Justice is a key guiding ethical principle in bioethics. When justice is addressed in bioethics the focus is primarily on the fair distribution of resources, that is, distributive justice. In this thesis, I argue that a distributive conception of justice is unable to adequately address many of the relevant issues of justice within bioethics. These issues are better understood and addressed using a social conception of justice. Social justice is concerned with ensuring that the norms and rules of social structures (...) are fair and equitable. I argue that social and distributive justice are not only compatible, but also complementary. As a result, both conceptions of justice need to be applied to bioethical issues if we are to achieve a truly just outcome. As a case study, I apply this analysis to the controversial issue of the inclusion of pregnant women in clinical research trial. (shrink)

In recent decades, the intertwining ideas of self-determination and well-being have received tremendous support in bioethics. Discussions regarding self-determination, or autonomy, often focus on two dimensions—the capacity of the patient and the freedom from external coercion. The practice of obtaining informed consent, for example, has become a standard procedure in therapeutic and research medicine. On the surface, it appears that patients now have more opportunities to exercise their self-determination than ever. Nonetheless, discussions of patient autonomy in the bioethics literature, which (...) focus on individual patients making particular decisions, neglect the social structure within which health-care decisions are made. Looking through the lens of disability and informed by the feminist conception of relational autonomy, this essay argues that the issue of autonomy is much more complex than the individualist model suggests. The social system and the ableist ideology impose various forms of pressure or oppressive power that can affect people’s ability to choose according to their value system. Even if such powers are not directly coercive, they influence potential parents’ decisions indirectly—they structure their alternatives in such a way that certain options are never considered as viable and other decisions must be made. This paper argues that, instead of only focusing on the individual act of decision-making, we need to pay attention to the social structure that frames people’s decision. (shrink)

She was intensely sympathetic. She was immensely charming. She excelled in the difficult arts of family life. She sacrificed herself daily. If there was chicken, she took the leg, if there was a draught, she sat in it—in short, she was so constituted that she never had a mind or wish of her own, but preferred to sympathise always with the minds and wishes of others. — Virginia Woolf (1979, 59).

: The article first develops an account of autonomy, explaining individual autonomy by means of three normative components and then discussing two objections. The first objection claims that autonomy has to be thought of as essentially relational; this objection is refuted. The second objection, labeled the skeptical objection, claims that we simply do not live autonomously, nor could we ever. Reference is made to novels by Iris Murdoch to present a skeptical solution to this objection.

Centre for Applied Philosophy and Public Ethics University of Melbourne, Parkville, 3010, Australia and.

Drawing on recent cognitive theories of the emotions, this article develops an account of critical reflection as requiring emotional flexibility and involving the ability to envisage alternative reasons for action. The focus on the role of emotions in critical reflection, and in agents' resistance to reflection, suggests the need to move beyond an introspective to a more social and relational conception of the process of reflection. It also casts new light on the intractable problem of explaining how oppressive socialisation impairs (...) the capacity for autonomy. (shrink)

Journal of Social Philosophy, EarlyView.

In this paper, we locate a general rhetorical strategy employed in theoretical discourse wherein philosophers argue from the mere existence of internalized oppression to some kind of epistemic, moral, political, or cognitive deficiency of oppressed people. We argue that this strategy has harmful consequences for oppressed people, breaking down our analysis in terms of individual and structural harms within both epistemic and moral domains. These harms include attempting to undermine the self-trust of oppressed people, reinforcing unjust epistemic power hierarchies, undermining (...) the moral agency of oppressed people, and obscuring real issues of oppression. In light of these many harms, we conclude that there are pro tanto reasons not to employ this strategy, and instead offer a series of suggestions for those considering adopting such a rhetorical move. (shrink)

