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The High Court continues to exercise its inherent jurisdiction to make declarations about interventions into the lives of situationally vulnerable adults with mental capacity. In light of protective responses of health care providers and the courts to decision-making situations involving capacitous vulnerable adults, this paper has two aims. The first is diagnostic. The second is normative. The first aim is to identify the harms to a capacitous vulnerable adult’s autonomy that arise on the basis of the characterisation of situational vulnerability (...) |
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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 (...) |
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According to many of its proponents, shared decision making ("SDM") is the right way to interpret the clinician-patient relationship because it respects patient autonomy in decision-making contexts. In particular, medical ethicists have claimed that SDM respects a patient's relational autonomy understood as a capacity that depends upon, and can only be sustained by, interpersonal relationships as well as broader health care and social conditions. This paper challenges that claim. By considering two primary approaches to relational autonomy, this paper argues that (...) |
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To be autonomous is to be a law to oneself; autonomous agents are self-governing agents. Most of us want to be autonomous because we want to be accountable for what we do, and because it seems that if we are not the ones calling the shots, then we cannot be accountable. More importantly, perhaps, the value of autonomy is tied to the value of self-integration. We don't want to be alien to, or at war with, ourselves; and it seems that (...) |
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This paper argues for a conception of autonomy that takes social oppression seriously without sapping autonomy of its valuable focus on individual self-direction. Building on recent work in relational accounts of autonomy, the paper argues that current conceptions of autonomy from liberal, feminist and critical theorists do not adequately account for the social features of belief formation. The paper then develops an alternative conception of relational autonomy that focuses on how autonomy contains both individualistic and social epistemic features. Rather than (...) |
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While many profound philosophical questions arise about psychopaths, I wish to draw attention to two limitations in current debates. First, philosophers mainly deal with offender and forensic populations neglecting so-called ‘successful’ psychopaths. Second, philosophers mainly focus on the issue of empathy and responsibility, while relatively little attention is paid to volitional aspects. I address these two limitations together and argue that ‘successful’ psychopaths are volitionally constrained. In order to grasp and explore this deficiency, I argue in favour of a more (...) |
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This paper takes as its starting point a debate between Harry Frankfurt and J. David Velleman. Frankfurt argues that we need to resolve ambivalence since it necessarily threatens autonomy. Velleman challenges this claim, arguing that a desire to resolve ambivalence threatens autonomy when it prompts repression. I argue that the relationship between ambivalence and autonomy is more ambiguous than either theorist tends to acknowledge. In doing so, I recommend three features relevant for assessing whether or not ambivalence threatens autonomy. |
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