General Issues in Applied Ethics

The COVID-19 global pandemic has shone a light on several important ethical questions, ranging from fairness in resource allocation to the ethical justification of government mandates. In addition to these institutional issues, there are also several ethical questions that arise at the interpersonal level. This essay focuses on several of these issues. In particular, I argue that, despite the insistence in public health messaging that avoiding infecting others constitutes ‘saving lives’, virus transmission that results in death constitutes an act of (...) killing. Whether this killing is wrongful depends on several factors. I consider one intuitively plausible view—namely, that in many cases, killing via unintentional transmission is not wrongful, because the parties in question have implicitly waived their rights against this harm, often via reciprocal risk imposition. I argue that this view is mistaken, but that its central insight can be better captured by identifying the appropriate standards of blame that we ought to apply during a pandemic. I conclude by showing how these conclusions can be fruitfully applied to certain institutional questions, such as helping to justify restricting government mandates. (shrink)

Purpose – With the growing demand for ethical standards in the prevailing business environment, ethical leadership has been under increasingly more focus. Based on the social exchange theory and social learning theory, this study scrutinized the impact of ethical leadership on the presentation of ethical conduct by employees through the ethical climate. Notably, this study scrutinized the moderating function of the person organization fit (P-O fit) in relation to ethical climate and the ethical conduct of employees. -/- Design/methodology/approach – To (...) evaluate the research hypotheses, two-wave data were collected from 295 individuals who are currently employed in various Iraqi organizations (i.e. manufacturing, medical, and insurance industries). -/- Findings – In line with the hypotheses, the outcomes from a sample of 295 workers working in different Iraqi entities exhibited a positive relationship between the ethical behavior of leaders and the ethical conduct of employees in the ethical climate. Moreover, it was observed that the P-O fit of employees moderated the relationship between ethical climate and the ethical conduct of employees such that the relationship was more robust for those with a high P-O fit in comparison to those with a low P-O fit. -/- Research limitations/implications – The primary limitation of this study is in the data, which was obtained from a single source. Although the study conducted two surveys and utilized a mediation and moderation variables model that was less likely to be influenced by common method bias (CMB) (Podsakoff et al., 2012), one cannot completely rule out CMB. Apart from the potential effects of the CMB, the consistency of the empirical findings could have also been compromised since self-reported data were utilized in measuring ethical behavior, which can be a very complex and sensitive issue. For this reason, the social desirability response bias cannot be ruled out completely. When possible, future studies must gather data from multiple sources. Furthermore, supervisors must evaluate the ethical behavior of employees. Another limitation was that the findings of this study were based on a sample in a Middle Eastern cultural context such as in Iraq. Perhaps, the particular cultural features of this context, which encompassed, among other things, strong adherence to religious values (Moaddel, 2010), could have influenced the findings of this study. It is true that the effects of differences (P–O fit) are highly likely to replicate across cultural contexts (Triandis et al., 1988). However, it can be seen that further studies are needed to evaluate the context-sensitivity of these findings (Whetten, 2009) by analyzing other cultures, where the importance of religiosity is on the decline (i.e. in Western countries, Ribberink et al., 2018) or where the cultural features are very much different from those that apply to Iraq. Lastly, other external factors were not taken into account by this study as it tried to explain ethical behavior. Ethics is a highly complex subject and is influenced by numerous variables at the organizational, individual, and external environment levels. Thus, caution must be observed when making inferences from the present study which, to a certain degree, offered a simplified version of ethical behavior by concentrating on a few variables such as the Arab culture’s traditional ideology, which dominates even science (Abu Khalil, 1992). In addition, there are political conflicts in the Middle Eastern cultural context such as what is happening in Iraq (Harff, 2018). Thus, it is important to include such aspects in future researches. -/- Practical implications – In terms of management, the findings send a clear signal to those in the upper echelon that, without ignoring the issue of ethics in organizations, employees are a critical aspect to be taken into account to encourage ethical behavior at the workplace. This study has important practical implications. First, this study determined that ethical leadership (here, of the supervisors) positively influences the behavior of subordinates (refers to the supervisors here); this, in turn, further improves the ethical behavior of employees. It is vital that managers or supervisors are motivated to practice ethical leadership because they directly influence the employees. It has been suggested that top managers, especially chief executive officers, have the ability to shape the ethical climate, which also influences the ethical behavior of employees further. This study offered several feasible ways that managers can apply to achieve that. In particular, top managers may utilize the ethical climate as a way of communicating the ethical values that they have to their subordinates, thereby serving as a motivation for the subordinates to adopt ethical behavior. It was also suggested by this study that ethical climate and the P–O fit may, to some degree, substitute each other as they influence the ethical behavior of employees. Therefore, firms that were identified to have a low level of ethical standards, practices, and policies, at least from the employees’ perspective, are better poised to conduct ethical issues in order to construct the ethical behavior of their subordinates. More importantly, it is highly essential that the value congruence between an organization and its followers be considered. -/- Social implications – This study highlighted the notion of ethics and how it’s essential for society. Ethics refers to the norms, standards, and values that direct the behavior of an individual. Ethical behavior is vital in society because we need to be treated with respect as human beings. -/- Originality/value – This study responds to recent calls for more research to identify factors that may strengthen or mitigate the influence of ethical behavior in the workplace such as ethical leadership, ethical climate, and Person–Organization. (shrink)

