19 |url=https://philpapers.org/rec/KLEAWP |access-date=2020-11-20 |archive-date=2021-02-05 |archive-url=https://web.archive.org/web/20210205024216/https://philpapers.org/rec/KLEAWP |url-status=live }}</ref><ref>{{cite web |last1=Dryden |first1=Jane |title=Autonomy |url=https://iep.utm.edu/autonomy/ |website=Internet Encyclopedia of Philosophy |access-date=20 November 2020 |archive-date=11 November 2020 |archive-url=https://web.archive.org/web/20201111213519/https://iep.utm.edu/autonomy/ |url-status=live }}</ref> Self-legislation may be interpreted as laying down laws or principles that are to be followed. Audi agrees with this school in the sense that we should bring reasons to bear in a principled way. Responding to reasons by mere whim may still be considered free but not autonomous.<ref name="Audi"/>{{rp|249, 257}} A commitment to principles and projects, on the other hand, provides autonomous agents with an identity over time and gives them a sense of the kind of persons they want to be. But autonomy is neutral as to which principles or projects the agent endorses. So different autonomous agents may follow very different principles.<ref name="Audi"/>{{rp|258}} But, as Audi points out, self-legislation is not sufficient for autonomy since laws that do not have any practical impact do not constitute autonomy.<ref name="Audi"/>{{rp|247–248}} Some form of motivational force or executive power is necessary in order to get from mere self-legislation to self-government.<ref>{{cite journal |last1=Audi |first1=Robert |title=Weakness of Will and Rational Action |journal=Australasian Journal of Philosophy |date=1990 |volume=68 |issue=3 |pages=270–281 |doi=10.1080/00048409012344301 |url=https://philpapers.org/rec/AUDWOW |access-date=2020-11-20 |archive-date=2021-01-21 |archive-url=https://web.archive.org/web/20210121205346/https://philpapers.org/rec/AUDWOW |url-status=live }}</ref> This motivation may be inherent in the corresponding practical judgment itself, a position known as ''motivational internalism'', or may come to the practical judgment externally in the form of some desire independent of the judgment, as ''motivational externalism'' holds.<ref name="Audi"/>{{rp|251–252}}
In the [[Humeanism#Practical reason|Humean]] tradition, intrinsic desires are the reasons the autonomous agent should respond to. This theory is called ''instrumentalism''.<ref>{{cite web |last1=Cohon |first1=Rachel |title=Hume's Moral Philosophy |url=https://plato.stanford.edu/entries/hume-moral/ |website=The Stanford Encyclopedia of Philosophy |publisher=Metaphysics Research Lab, Stanford University |access-date=20 November 2020 |date=2018 |archive-date=10 January 2018 |archive-url=https://web.archive.org/web/20180110170335/https://plato.stanford.edu/entries/hume-moral/ |url-status=live }}</ref><ref>{{cite journal |last1=Setiya |first1=Kieran |title=Hume on Practical Reason |journal=Philosophical Perspectives |date=2004 |volume=18 |pages=365–389 |doi=10.1111/j.1520-8583.2004.00033.x |jstor=3840940 |url=https://www.jstor.org/stable/3840940 |issn=1520-8583 |access-date=2020-11-20 |archive-date=2020-11-28 |archive-url=https://web.archive.org/web/20201128024940/https://www.jstor.org/stable/3840940 |url-status=live }}</ref> Audi rejects instrumentalism and suggests that we should adopt a position known as ''axiological objectivism''. The central idea of this outlook is that objective values, and not subjective desires, are the sources of normativity and therefore determine what autonomous agents should do.<ref name="Audi"/>{{rp|261ff}}
==Child development==
Autonomy in childhood and adolescence is when one strives to gain a sense of oneself as a separate, self-governing individual.<ref name="Berk">{{cite book|last1=Berk|first1=Laura|title=Child Development|date=2013|publisher=Pearson|edition=9}}</ref> Between ages 1–3, during the second stage of Erikson's and Freud's stages of development, the psychosocial crisis that occurs is autonomy versus shame and doubt.<ref name="Shaffer">{{cite book|last1=Shaffer|first1=David|title=Social and Personality Development|edition=6}}</ref> The significant event that occurs during this stage is that children must learn to be autonomous, and failure to do so may lead to the child doubting their own abilities and feel ashamed.<ref name="Shaffer" /> When a child becomes autonomous it allows them to explore and acquire new skills. Autonomy has two vital aspects wherein there is an emotional component where one relies more on themselves rather than their parents and a behavioural component where one makes decisions independently by using their judgement.<ref name="Berk" /> The styles of child rearing affect the development of a child's autonomy.  Autonomy in adolescence is closely related to their quest for identity.<ref name="Berk" /> In adolescence parents and peers act as agents of influence. Peer influence in early adolescence may help the process of an adolescent to gradually become more autonomous by being less susceptible to parental or peer influence as they get older.<ref name="Shaffer" /> In adolescence the most important developmental task is to develop a healthy sense of autonomy.<ref name="Shaffer" />
==Religion==
In [[Christianity]], autonomy is manifested as a partial self-governance on various levels of church administration. During the history of Christianity, there were two basic types of autonomy. Some important parishes and monasteries have been given special autonomous rights and privileges, and the best known example of monastic autonomy is the famous [[Eastern Orthodox]] monastic community on [[Mount Athos]] in [[Greece]]. On the other hand, administrative autonomy of entire ecclesiastical provinces has throughout history included various degrees of internal self-governance.
