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)

This book offers an original account of a distinctly republican theory of social and global justice. The book starts by exploring the nature and value of Hegelian recognition theory. It shows the importance of that theory for grounding a normative account of free and autonomous agency. It is this normative account of free agency which provides the groundwork for a republican conception of social and global justice, based on the core-ideas of freedom as non-domination and autonomy as non-alienation. As the (...) author argues, republicans should endorse a sufficientarian account of social justice, which focuses on the nature of social relationships and their effects on people's ability to act freely and realize their fundamental interests. On the global level, the book argues for the cosmopolitan extension of the republican principles of non-domination and non-alienation within a multi-level democratic system. In so doing, the book addresses a major gap in the existing literature, presenting an original theory of justice, which combines Hegelian recognition theory and republican ideas of freedom, and applying this hybrid theory to the global domain. Fabian Schuppert creates a grand synthesis uniting neo-republican insights on freedom with Hegelian recognition theory. The result is an account of agency that arises from the idea of non-domination whose aim it is to safeguard individual freedom. When combined with Hegelian recognition theory a social focus also emerges. This amalgam comments on many of the major disputes concerning global justice from a cosmopolitan perspective. Because of the broad scope and the many contemporary discussions engaged this book will be of keen interest to scholars as well as a welcome addition to the classroom. (shrink)

This paper argues for a conception of autonomy that takes social oppression seriously without sapping autonomy of its valuable focus on individual self-direction. Building on recent work in relational accounts of autonomy, the paper argues that current conceptions of autonomy from liberal, feminist and critical theorists do not adequately account for the social features of belief formation. The paper then develops an alternative conception of relational autonomy that focuses on how autonomy contains both individualistic and social epistemic features. Rather than (...) consider autonomy to reside in an impenetrable inner citadel, a place immune from external influences, the paper argues that we must acknowledge the hermeneutic relationship between individual and social processes of belief adjudication. Taking such an argument seriously results in the need to alter our conception of autonomy and the schooling needed to foster its growth. (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)

John Christman has argued that constitutively relational accounts of autonomy, as defended by some feminist theorists, are problematically perfectionist about the human good. I argue that autonomy is constitutively relational, but not in a way that implies perfectionism: autonomy depends on a dialogical disposition to hold oneself answerable to external, critical perspectives on one's action-guiding commitments. This type of relationality carries no substantive value commitments, yet it does answer to core feminist concerns about autonomy.

In a world where issues of food safety and food security are increasingly important, the social responsibility of central actors in the food chain—producers and the main grocery chains—becomes more pressing. As a response, these actors move from implicitly assuming social responsibilities implied in laws, regulations and ethical customs, towards explicitly expressing social responsibilities. In this paper, we discuss the ethical values relevant for the social responsibility of central food producers and retailers in Norway, one of the most subsidized and (...) protected areas of food production in the world. How do the actors perceive and express their social responsibility, and—given their position in the local, national and global market—how should they handle these responsibilities? We analyze Tine and Nortura, two producers owned by farmer cooperatives with market regulator function, as well as Coop—a dominant grocery chain in Norway, with basis in the same public ownership model as the farmer-owned cooperative producers. While the complex roles of these key actors in the Norwegian food market have been criticized from several angles, we argue that these multifaceted roles put them in a good position to promote informed consumer choices in a globalized market. (shrink)

So far, recognition theory has focused its attention on modern capitalism and its formation in richer Western societies and has neglected issues of global poverty. A brief sketch of Axel Honneth's recognition theory precedes an examination of how the theory can contribute to a better understanding of global poverty, and justice in relation to poverty. I wish to highlight five ways in which recognition theory can enrich our inventory of theories dealing with global poverty and justice: It emphasizes the importance (...) of giving victims of poverty due weight in theorizing about poverty. It provides a vocabulary to conceptualize the experiences of suffering by poverty in terms of misrecognition. It highlights the importance of legal recognition and of actually having certain rights in order to be respected. It bases its critique of poverty on a particular idea of justice and how it should unfold. Finally, recognition theory demands that the poor must be involved in decision-making processes and their agency has .. (shrink)

In this article I argue that it does not make sense – either empirically or normatively – to speak of ‘authentic’ cultures. All we need when talking about cultures is a relatively weak concept that still carries enough normative weight to function as the meaningful background of a person’s identity, autonomy and good life. Discussing the authentic culture, I refer to the debates around the German Leitkultur as well as the Dutch populist movement as examples. However, I am interested not (...) only in the concept of the authenticity of a culture but also in the concept of the authenticity of persons: if an ‘authentic culture’ is not feasible, does this have repercussions on the concept of the autonomy and authenticity of persons? In suggesting that this might be the case, I argue that persons can be autonomous without always being fully authentic. (shrink)

