Customarily patient advocacy is argued to be an essential part of nursing, and this is reinforced in contemporary nursing codes of conduct, as well as codes of ethics and competency standards governing practice. However, the role of the nurse as an advocate is not clearly understood. Autonomy is a key concept in understanding advocacy, but traditional views of individual autonomy can be argued as being outdated and misguided in nursing. Instead, the feminist perspective of relational autonomy is arguably more relevant (...) within the context of advocacy and nurses’ work in clinical healthcare settings. This article serves to highlight and problematise some of the assumptions and influences around the perceived role of the nurse as an advocate for patients in contemporary Western healthcare systems by focusing on key assumptions concerning autonomy inherent in the role of the advocate. (shrink)

In this paper, we give an account of some of the necessary conditions for an effectively functioning public sphere, and then explore the question of whether these conditions allow for the expression of ideas and values that are fundamentally incompatible with those of liberalism. We argue that speakers who advocate or glorify violence against democratic institutions fall outside the parameters of what constitutes legitimate public debate and may in fact undermine the conditions necessary for the flourishing of free speech and (...) public dialogue more generally. (shrink)

In this open access book, Timothy Aylsworth and Clinton Castro draw on the deep well of Kantian ethics to argue that we have moral duties, both to ourselves and to others, to protect our autonomy from the threat posed by the problematic use of technology. The problematic use of technologies like smartphones threatens our autonomy in a variety of ways, and critics have only begun to appreciate the vast scope of this problem. In the last decade, we have seen a (...) flurry of books making “self-help” arguments about how we could live happier, more fulfilling lives if we were less addicted to our phones. But none of these authors see this issue as one involving a moral duty to protect our autonomy. (shrink)

Ascribing autonomous status to agents is a valuable practice. As such, we ought to care about how we engage in practices of autonomy ascription. However, disagreement between first-personal experiences of an agent's autonomy and third-personal determinations of their autonomy presents challenges of ethical and epistemic concern. My view is that insights from a dialogical rather than nondialogical account of autonomy give us the resources to combat the challenges associated with autonomy ascription. I draw on Andrea Westlund's account of dialogical autonomy—on (...) which autonomy requires a dialogical disposition to hold oneself answerable to external critical perspectives—to make my case. (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...

At first glance, hate speech and microaggressions seem to have little overlap beyond being communicated verbally or in written form. Hate speech seems clearly macro-aggressive: an intentional, obviously harmful act lacking the ambiguity (and plausible deniability) of microaggressions. If we look back at historical discussions of hate speech, however, many of these assumed differences turn out to be points of similarity. The harmfulness of hate speech only became widely acknowledged after a concerted effort by critical race theorists, feminists, and other (...) activists. Before the 1990s, slurs were widely considered socially acceptable behavior: mere jokes that weren’t intended to be harmful. Authors like Richard Delgado, Mari Matsuda, and Charles Lawrence pushed back against this dismissal. In this chapter, I show that their arguments for the serious harmfulness of hate speech prefigure and provide support for current debates about the serious harmfulness of microaggressions. Exploring resonances with the 1980s hate speech debate will allow us to explain why microaggressions fall below the cutoff for legal liability but remain apt targets for moral blame. (shrink)

Goffman’s (1959) dramaturgical identity theory requires modification when theorising about presentations of self on social media. This chapter contributes to these efforts, refining a conception of digital identities by differentiating them from ‘corporatised identities’. Armed with this new distinction, I ultimately argue that social media platforms’ production of corporatised identities undermines their users’ autonomy and digital well-being. This follows from the disentanglement of several commonly conflated concepts. Firstly, I distinguish two kinds of presentation of self that I collectively refer to (...) as ‘expressions of digital identity’. These digital performances (boyd 2007) and digital artefacts (Hogan 2010) are distinct, but often confused. Secondly, I contend this confusion results in the subsequent conflation of corporatised identities – poor approximations of actual digital identities, inferred and extrapolated by algorithms from individuals’ expressions of digital identity – with digital identities proper. Finally, and to demonstrate the normative implications of these clarifications, I utilise MacKenzie’s (2014, 2019) interpretation of relational autonomy to propose that designing social media sites around the production of corporatised identities, at the expense of encouraging genuine performances of digital identities, has undermined multiple dimensions of this vital liberal value. In particular, the pluralistic range of authentic preferences that should structure flourishing human lives are being flattened and replaced by commercial, consumerist preferences. For these reasons, amongst others, I contend that digital identities should once again come to drive individuals’ actions on social media sites. Only upon doing so can individuals’ autonomy, and control over their digital identities, be rendered compatible with social media. (shrink)