This paper considers the potentially wrongful discriminatory nature of certain of our dating preferences. It argues that the wrongfulness of such preferences lies primarily in the simple lookism they involve. While it is ultimately permissible for us to date people partly because of how they look, I argue that we have a duty to ‘look behind’ people’s appearance, which I take to mean that we ought not, on the basis of their appearance, to regard them as absolutely out of the (...) question for us to engage with in a romantic setting. Further, constraints similar to those suggested by a duty to look behind people’s appearance gain support from another duty we have, namely, a duty to counteract, also in our daily lives, the fact that people are undeservedly disadvantaged in various ways. (shrink)

Disclosure in clinical practice is aimed at promoting patient autonomy, usually culminating in patient choice (e.g., to consent to an operation or not, or between different medications). In medical ethics, there is an implicit background assumption that knowing more about (X) automatically translates to greater, or more genuine, autonomy with respect to one's choices involving (X). I challenge this assumption by arguing that in rare cases, withholding information can promote a patient's autonomy (understood as the capacity for rational choice in (...) alignment with one's values and goals). (shrink)

Certain forms of practical deference seem to be incompatible with personal autonomy. I argue that such deference undermines autonomy not by compromising the governance of an authentic self, nor by constituting a failure to track objective reasons, but by constituting a particular social relation: one of interpersonal rule. I analyse this social relation and distinguish it from others, including ordinary relations of love and care. Finally, I argue that the particular form of interpersonal rule constituted by dispositions of practical deference (...) in itself entails a partial, though not total, disconnection from the good of a self-authored life. (shrink)

How social media impacts the autonomy of its users is a topic of increasing focus. However, much of the literature that explores these impacts fails to engage in depth with the philosophical literature on autonomy. This has resulted in a failure to consider the full range of impacts that social media might have on autonomy. A deeper consideration of these impacts is thus needed, given the importance of both autonomy as a moral concept and social media as a feature of (...) contemporary life. By drawing on this philosophical literature, we argue that autonomy is broadly a matter of developing autonomy competencies, having authentic ends and control over key aspects of your own life, and not being manipulated, coerced, and controlled by others. We show how the autonomy of users of social media can be disrespected and harmed through the control that social media can have over its users’ data, attention, and behaviour. We conclude by discussing various recommendations to better regulate social media. (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)

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)

This is an open-access textbook designed for introduction to philosophy courses that contain a section on ethics, or for introductory courses in moral theory. In this edited work, chapter authors explore both historical and contemporary approaches to understanding and justifying moral and ethical norms. The chapters cover a wide range of topics, including moral relativism, the relationship between ethics and religion, virtue ethics in the Western and Eastern traditions, the question of self-interest and ethics, utilitarianism, Kantian deontological ethics, and recent (...) work in feminist ethics and evolutionary ethics. -/- Introduction to Philosophy: Ethics, edited by George Matthews (Plymouth State University), is one of a series of open-access textbooks for introduction to philosophy courses edited by Christina Hendricks (University of British Columbia), published with the support of The Rebus Community. (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)

Kant makes and elaborates upon a distinction between active citizenship and passive citizenship. Active citizens enjoy the right to vote and rights of political participation generally. Passive citizens do not, though they still enjoy the protection of the law as citizens. Kant’s examples have left commentators puzzling over how these distinctions follow from his stated rationale or justification for active citizenship, namely, that active citizens possess a kind of political and economic self-sufficiency. This essay focuses on one subset passive citizenry (...) – that of traveling blacksmiths, barbers, and day laborers in order to examine Kant’s distinctions. I argue that these examples show that Kant’s concerns regarding dependence are, at least in some cases, pragmatic rather than political. (shrink)