Is implementing the beneficent nudge program morally permissible in worlds like ours? I argue that there is reason for serious doubt. I acknowledge that beneficent nudging is highly various, that nudges are in some circumstances morally permissible and even called for, and that nudges may exhibit respect for genuine autonomy. Nonetheless, given the risk of epistemic injustice that nudges typically pose, neither the moral permissibility of beneficent nudging in the abstract, nor its case-by-case vindication, appears sufficient to justify implementing a (...) nudge program in worlds like ours. Drawing on Miranda Fricker’s account of epistemic injustice, I argue that the cogent defense of any nudge program, relative to worlds like ours, stands in need of serious attention to its potential for fostering or sustaining epistemic injustice. A more specific point hinges on recognizing a form of epistemic injustice not enough attended to in the literature to date, which I call reflective incapacitational injustice. This includes relative disadvantages in the attaining of the capacity to engage in critical reason, such as the capacity to go in for potentially critical reasoned deliberation and discursive exchange concerning ends. Since Cass Sunstein’s First Law of behaviorally informed regulation would be taken, in worlds like ours, to justify indeterminately many nudges leading to such epistemic injustice we have general grounds for doubting the moral permissibility of this nudge program. We should hence oppose the implementation of any such program until it is shown not to violate the demands of epistemic justice. (shrink)

Ageism within the context of care has attracted increasing attention in recent years. Similarly, autonomy has developed into a prominent concept within health care law and ethics. This paper explores the way that ageism, understood as a set of negative attitudes about old age or older people, may impact on an older person’s ability to make maximally autonomous decisions within health care. In particular, by appealing to feminist constructions of autonomy as relational, I will argue that the key to establishing (...) this link is the concept of self-relations such as self-trust, self-worth and self-esteem. This paper aims to demonstrate how these may be impacted by the internalisation of negative attitudes associated with old age and care. In light of this, any legal or policy response must be sensitive to and flexible enough to deal with the way in which ageism impacts autonomy. (shrink)

El trabajo desarrolla una crítica y una propuesta sobre el uso de la calificación de vulnerable desde una perspectiva de género. A partir de un análisis crítico del concepto de autonomía clásica, se propone como científicamente más productiva la noción de autonomía relacional, que se considera más apta para explicar las acciones humanas reales, de personas no idealizadas, y se revela capaz de dar sentido al caso de las acciones relativamente constreñidas. Desde esta perspectiva se aborda el análisis de algunos (...) casos reales de aplicación del derecho donde la calificación de vulnerabilidad aplicada al contexto se muestra útil para identificar un espacio de derecho positivo perjudicial para las mujeres o las minorías. (shrink)

Many popular artificial intelligence (AI) ethics frameworks center the principle of autonomy as necessary in order to mitigate the harms that might result from the use of AI within society. These harms often disproportionately affect the most marginalized within society. In this paper, we argue that the principle of autonomy, as currently formalized in AI ethics, is itself flawed, as it expresses only a mainstream mainly liberal notion of autonomy as rational self-determination, derived from Western traditional philosophy. In particular, we (...) claim that the adherence to such principle, as currently formalized, does not only fail to address many ways in which people’s autonomy can be violated, but also to grasp a broader range of AI-empowered harms profoundly tied to the legacy of colonization, and which particularly affect the already marginalized and most vulnerable on a global scale. To counter such a phenomenon, we advocate for the need of a relational turn in AI ethics, starting from a relational rethinking of the AI ethics principle of autonomy that we propose by drawing on theories on relational autonomy developed both in moral philosophy and Ubuntu ethics. (shrink)

This paper explores the ambivalent effects of recognition through a critical examination of Axel Honneth’s theory of recognition. I argue that his underlying perfectionist account and his focus on the psychic effects of recognition lead him to overlook important connections between recognition and power. These claims are substantiated through Butler’s theory of gender performativity and recognition; and issues connected to the socio-institutional recognition of transgender identities. I conclude by suggesting that certain problems with Butler’s own position can corrected by drawing (...) more from the Foucauldian aspects of her work. I argue that this is the most promising way to conceptualise recognition and its complex, ambivalent effects. (shrink)

In this paper we defend the notion of narrative identity against Galen Strawson's recent critique. With reference to Elyn Saks's memoir of her schizophrenia, we question the coherence ofStrawsons conception of the Episodic self and show why the capacity for narrative integration is important for a flourishing life. We aho argue that Scú put pressure on narrative theories that specify unduly restncúve constraints on self-constituting narratives, and chrify the need to distinguish identity from autonomy.