Miranda Fricker’s original presentation of Hermeneutical Injustice left open theoretical choice points leading to criticisms and subsequent clarifications with the resulting dialectic appearing largely verbal. The absence of perspicuous exposition of hallmarks of Hermeneutical Injustice might suggest scenarios exhibiting some – but not all – such hallmarks are within its purview when they are not. The lack of clear hallmarks of Hermeneutical Injustice, moreover, obscures both the extent to which Fricker’s proposed remedy Hermeneutical Justice – roughly, virtuous communicative practices – (...) adequately addresses the injustice, and the accuracy of criticisms suggesting that Hermeneutical Justice is insufficient to the task. In what follows, after briefly defending necessary and sufficient conditions for what I take to be the best candidate interpretation of Hermeneutical Injustice, I build on recent work on moral responsibility to construct and defend a rigorous explication of Hermeneutical Justice. (shrink)

The categorization of disasters as natural or manmade does little for our understanding of the moral stakes of institutions and collectives involved in the aftermath of disasters. This paper presents a brief account of how disasters can be understood philosophically taking cues from studies in sociology. Having articulated the gap in conceptualizing disasters, the paper argues that an interpretation of disasters as “events of social suffering,” will help foreground the complex moral and phenomenological nature of such events to prompt a (...) more ethical response from institutions and collectives. (shrink)

A substantial proportion of human embryos spontaneously abort soon after conception, and ethicists have argued this is problematic for the pro-life view that a human embryo has the same moral status as an adult from conception. Firstly, if human embryos are our moral equals, this entails spontaneous abortion is one of humanity’s most important problems, and it is claimed this is absurd, and a reductio of the moral status claim. Secondly, it is claimed that pro-life advocates do not act as (...) if spontaneous abortion is important, implying they are failing to fulfill their moral obligations. We report that the primary cause of spontaneous abortion is chromosomal defects, which are currently unpreventable, and show that as the other major cause of prenatal death is induced abortion, pro-life advocates can legitimately continue efforts to oppose it. We also defend the relevance of the killing and letting die distinction, which provides further justification for pro-life priorities. (shrink)

Selection within the educational domain breeds a special kind of suspicion. Whether it is the absence of transparency in the selection procedure, the observable outcomes of the selection, or the criteria of selection itself, there is much to corroborate the suspicion many have that selection in practice is unfair. And certainly as it concerns primary and secondary education, the principle of educational equity requires that children not have their educational experiences or opportunities determined by their postcode, their ethnic status, first (...) language, or family wealth. Indeed educational opportunities determined by unearned advantage or disadvantage offend against basic notions of fairness. But are public schools even permitted to select their students, and if so, how can selection procedures used by schools be best structured to achieve equitable ends? In this article we delineate, describe, and defend what we believe are the essential features of selection and also why we need to pay equal attention to both the outcomes and the processes leading to those outcomes. Provided the selection is motivated and guided by the right reasons, as well as appropriately monitored, we argue that selection can be equity promoting. (shrink)

In international law and just war theory, war is treated as normatively and legally unique. In the context of international law, war’s special status gives rise to a specific set of belligerent rights and duties, as well as a complex set of laws related to, among other things, the status of civilians, prisoners of war, trade and economic relationships, and humanitarian aid. In particular, belligerents are permitted to derogate from certain human rights obligations and to use lethal force in a (...) far more permissive manner than is the case in other kinds of conflicts and in domestic law enforcement operations. Given war’s unique status, the task of defining war requires not just identifying the empirical features that are characteristic of war but explaining and justifying war’s special legal and moral status. In this chapter, I propose a definition of war that captures war’s unique features and can offer insights into when and how some forms of unarmed conflict could count as wars. (shrink)

Mirvac chief executive Susan Lloyd-Hurwitz, not one usually associated with sympathy for tenants on the rental market, said earlier this year that ‘renting in Australia is generally a very miserable customer experience…the whole industry is set up to serve the owner not the tenant’ Her observation is basically correct and the solution she offers is to change the current situation where small investors, supported by generous government tax concessions, provide effectively all of the country’s private rental housing. Lloyd-Hurwitz wants Mirvac, (...) a property group currently managing over $15 billion of assets, to become an apartment landlord that would own not one or several properties like small investors currently do but rather thousands of properties to rent out. The proposal is for Mirvac to build apartment blocks and then, instead of selling individual apartments, rent them out on long-term or indefinite leases. This build-to-rent housing scheme would of course make the real estate–investment company a great deal of money. At the same time it would do very little to alleviate the current housing crisis. Such schemes are a nonstarter for people who want the security, stability and independence of home ownership, which is a very Australian aspiration that is increasingly becoming unobtainable not only for those experiencing homelessness, but also for the poor and middle-class. Those of us who care about finding a real solution to the housing crisis would do well to consider how we got into this situation in the first place, and then consider how this might inform what we do next. The following then, traces some of the historical and philosophical roots of our understanding of property and their institutionalisation via various levels of government, especially in the Australian context. (shrink)