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 (...) and autonomy as fundamentally opposed concepts or the failure to adequately acknowledge the conceptual relationship between them at common law. The second part of this aim is to draw upon developments in analytic feminist philosophy to illustrate how standard approaches to autonomy are ill-equipped to capture the autonomy issues of capacitous vulnerable adults when their decisions regarding care and treatment are at stake. The second (normative) aim is to develop an account of self-authorised, intersubjective autonomy on the basis of analytic feminist insights into the relational practices of recognition. This account not only attempts to capture the autonomy of capacitous vulnerable adults and account for the necessary harms to their autonomy that arise from standard common law responses to their situational vulnerability, it is also predicated on the distinctions between mental capacity, the satisfaction of conditions for informed consent and the exercise of autonomy, meaning that it is better placed to fulfil the primary aim of the inherent jurisdiction – to facilitate the autonomy of vulnerable adults with capacity. (shrink)

En los sectores políticos democráticos liberales, el principio del respeto a la autonomía es ampliamente aceptado —en teoría, si no siempre en la práctica— como un valor moral cardinal que debería guiar tanto la deliberación política, la política pública y las prácticas, como nuestras actitudes respecto a nuestros conciudadanos. En términos simples, respetar la autonomía es respetar los intereses de cada persona de vivir su vida según su propia concepción del bien. En la base del requisito normativo de respetar la (...) autonomía de otro está la presunción de que la autonomía confiere autoridad normativa sobre la propia vida; la autoridad para tomar decisiones de importancia práctica para la propia vida, por razones propias, cualesquiera que sean. Se asume que las personas autónomas tienen la capacidad, el derecho y la responsabilidad de ejercer esta autoridad, incluso si no siempre lo hacen sabiamente. (shrink)

This paper proposes a distinctive kind of agency that can vindicate the agency of members of marginalised groups while accommodating the autonomy-undermining influences of oppression. Socially-embedded agency—the locus of which is in the exercise of our ability to negotiate between different social features—is compatible with, and can explain, various phenomena, including double-consciousness and white fragility. Moreover, although socially-embedded agency is neither necessary nor sufficient for autonomy, exercising it is practically necessary for autonomy, at least for members of marginalised groups in (...) our non-ideal world. (shrink)

I give an account of the structure of “oppressive double binds,” the double binds that exist in virtue of oppression. I explain how these double binds both are a product of and serve to reinforce o...

Personal autonomy is often lauded as a key value in contemporary Western bioethics. Though the claim that there is an important relationship between autonomy and rationality is often treated as uncontroversial in this sphere, there is also considerable disagreement about how we should cash out the relationship. In particular, it is unclear whether a rationalist view of autonomy can be compatible with legal judgments that enshrine a patient's right to refuse medical treatment, regardless of whether the reasons underpinning the choice (...) are known and rational, or indeed whether they even exist. Jonathan Pugh brings recent philosophical work on the nature of rationality to bear on the question of how we should understand personal autonomy in contemporary bioethics. In doing so, he develops a new framework for thinking about the concept of autonomy, one that is grounded in an understanding of the different roles that rational beliefs and rational desires have to play in it. Pugh's account allows for a deeper understanding of d the relationship between our freedom to act and our capacity to decide autonomously. His rationalist perspective is contrasted with other prominent accounts of autonomy in bioethics, and the revisionary implications it has for practical questions in biomedicine are also outlined. (shrink)

This chapter first introduces naturalistic approaches to ethics more generally and distinguishes methodological ethical naturalism (the focus of this chapter), from metaphysical ethical naturalism. The second part then discusses evolutionary ethics as a specific variant of methodological ethical naturalism. After introducing the concepts of evolutionary theory that are relevant for evolutionary ethics, I will sketch the history of evolutionary ethics, which offers an interesting lesson about why it became a controversial topic, and then focus on four central questions about ethics (...) that can be approached from within the framework of evolutionary ethics: 1. What should we do? 2. Why are we moral? 3. Are there moral facts? 4. Can we have justified moral beliefs and moral knowledge? (shrink)

