Both legal and moral theorists have offered broadly “communicative” theories of criminal and moral responsibility. According to such accounts, we can understand the nature of responsibility by appealing to the idea that responsibility practices are in some fundamental sense expressive, discursive, or communicative. In this essay, I consider a variety of issues in connections with this family of views, including its relationship to free will, the theory of exemptions, and potential alternatives to the communicative model. Focusing on Michael McKenna’s Conversation (...) and Responsibility, I argue that communicative accounts, and the conversational model in particular, direct our attention to important and under-appreciated elements of our responsibility practices. However, rather than focusing on a model of conversation-as-address, as McKenna does, we do better to regard gossip as the paradigmatic conversational form that captures the main features of moral responsibility. (shrink)

From 1965, the Swedish penal law does not require accountability as a condition for criminal responsibility. Instead, severely mentally disordered offenders are sentenced to forensic psychiatric care. The process that led to the present legislation had its origins in a critique of the concept of accountability that was first launched 50 years earlier by the founding father of Swedish forensic psychiatry, Olof Kinberg. The concept severe mental disorder is part of the Criminal Code as well as the Compulsory Mental Act. (...) The medical conditions for being sentenced to forensic psychiatric care are supposed to be the same as those for being admitted to involuntary psychiatric care. What these conditions are is not regulated in any law. For the guidance of the courts and others, there is a collection of examples in the government bill drafting the legislation in question. On the basis of these examples the content of the concept of severe mental disorder is chiselled out. However, the purposes of imposing penal law sanction and admitting someone to psychiatric care are not the same, and therefore the content of the concept severe mental disorder is bound to differ accordingly. Severe mental disorder is a legal concept that masks as a psychiatric one. In its applications in penal law, the court determines its content. But for the forensic psychiatrist it is more natural to interpret the term as a medical one. This creates a tension that has led to several controversies in recent criminal cases in Sweden. The best way to alleviate the situation is to discard the concept of severe mental disorder from criminal law. This will allow for a better separation of the roles of the psychiatrist and the court. (shrink)

Given the ubiquity and centrality of social and relational influences to the human experience, our conception of self-governance must adequately account for these external influences. The inclusion of socio-historical, externalist considerations into more traditional internalist accounts of autonomy has been an important feature of the debate over personal autonomy in recent years. But the relevant socio-temporal dynamics of autonomy are not only historical in nature. There are also important, and under-examined, future-oriented questions about how we retain autonomy while incorporating new (...) values into the existing set that guides our interaction with the world. In this paper, we examine these questions from two complementary perspectives: philosophy and neuroscience. After contextualizing the philosophical debate, we show the importance to theories of autonomous agency of the capacity to appropriately adapt our values and beliefs, in light of relevant experiences and evidence, to changing circumstances. We present a plausible philosophical account of this process, which we claim is generally applicable to theories about the nature of autonomy, both internalist and externalist alike. We then evaluate this account by providing a model for how the incorporation of values might occur in the brain; one that is inspired by recent theoretical and empirical advances in our understanding of the neural processes by which our beliefs are updated by new information. Finally, we synthesize these two perspectives and discuss how the neurobiology might inform the philosophical discussion. (shrink)

Helen Steward holds that an agent’s settling something does not require a conscious, full-fledged intention. Rather, sub-intentional acts can be instances of settling by the agent if that act is subordinated to the agent’s personal-level conscious systems. I argue that this position is mistaken, and that agential settling does in fact require a conscious intention. I argue for this claim by offering a case which on Steward’s position has counterintuitive implications. I consider a variety of ways in which Steward might (...) respond, and show how each response incurs serious dialectical burdens. I then propose my preferred view of agential settling which does not share the aforementioned counterintuitive claims. (shrink)

This article is a critical discussion of Derk Pereboom’s “disappearing agent objection” to event-causal libertarianism in his Free Will, Agency, and Meaning in Life. This objection is an important plank in Pereboom’s argument for free will skepticism. It is intended to knock event-causal libertarianism, a leading pro-free-will view, out of contention. I explain why readers should not find the objection persuasive.

The “problem of present luck” targets a standard libertarian thesis about free will. It has been argued that there is an analogous problem about luck for compatibilists. This article explores similarities and differences between the alleged problems.

