Modern psychological and political theory meet head-on in this powerful re-evaluation of America's contradictory and sometimes dangerous addiction to individualism. Best-selling author Gaylin and co-author Jennings investigate the contentious intersections of interdependence and autonomy, rights and public responsibility. They examine the painful abrasion occurring between America's tradition of personal freedom and privacy, as it rubs against the still valuable if almost vanishing ideals of sacrifice and social order.

Our current culture of autonomy—championed by both liberals on the left and libertarians on the right—is based on the idea of rationality as the motivation for human conduct. But, as the authors remind us, people are not simply rational creatures—appeals to emotions are always far more effective than logical argument in changing our behavior.

This timely edition includes a new preface; updated examples and illustrations throughout; and new coverage of contemporary social critics and their work since the publication of the first edition. Two essential new chapters, one on the movement to forgo life-sustaining treatment and the other on physician-assisted suicide, particularly clarify the authors' arguments. Drawing on these and numerous other illustrations—with significant emphasis on the state of American health care—Gaylin and Jennings demonstrate that society has not just the right but the duty to occasionally invoke fear, shame, and guilt in order to motivate humane behavior.

As cases of AIDS are once again on the upswing, as the dangerously mentally ill are allowed to wander free and untreated, as starvation and poverty still hold too many in its grip in the richest nation on the planet, this controversial book, considerably revised and expanded, is needed more than ever. If we are to indeed preserve and nurture a genuinely free—and liberal—society, the authors suggest that these "coercions" may be essential for the health and the maturity of a nation where we all too often avert our eyes, not seeing that our neighbor is in pain or trouble and needs our help.

Willard Gaylin, MD, is a clinical professor of psychiatry at Columbia College of Physicians and Surgeons. He cofounded The Hastings Center in 1969 and is a member of the Human Rights Committee of the Institute of Medicine.

Bruce Jennings is a senior research scholar at The Hastings Center, and also teaches at the Yale University School of Medicine in the Department of Epidemiology and Public Health. Trained as a political scientist, Jennings has written and lectured widely on social, educational, and public policy issues.

Preface

1. Freedom, Coercion, and Commonsense Morality

Part IThe Culture of Autonomy 2. A Self of One's Own: The Meaning of Autonomy3. Land of the Free: Autonomy in American Life Today4. Seduced by Autonomy: Heeding the Grand Inquisitor and Other Critics

Part IIThe Biological Limits of Autonomy 5. It's Only Human Nature6. Growing Up Good7. Irrational Man

Part IIIThe Ethical Limits of Autonomy and the Uses of Coercion 8. The Multiple Meanings of Coercion9. In Defense of Social Control: The Ethics of Coercion10. Autonomy Gone Bonkers: The Mentally Impaired11. Last Rights I: Decisions o Forgo Life-Sustaining Medical Treatment12. Last Rights II: Autonomy, Moral Trespass, and Physician-Assissted Suicide13. Beyond Autonomy: Toward an Ethic of Interdependence

NotesIndex