In healthcare ethics there is a discussion regarding whether autonomy of personal preferences, what sometimes is referred to as authenticity, is necessary for autonomous decision-making. It has been argued that patients’ decisions that lack sufficient authenticity could be deemed as non-autonomous and be justifiably overruled by healthcare staff. The present paper discusses this issue in relation certain psychiatric disorders. It takes its starting point in recent qualitative studies of the experiences and thoughts of patients’ with anorexia nervosa where issues related (...) to authenticity seem particularly relevant. The paper examines different interpretations of authenticity relevant for autonomy and concludes that the concept, as it has been elaborated in recent debate, is highly problematic to use as a criterion for autonomous decision-making in healthcare. (shrink)

One widespread argument against the efficacy of subjective well-being as a measure of well-being is the adaptation problem as formulated by Sen and Nussbaum: the phenomenon that people may adapt to deprivation and find satisfaction or happiness in objectively bad circumstances. It is not generally noticed that there are two distinct arguments for why the phenomenon of adaptation is a problem for subjective well-being as a measure of well-being. The Axiological Adaptation Argument is a counter-example to theories of well-being that (...) rely on mental states. The Epistemic Adaptation Argument illustrates that levels of happiness or satisfaction cannot be measured well when people have adapted. I argue that the most serious threat to subjective well-being measures is not the Axiological Argument, but the Epistemic Argument. I reflect on the implications the epistemic problem has for the empirical literature in general, and for research on the phenomenon of adaptation in particular. (shrink)