Autonomy and the subjective character of experience

J Appl Philos. 2000;17(1):71-9. doi: 10.1111/1468-5930.00141.


In his famous paper, What Is It Like To Be a Bat?, Thomas Nagel argues against a reductive physicalist account of consciousness by highlighting what he calls "the subjective character of experience." In this paper I will argue that Nagel's insight is important for understanding the value placed on patient autonomy in medical ethics. Appreciation of the subjective character experience brings with it the necessity for an epistemological humility with respect to the lives of others and what can be said to be "right" for them. Appreciation of the subjective character of experience lies at the heart of empathy and our capacity to make decisions that genuinely reflect respect for the patient's autonomy. Through the example of a case involving extreme medical intervention, I identify some impediments to the proper recognition of autonomy. These kind of cases highlight the significance of affective responses with respect to the subjective character of experience, and, by extension, to our capacity to imagine and act in accordance with another's perspective. I argue that affective responses are appropriate and needed considerations in the case where one must attempt to assume another's perspective in order to respect autonomy. I conclude that understanding that experience has an irreducibly subjective character is essential to respecting patient autonomy.

MeSH terms

  • Decision Making*
  • Empathy*
  • Family
  • Freedom
  • Heart-Assist Devices*
  • Humans
  • Individuality*
  • Philosophy*
  • Surgical Procedures, Operative*
  • Third-Party Consent*
  • Ventricular Dysfunction, Right / surgery*