The Cambridge Law Journal



John Coggona1 and José Miolaa2

a1 School of Law, University of Manchester.

a2 School of Law, University of Leicester.

A central tenet to much ethical argument within medical law is patient autonomy. Although we have seen a welcome move away from a system governed by largely unchecked paternalism, there is not universal agreement on the direction in which medical law should advance. Competing concerns for greater welfare and individual freedom, complicated by an overarching commitment to value-pluralism, make this a tricky area of policy-development. Furthermore, there are distinct understandings of, and justifications for, different conceptions of autonomy. In this paper, we argue that in response to these issues, there has been a failure by the courts properly to distinguish political concepts of liberty and moral concepts of autonomy.


The authors would like to thank Sara Fovargue, Kirsty Keywood, Jean McHale, Suzanne Ost, and two anonymous reviewers for their comments on this paper. All errors remain our own. John Coggon gratefully acknowledges the support of the British Academy postdoctoral fellowship scheme and the Wellcome Strategic Programme in the Human Body, its Scope, Limits and Future. This paper arose out of a discussion between the authors at a conference at Lancaster University entitled “Exploring Health Care Law's Recognition of Autonomy and Rights”, on the 16th March 2009, and both authors express their thanks to the organisers for the stimulation provided by that meeting.