Many political philosophers argue that interference (or vulnerability to interference) threatens a person’s agency. And they cast political freedom in opposition to interpersonal threats to agency, as non-interference (or non-subjection). I argue that this approach relies on an inapt model of agency, crucial aspects of which emerge from our relationships with other people. Such relationships involve complex patterns of vulnerability and subjection, essential to our constitution as particular kinds of agents: as owners of property, as members of families, and as (...) participants in a market for labor. We should construct a conception of freedom that targets the structures of our interpersonal relations, and the kinds of agents these relations make us. Such a conception respects the interpersonal foundations of human agency. It also allows us to draw morally significant connections between diverse species of unfreedom—between, for instance, localized domination and structural oppression. (shrink)

Whatever its implications for the other features of human agency at its best — for moral responsibility, reasons-responsiveness, self-realization, flourishing, and so on—addiction is universally recognized as impairing autonomy. But philosophers have frequently misunderstood the nature of addiction, and therefore have not adequately explained the manner in which it impairs autonomy. Once we recognize that addiction is not incompatible with choice or volition, it becomes clear that none of the Standard accounts of autonomy can satisfactorily explain the way in which (...) it undermines fully autonomous agency. In order to understand to what extent and in what ways the addicted are autonomy-impaired, we need to understand autonomy as consisting, essentially, in the exercise of the capacity forextended agency.It is because addiction undermines extended agency, so that addicts are not able to integrate their lives and pursue a Single conception of the good, that it impairs autonomy. (shrink)

Accounts of adaptive preferences are of two kinds: well-being accounts fully theorized for their own sake and political accounts theorized to facilitate the political project of reducing oppression and marginalization. Given their practical role, the latter are often less fully theorized, and are therefore less robust to theoretical criticism. In this paper, I first draw on well-being accounts to identify the well-theorized elements that political accounts should want to adopt in order to strengthen their project and avoid common criticisms. Second, (...) I appeal to the political project to show the shortcomings of the well-being accounts on which I draw. (shrink)

Feminists have argued that oppressive socialization undermines the liberal model of autonomy. We contend that this argument can also be employed effectively as a challenge to the standard bioethical model of informed consent. We claim that the standard model is inadequate because it relies on presumptions of procedural autonomy and rational choice that overlook the problem of how agents are often socialized so that they adopt and internalize oppressive norms as part of their motivational structure. The argument that oppressive socialization (...) undermines liberalism’s view of autonomy is most relevant to what Beauchamp and Childress call the threshold elements of informed consent—competence and voluntariness. We show how these elements fail to account for morally relevant factors such as oppressive socialization. (shrink)

Controversial and provocative, To Be Real is a blueprint for the creation of a new political force.

When women become perpetrators of suicide bombing, their agency – their ability to act upon and affect the world – is often denied. There are a number of reasons for this and one this thesis considers is that – as females – they are not expected to be violent. Accordingly, such women are judged to be coerced or incompetent, and so unable to rule themselves sufficiently as agents. Models of autonomy propose various frameworks for assessing whether acts or persons are (...) self-governing, and the relational approach in particular has garnered much support recently. However, some aspects of the relational account remain under-theorised, including how autonomy might be measured. In this thesis, I aim to bring these two elements together by examining whether an extension of the relational model may offer a way in which to estimate the autonomy of the bombers in a more nuanced fashion. I make two claims. First, that the relational conception of the agent and autonomy ‘fits’ the bombers. Second, that my spectrum view, which is rooted in the relational approach, maps the bomber’s autonomy approximately but in detail. As such, my spectrum view is a befitting notion of autonomy and allows a graded and comparative representation of the bomber’s autonomy. (shrink)

This paper argues that potential cases of oppression, such as sex trafficking, can sometimes comprise autonomous choices by the trafficked individuals. This issue still divides radical from liberal feminists, with the former wanting to ‘rescue’ the ‘victims’ and the latter insisting that there might be good reasons for ‘hiding from the rescuers.’ This article presents new arguments for the liberal approach and raises two demands: first, help organizations should be run by affected women and be open-minded about whether or not (...) the trafficked individuals should remain in the sex industry. Second, the career choices of trafficked individuals should be expanded by the introduction of an opportunity-extending right to asylum. (shrink)