In [[ecclesiology]] of [[Eastern Orthodox Church]]es, there is a clear distinction between autonomy and [[autocephaly]], since autocephalous churches have full self-governance and independence, while every autonomous church is subject to some autocephalous church, having a certain degree of internal self-governance. Since every autonomous church had its own historical path to ecclesiastical autonomy, there are significant differences between various autonomous churches in respect of their particular degrees of self-governance. For example, churches that are autonomous can have their highest-ranking bishops, such as an [[archbishop]] or [[metropolitan bishop|metropolitan]], appointed or confirmed by the [[patriarch]] of the [[mother church]] from which it was granted its autonomy, but generally they remain self-governing in many other respects.
In the history of [[Western Christianity]] the question of ecclesiastical autonomy was also one of the most important questions, especially during the first centuries of Christianity, since various archbishops and metropolitans in [[Western Europe]] have often opposed centralizing tendencies of the [[Catholic Church|Church of Rome]].{{sfn|Meyendorff|1989|pp=59–66, 130–139}} {{As of|2019}}, the [[Catholic Church]] comprises 24 autonomous (''[[sui iuris]]'') Churches in communion with the [[Holy See]]. Various denominations of [[Protestant church]]es usually have more decentralized power, and churches may be autonomous, thus having their own rules or laws of government, at the national, local, or even individual level.
[[Jean-Paul Sartre|Sartre]] brings the concept of the Cartesian god being totally free and autonomous. He states that existence precedes essence with god being the creator of the essences, eternal truths and divine will. This pure freedom of god relates to human freedom and autonomy; where a human is not subjected to pre-existing ideas and values.<ref name=":2">{{cite book|last=Macken|first=John|date=2008|title=The Autonomy Theme in the Church Dogmatics: Karl Barth and his Critics}}</ref>
According to the [[First Amendment to the United States Constitution|first amendment]], In the [[United States|United States of America]], the federal government is restricted in building a national church. This is due to the [[First Amendment to the United States Constitution|first amendment's]] recognizing people's freedom's to worship their faith according to their own belief's. For example, [[Federal government of the United States|the American government]] has removed the church from their "sphere of authority"<ref>{{cite web|url=http://heinonline.org/HOL/Page?handle=hein.journals/nkenlr35&div=11&id=&page=&collection=journals|title=Spheres of Sovereignty: Church Autonomy Doctrine and the Theological Heritage of the Separation of Church and State|last1=Renaud|first1=Robert Joseph|last2=Weinberger|first2=Laed Daniel|date=2008|website=heinonline.org|access-date=2018-03-17|archive-date=2018-03-18|archive-url=https://web.archive.org/web/20180318054413/http://heinonline.org/HOL/Page?handle=hein.journals/nkenlr35&div=11&id=&page=&collection=journals|url-status=live}}</ref> due to the churches' historical impact on politics and their authority on the public. This was the beginning of the [[disestablishment]] process. The Protestant churches in the United States had a significant impact on American culture in the nineteenth century, when they organized the establishment of schools, hospitals, orphanages, colleges, magazines, and so forth.<ref>{{Cite book|title=Religion and personal autonomy: the third disestablishment in America.|last=Hammond|first=Phillip|year=1992}}</ref> This has brought up the famous, however, misinterpreted term of the [[separation of church and state]]. These churches lost the legislative and financial support from the state.
