Respect for Autonomy (RFA) has been a mainstay of medical ethics since its 
enshrinement as one of the four principles of biomedical ethics by Beauchamp and 
Childress' in the late 1970s. This paper traces the development of this modern 
concept from Antiquity to the present day, paying attention to its Enlightenment 
origins in Kant and Rousseau. The rapid C20th developments of bioethics and RFA 
are then considered in the context of the post-war period and American 
socio-political thought. The validity and utility of the RFA are discussed in 
light of this philosophical-historical account. It is concluded that it is not 
necessary to embrace an ethic of autonomy in order to guard patients from 
coercion or paternalism, and that, on the contrary, the dominance of autonomy 
threatens to undermine those very things which have helped doctors come to view 
and respect their patients as persons.