A strong distinction is often made between personal autonomy and moral autonomy. Personal autonomy involves governing yourself in the pursuit of your own conception of the good. Moral autonomy involves legislating the moral law for yourself. Viewed in this way personal autonomy seems at best marginal and at worst a positive hindrance to moral autonomy, since personal autonomy can conflict with moral autonomy. Given that Kantian approaches to morality are closely aligned with moral autonomy, does that mean that the Kantian (...) must view personal autonomy as a moral hindrance? Can there be a legitimate role for personal autonomy within Kant’s ethical framework? This paper will seek to argue: that personal and moral autonomy need not be seen as in tension or at odds with one another; that Kant defends an attractive weak substantive theory of personal autonomy; that socialisation plays an important role (both positive and negative) in the development of autonomy competences in Kant’s theory; and that personal autonomy (properly understood) has an essential role to play in Kant’s ethical framework. (shrink)

The received view in medical contexts is that informed consent is both necessary and sufficient for patient autonomy. This paper argues that informed consent is not sufficient for patient autonomy, at least when autonomy is understood as a "relational" concept. Relational conceptions of autonomy, which have become prominent in the contemporary literature, draw on themes in the thought of Charles Taylor. I first identify four themes in Taylor's work that together constitute a picture of human agency corresponding to the notion (...) of agency implicit in relational accounts of autonomy. Drawing on these themes, I sketch two arguments against the position that informed consent secures autonomy. The first is that informed consent is an "opportunity" concept whereas autonomy is an "exercise" concept; the second is that informed consent requires merely weak evaluation and not strong evaluation. On Taylor's analysis of agency, strong evaluation is required for agency and for autonomy. (shrink)

The influence of pervasive cultural norms on people’s actions constitutes a longstanding problem for autonomy theory. On the one hand, such norms often seem to elude the kind of reflection that autonomous agency requires. On the other hand, they are hardly entirely beyond the pale of autonomy: people do sometimes reflect critically on them and resist them. This paper draws on phenomenological accounts of embodiment in order to reconcile these observations. We suggest that pervasive cultural norms exert a strong and (...) elusive, but occasionally resistible, influence because they are incorporated – they operate on the largely pre-reflective bodily level of human existence. As an illustration we discuss parental decisions about surgery for children born with unclear sex, decisions permeated by deeply entrenched norms about sexual difference and genital appearance. (shrink)

In this paper, I discuss a subset of preferences in which a person desires the fulfillment of a choice they have made, even if it involves the violation of their desires, as in rape fantasies. I argue that such cases provide us with a unique insight into personal autonomy from a proceduralist standpoint. In its first part, I analyze some examples in light of Frankfurt's endorsement theory and argue that even when we cannot endorse a practical decision that involves being (...) violated, we nonetheless regard those cases as instances of autonomy. Therefore, autonomy does not necessarily require endorsement. Instead, I propose that the nature of the relevant highest-order volition dictates the procedure that should be established in one’s desire structure for its fulfillment. In the second part, I discuss how an agent may effectively consent to the violation of their decision by another person. Ordinary consent typically refers to actions but fails to communicate one's higher-order desires or commitments. To address this limitation, I propose a practical tool that accomplishes this by signaling shifts in the normative context where the agents are interacting. (shrink)

Feminists debate whether women can autonomously embrace their own subordination. Some argue that it is the process of identifying with desires and values that matters; others, that it is the content of the desires and values that matters. In this paper, I introduce a novel class of cases of ‘thwarted autonomy,’ in which women pursue autonomy but in ways that reinforce gendered subordination, and draw on these cases to develop an expressivist view of women’s autonomy. On this view, agents must (...) embody desires and values in the social world if they are to achieve self-understanding, such that the social world mediates the relation-to-self. Oppressive meanings and norms can channel this expressive activity in ways that violate women’s physical integrity and involve self-abnegation that is incompatible with autonomy. (shrink)

