Autonomy as Capacity

There are three elements to the psychological capacity of autonomy: agency, independence, and rationality. Agency is awareness of oneself as having desires and intentions and of acting on them. (Desire includes inclinations, aversions, wants, and similar terms.) When people have a desire for some state of affairs, they form an intention to do what they believe will bring about the desired state of affairs; further, they want their desire to determine their action (Benn; Haworth).

The capacity for agency distinguishes persons from inanimate objects and from nonhuman animals. Inanimate objects can be affected by objects and conditions external to them, as can persons, but unlike persons, inanimate objects cannot be said to act on desires. Nonhuman animals have desires, but there is no (noncontroversial) reason to believe that they have the capacity for self-consciousness that is manifest in having an awareness of desires and wanting them to be effective in action. Agency does not imply that persons are never influenced by external forces or that persons never act impulsively. It is an account of how persons are able to act and not how they always act.

Independence is the absence of influences that so control what a person does that it cannot be said that he or she wants to do it. This may seem a feature of an autonomous action rather than an element of psychological capacity. However, there are cases in which a person's course of life is under constant threat of violence from others, and the person acts always to avoid harm: war, poverty, abusive relationships, police states. When the whole of a person's beliefs, plans, self-image, and ways of relating to others are the result of unrelenting coercion and manipulation, then that person has little or no capacity for autonomy.

Autonomy also requires that persons have an adequate range of options. Coercion and manipulation limit options, but options are also limited by social and physical environments. If a person's options are numerous and noncoerced but are trivial in relation to what is valued by the person, then there is no capacity for autonomy in a significant sense (Raz). This would be the case in a totalitarian, caste, or slave society where a combination of coercion and ideology suppress the aspirations and real options of a segment of the members of the society. A full account of the conception of autonomy must distinguish external influences that defeat autonomy from external influences that are consistent with being autonomous. The former includes coercion and manipulation, and the latter includes persuasion and the normal limitations of physical and social environments.

The third element of the capacity for autonomy is means-end rationality, or rational decision making. In addition to the self-consciousness of agency, the capacity for rational decision making requires a person: (1) whose beliefs are subject to standards of truth and evidence; (2) with ability to recognize commitments and to act on them;

(3) who can construct and evaluate alternative decisions;

(4) whose changes in beliefs and values can change decisions and actions; and (5) whose beliefs and values yield rankings of action commitments. Another way to understand rationality as an element of the capacity for autonomy is as the capacity for reflection on desires. A rational person can have a desire for or fear of something, such as a desire for food or a fear of surgery, and also have the wish that he or she not have that desire or not be moved by that fear (Dworkin, 1976, 1988; Childress). Persons who lack the psychological capacity for rational decision making are those who are severely mentally ill—paranoiacs, compulsive neurotics, schizophrenics, and psychopaths. Such persons have the capacity for agency, that is, they are aware of acting on their desires, but they fail to meet one or more of the above conditions. For example, a paranoid patient who persists in a delusion that the healthcare professionals are Martians attempting to capture him is unable to adjust beliefs and actions to a reality confirmed by evidence (Benn).

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