=== The disestablishment process ===
The first disestablishment began with the introduction of the [[bill of rights]].<ref name=":1">{{cite book|title=Religion and personal autonomy: the third disestablishment in America|last=Hammond|first=Phillip|date=1992|isbn=978-0872498204|publisher=University of South Carolina Press|edition=First}}</ref> In the twentieth century, due to the [[Great Depression|great depression]] of the 1930s and the completion of the second world war, the American churches were revived. Specifically the Protestant churches. This was the beginning of the second disestablishment<ref name=":1" /> when churches had become popular again but held no legislative power. One of the reasons why the churches gained attendance and popularity was due to the [[baby boom]], when soldiers came back from the [[World War II|second world war]] and started their families. The large influx of newborns gave the churches a new wave of followers. However, these followers did not hold the same beliefs as their parents and brought about the political, and religious revolutions of the 1960s.
During the 1960s, the collapse of religious and cultural middle brought upon the third disestablishment.<ref name=":1" /> Religion became more important to the individual and less so to the community. The changes brought from these revolutions significantly increased the personal autonomy of individuals due to the lack of structural restraints giving them added freedom of choice. This concept is known as "new voluntarism"<ref name=":1" /> where individuals have free choice on how to be religious and the free choice whether to be religious or not.
==Medicine==
In a [[medicine|medical]] context, respect for a patient's personal autonomy is [[medical ethics|considered]] one of many fundamental ethical principles in medicine.<ref>{{Cite journal|last=Varelius|first=Jukka|date=December 2006|title=The value of autonomy in medical ethics|journal=Medicine, Health Care and Philosophy|volume=9|issue=3|pages=377–388|doi=10.1007/s11019-006-9000-z|issn=1386-7423|pmc=2780686|pmid=17033883}}</ref> Autonomy can be defined as the ability of the person to make his or her own decisions. This faith in autonomy is the central premise of the concept of [[informed consent]] and [[shared decision making]]. This idea, while considered essential to today's practice of medicine, was developed in the last 50 years. According to [[Tom Beauchamp]] and [[James Childress]] (in ''Principles of Biomedical Ethics''), the [[Doctors' Trial|Nuremberg trials]] detailed accounts of horrifyingly exploitative medical "experiments" which violated the subjects' physical integrity and personal autonomy.<ref>{{Cite book|title=Principles of biomedical ethics|last=Beauchamp|first=Tom L.|date=2013|publisher=Oxford University Press|others=Childress, James F.|isbn=978-0199924585|edition=7th |location=New York|oclc=808107441}}</ref> These incidences prompted calls for safeguards in [[medical research]], such as the [[Nuremberg Code]] which stressed the importance of voluntary participation in medical research. It is believed that the Nuremberg Code served as the premise for many current documents regarding research ethics.<ref>{{Cite journal|last=Fischer|first=Bernard A|date=January 2006|title=A Summary of Important Documents in the Field of Research Ethics|journal=Schizophrenia Bulletin|volume=32|issue=1|pages=69–80|doi=10.1093/schbul/sbj005|issn=0586-7614|pmc=2632196|pmid=16192409}}</ref>
Respect for autonomy became incorporated in health care and patients could be allowed to make personal decisions about the health care services that they receive.<ref>{{Cite journal|last=Leo|first=Raphael J.|date=October 1999|title=Competency and the Capacity to Make Treatment Decisions: A Primer for Primary Care Physicians|journal=Primary Care Companion to the Journal of Clinical Psychiatry|volume=1|issue=5|pages=131–141|issn=1523-5998|pmid=15014674|pmc=181079|doi=10.4088/PCC.v01n0501}}</ref> Notably, autonomy has several aspects as well as challenges that affect health care operations. The manner in which a patient is handled may undermine or support the autonomy of a patient and for this reason, the way a patient is communicated to becomes very crucial. A good relationship between a patient and a health care practitioner needs to be well defined to ensure that autonomy of a patient is respected.<ref>{{cite book|last1=Riis|first1=A.H|title=Autonomy, culture and healthcare}}</ref> Just like in any other life situation, a patient would not like to be under the control of another person. The move to emphasize respect for patient's autonomy rose from the vulnerabilities that were pointed out in regards to autonomy.
However, autonomy does not only apply in a research context. Users of the health care system have the right to be treated with respect for their autonomy, instead of being dominated by the [https://books.google.com/books?id=x1DNCNNX8AIC&q=silent+world+of+doctor+and+patient physician].<ref>{{Cite web |last=Gandhi |first=Akash |title=Medical Ethics - The Principles |url=https://www.theukcatpeople.co.uk/application-guide/interview/answering-medical-ethics-interview-questions |access-date=28 February 2024 |website=www.theukcatpeople.co.uk}}</ref> This is referred to as [[paternalism]]. While paternalism is meant to be overall good for the patient, this can very easily interfere with autonomy.<ref>{{cite journal|last1=Sandman|first1=Lars|title=Adherence, Shared Decision-Making and Patient Autonomy|journal=Medicine, Health Care and Philosophy|date=2012|volume=15|issue=2|pages=115–27|doi=10.1007/s11019-011-9336-x|pmid=21678125|s2cid=30120495}}</ref> Through the [[therapeutic relationship]], a thoughtful dialogue between the client and the physician may lead to better outcomes for the client, as he or she is more of a participant in [[decision-making]].