In this paper I argue that the way to reduce the power of overdemanding beauty ideals is not to advocate that individuals have a ‘duty to resist’, a duty to stop engaging in appearance enhancing practices and body work. I begin by arguing against the claim that women who ‘do’ beauty are suffering from false consciousness. I then give four further additional arguments against advocating a ‘duty to resist’ as an effective means to challenge dominant beauty norms. First, that as (...) a tactic it is ineffective. Second, it is an individual approach which divides and silences. Third, it induces shame and blame, and undermines effective collective action. Fourth, it fails to recognize the privilege of the group norms which make resistance possible. (shrink)

It is common in the autonomy literature to claim that some more demanding theories of autonomy disrespect certain individuals by giving the result that those individuals lack autonomy. This claim is often made in the context of the debate between substantive and content-neutral theories of autonomy. Proponents of content-neutral theories often argue that, in deeming certain people non-autonomous—especially certain oppressed people who seem to have internalized their oppression in certain ways—the substantive theories disrespect those people. They take this as reason (...) to accept content-neutral views over substantive views. Despite its ubiquity, this concern about disrespect is hard to pin down precisely. In this paper, I articulate two questions that need to be answered before we can understand the disrespect objection. First: Who, exactly, is supposedly being disrespected by substantive views? Second: Why is it that excluding people with these features is disrespectful? I consider a number of possible answers to each of these questions, and I argue that none of them gives us a plausible explanation of why we should think substantive theories of autonomy are disrespectful to anyone. No matter how we fill in the details, I will argue, there is simply no reason to prefer content-neutral theories of autonomy over substantive ones on the grounds of respect. (shrink)

Scholars across disciplines recognize sport as an institution perpetuating sexism and bias against women in light of its masculine ideals. However, little philosophical research identifies how a masculine environment impacts women’s possibilities in sport. This paper shows that socially structured masculine ideals of athletic excellence impact recognition of women’s athletic achievements while contributing to contexts endangering respect and self-respect. Exploring athletic disrespect reveals connections to more broadly harmful sport practices that include physical and sexual violence. Thus, the practical concern is (...) that sport’s masculine ideals might undermine women’s pursuit of athletic excellence in more harmful ways than previously recognized. (shrink)

This paper presents a reconceptualization of autonomy as the iterative realization of one’s capacity for “effective self-definition,” that is, possessing a sense of clarity and coherence in “who I am,” and exercising the decisional and volitional ownership over my life that this engenders. This process is “Relational,” wherein people’s interpersonal interactions have a deep and pervasive influence on their ability to recognize and exercise their autonomous capacities. This Relational understanding of autonomy is contextualized within the field of addiction rehabilitative practice. (...) Addiction is a pathology that progressively and insidiously undermines autonomy – producing a number of negative consequences that present themselves along a “continuum of pervasiveness.” In order to most fully foster rehabilitation, therapeutic alliances should to be attentive to facilitating autonomy’s dialogical antecedents. Here, interpersonal recognition can help clients to more fully recognize their own autonomous resources – enabling them to embark on their rehabilitative journey and achieve broader autonomous living. This paper concludes by proposing ways that practitioners can manifest their recognition of their clients’ autonomy within the therapeutic encounter. (shrink)

To perceive an affordance is to perceive an object or situation as presenting an opportunity for action. The concept of affordances has been taken up across wide range of disciplines, including AI. I explore an interesting extension of the concept of affordances in robotics. Among the affordances that artificial systems have been engineered to detect are affordances to deliberate. In psychology, affordances are typically limited to bodily action, so the it is noteworthy that AI researchers have found it helpful to (...) extend the concept to encompass mental actions. I propose that psychologists can learn from this extension, and argue that human subjects can perceive mental affordances, such as affordances to attend, affordances to imagine and affordances to count. (shrink)

