Authenticity in Bioethics: Bridging the Gap between Theory and Practice

The aim of this doctoral thesis is to bridge the gap between theoretical ideals of authenticity and practical authenticity-related problems in healthcare. In this context, authenticity means being "genuine," "real," "true to oneself," or similar, and is assumed to be closely connected to the autonomy of persons. The thesis includes an introduction and four articles related to authenticity. The first article collects various theories intended to explain the distinction between authenticity and inauthenticity in a taxonomy that enables oversight and analysis. It is argued that (in-)authenticity is difficult to observe in others. The second article offers a solution to this difficulty in one theory of authenticity. It is proposed that under certain circumstances, it is morally justified to judge that the desires underlying a person's decisions are inauthentic. The third article incorporates this proposition into an already established theory of personal autonomy. It is argued that the resulting conceptualization of autonomy is fruitful for action-guidance in authenticity-related problems in healthcare. The fourth article collects nine cases of possible authenticity-related problems in healthcare. The theory developed in the third article is applied to the problems, when this is allowed by the case-description, to provide guidance with regard to them. It is argued that there is not one universal authenticity-related problem but many different problems, and that there is thus likely not one universal solution to such problems but various particular solutions.