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This can only be avoided by considering autonomy to be the only, or supreme, moral value, making all other moral considerations irrelevant, which faces a number of significant challenges. Furthermore, catalytic and intrinsic approaches to the value of autonomy are not incompatible or mutually exclusive, which can be explained by understanding autonomy to be valuable because it is necessary for human agency. Agency-based virtue ethics, understanding the virtues to be the traits which promote human agency in terms of the production and realisation of goals, explains this fundamental importance of autonomy and human agency to morality, as well as providing the virtues as a moral framework for understanding how the autonomous actions of human agents can be considered virtuous or vicious depending on whether they promote or hinder human agency.<\/jats:p>","DOI":"10.1136\/jme-2026-112408","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T17:20:11Z","timestamp":1785950411000},"page":"jme-2026-112408","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Autonomy, agency and value: an intrinsic approach to the value of autonomy does not escape the expressivist objection \u2013 a reply to Long"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8257-2675","authenticated-orcid":false,"given":"Thomas","family":"Donaldson","sequence":"first","affiliation":[{"name":"School of Law, University of Manchester, Manchester School of Law, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"2026080510200436000_jme-2026-112408v1.1","doi-asserted-by":"crossref","unstructured":"Long B . 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International Journal of Philosophical Studies 2026;1\u201326. doi:10.1080\/09672559.2026.2652237","DOI":"10.1080\/09672559.2026.2652237"},{"key":"2026080510200436000_jme-2026-112408v1.7","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1017\/S1358246118000371","article-title":"Moral Enhancement and Moral Freedom: A Critique of the Little Alex Problem","volume":"83","author":"Danaher","year":"2018","journal-title":"Roy Inst Philos Suppl"}],"container-title":["Journal of Medical Ethics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jme-2026-112408","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T17:20:15Z","timestamp":1785950415000},"score":1,"resource":{"primary":{"URL":"https:\/\/jme.bmj.com\/lookup\/doi\/10.1136\/jme-2026-112408"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,5]]},"references-count":7,"alternative-id":["10.1136\/jme-2026-112408"],"URL":"https:\/\/doi.org\/10.1136\/jme-2026-112408","relation":{},"ISSN":["0306-6800","1473-4257"],"issn-type":[{"value":"0306-6800","type":"print"},{"value":"1473-4257","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,5]]}}}