There are many different definitions of autonomy, many of which place the individual in a social context. Relational autonomy, which suggests that a person is defined through their relationships with others, is increasingly considered in medicine and particularly in critical<ref>{{Cite journal |last1=Grignoli |first1=Nicola |last2=Di Bernardo |first2=Valentina |last3=Malacrida |first3=Roberto |date=2018-10-11 |title=New perspectives on substituted relational autonomy for shared decision-making in critical care |journal=Critical Care |volume=22 |issue=1 |page=260 |doi=10.1186/s13054-018-2187-6 |issn=1364-8535 |pmc=6182794 |pmid=30309384 |doi-access=free }}</ref> and end-of-life care.<ref>{{Cite journal |last1=Gómez-Vírseda |first1=Carlos |last2=de Maeseneer |first2=Yves |last3=Gastmans |first3=Chris |date=2019-10-26 |title=Relational autonomy: what does it mean and how is it used in end-of-life care? A systematic review of argument-based ethics literature |journal=BMC Medical Ethics |volume=20 |issue=1 |pages=76 |doi=10.1186/s12910-019-0417-3 |issn=1472-6939 |pmc=6815421 |pmid=31655573 |doi-access=free }}</ref> Supported autonomy<ref name="library.yorku.ca">{{cite web|url=https://www.library.yorku.ca/find/Record/2376624|title=Exemplaires: Consent and capacity in Ontario's civil mental|archive-url=https://web.archive.org/web/20150524174134/https://www.library.yorku.ca/find/Record/2376624|archive-date=2015-05-24|url-status=live|access-date=2015-05-24}}</ref> suggests instead that in specific circumstances it may be necessary to temporarily compromise the autonomy of the person in the short term in order to preserve their autonomy in the long-term. Other definitions of the autonomy imagine the person as a contained and self-sufficient being whose rights should not be compromised under any circumstance.<ref>{{cite web|url=http://www.goodreads.com/book/show/634749.The_Inner_Citadel|title=The Inner Citadel|archive-url=https://web.archive.org/web/20150924145857/http://www.goodreads.com/book/show/634749.The_Inner_Citadel|archive-date=2015-09-24|url-status=live|access-date=2015-05-24}}</ref>
There are also differing views with regard to whether modern health care systems should be shifting to greater patient autonomy or a more paternalistic approach. For example, there are such arguments that suggest the current patient autonomy practiced is plagued by flaws such as misconceptions of treatment and cultural differences, and that health care systems should be shifting to greater paternalism on the part of the physician given their expertise.<ref>{{Cite journal|last=Caplan|first=Arthur L|date=2014|title=Why autonomy needs help|journal=Journal of Medical Ethics|volume=40|issue=5|pages=301–302|issn=0306-6800|jstor=43282987|doi=10.1136/medethics-2012-100492|pmid=22337604|s2cid=207010293}}</ref>  On the other hand, other approaches suggest that there simply needs to be an increase in relational understanding between patients and health practitioners to improve patient autonomy.<ref>{{Cite journal|last1=Entwistle|first1=Vikki A.|last2=Carter|first2=Stacy M.|last3=Cribb|first3=Alan|last4=McCaffery|first4=Kirsten|author-link4=Kirsten McCaffery|date=July 2010|title=Supporting Patient Autonomy: The Importance of Clinician-patient Relationships|journal=Journal of General Internal Medicine|volume=25|issue=7|pages=741–745|doi=10.1007/s11606-010-1292-2|issn=0884-8734|pmc=2881979|pmid=20213206}}</ref>
One argument in favor of greater patient autonomy and its benefits is by Dave deBronkart, who believes that in the technological advancement age, patients are capable of doing a lot of their research on medical issues from their home. According to deBronkart, this helps to promote better discussions between patients and physicians during hospital visits, ultimately easing up the workload of physicians.<ref name=":0">{{Cite journal|last=deBronkart|first=Dave|date=2015|title=From patient centred to people powered: autonomy on the rise|journal=BMJ: British Medical Journal|volume=350|issn=0959-8138|jstor=26518242}}</ref> deBronkart argues that this leads to greater patient empowerment and a more educative health care system.