Let us suppose that we accept that humans can be correctly characterized as agents. Let us further presume that this capacity contrasts with most non-human animals. Thus, since agency is what uniquely constitutes what it is to be human, it must be of supreme importance. If these claims have any merit, it would seem to follow that, if agency can be nurtured through education, then it is an overarching moral imperative that educational initiatives be undertaken to do that. In this (...) paper, it will be argued that agency can indeed be enhanced, and that the worldwide educational initiative called Philosophy for Children, and others like it, are in a unique position to do just that, and, therefore, that P4C deserves our praise and support; while denigrations of such efforts for not being “real philosophy” ought to be thoroughly renounced. (shrink)

The aim of this paper is to link empirical findings concerning environmental inequalities with different normative yard-sticks for assessing whether these inequalities should be deemed unjust, or not. We argue that such an inquiry must necessarily take into account some caveats regarding both empirical research and normative theory. We suggest that empirical results must be contextualised by establishing geographies of risk. As a normative yard-stick we propose a moderately demanding social-egalitarian account of justice and democratic citizenship, which we take to (...) be best suited to identify unjust as well as legitimate instances of socio-environmental inequality. (shrink)

Sources of evolutionary risk for stable strategy of adaptive Homo sapiens are an imbalance of: (1) the intra-genomic co-evolution (intragenomic conflicts); (2) the gene-cultural co-evolution; (3) inter-cultural co-evolution; (4) techno-humanitarian balance; (5) inter-technological conflicts (technological traps). At least phenomenologically the components of the evolutionary risk are reversible, but in the aggregate they are in potentio irreversible destructive ones for biosocial, and cultural self-identity of Homo sapiens. When the actual evolution is the subject of a rationalist control and/or manipulation, the magnitude (...) of the 4th and 5th components of the evolutionary risk reaches a level of existential significance. (shrink)

There can be situations in which, if I contribute to a pool of resources for helping a large number of people, the difference that my contribution makes to any of the people helped from the pool will be imperceptible at best, and maybe even non-existent. And this can be the case where it is also true that giving the same amount directly to one of the intended beneficiaries of the pool would have made a very large difference to her. Can (...) non-contribution to the pool be morally justified on this ground? I argue that it cannot. For, first, this line of thought leaves unaffected any reasons for holding that failing to perform the direct action of benefiting someone greatly would be wrong. But the pooling system of helping people is often better than a system separating the help which is given — better because of the perceptible difference it makes to its beneficiaries. If so, failing to contribute to the pool will be at least as wrong as failing to have helped directly would have been. The paper clarifies and defends an argument of this form, showing how it can be formulated in a way that avoids apparent counterexamples, and identifying the assumptions on which it rests. (shrink)

Biomedical technologies can increasingly be used not only to combat disease, but also to augment the capacities or traits of normal, healthy people – a practice commonly referred to as biomedical enhancement. Perhaps the best‐established examples of biomedical enhancement are cosmetic surgery and doping in sports. But most recent scientific attention and ethical debate focuses on extending lifespan, lifting mood, and augmenting cognitive capacities.

A plausible explanation of the wrongfulness of threatening, advanced most explicitly by Mitchell Berman, is that the wrongfulness of threatening derives from the wrongfulness of the act threatened. This essay argues that this explanation is inadequate. We can learn something important about the wrongfulness of threatening (with implications for thinking about coercion) by comparing credible threats to some other claims of impending harm. A credible bluff threat to do harm is likely to be more and differently wrongful than making intentionally (...) false warnings about other sources of harm. This essay surveys some examples to secure this point, shows that Berman's moralized account of their wrongfulness is wanting, and offers the outline of an approach better suited to explain the wrongfulness of threatening.1. (shrink)

The letter analyzes the country-specific structural stigma in the modern media development of People’s Republic of China. It raises the issues on unconventional cybersecurity risks in mental & psychological health with a lens of justice in gender & marriage, and critical discourses in the media environment with the Chinese revisionist nationalism. It studied media coercion in relation to the breaches of humanitarian law in the constitutionalism context of PRC, and adopted a critical theory approach to religion with the background of (...) the militarization of religion by the Chinese “United Front”. With the non-identity problem in the totalitarian regime, structural stigma is analyzed with coercion theory and religion in queer gender. Ménage à trois is justified by case specificity in human development and global economy. (shrink)

Phenomenology gives rise to certain ontological considerations that have far-reaching implications for standard conceptions of patient autonomy in medical ethics, and, as a result, the obligations of and to patients in clinical decision-making contexts. One such consideration is the phenomenological reduction in classical phenomenology, a core feature of which is the characterisation of our primary experiences as immediately and inherently meaningful. This paper builds on and extends the analyses of the phenomenological reduction in the works of Husserl, Heidegger, and Merleau-Ponty (...) in order to identify and explain its implications for our current understanding of the principle of respect for patient autonomy and the norms of clinical decision making. (shrink)

