The ethics of xenotransplantation.

Two recent articles in this journal' 2 addressed the issue of autonomy. Both provided very interesting arguments. Here, I address the connections between Spriggs's' approach to autonomy in disruptive conditions and Turner's2 approach to social regulation of individual autonomy, introducing the connection between identity and autonomy in this context. Individual recognition of self-identity relates to the continuity of the self. This is essentially a connection between past and present, but the assumption of past-present continuity allows projection into the future. This projection merely states an expectation that future events will allow interpretation in such a way as not to endanger selfidentity, that is, allowing for the past-present continuity in the future. Autonomy is the capacity for decision regarding one's relation with the external world. Its major role is the preservation of the past-present continuity, allowing recognition of selfidentity through the recognition of a coherent (meaning: continuous-like) way of conducting one's life a sort of mastery over one's destiny. Sudden turning points will happen from time to time, and some reinterpretation of self-identity will be needed to cope with such sudden changes (the process of growing). This reinterpretation is done regularly for minor turning points, but exceptionally important events will take a more ritualised process of self-reinterpretation we call it grieving. During this process of readjustment, there is a fragilisation of selfidentity, and consequentially, of autonomy. As this process is more or less time-consuming, the lack ofautonomy could be more or less prolonged. Such duration will be dependent on the intensity of the provoking event and on the space allowed for the unexpected in the person's attitude to life. Nevertheless, autonomy is essential to deal with the unexpected in such a way that identity is still self-recognisable. In Spriggs's' presentation, it is the survivors' (those able to cope) accounts we hear. Through them, we also hear the others, those who had lost their self-identity, and their autonomy with it the available time was not enough for their grieving. The present did not fit in with their perception of self-identity, and they were simply pushed by events without deciding or even acknowledging what was happening humans without a present. We have to recognise that there is wide variation in the time required to regain individual autonomy, and that this will be reflected in an individual's capacity for decision making. Some individuals will take whatever comes to them and make the most of it, keeping control of their identity and autonomy. Others are extremely dependent on external stability, and will take more time to regain their autonomous decision-making capacity. Society is a self-preserving entity, and does not rely on chance for survival. This unreliability of individuals to retain their decision-making capabilities, and this capability to re-interpret selfidentity (creating a "new" member in place of the old) was recognised by societies (ie organised communities: family, profession, nation, etc); the development of those societies, tending to adopt those rules which would stabilise the community, created mechanisms to regulate the exercise of individual autonomy. These mechanisms consist in the partial surrender of individual autonomy to society, so the individual accepts society's decisions regarding private life. Those societies presented by Turner2 as more intrusive in the individual's private affairs, can be recognised as those where marriage rules, family traditions in professional areas, and other "intrusive" rulings, persist for longer the "patriarchal" or "matriarchal" societies. The goal is to preserve individual identity, not as self-recognised, but as socially recognised. As this surrender is cultural and, as such, "built-in" as opposed to "coercive", it may be said that such surrender of individual autonomy is an autonomous act. What I would like to stress is the need to support autonomy, if selfidentity is to be recovered in such crises, and the need, also, to allow for the diversity of humanity, resisting the normative tendencies of society.