<ref name=":0" /> In opposition to this view, technological advancements can sometimes be viewed as an unfavorable way of promoting patient autonomy. For example, self-testing medical procedures which have become increasingly common are argued by Greaney et al. to increase patient autonomy, however, may not be promoting what is best for the patient. In this argument, contrary to deBronkart, the current perceptions of patient autonomy are excessively over-selling the benefits of individual autonomy, and is not the most suitable way to go about treating patients.<ref name=":3">{{Cite journal|last1=Greaney|first1=Anna-Marie|last2=O'Mathúna|first2=Dónal P.|last3=Scott|first3=P. Anne|date=2012-11-01|title=Patient autonomy and choice in healthcare: self-testing devices as a case in point|journal=Medicine, Health Care and Philosophy|volume=15|issue=4|pages=383–395|doi=10.1007/s11019-011-9356-6|pmid=22038653|s2cid=915117|issn=1572-8633|url=http://doras.dcu.ie/19339/1/AMG_Patient_autonomy_and_choice_in_healthcare_Self-testing_devices_as_a_case_in_point_Revised_Manuscript__MHEP.pdf|access-date=2019-06-16|archive-date=2017-09-22|archive-url=https://web.archive.org/web/20170922024806/http://doras.dcu.ie/19339/1/AMG_Patient_autonomy_and_choice_in_healthcare_Self-testing_devices_as_a_case_in_point_Revised_Manuscript__MHEP.pdf|url-status=live}}</ref> Instead, a more inclusive form of autonomy should be implemented, relational autonomy, which factors into consideration those close to the patient as well as the physician.<ref name=":3" /> These different concepts of autonomy can be troublesome as the acting physician is faced with deciding which concept he/she will implement into their clinical practice.<ref>{{Cite journal|last1=Ross|first1=Lainie Friedman|last2=Walter|first2=Jennifer K.|date=2014-02-01|title=Relational Autonomy: Moving Beyond the Limits of Isolated Individualism|url=https://pediatrics.aappublications.org/content/133/Supplement_1/S16|journal=Pediatrics|volume=133|issue=Supplement 1|pages=S16–S23|doi=10.1542/peds.2013-3608D|issn=0031-4005|pmid=24488536|doi-access=free|access-date=2019-04-14|archive-date=2019-04-13|archive-url=https://web.archive.org/web/20190413172948/https://pediatrics.aappublications.org/content/133/Supplement_1/S16|url-status=live}}</ref> It is often references as one of the four pillars of medicine, alongside beneficence, justice and nonmaleficence<ref>{{Cite web |title=Medical Ethics Interview Questions Guide – {{!}} Interview |url=https://www.theukcatpeople.co.uk/application-guide/interview/answering-medical-ethics-interview-questions |url-status=live |archive-url=https://web.archive.org/web/20230207003454/https://www.theukcatpeople.co.uk/application-guide/interview/answering-medical-ethics-interview-questions |archive-date=2023-02-07 |access-date=2023-02-07 |website=www.theukcatpeople.co.uk |language=en}}</ref>
Autonomy varies and some patients find it overwhelming especially the minors when faced with emergency situations. Issues arise in emergency room situations where there may not be time to consider the principle of patient autonomy. Various ethical challenges are faced in these situations when time is critical, and patient consciousness may be limited. However, in such settings where informed consent may be compromised, the working physician evaluates each individual case to make the most professional and ethically sound decision.<ref name=":4">{{Cite journal|last1=Muskens|first1=Ivo S.|last2=Gupta|first2=Saksham|last3=Robertson|first3=Faith C.|last4=Moojen|first4=Wouter A.|last5=Kolias|first5=Angelos G.|last6=Peul|first6=Wilco C.|last7=Broekman|first7=Marike L. D.|date=2019-01-26|title=When Time Is Critical, Is Informed Consent Less So? A Discussion of Patient Autonomy in Emergency Neurosurgery|journal=World Neurosurgery|volume=125|pages=e336–e340|doi=10.1016/j.wneu.2019.01.074|issn=1878-8769|pmid=30690144|url=https://www.repository.cam.ac.uk/handle/1810/288856|hdl=1887/3195421|s2cid=59339055|hdl-access=free|access-date=2019-06-16|archive-date=2019-06-16|archive-url=https://web.archive.org/web/20190616194605/https://www.repository.cam.ac.uk/handle/1810/288856|url-status=live}}</ref> For example, it is believed that neurosurgeons in such situations, should generally do everything they can to respect patient autonomy. In the situation in which a patient is unable to make an autonomous decision, the neurosurgeon should discuss with the surrogate decision maker in order to aid in the decision-making process.<ref name=":4" /> Performing surgery on a patient without informed consent is in general thought to only be ethically justified when the neurosurgeon and his/her team render the patient to not have the capacity to make autonomous decisions. If the patient is capable of making an autonomous decision, these situations are generally less ethically strenuous as the decision is typically respected.<ref name=":4" />