The aims of this paper are to: identify the best framework for comprehending multidimensional impact of deep brain stimulation on the self; identify weaknesses of this framework; propose refinements to it; in pursuing, show why and how this framework should be extended with additional moral aspects and demonstrate their interrelations; define how moral aspects relate to the framework; show the potential consequences of including moral aspects on evaluating DBS’s impact on patients’ selves. Regarding, I argue that the pattern theory of (...) self can be regarded as such a framework. In realizing and, I indicate that most relevant issues concerning PTS that require resolutions are ontological issues, including the persistence question, the “specificity problem”, and finding lacking relevant aspects of the self. In realizing, I identify aspects of the self not included in PTS which are desperately needed to investigate the full range of potentially relevant DBS-induced changes—authenticity, autonomy, and responsibility, and conclude that how we define authenticity will have implications for our concept of autonomy, which in turn will determine how we think about responsibility. Concerning, I discuss a complex relation between moral aspects and PTS—on one hand, they serve as the lens through which a particular self-pattern can be evaluated; on the other, they are, themselves, products of dynamical interactions of various self-aspects. Finally, I discuss, demonstrating novel way of understanding the effects of DBS on patients’ selves. (shrink)

In this paper, I argue that the principle of respect for autonomy can serve as the basis for laws that significantly limit conduct, including orders mandating isolation and quarantine. This thesis is fundamentally at odds with an overwhelming consensus in contemporary bioethics that the principle of respect for autonomy, while important in everyday clinical encounters, must be 'curtailed', 'constrained', or 'overridden' by other principles in times of crisis. I contend that bioethicists have embraced an indefensibly 'thin' notion of autonomy that (...) uproots the concept from its foundations in Kantian ethics. According to this thin conception, respect for autonomy, if unconditioned by competing principles (beneficence, justice, non-maleficence) would give competent adults the right to do anything they desired to do so long as they satisfied certain baseline psychological conditions. I argue that the dominant 'principlist' model of bioethical reasoning depends on this thin view of autonomy and show how it deprives us of powerful analytical tools that would help us to think seriously about the foundations of human rights, justice, and law. Then, I offer a brief sketch of a 'thick', historically grounded notion of autonomy and show what we could gain by taking it seriously. (shrink)

The COVID-19 pandemic has intensified the extent to which economies in the developed and developing world rely on gig workers to perform essential tasks such as health care, personal transport, food and package delivery, and ad hoc tasking services. As a result, workers who provide such services are no longer perceived as mere low-skilled laborers, but as essential workers who fulfill a crucial role in society. The newly elevated moral and economic status of these workers increases consumer demand for corporate (...) social responsibility regarding this stakeholder group – specifically for practices that increase worker freedom and rewards. We provide algorithmic tools for online labor platforms to meet this demand, thereby bolstering their social purpose and ethical branding while better protecting themselves from future reputational crises. To do so, we advance a managerial strategy rooted in moral self-awareness theory in order to leverage customers’ virtuous self-perception and increase gig-worker freedom. (shrink)

In the debates regarding the ethics of human organoid biobanking, the locus of donor autonomy has been identified in processes of consent. The problem is that, by focusing on consent, biobanking processes preclude adequate engagement with donor autonomy because they are unable to adequately recognise or respond to factors that determine authentic choice. This is particularly problematic in biobanking contexts associated with organoid research or the clinical application of organoids because, given the probability of unforeseen and varying purposes for which (...) a donor’s organoids could be employed and given the different ways in which a donor can relate to her biospecimens, a donor can value her organoids differently in different contexts and her reasons for autonomously permitting use of her cells and tissues in one case may not support an autonomous decision in another. In response, this paper has three aims: firstly, to make the case for why organoid biobanks ought to respect donor autonomy conceived as authentic choice; secondly, to explore the autonomy-respecting limits of established and widely prevalent models of biobank consent; and thirdly, to propose certain conditions that organoid biobanks ought to support or facilitate in order to respect donor autonomy. (shrink)

Social robots are robots that can interact socially with humans. As social robots and the artificial intelligence that powers them becomes more advanced, they will likely take on more social and work roles. This has many important ethical implications. In this paper, we focus on one of the most central of these, the impacts that social robots can have on human autonomy. We argue that, due to their physical presence and social capacities, there is a strong potential for social robots (...) to enhance human autonomy as well as several ways they can inhibit and disrespect it. We argue that social robots could improve human autonomy by helping us to achieve more valuable ends, make more authentic choices, and improve our autonomy competencies. We also argue that social robots have the potential to harm human autonomy by instead leading us to achieve fewer valuable ends ourselves, make less authentic choices, decrease our autonomy competencies, make our autonomy more vulnerable, and disrespect our autonomy. Whether the impacts of social robots on human autonomy are positive or negative overall will depend on the design, regulation, and use we make of social robots in the future. (shrink)

Some have claimed that moral bioenhancement undermines freedom and authenticity – thereby making moral bioenhancement problematic or undesirable – whereas others have said that moral bioenhancement does not undermine freedom and authenticity – thereby salvaging its ethical permissibility. These debates are characterized by a couple of features. First, a positive relationship is assumed to hold between these agency-related concepts and the ethical permissibility of moral bioenhancement. Second, these debates are centered around individualistic conceptions of agency, like free choice and authenticity, (...) which hail from an atomistic tradition of autonomy. My view is that emphasizing individualistic conceptions of autonomy do not provide particularly strong foundations on which to argue about the issue of the permissibility of moral bioenhancement. This is because individualistic autonomy is not the kind of agency-related consideration we ought to value. Instead, I propose that we investigate the relationship between moral bioenhancement and a more relational kind of autonomy. Focusing on this latter relationship, on my view, clarifies the potential for moral bioenhancement to support or enhance people’s autonomy. (shrink)

