Reconsidering Autonomy:: Ethical Reflections from the Frontlines of IDD Dental Care

Ever since the first publication of Beauchamp and Childress’s landmark bioethics textbook, US healthcare has championed patient autonomy as the guiding principle of doctor/patient encounters. Although US bioethics seems to regard autonomy as sacrosanct and beyond questioning, we wonder whether dominant ways of understanding patient autonomy fail to consider the lived experiences of large swaths of disabled people who routinely interact with healthcare providers. Reflecting on our experiences treating and working with patients with intellectual and developmental disabilities (IDD), we interrogate and ultimately challenge the bioethical principle of autonomy by critically engaging with the philosophical ideas undergirding it, namely personhood, consent, and desire.