Not every patient is capable of making an autonomous decision. For example, a commonly proposed question is at what age children should be partaking in treatment decisions.<ref name=":5">{{Cite news|url=https://www.nytimes.com/2016/09/19/well/family/when-should-children-take-part-in-medical-decisions.html|title=When Should Children Take Part in Medical Decisions?|last1=Klass|first1=Perri|date=2016-09-20|work=The New York Times|access-date=2019-04-21|issn=0362-4331|archive-date=2019-04-02|archive-url=https://web.archive.org/web/20190402185953/https://www.nytimes.com/2016/09/19/well/family/when-should-children-take-part-in-medical-decisions.html|url-status=live}}</ref> This question arises as children develop differently, therefore making it difficult to establish a standard age at which children should become more autonomous.<ref name=":5" /> Those who are unable to make the decisions prompt a challenge to medical practitioners since it becomes difficult to determine the ability of a patient to make a decision.<ref>{{cite journal|last1=Cole|first1=Clare|last2=Wellard|first2=Sally|last3=Mummery|first3=Jane|title=Problematising autonomy and advocacy in nursing|journal=Nursing Ethics|volume=21|issue=5|pages=576–582|doi=10.1177/0969733013511362|pmid=24399831|year=2014|s2cid=10485758}}</ref> To some extent, it has been said that emphasis of autonomy in health care has undermined the practice of health care practitioners to improve the health of their patient as necessary. The scenario has led to tension in the relationship between a patient and a health care practitioner. This is because as much as a physician wants to prevent a patient from suffering, they still have to respect autonomy. Beneficence is a principle allowing physicians to act responsibly in their practice and in the best interests of their patients, which may involve overlooking autonomy.<ref>{{Cite journal|last=MacKenzie|first=C. Ronald|date=September 2009|title=What Would a Good Doctor Do? Reflections on the Ethics of Medicine|journal=HSS Journal|volume=5|issue=2|pages=196–199|doi=10.1007/s11420-009-9126-7|issn=1556-3316|pmc=2744764|pmid=19626379}}</ref> However, the gap between a patient and a physician has led to problems because in other cases, the patients have complained of not being adequately informed.
The seven elements of informed consent (as defined by Beauchamp and Childress) include threshold elements (competence and voluntariness), information elements (disclosure, recommendation, and understanding) and consent elements (decision and authorization).<ref>[https://books.google.com/books?id=b6w7V7gCkSIC&q=informed+consent Informed Consent : Legal Theory and Clinical Practice: Legal Theory and ...] {{Webarchive|url=https://web.archive.org/web/20240219171942/https://books.google.com/books?id=b6w7V7gCkSIC&q=informed+consent#v=snippet&q=informed%20consent&f=false |date=2024-02-19 }} – Schools of Law and Medicine Jessica W. Berg Assistant Professor of Law and Bioethics Case Western Reserve University, Paul S. Appelbaum A. F. Zeleznik Distinguished Professor and Chair University of Massachusetts, Medical School and Director of the Center for Mental Health Services Research Charles W. Lidz Research Professor of Psychiatry University of Massachusetts, Center for Bioethics and Health Law University of Pittsburgh Lisa S. Parker Associate Professor and Director of Graduate Education – Google Books. Retrieved on 2013-07-12.</ref> Some philosophers such as Harry Frankfurt consider Beauchamp and Childress criteria insufficient. They claim that an action can only be considered autonomous if it involves the exercise of the capacity to form higher-order values about desires when acting intentionally.<ref>Mappes Thomas, A., and David DeGrazia. ''Biomedical Ethics''. (2006). pp. 54–55 {{ISBN?}}</ref> What this means is that patients may understand their situation and choices but would not be autonomous unless the patient is able to form value judgements about their reasons for choosing treatment options they would not be acting autonomously.