This article explores the conceptual connections between free action and action for which the agent is morally responsible. Questions addressed include the following. Can agents who are never morally responsible for anything sometimes act freely? Can agents who never act freely be morally responsible for some of their actions? Various compatibilist and incompatibilist responses to these questions are discussed, as is the control over their behavior that ordinary agents attribute to themselves.

We have two main aims: to construct mathematical models for analysing determinism, causality and supervenience; and then to use these to demonstrate the possibility of constructing an ontic construal of the operation of free will - one requiring both the presentation of genuine alternatives to an agent and their selecting between them in a manner that permits the attribution of responsibility. Determinism is modelled using trans-temporal ontic links between discrete juxtaposed universe states and shown to be distinct from predictability. Causality (...) is defined on a temporal sequence of δ-algebras and quantified using a measure. The measure leads to definitions of causal overdetermination and epiphenomena. Proofs are constructed to demonstrate deterministic universes must carry their properties essentially but not necessarily locally. We argue determinism and causality are separate doctrines. These models and results are marshalled to put the case that a counterfactual construal of ontic choice cannot work. In response we propose ‘immanence’ - a modified form of indeterminism whereby a universe can present choices to its denizens. We prove that beings subsumed within a universe cannot pilot their own actions. We then argue these beings can exercise free will only when selecting between choices inhering within immanent relata. A being is responsible for its selections if and only if it is constituted of a temporally evolving deterministic substructure. Our proposal is novel: it avoids injecting indeterminism into the decision process. Topological models for property supervenience are developed and used to reconstruct standard definitions from the literature. These are then used to demonstrate considerations of supervenience do not affect our arguments. We have demonstrated that a model of the exercise of free will involving both genuine choices and responsibility is possible but can only operate within a non-deterministic universe possessing specific traits. (shrink)

Recent studies within neuroscience and cognitive psychology have explored the place of conscious willing in the generation of purposive action. Some have argued that certain findings indicate that the commonsensical view that we control many of our actions through conscious willing is largely or wholly illusory. I rebut such arguments, contending that they typically rest on a conflation of distinct phenomena. Nevertheless, I also suggest that traditional philosophical accounts of the will need to be revised: a raft of studies indicate (...) that control over one’s own will among human beings is limited, fragile, and – insofar as control depends to an extent on conscious knowledge – admitting of degrees. I briefly sketch several dimensions along which freedom of the will may vary over time and across agents. (shrink)

Compatibilists disagree over whether there are historical conditions on moral responsibility. Historicists claim there are, whilst structuralists deny this. Historicists motivate their position by claiming to avoid the counter-intuitive implications of structuralism. I do two things in this paper. First, I argue that historicism has just as counter-intuitive implications as structuralism when faced with thought experiments inspired by those found in the personal identity literature. Hence, historicism is not automatically preferable to structuralism. Second, I argue that structuralism is much more (...) plausible once we accept that personal identity is irrelevant to moral responsibility. This paves the way for a new structuralist account that makes clear what it takes to be the diachronic ownership condition (which is normally taken to be personal identity) and the locus of moral responsibility (which is normally taken to be ‘whole’ person), and helps to alleviate the intuitive unease many have with respect to structuralism. (shrink)

This article argues against Benjamin Libet's claim that his experiment has shown that our actions are caused by brain events which begin before we consciously undertake the action. It clarifies what exactly should be meant by saying that the readiness potential causes, initiates, or prepares an action. It shows why Libet's experiment does not support his claim and why the experiments by Herrmann et al. and by Trevena \& Miller provide evidence against it. The empirical evidence is compatible with strong (...) libertarian free will. Neither the readiness potential nor the lateralized readiness potential cause our actions. (shrink)

Some scientists have reported what they regard as evidence of indeterministic brain processes that influence behavior (Brembs 2011, Maye et al. 2007). How do these reports bear on the positive side of libertarianism about free will? That is an approximation of my guiding question in this article. I make the question more precise in section 1, in light of some conceptual and scientific background. In the remainder of the article, I seek—and eventually offer—an answer. Topics dis-cussed along the way include (...) control, Frankfurt-style cases, and whether event-causal libertarianism is an uninhabitable half-way house between compatibilism and agent-causal libertarianism. (shrink)

Typical incompatibilists about moral responsibility and determinism contend that being basically morally responsible for a decision one makes requires that, if that decision has proximal causes, it is not deterministically caused by them. This article develops a problem for this contention that resembles what is sometimes called the problem of present (or cross-world) luck. However, the problem makes no reference to luck nor to contrastive explanation. This article also develops a solution.