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)

John Christman has recently objected to substantive conceptions of autonomy on the grounds that they introduce unwanted perfectionism into political thinking. I defend substantive conceptions of autonomy against Christman’s critique on two fronts. First, I defend substantive conceptions of autonomy against the charge that their utilisation in political theory would result in the inappropriate exclusion from democratic respect of individuals in oppressive relations. Second, I defend substantive conceptions of autonomy from the charge that they fail the ‘endorsement constraint’, i.e. that (...) incorporating a substantive conception of autonomy into the concept of the person at the heart of a political theory would be alienating for citizens. (shrink)

Autonomous e-coaching systems offer their users suggestions for action, thereby affecting the user's decision-making process. More specifically, the suggestions that these systems make influence the options for action that people actually consider. Surprisingly though, options and the corresponding process of option generation --- a decision-making stage preceding intention formation and action selection --- has received very little attention in the various disciplines studying decision making. We argue that this neglect is unjustified and that it is important, particularly for designers of (...) autonomous e-coaching systems, to understand how human option generation works. The aims of this paper are threefold. The first aim is to generate awareness with designers of autonomous e-coaching systems that these systems do in fact influence their users' options. The second is to show that understanding the interplay between a person's options and the e-coaching system's suggestions is important for improving the effectiveness of the system. The third is that the very same interplay is also crucial for designing e-coaching systems that respect people's autonomy. (shrink)

Risk is implicit in economic development. When does a course of economic development ethically balance risk and likely benefit? This paper examines the view of risk we find in Amartya Sen’s work on development. It shows that Sen’s capabilities approach leads to a more sensitive understanding of risk than traditional utility theory. Sen’s approach also supplies the basis of an argument for risk aversion in interventions that affect economic development. Sen’s approach describes development as aiming at freedom. The paper shows (...) how this claim can be made compatible with the social and relational basis of African communitarianism. (shrink)

What is the moral value of formal democratic decision-making? Egalitarian accounts of democracy provide a powerful answer to this question. They present formal democratic procedures as a way for a society of equals to arrive at collective decisions in a transparent and mutually acceptable manner. More specifically, such procedures ensure and publicly affirm that all members of a political community, in their capacity as autonomous actors, are treated as equals who are able and have a right to participate in collective (...) decision-making. Recently, a number of authors have raised what I describe as the ‘no impact’ objection. This objection focuses on the egalitarian emphasis on autonomy to cast doubt on the moral value of formal democratic procedures. It holds that individual participation in formal democratic decision-making has no impact on the eventual result, and therefore cannot be understood as an exercise in autonomy. Consequently, the ‘no impact’ objection claims that the moral value of formal democracy cannot be explained with reference to an egalitarian ideal of ‘rule by the people’. In this article, I refute this objection by complementing an egalitarian account of democracy with an account of basic autonomy. (shrink)

Relational conceptions of autonomy attempt to take into account the social aspects of autonomous agency. Those views that incorporate not merely causally, but constitutively necessary relational conditions, incorporate a condition that has the form: A necessary condition for autonomous agency is that the agent stands in social relations S. I argue that any account that incorporates such a condition cannot play one of autonomy’s key normative roles: identifying those agents who ought to be protected from paternalistic intervention. I argue, against (...) objections from Oshana, that there are good reasons for maintaining the notion of autonomy in this role, and thus that such relational conceptions should not be accepted. This rejection goes beyond that from John Christman, which holds only for those relational conditions which are value-laden. (shrink)

National minority women’s defense of nonliberal minority cultures that encompass sexist customs and rules has greatly perplexed liberal theorists. Many attempted to resolve this puzzle by attributing constrained agency to such women and dismissing their defense as unreasonable. This article argues that this liberal assessment of minority women’s position is philosophically indefensible and that the failure of mainstream liberalism to make sense of these women’s response indicates not that these women’s agency is compromised but rather that the liberal conception of (...) agency as autonomy at the heart of the liberal framework has limits in its crosscultural applicability. A conception of agency, valuational agency, that illuminates minority women’s agency is proposed as a more plausible alternative for radically pluralistic societies. -/- . (shrink)