In certain unique circumstances, government may have the right to temporarily override the right to [[bodily integrity]] in order to preserve the life and well-being of the person. Such action can be described using the principle of "supported autonomy",<ref name="library.yorku.ca"/> a concept that was developed to describe unique situations in mental health (examples include the [[forced feeding]] of a person dying from the [[eating disorder]] [[anorexia nervosa]], or the temporary treatment of a person living with a [[psychotic disorder]] with [[antipsychotic medication]]). While controversial, the principle of supported autonomy aligns with the role of government to protect the life and liberty of its citizens. Terrence F. Ackerman has highlighted problems with these situations, he claims that by undertaking this course of action physician or governments run the risk of misinterpreting a conflict of values as a constraining effect of illness on a patient's autonomy.<ref>Mappes Thomas, A., and David DeGrazia. ''Biomedical Ethics.'' (2006). p. 62</ref>
Since the 1960s, there have been attempts to increase patient autonomy including the requirement that physician's take bioethics courses during their time in medical school.<ref>{{cite journal|last1=Pilnick|first1=Alison|last2=Dingwall|first2=Robert|title=On the Remarkable Persistence of Asymmetry in Doctor/Patient Interaction: A Critical Review|journal=Social Science & Medicine|date=April 2011|volume=72|issue=8|pages=1374–1382|doi=10.1016/j.socscimed.2011.02.033|pmid=21454003}}</ref> Despite large-scale commitment to promoting patient autonomy, public mistrust of medicine in developed countries has remained.<ref>O'neill, Onora. ''Autonomy and Trust in Bioethics''. Cambridge University Press, 2002. p. 3 {{ISBN?}}</ref> [[Onora O'Neill]] has ascribed this lack of trust to medical institutions and professionals introducing measures that benefit themselves, not the patient. O'Neill claims that this focus on autonomy promotion has been at the expense of issues like distribution of healthcare resources and public health.
One proposal to increase patient autonomy is through the use of support staff. The use of support staff including medical assistants, physician assistants, nurse practitioners, nurses, and other staff that can promote patient interests and better patient care.<ref>{{cite journal|last1=Sheather|first1=Julian|title=Patient Autonomy|journal=Student BMJ|date=2011|volume=19}}</ref> Nurses especially can learn about patient beliefs and values in order to increase informed consent and possibly persuade the patient through logic and reason to entertain a certain treatment plan.<ref>{{cite journal|last1=Charles|first1=Sonya|title=The Moral Agency of Institutions: Effectively Using Expert Nurses to Support Patient Autonomy|journal=Journal of Medical Ethics|date=2017|volume=43|issue=8|pages=506–509|doi=10.1136/medethics-2016-103448|pmid=27934774|s2cid=11731579}}</ref><ref>{{cite journal|last1=Humphreys|first1=Sally|title=Patient Autonomy|journal=British Journal of Perioperative Nursing|date=January 2005|volume=15|issue=1|pages=35–38, 40–41, 43|doi=10.1177/175045890501500103|pmid=15719905|s2cid=11528632}}</ref> This would promote both autonomy and beneficence, while keeping the physician's integrity intact. Furthermore, Humphreys asserts that nurses should have professional autonomy within their scope of practice (35–37). Humphreys argues that if nurses exercise their professional autonomy more, then there will be an increase in patient autonomy (35–37).
==Celebrity culture on teenage autonomy==
A study conducted by David C. Giles and John Maltby conveyed that after age-affecting factors were removed, a high emotional autonomy was a significant predictor of celebrity interest, as well as high attachment to peers with a low attachment to parents. Patterns of intense personal interest in celebrities was found to be conjunction with low levels of closeness and security. Furthermore, the results suggested that adults with a secondary group of pseudo-friends during development from parental attachment, usually focus solely on one particular celebrity, which could be due to difficulties in making this transition.<ref>{{Cite journal |doi=10.1016/S0191-8869(03)00154-5|title=The role of media figures in adolescent development: Relations between autonomy, attachment, and interest in celebrities|journal=Personality and Individual Differences|volume=36|issue=4|pages=813–822|year=2004|last1=Giles|first1=David C.|last2=Maltby|first2=John}}</ref>
==Various uses==
* In computing, an [[autonomous peripheral]] is one that can be used with the computer turned off.
* Within [[self-determination theory]] in psychology, autonomy refers to 'autonomy support versus control', "hypothesizing that autonomy-supportive social contexts tend to facilitate self-determined motivation, healthy development, and optimal functioning."
* In mathematical analysis, an [[ordinary differential equation]] is said to be [[Autonomous system (mathematics)|autonomous]] if it is time-independent.
* In [[linguistics]], an [[autonomous language]] is one which is independent of other languages, for example, has a standard variety, grammar books, dictionaries or literature, etc.
* In [[robotics]], "autonomy means independence of control. This characterization implies that autonomy is a property of the relation between two agents, in the case of robotics, of the relations between the designer and the [[autonomous robot]]. Self-sufficiency, situatedness, learning or development, and evolution increase an agent's degree of autonomy.", according to Rolf Pfeifer.
* In [[spaceflight]], autonomy can also refer to crewed missions that are operating without control by ground controllers.
* In [[economics]], [[autonomous consumption]] is consumption expenditure when income levels are zero, making spending ''autonomous'' to income.