Human beings seek to transcend limits. This is part of our potential greatness, since it is how we can realize what is best in our humanity. However, the limit-transcending feature of human life is also part of our potential downfall, as it can lead to dehumanization and failure to attain important human goods and to prevent human evils. Exploring the place of limits within a well-lived human life this work develops and defends an original account of limiting virtues, which are (...) concerned with recognizing proper limits in human life. The limiting virtues that are the focus are humility, reverence, moderation, contentment, neighborliness, and loyalty, and they are explored in relation to four kinds of limits: existential limits, moral limits, political limits, and economic limits. These virtues have been underexplored in discussions about virtue ethics, and when they have been explored it has not been with regard to the general issue of the place of limits within a well-lived human life. The account of the limiting virtues provided here, however, is intended as a counter to other prominent approaches to ethics: namely, autonomy-centered approaches and consequentialist (or maximizing) approaches. This account is also used to address a number of important contemporary issues such as genetic engineering, distributive justice, cosmopolitanism vs. patriotism, and the ethical status of growth-based economics. (shrink)

An important topic in the ethics of technology is the extent to which recent digital technologies undermine user autonomy. Supporting evidence includes the fact that recent digital technologies are known to have an impact on attention, which balances "bottom-up" and "top-down" influences on cognition. As described in numerous papers, these technologies manipulate bottom-up influences through cognitive fluency, intermittent variable rewards, and other techniques, making them more attractive to the user. We further reason that recent digital technologies reduce the user’s ability (...) to exert top-down attention due to the scale of the content—they provide far more content at a much faster pace than other technologies, which over time reweights the balance of attention in favor of bottom-up influences. After reviewing evidence for these effects, including their temporal duration, we consider their downstream effects on both autonomy and creativity. We find that while the impact of recent digital technologies on top-down attention may allow for more idea generation, that creativity also depends on control, which is undermined by these technologies. We are more circumspect with autonomy, reasoning that in certain cases it might not make sense to see user autonomy as harmed through these effects. We conclude with other ways that recent digital technologies may improve creativity, which may act as an offset to the detrimental impacts of these technologies. (Part of the essay collection from the 2021 Workshop in the History of Science at Princeton on the theme of Attention, to be published in 2023). (shrink)

This paper aims to analyze the ethical challenges in experimental drug use during the early stage of the COVID-19 pandemic, using Germany as a case study. In Germany uniform ethical guidelines were available early on nationwide, which was considered as desirable by other states to reduce uncertainties and convey a message of unity. The purpose of this ethical analysis is to assist the preparation of future guidelines on the use of medicines during public health emergencies. The use of hydroxychloroquine, remdesivir (...) and COVID-19 convalescent plasma in clinical settings was analyzed from the perspective of the ethical principles of beneficence, non-maleficence, justice and autonomy. We observed that drug safety and drug distribution during the pandemic affects all four ethical principles. We therefore recommend to establish ethical guidelines (i) to discuss experimental treatment options with patients from all population groups who are in urgent need, (ii) to facilitate the recording of patient reactions to drugs in off-label use, (iii) to expand inclusion criteria for clinical studies to avoid missing potentially negative effects on excluded groups, and (iv) to maintain sufficient access to repurposed drugs for patients with prior conditions. (shrink)

Charland's article suggests that we need to think more about whether decision-making capacity is impaired in severe addiction, working from the idea that drug dealers rely on this understanding of addiction to draw in their clients. Charland argues that it is possible to make a choice without being in control (to make decisions without having decision-making capacity). I argue in support of Charland's ideas by examining the reasons supporting a medical model of addiction and its importance. (For Charland's article and (...) the full set of commentaries, please see the Research Gate link). (shrink)

Summary Background Self-binding directives instruct clinicians to overrule treatment refusal during future severe episodes of illness. These directives are promoted as having potential to increase autonomy for individuals with severe episodic mental illness. Although lived experience is central to their creation, service users’ views on self-binding directives have not been investigated substantially. This study aimed to explore whether reasons for endorsement, ambivalence, or rejection given by service users with bipolar disorder can address concerns regarding self-binding directives, decision-making capacity, and human (...) rights. Methods This study used qualitative data from an internet-based survey distributed to the mailing list of the UK charity Bipolar UK, which contained multiple closed and open questions on advance decision-making in bipolar disorder. Quantitative analysis of a closed question about self-binding directives had already demonstrated endorsement amongst a very high proportion of participants with bipolar disorder who completed the survey. We conducted thematic analysis of responses from those participants who answered a subsequent open question about reasons for their view. Research was co-produced within a multi-disciplinary team, with clinical, legal, and ethical expertise, and lived experience of bipolar disorder. Ideas and methodologies associated with all these areas of expertise were used in the analysis of these reasons and to gain insight into the thoughts of individuals with bipolar disorder about self-binding directives and associated issues. Findings Between Oct 23 and Dec 5, 2017, 932 individuals with a self-reported clinical diagnosis of bipolar disorder completed the internet survey, with 565 (154 men; 400 women; 11 transgender or other) providing free text answers to the open question. A large majority of respondents endorsed self-binding directives, nearly all describing a determinate shift to types of distorted thinking and decision-making when unwell as their key justification. Responses indicating ambivalence were dominated by logistical concerns about the drafting and implementation of self-binding directives, while those who rejected self-binding directives also cited logistical concerns, validity of their thinking when unwell, and potential contravention of human rights. Interpretation This study is, to our knowledge, the first large study of reasons why mental health service users might endorse or reject the use of self-binding directives. The findings provide empirical support for introducing self-binding directives into mental health advance decision-making practice and policy and may help to address enduring ethical concerns surrounding possible implementation of the directive while a person retains decision-making capacity. The opinions expressed here in responses given by multiple service users with bipolar disorder challenge a prominent view within international disability rights debates that involuntary treatment and recognition of impaired mental capacity constitute inherent human rights violations. Funding The Wellcome Trust . (shrink)