Ethical evaluation of deep brain stimulation as a treatment for Parkinson’s disease is complicated by results that can be described as involving changes in the patient’s identity. The risk of becoming another person following surgery is alarming for patients, caregivers and clinicians alike. It is one of the most urgent conceptual and ethical problems facing deep brain stimulation in Parkinson’s disease at this time. In our paper we take issue with this problem on two accounts. First, we elucidate what is (...) meant by “becoming another person” from a conceptual point of view. After critically discussing two broad approaches we concentrate on the notion of “individual identity” which centers on the idea of “core attitudes”. Subsequently we discuss several approaches to determine what distinguishes core attitudes from those that are more peripheral. We argue for a “foundational-function model” highlighting the importance of specific dependency relations between these attitudes. Our second aim is to comment on the possibility to empirically measure changes in individual identity and argue that many of the instruments now commonly used in selecting and monitoring DBS-patients are inappropriate for this purpose. Future research in this area is advised combining a conceptual and an empirical approach as a basis of sound ethical appraisal. (shrink)

In this review essay on Mele's Free Will and Luck, I evaluate the 'daring soft libertarian' view presented in the heart of the book, and in particular the way that it provides an answer to the objection that introducing indeterminism into one's view of freedom merely adds an element of luck and so undermines freedom. I also compare the view's strengths and weaknesses to those of traditional libertarian views. Finally, I consider the 'zygote' argument that Mele takes to be his (...) reason for remaining agnostic about whether determinism is compatible with freedom, and argue that if one accepts the main arguments presented earlier in the book, one should not let this argument stand in the way of accepting compatibilism. (shrink)

Compatibilists about determinism and moral responsibility disagree with one another about the bearing of agents’ histories on whether or not they are morally responsible for some of their actions. Some stories about manipulated agents prompt such disagreements. In this article, I call attention to some of the main features of my own “history-sensitive” compatibilist proposal about moral responsibility, and I argue that arguments advanced by Michael McKenna and Manuel Vargas leave that proposal unscathed.

According to what I call the reductive standard-causal theory of agency, the exercise of an agent's power to act can be reduced to the causal efficacy of agent-involving mental states and events. According to a non-reductive agent-causal theory, an agent's power to act is irreducible and primitive. Agent-causal theories have been dismissed on the ground that they presuppose a very contentious notion of causation, namely substance-causation. In this paper I will assume, with the proponents of the agent-causal approach, that substance-causation (...) is possible, as I will argue against that theory on the ground that it fails as a theory of agency. I will argue that the non-reductive agent-causal theory fails to account for agency, because it fails to account for agential control: it cannot explain why the stipulated irreducible relation between the agent and an action constitutes the agent's exercise of control over the action. This objection, I will argue, applies to the agent-causal theory in particular, and to the non-reductive approach in general. (shrink)

The article presents the nature of shared intentions and collective responsibility in simultaneous discussion of individualism, which views that collective agents and shared intentions are to be analyzed in relation between individual agents who are members of the collectives. It discusses as well the agent meaning theory that states that an agent moves against the interpretive background of action evaluation shared by the agent and the moral community.

I will argue that close attention to deciding casts doubt on the simple view and the single phenomena view of intentional action. That is my thesis. My aim is much broader—to improve our understanding of deciding and of the bearing of the phenomenon of deciding on free will and moral responsibility.

Contrary to philosophical tradition, modern theorists of the mind have often downplayed the importance of consciousness. Instead, they have accounted for the mind in terms of phenomena like mechanisms, dispositions, abilities and even environmental features. One of many inspirations for this trend is a series of passages of the later Wittgenstein. These passages discuss a variety of specific mental phenomena, like searching, comparing, understanding and reading. The passages have often been taken them to show that one may exemplify any of (...) the phenomena at issue without being in any particular type of conscious state. I claim that the passages do not support this conclusion, and that the conclusion is, arguably, false. My conclusion is that consciousness may be a more important aspect of the mind than is supposed by many contemporary theorists--both Wittgensteinians and others. (shrink)