* In [[politics]], [[Territorial autonomy|autonomous territories]] are States wishing to retain territorial integrity in opposition to ethnic or indigenous demands for [[self-determination]] or [[independence]] ([[sovereignty]]).
* In [[anti-establishment]] [[activism]], an [[autonomous space]] is another name for a non-governmental [[social center]] or free space (for community interaction).
* In [[social psychology]], autonomy is a personality trait characterized by a focus on personal achievement, independence, and a preference for solitude, often labeled as an opposite of [[sociotropy]].<ref>{{Cite journal |last=Bieling |first=Peter J. |year=2000 |title=The Sociotropy–Autonomy Scale: Structure and Implications |journal=Cognitive Therapy and Research |volume=24 |issue=6 |pages=763–780 |doi=10.1023/A:1005599714224|s2cid=38957013 }}</ref>
== Limits to autonomy ==
Autonomy can be limited. For instance, by disabilities, civil society organizations may achieve a degree of autonomy albeit nested within—and relative to—formal bureaucratic and administrative regimes. Community partners can therefore assume a hybridity of capture and autonomy—or a mutuality—that is rather nuanced.<ref>{{Cite journal|last=O'Hare|first=Paul|date=March 2018|title=Resisting the 'Long-Arm' of the State? Spheres of Capture and Opportunities for Autonomy in Community Governance|journal=International Journal of Urban and Regional Research|volume=42|issue=2|pages=210–225|doi=10.1111/1468-2427.12606|url=https://e-space.mmu.ac.uk/620226/1/Resisting%20the%20long%20arm%20of%20the%20state.pdf|access-date=2020-06-04|archive-date=2020-05-06|archive-url=https://web.archive.org/web/20200506073104/https://e-space.mmu.ac.uk/620226/1/Resisting%20the%20long%20arm%20of%20the%20state.pdf|url-status=live}}</ref>
===Semi-autonomy===
The term ''semi-autonomy'' (coined with prefix [[semi-]] / "half") designates partial or limited autonomy. As a relative term, it is usually applied to various semi-autonomous entities or processes that are substantially or functionally limited, in comparison to other fully autonomous entities or processes.
===Quasi-autonomy===
The term ''quasi-autonomy'' (coined with prefix [[quasi-]] / "resembling" or "appearing") designates formally acquired or proclaimed, but functionally limited or constrained autonomy. As a descriptive term, it is usually applied to various quasi-autonomous entities or processes that are formally designated or labeled as autonomous, but in reality remain functionally dependent or influenced by some other entity or process. An example for such use of the term can be seen in common designation for [[quasi-autonomous non-governmental organizations]].
==See also==
{{EB1911 poster|Autonomy}}
* [[Autonomism]]
* [[List of autonomous areas by country]]
* [[Autonomy Day]]
* [[Cornelius Castoriadis]]
* [[Counterdependency]]
* [[Direct democracy]]
* [[Equality of autonomy]]
* [[Essential facilities doctrine]]
* [[Flat organization]]
* [[Takis Fotopoulos]]
* [[Home rule]]
* [[Happiness at work#Job autonomy|Job autonomy]]
* [[Personal boundaries]]
* [[Self-governing colony]]
* [[Self-sufficiency]]
* [[Teaching for social justice]]
* [[Viable system model]]
* [[Workplace democracy]]
== Notes ==
{{NoteFoot}}
== References ==
=== Citations ===
{{Reflist}}
=== Sources ===
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* {{cite book |last = Meyendorff |first = John |author-link = John Meyendorff |year = 1989 |title = Imperial unity and Christian divisions: The Church 450–680 A.D. |series = The Church in history |volume = 2 |location = Crestwood, NY |publisher = St. Vladimir's Seminary Press |isbn = 978-0881410563 |url = https://books.google.com/books?id=6J_YAAAAMAAJ |access-date = 2016-09-12 |archive-date = 2023-01-12 |archive-url = https://web.archive.org/web/20230112174712/https://books.google.com/books?id=6J_YAAAAMAAJ |url-status = live }}
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== External links ==
{{Wiktionary}}
{{Wikiquote}}
* Kastner, Jens. [http://www.uni-bielefeld.de/cias/wiki/a_Autonomy.html "Autonomy"] (2015). University Bielefeld – Center for InterAmerican Studies.
* [https://interautonomy.org/en/what-is-self-sustainability/ "Self-sustainability strategies for Development Initiatives: What is self-sustainability and why is it so important?"]
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[[Category:Autonomy| ]]
[[Category:Ethical principles]]
[[Category:Individualism]]
[[Category:Organizational cybernetics]]