For the Routledge Handbook of Autonomy (edited by Ben Colburn) -/- Our values change. What we value, want, desire, prefer, and how much; for nearly everyone, these will be different at different times in their life. These changes can be gradual or abrupt; they can be long-lasting or short-lived; and they can be induced by forces outside yourself or they can come from within or they can have no specific catalyst at all. Such preference change raises a number of questions (...) for our theorising about rational choice, and these have been discussed at length. In §2 and §3, I’ll outline two of these questions along with some of the putative solutions that have been proposed. But preference change also raises questions for our theorising about autonomy, and these have hardly been considered at all. In §4, I’ll outline three problems for personal autonomy; and in §5, I’ll outline one problem for political autonomy. In §6, I conclude. (shrink)

Philosophy and Phenomenological Research, EarlyView. Despite the acknowledgement of the moral significance of consent there is still much work to be done in determining which specific sexual encounters count as unproblematically consensual. This paper focuses on the impact of deception. It takes up the specific case of deception about one's self. It may seem obvious that one ought not to lie to a sexual partner about who one is, but determining which features of oneself are most relevant, as well as (...) the lies which it follows would be impermissible to tell, is complicated. It is argued here that deception about one's morally valenced character traits, those we think of as virtues and vices, are particularly problematic. This is true regardless of whether knowing the truth about those traits would have made a difference to one's partner's consent. Attention is then drawn to a range of types of lies that one ought not to tell. (shrink)

Love enhancement can give us as a say on whom we love and thus ‘free’ us from our brain chemistry, which is mostly out of our control. In that way, we become more autonomous in love and in our life in general, as long as love enhancement is a free, voluntary choice. So goes the argument in favour of this addition to medical interventions of relationships. In this paper, I show that proponents of love enhancement have overlooked, or at least (...) underestimated, the fact that love itself impacts people’s choices. Since this could include the choice for love or anti-love drugs, I call for a re-formulation of the underlying view on autonomy before this medical intervention is made available to the public. (shrink)

A book chapter exploring the potential consquences and ethical ramifications of using coercive measures within community mental healthcare. We argue that, althogh the move towards 'care in the community' may have had liberalising motivations, the subsequent reduction in inpatient or other supported residential provision, means that there has been an increasing move towards coercive measures outside of formal inpatient detention. We consider measures such as Community Treatment Orders, inducements, and other forms of leverage, explaining the underlying concepts, aims, and exploring (...) adverse consequences and ethical difficulties. (shrink)

Optogenetics is an invasive neuromodulation technology involving the use of light to control the activity of individual neurons. Even though optogenetics is a relatively new neuromodulation tool whose various implications have not yet been scrutinized, it has already been approved for its first clinical trials in humans. As optogenetics is being intensively investigated in animal models with the aim of developing novel brain stimulation treatments for various neurological and psychiatric disorders, it appears crucial to consider both the opportunities and dangers (...) such therapies may offer. In this review, we focus on the memory-modifying potential of optogenetics, investigating what it is capable of and how it differs from other memory modification technologies. We then outline the safety challenges that need to be addressed before optogenetics can be used in humans. Finally, we re-examine crucial neuroethical concerns expressed in regard to other MMTs in the light of optogenetics and address those that appear to be unique to the memory-modifying potential of optogenetic technology. (shrink)

According to the High Court in England and Wales, the primary purpose of legal interventions into the lives of vulnerable adults with mental capacity should be to allow the individuals concerned to regain their autonomy of decision making. However, recent cases of clinical decision making involving capacitous vulnerable adults have shown that, when it comes to medical law, medical ethics and clinical practice, vulnerability is typically conceived as opposed to autonomy. The first aim of this paper is to detail the (...) problems that arise when the courts and health care practitioners respond to the vulnerability of capacitous adults on the basis of such an opposition. It will be shown that not only does the common law approach to vulnerability fail to adequately capture the autonomy of capacitous vulnerable adults, the conception of vulnerability and autonomy in oppositional terms leads to objectionably paternalistic health care responses that undermine the autonomy of vulnerable patients as well as clinical and legal interventions that violate their autonomy. In response, the second aim of this paper is to show that the concepts of autonomy and vulnerability are necessarily entwined and, on that basis, the focus should be on promoting the autonomy of capacitous vulnerable adults where possible. In order to make this case, the paper explains the limitations of standard approaches to the autonomy of vulnerable adults and, in their place, offers a conception of legitimate, self-authorised autonomy that is fundamentally dependent on intersubjective practices of recognition. (shrink)