This article articulates and defends an indeterministic weightings model of libertarian free will. It begins by defining the conception of free will at issue and then goes on to present versions of the luck objection which is often made against theories of LFW. It is argued that the sort of indeterministic weightings model of LFW which has been defended in the recent literature by Storrs McCall and E.J. Lowe and John Lemos has the resources to answer such luck objections while (...) possessing virtues which some other libertarian views lack. According to the indeterministic weightings model of LFW, in making undetermined free-willed choices between two courses of action, A or B, the reasons for choosing each option don’t come with pre-established evaluative weights. During the process of deliberation, the agent assigns weight in an undetermined way to the reasons for each option and this typically leads to the choice of the option that has been assigned a greater value. In the paper, it is not only argued that this theory can resolve worries about luck but also that the view has virtues which certain other libertarian views lack, as such the view is contrasted with the modest libertarian models of LFW from Daniel Dennett and Alfred Mele as well as Robert Kane’s view. (shrink)

The so-called “problem” of structure and agency is clearly related to the philosophical problem of free will and determinism, yet the central philosophical issues are not well understood by theorists of structure and agency in the social sciences. In this article I draw a map of the available stances on the metaphysics of free will and determinism. With the aid of this map the problem of structure and agency will be seen to dissolve. The problem of structure and agency is (...) sustained by a failure to distinguish between metaphysical and empirical senses of the relation between social structure and individual agency. The ramifications of this distinction are illustrated via a case study of competing explanations of perpetrator behavior in Christopher Browning’s and Daniel Goldhagen’s studies of the German Order Police in the Holocaust. (shrink)

Most prominent accounts of autonomy are active accounts, which means they hold that an agent can be autonomous with respect to a given action only if that agent has appropriately sanctioned that action. Active accounts, however, are vulnerable to the regress problem, since it seems that the required sanctioning actions are themselves just actions that must be sanctioned. Passive accounts hope to avoid the regress problem by eschewing the notion that autonomous action requires agential sanction, but face in its place (...) what I call the incompleteness problem for passive accounts. Here, I evaluate one passive account, recently defended by Sarah Buss, and argue that it can avoid the incompleteness problem only if it is supplemented by a satisfactory account of the development of autonomy. I then suggest that one development account, offered by Ishtiyaque Haji and Stefaan Cuypers, is an especially good supplement. My conclusion is that Buss’s account, supplemented in the way I suggest, can avoid the incompleteness problem. (shrink)

Do people sometimes exercise self-control in such a way as to bring it about that they do not act on present-directed motivation that continues to be motivationally strongest for a significant stretch of time (even though they are able to act on that motivation at the time) and intentionally act otherwise during that stretch of time? This paper explores the relative merits of two different theories about synchronic self-control that provide different answers to this question. One is due to Sripada (...) (Noûs 1–38, 2012) and the other to Mele (Irrationality, 1987; Autonomous agents, 1995; Motivation and agency, 2003). Special attention is paid to evidence Sripada offers for an affirmative answer to the question, and some guidance is offered on the project of finding evidence for an affirmative answer. (shrink)

This essay presents a skeleton of a potential conceptual framework for human flourishing in a free society. Its aim is to present a diagram that illustrates the ways in which its topics relate to one another and why they do. It argues for a plan of conceptualization rather than for the topics themselves. It emphasizes the interconnections among the components of the schema presented. It sees an essential interconnection between objective concepts, arguing that all of the disciplines of human action (...) can be integrated into a paradigm of human flourishing based on the nature of man and the world. (shrink)

In Responsibility and Control: A Theory of Moral Responsibility John Martin Fischer and Mark Ravizza propose an account of moral responsibility according to which an agent is morally responsible for an action just when that action is the product of her own moderately reasons-responsive mechanism, where reasons-responsiveness is explained in terms of the mechanism’s regular reasons-receptivity and weak reasons-reactivity. In a review of Fischer and Ravizza’s book Mele contends that their weakly reasons-reactivity condition is inadequate, constructing a case in which, (...) according to their theory, an extreme agoraphobic is morally responsible for his staying in his home. In this paper I modify Fischer and Ravizza’s account of moral responsibility in light of Mele’s problematic example, suggesting a refinement of their weakly reasons-reactivity requirement via a distinction between weakly sufficient reasons and strongly sufficient reasons. (shrink)

This article’s guiding question is about bullet biting: When should compatibilists about moral responsibility bite the bullet in responding to stories used in arguments for incompatibilism about moral responsibility? Featured stories are vignettes in which agents’ systems of values are radically reversed by means of brainwashing and the story behind the zygote argument. The malady known as “intuition deficit disorder” is also discussed.

