| Summary: | This article critically examines the role of autonomy within the four-principle framework of bioethics—comprising autonomy, beneficence, nonmaleficence, and justice—as originally articulated by Tom Beauchamp and James Childress. It argues that the prevailing "thin" conception of autonomy, which treats it as a defeasible and commensurable principle balanced against the others, leads to deliberative deadlock due to autonomy’s infinite availability, ambiguous normative valence, and lack of a clear metric for weighing its importance. The article suggests that autonomy should be reconceptualized not as a competing principle but as a foundational condition that structures and enables the application of the other principles, thereby avoiding stalemates and enhancing ethical deliberation in biomedical contexts. This reframing calls for a "thicker" account of autonomy that integrates considerations of beneficence, nonmaleficence, and justice within its scope.
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