A mais de um século que o fenômeno da automatização dos meios de trabalho vem criando grande apreensão entre nós. Afinal, seríamos todos substituídos por máquinas em algum futuro próximo? Seriam todas as formas de trabalho automatizáveis? Tais questionamentos vêm levantando uma série de críticas pela comunidade engajada em ética de máquina e ética da inteligência artificial. Contudo, gostaria de nesta breve resenha, atacar este problema por outro ângulo, afinal, podemos criticar tal fenômeno de uma ampla variedade de pontos de (...) vista. Gostaria de convidar o leitor a avaliar pela seguinte perspectiva: e se a automação dos meios de trabalho for algo benéfico? E se a emancipação humana realmente venha através de nosso desenvolvimento tecnológico? Se a resposta for sim, por quê quê ainda trabalhamos tanto? Acredito que se os processos de automação forem aplicados a pontos chave de nossa estrutura social, podemos vir a emancipar o indivíduo de uma realidade onde realmente trabalhamos por motivo nenhum, inutilmente. Se abandonarmos a cultura do consumismo, a cultura que atrela o trabalho e o consumo a moralidade, uma alternativa mais próspera seria adotarmos a cultura que abraça o valor da autonomia e liberdade do indivíduo humano. (shrink)

In this short paper I will discuss the ambiguous and, even, controversial term ‘right to die’ in the context of the euthanasia debate and, in particular, in the case of passive euthanasia. First I will present the major objections towards the moral legitimacy of a right to die, most of which I also endorse myself; then I will investigate whether the right to die could acquire adequate moral justification in the case of passive euthanasia. In the light of the Kantian (...) tradition I will argue that since rights are understood as based upon duties, the right to die should also presuppose a corresponding duty, which to me could be either an imperfect, solidarity-related duty, or an autonomy-related one, at least as far as the unwanted prolongation of life is concerned. I will conclude with the view that the right to die could actually be considered a legitimate one in the case of passive euthanasia, when the application of life-supporting techniques is against the wishes and the best interests of the patient. (shrink)

It is well documented that people with moderate-to-severe traumatic brain injury (TBI) can undergo personality changes, including becoming more impulsive in terms of how they behave. Legal guidance and academic commentary support the view that impulsiveness can render someone decisionally incompetent as defined by English and Welsh law. However, impulsiveness is a trait found within the healthy population. Arguably, impulsiveness is also a trait that gives rise to behaviours that should normally be tolerated even when they cause harm to the (...) person enacting the behaviours. The purpose of this paper is to show why both of these considerations present as significant challenges to the law in England and Wales. (shrink)

In this commentary, I critique three aspects of Emily Walsh's proposal to reduce the moral and legal weight of advance directives: (1) the ambiguity of its initial thesis, (2) its views about the ethics and legality of clinical practice, and (3) its interpretation and application of Ronald Dworkin’s account of advance directives and L.A. Paul's view on transformative experience. I also consider what Walsh’s proposal would mean for people facing the prospect of dementia. I conclude that our reasons to honor (...) many advance directives survive the move to a transformative experience framework. (shrink)

Volume 20, Issue 8, August 2020, Page W8-W11.

ABSTRACT: So far in this book, we have examined algorithmic decision systems from three autonomy-based perspectives: in terms of what we owe autonomous agents (chapters 3 and 4), in terms of the conditions required for people to act autonomously (chapters 5 and 6), and in terms of the responsibilities of agents (chapter 7). -/- In this chapter we turn to the ways in which autonomy underwrites democratic governance. Political authority, which is to say the ability of a government to exercise (...) power, may be justifiable or not. Whether it is justified and how it can come to be justified is a question of political legitimacy. Political legitimacy is another way in which autonomy and responsibility are linked. This relationship is the basis of the current chapter, and it is important in understanding the moral salience of algorithmic systems. We will draw the connection as follows. We begin, in section 8.1, by describing two uses of technology: crime predicting technology used to drive policing practices and social media technology used to influence elections (including by Cambridge Analytica and by the Internet Research Agency). In section 8.2 we consider several views of legitimacy and argue for a hybrid version of normative legitimacy based on one recently offered by Fabienne Peter. In section 8.3 we will explain that the connection between political legitimacy and autonomy is that legitimacy is grounded in legitimating processes, which are in turn based on autonomy. Algorithmic systems—among them PredPol and the Cambridge Analytica-Facebook-Internet Research Agency amalgam—can hinder that legitimation process and conflict with democratic legitimacy, as we argue in section 8.4. We will conclude by returning to several cases that serve as through-lines to the book: Loomis, Wagner, and Houston Schools. -/- The link below is to an open-access copy of the chapter. (shrink)

ABSTRACT: One important criticism of algorithmic systems is that they lack transparency. Such systems can be opaque because they are complex, protected by patent or trade secret, or deliberately obscure. In the EU, there is a debate about whether the General Data Protection Regulation (GDPR) contains a “right to explanation,” and if so what such a right entails. Our task in this chapter is to address this informational component of algorithmic systems. We argue that information access is integral for respecting (...) autonomy, and transparency policies should be tailored to advance autonomy. -/- To make this argument we distinguish two facets of agency (i.e., capacity to act). The first is practical agency, or the ability to act effectively according to one’s values. The second is what we call cognitive agency, which is the ability to exercise what Pamela Hieronymi calls “evaluative control” (i.e., the ability to control our affective states, such as beliefs, desires, and attitudes). We argue that respecting autonomy requires providing persons sufficient information to exercise evaluative control and properly interpret the world and one’s place in it. We draw this distinction out by considering algorithmic systems used in background checks, and we apply the view to key cases involving risk assessment in criminal justice decisions and K-12 teacher evaluation. -/- The link below is to an open access version of the chapter. (shrink)