Richard Holton has developed a view of the nature of weak-willed actions, and I have done the same for akratic actions. How well does this view of mine fare in the sphere of weakness of will? Considerably better than Holton’s view. That is a thesis of this article. The article’s aim is to clarify the nature of weak-willed actions. Holton reports that he is "trying to give an account of our ordinary notion of weakness of will" (1999, p. 262). One (...) way to get evidence about ordinary notions is to conduct survey studies with ordinary people. I conducted four such studies on weakness of will. (shrink)

As good a definition as any of a _philosophical_ conundrum is a problem all of whose possible solutions are unsatisfactory. The problem of understanding the springs of action for morally responsible agents is commonly recognized to be such a problem. The origin, nature, and explanation of freely-willed actions puzzle us today as they did the ancients Greeks, and for much the same reasons. However, one can carry this ‘perennial-puzzle’ sentiment too far. The unsatisfactory nature of philosophical theories is a more (...) or less matter, and some of them have admitted of improvement over time. This, at any rate, is what we self-selecting metaphysicians tend to suppose, and I will pursue that high calling by suggesting a few improvements to a theory of metaphysical freedom, or freedom of the will. (shrink)

Although irrationality always presupposes rationality, I think there are good arguments to claim that sometimes rationality presupposes irrationality.This paper tries to show how irrational action can support rationality in two ways: it can develop and preserve rationality. I also argue that sometimes the development and the conservation of rationality can only be realized by irrational action.

Harry Frankfurt dramatically shaped the debates over freedom and responsibility by arguing that the sort of freedom germane to responsibility does not involve the freedom to do otherwise. His argument turns upon an example meant to disprove the Principle of Alternative Possibilities: A person is morally responsible for what she has done only if she could have done otherwise. Debate over Frankfurt's argument has turned almost exclusively on the success of the example meant to defeat it. But there is more (...) to Frankfurt's argument than the example in question, and this is not widely recognized. Inattention to these other aspects of Frankfurt's argument has distorted the force of it. In this paper I shall explore avenues for both refuting and advancing Frankfurt's argument that look beyond the examples. These further considerations invite us to think in broader terms about moral responsibility's nature and the sort of freedom required for it. (shrink)

This paper contrasts a picoeconomic approach to theexplanation of akrasia with Davidson's divided-mind approach and defends theformer in a wider context. The distinctive merits of a picoeconomic model of mindlie in the following aspects: First, it relies on a scientifically well-groundeddiscovery about motivational dynamics of animals for its explanation of preference change,which elucidates or materializes some philosophers' speculations both about thepossible mismatch between valuation and motivation and about the relevance of temporalfactors to akrasia. Second, it grounds the necessity of endogenous (...) higher-order constraints,expressible in forms of judgment, in an intrapersonal dynamic process of interactivefirst-order temporary preferences. Thus the motivational basis for the normativeconstruction of the rationality of `best judgment' can also be illuminated with this model. (shrink)

To what extent should an analysis of an agent’s being morally responsible for an action that he performed—especially a compatibilist analysis of this—be sensitive to the agent’s history? In this article, I give the issue a clearer focus than it tends to have in the literature, I lay some groundwork for an attempt to answer the question, and I motivate a partial but detailed answer.

: 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.

Philosophers working on the morality of harm have paid surprisingly little attention to the problem of manipulation. The aim of this paper is to remedy this lacuna by exploring how liability to defensive harm is affected by the fact that someone posing an unjust threat has been manipulated into doing so. In addressing this problem, the challenge is to answer the following question: Why should it be the case that being misled into posing an unjust threat by manipulation makes a (...) difference to one’s liability, as compared to being misled into doing so by natural events or by someone’s honest attempt to persuade us? To answer this question, I first outline an account of manipulation and then use it to defend what I shall call the “Pre-emption Principle.”. (shrink)