This article examines the case of Insite, North America’s only supervised injection facility, to consider the relationship between dependence, relational autonomy, and vulnerability. At state-funded Insite, users inject illicit drugs under medical supervision. By conceiving of Insite as a health-care facility and addiction as disease, advocates evoke a shared sense of vulnerability among the nonusing public and users, garnering considerable support for the site. Through Insite, the state responds to vulnerability by reshaping the meaning of dependence and conferring recognition upon (...) users, in turn fostering users’ autonomy. However, the medicalized discourse surrounding Insite may obscure drug users’ vulnerabilities emerging not from “disease,” but from stigma and criminalization. Vulnerability analysis must emphasize not merely a naturalized conception of vulnerability, but the socially constructed nature of human beings’ experiences of vulnerability. (shrink)

I argue that a gendered division of labor is often the result of choices by women that count as fully voluntary because they are an expression of preferences and commitments that reflect women's understanding of their own good. Since liberalism has a commitment to respecting fully voluntary choices, it has a commitment to respecting these gendered choices. I suggest that justified political action may require that we fail to respect some people's considered choices.

Recent articles published in this journal have highlighted the shortcomings of individualistic approaches to health promotion, and the potential contributions of relational analyses of autonomy to public health ethics. I argue that the latter helps to elucidate the former, by showing that an inadequate analysis of autonomy leads to misassignment of both forward-looking and backward-looking responsibility for health outcomes. Health promotion programmes predicated on such inadequate analyses are then ineffective, because they assign responsibility to agents whose social environment inhibits their (...) ability to act on such responsibilities; inequitable, because the social barriers to autonomous agency display a socio-economic gradient; and stigmatizing, because they license blaming of individuals for their own poor health without taking into account how reasonable it is to hold these individuals responsible, given the social barriers to autonomy they face. I further sketch how incorporating a relational understanding of autonomy could help to produce health promotion programmes that do not succumb to these difficulties, while avoiding coercive paternalism, exploring potential applications in ecological approaches to health promotion. (shrink)

An ongoing debate between ‘procedural’ and ‘substantive’ theorists of personal autonomy addresses the following question: should agents have the final say on their own autonomy or should the object...

A growing proportion of clinical research funded by pharmaceutical companies, high-income country research agencies, and not-for-profit funders is conducted in low- and middle-income settings. Disparities in wealth and access to healthcare between the populations where new interventions are often tested and those where many of them are ultimately marketed raise concerns about exploitation. This chapter examines several ethical requirements frequently advanced as mechanisms for protecting research subjects in underserved communities from exploitation and evaluates the effectiveness of those mechanisms as responses (...) to exploitation worries. It goes on to highlight where the conceptual frameworks relied upon by research ethicists must be improved if we are to fully understand the nature of the moral claims and obligations that arise in research conducted in underserved communities. (shrink)

This article proposes a way to disambiguate the evaluative states currently identified as “adaptive preferences” in development literature. It provides a brief analysis of Serene Khader's Deliberative Perfectionist Approach, and demonstrates that distinguishing between adaptive states has important implications for the theory and practice of development intervention. Although I support Khader's general approach and consider my project to be complementary, I argue that the term preferences be replaced with four distinct terms: beliefs, choices, desires, and values. Distinguishing among adaptive states (...) can serve to prevent inappropriate intervention and appreciate the costs of transforming inappropriate adaptations. I argue that adaptive values are especially problematic, given how central a person's values are to their sense of meaning and self. Attempts to transform adaptive values are likely to produce internal conflict, resulting in psychological distress and diminished agency. Furthermore, some values preclude deliberation and comparison given their communal status as infinitely valuable. To deliberate about sacred values is to violate them. The emotional and psychological damage that may result from value transformation is thus likely to be extensive, and must be taken into account when determining whether, and what type of, intervention is justified. (shrink)