There is increasing concern about “surveillance capitalism,” whereby for-profit companies generate value from data, while individuals are unable to resist (Zuboff 2019). Non-profits using data-enabled surveillance receive less attention. Higher education institutions (HEIs) have embraced data analytics, but the wide latitude that private, profit-oriented enterprises have to collect data is inappropriate. HEIs have a fiduciary relationship to students, not a narrowly transactional one (see Jones et al, forthcoming). They are responsible for facets of student life beyond education. In addition to (...) classrooms, learning management systems, and libraries, HEIs manage dormitories, gyms, dining halls, health facilities, career advising, police departments, and student employment. HEIs collect and use student data in all of these domains, ostensibly to understand learner behaviors and contexts, improve learning outcomes, and increase institutional efficiency through “learning analytics” (LA). ID card swipes and Wi-Fi log-ins can track student location, class attendance, use of campus facilities, eating habits, and friend groups. Course management systems capture how students interact with readings, video lectures, and discussion boards. Application materials provide demographic information. These data are used to identify students needing support, predict enrollment demands, and target recruiting efforts. These are laudable aims. However, current LA practices may be inconsistent with HEIs’ fiduciary responsibilities. HEIs often justify LA as advancing student interests, but some projects advance primarily organizational welfare and institutional interests. Moreover, LA advances a narrow conception of student interests while discounting privacy and autonomy. Students are generally unaware of the information collected, do not provide meaningful consent, and express discomfort and resigned acceptance about HEI data practices, especially for non-academic data (see Jones et al. forthcoming). The breadth and depth of student information available, combined with their fiduciary responsibility, create a duty that HEIs exercise substantial restraint and rigorous evaluation in data collection and use. (shrink)

The suite of secretive national security programs initiated in the US since 9/11 has created debate not only about the merits of targeted killing, torture, secret detention, cyberwar, global signals intercepts, and data-mining, but about the very secrecy in which these programs were conceived, debated by government officials, and implemented. Law must be revealed to those who are expected to comply with its demands. Law is a mere pretext for coercion if the laws permitting the government to coerce people for (...) non-compliance are concealed. The purpose of this essay is to determine whether inhabitants of a liberal state—a type of state tracing the legitimacy of its coercive actions to the consent of the governed—also need to know the internal protocols and legal findings of the government agencies ostensibly serving them. To put this question another way, what, if anything, may government agencies in liberal states keep secret? (shrink)

According to one influential view, requirements to elicit consent for medical interventions and other interactions gain their rationale from the respect we owe to each other as autonomous, or self-governing, rational agents. Yet the popular presumption that consent has a central role to play in legitimate intervention extends beyond the domain of cases where autonomous agency is present to cases where far from fully autonomous agents make choices that, as likely as not, are going to be against their own best (...) interest. The question how we should understand the rationale for eliciting consent in this range of ‘non-ideal’ cases is comparatively ill understood. In this paper, I explore the prospects of accounting for consent requirements in such ‘non-ideal’ cases by appealing to a set of agency-based interests; including an interest in playing a meaningful part in joint decisions affecting ourselves and others. (shrink)

Response to commentaries on 'The right not to know and the obligation to know'.

There is significant controversy over whether patients have a ‘right not to know’ information relevant to their health. Some arguments for limiting such a right appeal to potential burdens on others that a patient’s avoidable ignorance might generate. This paper develops this argument by extending it to cases where refusal of relevant information may generate greater demands on a publicly funded healthcare system. In such cases, patients may have an ‘obligation to know’. However, we cannot infer from the fact that (...) a patient has an obligation to know that she does not also have a right not to know. The right not to know is held against medical professionals at a formal institutional level. We have reason to protect patients’ control over the information that they receive, even if in individual instances patients exercise this control in ways that violate obligations. (shrink)

Population obesity and associated morbidities pose significant public health and economic burdens in the United Kingdom, United States, and globally. As a response, public health initiatives often seek to change individuals’ unhealthy behavior, with the dual aims of improving their health and conserving health care resources. One such initiative—taxes on sugar‐sweetened beverages (SSB)—has sparked considerable ethical debate. Prominent in the debate are arguments seeking to demonstrate the supposed impermissibility of SSB taxes and similar policies on the grounds that they interfere (...) with individuals’ freedom and autonomy. Commentators have often assumed that a policy intended to restrict or change private individuals’ consumption behavior will necessarily curtail freedom and, as a corollary, will undermine individuals’ autonomy with respect to their consumption choices. Yet this assumption involves a conceptual mistake. To address the misunderstanding, it’s necessary to attend to the differences between negative liberty, freedom of options, and autonomy. Ultimately, concerns about negative liberty, freedom, and autonomy do not provide strong grounds for opposing SSB taxes. (shrink)