It is often held that people have a moral right to believe and say whatever they want. For instance, one might claim that they have a right to believe racist things as long as they keep those thoughts to themselves. Or, one might claim that they have a right to pursue any philosophical question they want as long as they do so with a civil tone. In this paper I object to those claims and argue that no one has such (...) unlimited moral rights. In Part 1 I explore the value of the freedoms of thought and expression. In Part 2 I argue against the unlimited moral right to free expression, focusing in particular on the special obligations and moral constraints that obtain for academics. In Part 3 I argue against the unlimited moral right to free thought. (shrink)

ABSTRACT This paper argues for a hidden way in which speech constitutes harm by enacting harmful norms. The paper then explores the potential legal consequences of uncovering such instances of harm constitution. In particular, the paper argues that some public racist speech constitutes harm and is thus harmful enough to warrant legal remedy. Such utterances are actionable, it is contended, because they enact discriminatory norms in public spaces.

This paper challenges the view that contentment leads to personal freedom and autonomy and argues for a relational and exercise concept of de facto freedom in the Zhuangzi 莊子. I first review influential interpretations of freedom in the Zhuangzi that equate freedom with contentment and nonfrustration, starting with Guo Xiang's 郭象 (d. 312 CE). By putting these interpretations in dialog with contemporary social philosophy (Christman, Meyers, Pettit, Elster, and Khader), I reflect on the two seminal problems of the psychologizing causal (...) and procedural approaches that allow the interpretation of freedom as contentment: the “happy slave” problem and the “sour grapes” problem. Proving this account of freedom inadequate, I argue for a different interpretation of freedom in the Zhuangzi that resembles a weakly substantive and constitutive account of freedom and autonomy in modern‐day social philosophy terms, such as Marina Oshana's. The theory of freedom that I analyze in the Zhuangzi, however, helps us correct the risk of material determinism of the constitutive account, offering a description of relational freedom and autonomy as constituted by socio‐material conditions but not determined by them. (shrink)

Attention to individual choice is a valuable dimension of public health policy; however, the creation of effective public health programmes requires policy makers to address the material and social structures that determine a person’s chance of actually achieving a good state of health. This statement summarizes a well understood and widely held view within public health practice. In this article, we (i) argue that advocates for public health can and should defend this emphasis on ‘structures’ by reference to citizen autonomy (...) and not simply by emphasizing concern for counter-balancing values such as ‘population health’ or ‘fairness’, (ii) map and critically explore the contrasting conceptions of autonomy that feature in such debates, with particular attention to conceptions of autonomy that might feature in the defence of an emphasis on structures. We draw on (i) a relational conception of autonomy and (ii) the distinction that can be made between autonomous deliberation and autonomous action to suggest that offering people the opportunity to make choices about their health without also supporting their capability to achieve the object of these choices falls short of what is often considered to be morally and politically important about promoting autonomy in relation to health. (shrink)

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)