This paper addresses whether universal, general education programs are enough to satisfy basic criteria of human rights, or whether comprehensive family planning programs, in conjunction with universal education programs, might also be morally required. Even before the Reagan administration instituted the ‘global gag rule’ at the 1984 conference in Mexico City, prohibiting funding to nongovernmental organizations that included providing information about abortion as a possible method of family planning, the moral acceptability of family planning programs has been called into question. (...) This paper makes a moral argument for family planning by appealing to both data and to theory: data about the efficacy of universal and comprehensive family planning education programs at reducing fertility and infant mortality, and theory about what is required for the establishment of autonomy. It reasons that universal educational programs are insufficient for the promotion of autonomy, and therefore argues on substantive autonomy grounds for comprehensive family planning programs in addition to universal education programs. (shrink)

This article discusses the educational significance of the moral demand for respect. In Ethics and Education, Richard Peters presents a conception of educational respect that was recently taken up by Krassimir Stojanov. This article responds to both Peters' and Stojanov's contributions and proposes another understanding of educational respect: to respect children is to treat them in a way that enables them to see themselves as persons endowed with dignity; that is, as having the equal standing to make claims on others.

This paper concerns the relationship between two questions. The first is a question about inner freedom: What is it to be rendered unfree, not by external obstacles, but by aspects of oneself? The second is a question about agency: What is it to fail at being a thing that genuinely acts, and instead to be a thing that is merely acted upon, passive in relation to its own behaviour? It is widely believed that answers to the first question must rest (...) on or be partly explained by answers to the second. Here I argue that this is a mistake: losses of inner freedom are not, after all, explicable in terms of failures of agency. To establish this conclusion, I consider three familiar lines of thought that appear to tie ideas about inner freedom to ideas about agency, each relating to a different conception of inner freedom: absence of inner constraint, self-government, and absence of determination by external forces. I argue that, in each case, any apparent conceptual reliance on a special conception of agency is merely illusory, the result being that we must allow clear water between our theories of inner freedom and our theories of agency. This conclusion is of significance for contemporary theories of agency and personal autonomy, as well as for ‘positive’ conceptions of political liberty. (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)

In almost all opt-in systems of postmortal organ procurement, if the deceased has not made a decision about donation, his relatives will be asked to make it. Can this decision power be justified? I consider three possible justifications. (1) We could presume the deceased to have delegated this power to his relatives. (2) It could be argued that, if the deceased has not made a decision, a proxy decision has to be made in his best interests. (3) The relatives could (...) have a standing of their own because they are singled out from the parties whose interests are being affected by the decision by the special relation they had to the deceased. None of these arguments turns out to be convincing. (shrink)

Cesarean delivery rates have been steadily increasing worldwide. In response, many countries have introduced target goals to reduce rates. But a focus on target goals fails to address practices embedded in standards of care that encourage, rather than discourage, cesarean sections. Obstetrical standards of care normalize use of technology, creating an imperative to use technology during labor and birth. A technological imperative is implicated in rising cesarean rates if physicians or patients fear refusing use of technology. Reproductive autonomy is at (...) stake since a technological imperative undermines patients’ ability to choose cesareans or refuse use of technology increasing the likelihood of cesareans. To address practices driven by a technological imperative I outline three physician obligations that are attached to respecting patient autonomy. These moral obligations show that a focus on respect for autonomy may prove not only an ideal ethical response but also an achievable practical response to lowering cesarean rates. (shrink)

The aim of this paper is to suggest that a necessary condition of autonomy has not been sufficiently recognized in the literature: the capacity to critically reflect on one’s practical attitudes (desires, preferences, values, etc.) in the light of new experiences . It will be argued that most prominent accounts of autonomy—ahistorical as well as history-sensitive—have either altogether failed to recognize this condition or at least failed to give an explicit account of it.

Recent philosophy has developed an overblown concept of autonomy. In fact we do not have moral autonomy, and personal autonomy we only have in the sense of being able to decide some things that affect the course of our lives, not in the sense of shaping these lives and being master over them; nor ought we to have autonomy in the latter sense, or come closer to having it. As for our political institutions, they do not presuppose, as prevailing doctrines (...) claim they do, citizens’ autonomy in a more demanding sense. Freedom and democracy as understood for instance in the German constitution only assume subordinates capable of deciding some matters on their own. Current talk of autonomy is just gilding people’s real dependence. (shrink)

This essay assess the compatibility of Eva Kittay's dependency critique with Rawlsian political liberalism. I argue for the inclusion of a modified version of Kittay's revisions within Rawlsian theory in order to yield a theory that suppports a substantial subset of dependency work. Beyond these selected changes, however, I argue that Kittay's other proposed changes should not be included because they are incompatible with Rawls, and furthermore, their incorporation does not yield a theory that includes utter dependents.

