believe that this is a better account of autonomy than the one that Dworkin assumed ( which amounts to a person ’ s ability to act upon their critical interests ). If we accept that demented patients , depending on the stage of dementia , can possess values , so long as they can make them known , and can be reasonably helped in some circumstances to achieve those , they can be said to have autonomy to that degree . I think the Dworkian account of autonomy places too much emphasis on the individual acting freely in such a way which is in line with his values . There are plenty of situations where people free of health issues and financial concerns need assistance to act upon their values . If I value donating to charity , then there must be a charity to which I can donate . If I value my democratic right to vote in a general election , even though I cannot physically walk to a polling station , then I am supported with the option of a postal vote , or perhaps someone ’ s goodwill in driving me to and from the polling station come election day . Autonomy is not bound up with one ’ s own full ability to act upon your values . These are only two examples that I pick out , but there are countless more which emphasise this point . Jaworska ’ s definition is more practical , and philosophically more convincing , simply because it widens the
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boundaries upon which autonomy is exercised . In Margo ’ s case , so long as she has values , such as valuing the fine arts such as painting and reading , even if Margo does need help in fulfilling these values , we can still accept the fact that she is an autonomous agent and can act autonomously in espousing these values .
Of course , this is still not without issue for our Margo case some may believe . As mentioned earlier , there is a possibility for the idea that throughout the brain degradation , we encounter multiple ‘ Margo ’ s ’ - multiple selves who do not have the capacity for overlapping phases of conscious experience . If this is the case , then how can we garner precisely what Margo ’ s values are , and how we are meant to act in her best interests whilst respecting her as an autonomous agent ? As shown through Jaworska ’ s work however is that we can fit this conception of the self into our dealings of autonomy . Margo may not substantially overlap in her phases of conscious experiences as the disease progresses , but that does not mean within those individual phases Margo cannot have values ; be them ones which may have some weak causal link between those previous phases ( which she cannot remember ). So long as she can state these values