Muchos autores que se han ocupado de la autonomía personal parecen identificar la capacidad de autonomía esencialmente con la capacidad de todo agente racional para identificar preferencias y tomar decisiones conforme a las mismas. Estos autores -entre los que podríamos ubicar a C. Nino- prescinden a menudo de ulteriores elementos o condiciones para su ejercicio. Sin embargo, resulta fundamental ahondar en esos aspectos a veces pasados por alto; ahondar principalmente en las opciones y el proceso de formación de preferencias de (...) los agentes, para delinear mejor los aspectos normativos de la autonomía. En este trabajo propongo recuperar un elemento central del concepto que ha sido extensamente desarrollado en la literatura feminista, me refiero al contexto de relaciones que ha dado lugar a la llamada "autonomía relacional". Propongo incorporar esta noción al núcleo conceptual de la autonomía sin renunciar, sin embargo, a otros elementos del concepto entre los que destacaré las "opciones relevantes", es decir, la presencia de cursos de acción, de oportunidades, que la persona es capaz de reconocer como propuestas no solo viables sino legítimas para sí. Para desarrollar esta idea comenzaré por definir la autonomía a través de los que considero los elementos o condiciones centrales del concepto, deteniéndome especialmente en la condición de opciones relevantes. A continuación se abordará la cuestión relativa al modo en que las opciones se perfilan, se construyen y son percibidas por los sujetos. En este punto el estudio se fijará específicamente en el entorno contextual y de relaciones que sirve de trasfondo para la construcción de las opciones, para proponer la noción de opciones relacionales. Many authors have written about autonomy focusing mainly on the capacity of the autonomous agent for identifying preferences and making decisions. These authors -C. Nino among them- do not take into consideration further elements or conditions for being autonomous. However, it is necessary to take other aspects into consideration; mainly it is important to take account of both options and the building of the agent’s preferences. This way, autonomy normative aspects will be better understood. I propose here to analyse the concept of "relational autonomy", which has been largely elaborated within feminist theory. My aim is to incorporate relations and options to the core of the concept of personal autonomy. In this article, I will define personal autonomy first, highlighting the importance of relevant options. Second, I will describe the way options are built and their perception by the agent. Finally, I will focus on the context and relations on the background, and I will propose the notion of relational options. (shrink)

Concerns about exploitation pervade the literature on commercial cross-border reproductive care, particularly egg selling and surrogacy. But what constitutes exploitation, and what moral weight does it have? I consider the relationship between vulnerability, limited choice, consent, and mutually advantageous exploitation. To elucidate the difference between limited choice and consent, I draw on an account of relational autonomy. In the absence of a normative principle of fair distribution, it is unclear whether the providers of reproductive goods and services are treated fairly (...) in such contracts, and therefore whether they have been exploited. I finish with some pragmatic recommendations for minimizing risks and empowering egg sellers and surrogates. (shrink)

The rare case of the patient unwilling to disclose genetic data to his or her family provides an opportunity to expand the atomistic conception of the autonomous individual in medical decision-making. Medical practitioners naturally avoid violating patient autonomy and privacy. However, unwilling disclosure can damage the health of people other than the patient. In this situation, professionals must weigh the principle of autonomy against the nature of relationships, duties, and confidentialities between patient, professional, and family. The paradigm case studied is (...) that of a patient with a potentially dangerous heart condition, Long QT Syndrome 3. Patients with Long QT 3 are at high risk for dying of ventricular tachycardia during rest, especially from ages 40–60. Once familial genetic testing was completed, the proband's mother, who was positive for the mutation, chose not to inform her estranged sister of the diagnosis. This paper examines the ethical duties of the physician to inform a patient's extended family of a serious genetic diagnosis, with a focus on the emotional and psychological effects of genetic testing. The need to adapt the process of violating confidentiality around considerations for the patient's emotional state and narrative will be addressed. This approach considers the patient’s narrative, standpoint, and relationships as a way to develop a support plan and will present a guideline for cases where the probability of significant harm to others supersedes the patient’s preference of non-disclosure as well as the physician’s respect of confidentiality. The paper seeks to expand the conversation on genetic testing and autonomy beyond principles by considering all parties involved and emphasizes the use of the varied resources available to medical practitioners, especially to provide the best help possible without overburdening physicians with duties. (shrink)