This article is part of a symposium on Alfred Mele’s Manipulated Agents: A Window to Moral Responsibility. It is Mele’s response to John Fischer, Ishtiyaque Haji, and Michael McKenna. Topics discussed include the bearing of manipulation on moral responsibility, the zygote argument, the importance of scenarios in which manipulators radically reverse an agent’s values, positive versus negative historical requirements for moral responsibility, the scope of moral responsibility, the value of intuitions, bullet-biting, and how we develop from neonates who are not (...) morally responsible for anything into morally responsible agents. A variety of scenarios featuring various kinds of manipulation are discussed. (shrink)

The aim of this paper is to challenge libertarian accounts of free will. It is argued that there is an irreconcilable tension between the way in which philosophers motivate the incompatibilist ability to do otherwise and the way in which they formally express it. Potential incompatibilist responses in the face of this tension are canvassed, and it is argued that each response is problematic. It is not claimed that incompatibilist accounts in general are incoherent, but rather that any incompatibilist account (...) that requires that an agent have alternative possibilities at the point of a free action fails. (shrink)

Two questions guide this article. First, according to Fischer and Ravizza (jointly and otherwise), what epistemic requirements for being morally responsible for performing an action A are not also requirements for freely performing A? Second, how much progress have they made on this front? The article's main moral is for philosophers who believe that there are epistemic requirements for being morally responsible for A-ing that are not requirements for freely A-ing because they assume that Fischer (on his own or otherwise) (...) has shown that this is so. In showing that this assumption is false, I reopen an important question for these philosophers: How are epistemic requirements for being morally responsible for A-ing related to requirements for freely A-ing? This is an interesting question in its own right, of course. (shrink)

In this essay, I defend the following two claims: reflective, critical reasoning is essential to the process of self-deception; and , the process of self-deception involves a certain characteristic error of self-knowledge. By appeal to and , I hope to show that we can adjudicate the current dispute about the nature of self-deception between those we might term "traditionalists," and those we might term "deflationists.".

Alicia Juarrero's Dynamics in action is an attempt to bring dynamical systems theory to bear on action theory. Juarrero claims that the vocabulary and examples from dynamical systems theory can help us resolve some pressing problems in action theory, including the problems of extended action and disrupted causal chains. In the process, Juarrero calls for a return to an Aristotelean plurality of causes and a serious scrutiny of modern Humean/positivist science as she sees it. Although her book has some inaccuracies (...) and fails to convince the skeptical reader, it provides an alternative point of view from which to launch further studies. (shrink)

Part I of the dissertation examines the cognitive aspects of autonomy. The central question concerns what kind of cognitive capacity autonomy is. It will be argued that the concept of autonomy is best understood in terms of a metacognitive capacity of the individual. It is argued that metacognition has two components: procedural reflexivity and metarepresentation. Metarepresentation in turn can be divided into inferential reflexivity and other-attributiveness. These two components are essential for autonomy. Particular emphasis is put on procedural reflexivity. Further, (...) since the essential function of metacognition is control, it is argued that the concept of autonomy, understood as a metacognitive capacity, can be interpreted in terms of control. Issues arising from empirical data from neuroscience on functional, as well as impaired, metacognition, and on undermined autonomy, are dealt with. It is argued that autonomy cannot be determined with respect to subjective conditions. Neurological impairments, like Anton’s Syndrome, dementia, and thought insertion in schizophrenia, are put forward in support of this claim. To determine autonomy we require external conditions. In order to determine whether an individual is autonomous, both the metacognitive status of the individual and the external setting must be considered, since they are in interplay and consequently influence each other. In Part II, the analysis put forward in Part I is applied to Swedish healthcare. It is argued that the distinction between autonomy as a right and as a capacity must be explicit in order to understand what autonomy means and to deal with it effectively in healthcare practice. A discussion about whether or not the patient’s right to autonomy sometimes tends to be over-emphasized in healthcare is put forward. Special emphasis is placed on psychitaric issues such as deinstitutionalization and participation. Following the closure of the mental hospitals, deinstitutionalization and community-based care have become central topics in psychiatry. At the same time, the implementation of such care can be demanding for patients suffering from a persistent mental disorder. In part II it is also suggested that the metacognitive account of the concept of autonomy might help clarify the criteria governing coercive care. Finally, some suggestions concerning developments and improvements in Swedish healthcare, especially in psychiatry, where the concept of autonomy is important but problematic, are put forward. (shrink)