In my judgment, applied ethics is ineluctably non-ideal and partial compliance theory. It’s ethics in the context of unjust institutions and conduct. Theorizing or teaching about concepts such as autonomy in abstraction from this recognition is misleading. Instead, questions such as how to realize autonomy should be framed in the context of incomplete justice. There’s much to be learned from the past nearly 50 years of discussions of justice to help with this enterprise, but they are too little known or discussed in much contemporary bioethics.
Francis, Leslie (2017). The Significance of Injustice for Bioethics. Teaching Ethics 17 (1):1-8.