Who should be recognized as a refugee? This article seeks to uncover the normative arguments at the core of legal and philosophical conceptions of refugeehood. It identifies three analytically dist...

The rapid recent expansion of copyright law worldwide has sparked efforts to defend the ‘public domain’ of non-propertized information, often on the ground that an expansive public domain is a condition of a ‘free culture’. Yet questions remain about why the public domain is worth defending, what exactly a free culture is, and what role (if any) authors’ rights might play in relation to it. From the standard liberal perspective shared by many critics of copyright expansionism, the protection of individual (...) expression by means of marketable property rights in authors’ works serves as an engine of progress towards a fully competitive ‘marketplace of ideas’ – though only if balanced by an extensive public domain from which users may draw in the exercise of their own expressivity. This article shows that a significantly different, and arguably richer, conception of what a free culture is and how authors’ rights underpin it emerges from a direct engagement with the philosophy of Immanuel Kant. For Kant, progress towards a fully emancipated (i.e. a ‘mature’ or ‘enlightened’) culture can only be achieved through the critical intellectual activity that public communication demands: individual expressive freedom is only a condition, not constitutive, of this ‘freedom to make public use of one’s reason in all matters’. The main thesis defended in this article is that when Kant’s writings on publicity (critical public debate) are read in relation to his writings on the legal organization of publishing, a necessary connection emerges between authors’ rights – as distinct from copyrights – and what Jürgen Habermas and others have named the public sphere. I conclude that it is the public sphere, and not the public domain as such, that should serve as the key reference point in any evaluation of copyright law’s role in relation to the possibility of a free culture. (shrink)

This paper investigates the philosophical tensions between secular-liberalism and Islam, and reviews Islamic conceptualisations of knowledge, personhood and education, in order to conceptualise shakhsiyah Islamiyah as an authentic and credible form of personal agency within an Islamic worldview. It begins by examining the liberal critique of Islamic education and explores notions of authority and autonomy in Islamic educational theory. It proposes that these tensions exist to varying degrees in all educational practice. Some theoretical work to develop an Islamic understanding of (...) personal autonomy as selfhood is presented and translated into a concept of shakhsiyah Islamiyah. Finally, the possibility of understanding shakhsiyah Islamiyah as a dialogical Muslim-self is explored. (shrink)

This article argues that all-affected principle needs to be reconceptualized to account for the differences in the historical and current social position of those who are or who should be making legitimacy claims. Drawing on Butler’s theory of vulnerability, this article advances a new and more robust all-affected principle that affords a stronger claim to legitimacy to those most-deeply affected by both the current decision in question and the historical process and practices shaping the choices available. In particular, this article (...) identifies three sets of exclusions of groups and claims that drive this reformulation: first, cases of historical injustice such as indigenous peoples; second, cases of current processes of minoritization which silence or render some groups and opinions as marginal such as women, ethnic minorities or even people in lower economic classes; and third, cases of state establishment of boundaries and ‘worthy’ citizenship such as refugees making claims for relocation and asylum. (shrink)

To be autonomous is to be a law to oneself; autonomous agents are self-governing agents. Most of us want to be autonomous because we want to be accountable for what we do, and because it seems that if we are not the ones calling the shots, then we cannot be accountable. More importantly, perhaps, the value of autonomy is tied to the value of self-integration. We don't want to be alien to, or at war with, ourselves; and it seems that (...) when our intentions are not under our own control, we suffer from self-alienation. What conditions must be satisfied in order to ensure that we govern ourselves when we act? Philosophers have offered a wide range of competing answers to this question. (shrink)

In this Introduction, I situate the underlying project “Autonomy and Mental Disorder” with reference to current debates on autonomy in moral and political philosophy, and the philosophy of action. I then offer an overview of the individual contributions. More specifically, I begin by identifying three points of convergence in the debates at issue, stating that autonomy is: 1) a fundamentally liberal concept; 2) an agency concept and; 3) incompatible with (severe) mental disorder. Next, I explore, in the context of decisional (...) capacity assessments, the difficulties to reconcile 1) and 2) with 3) which they at the same time seem to imply. Having clarified the centrality of a cogent notion of mental disorder for addressing these difficulties, I comment on three promising lines of inquiry about the nature and scope of autonomy that emerge from the following chapters. (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)

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)