Like the ‘thoughts and prayers’ so commonly offered by politicians in the aftermath of disaster, it is incredibly common to hear ‘autonomy and dignity’ invoked together in response to some threat to human wellbeing. As such, it seems natural to assume they must bear some kind of relation to one another. But are they merely two core human interests, that happen to be vulnerable to the same kinds of threat? Or are they interrelated in a deeper way? What I aim (...) to do in this chapter is draw on the philosophical literature on both concepts to consider how they might be connected, and explore whether certain ways of connecting them are more fruitful than others. I argue that the two most prominent connections drawn in the philosophical literature – that dignity is grounded in autonomy, and that respect for dignity is synonymous with respect for autonomy – are both highly problematic. Instead, I suggest we see autonomy and dignity as mutually supportive. Doing so has both practical and theoretical benefits: it can help us identify threats to both autonomy and dignity; and it exposes theoretical lacunae, especially within the autonomy literature. (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)

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)

Value conflicts between individualism and collectivism are common. In philosophy, such conflicts have been conceptualized as conflicts between individuality and conformity, among other things. This article develops a more detailed conceptual framework by combining philosophical analysis with empirical observations. The focus is on value conflicts pertaining to LGBT (lesbian, gay, bisexual, and transgender) factors in a non-individualist society (Georgia). Conservative or traditional norms sometimes constrain LGBT individuals by influencing them to adapt to social expectations. The phenomenon is intuitively clear and (...) has been reported on in numerous quantitative investigations. A qualitative study has been conducted on how LGBT individuals in Georgia experience the constraining influence of such norms. Deep interviews (n=8) have clarified how, more precisely, the effects of those influences should be conceptualized. The results indicate that important distinctions between different types of influences, as well as different objects of influence, have been overlooked in previous philosophical inquiries about value conflicts in this context. The conceptual framework developed throughout the article should be of use to philosophers and social scientists studying individualism and collectivism, and to policymakers working with LGBT issues. (shrink)

Some have claimed that moral bioenhancement undermines freedom and authenticity – thereby making moral bioenhancement problematic or undesirable – whereas others have said that moral bioenhancement does not undermine freedom and authenticity – thereby salvaging its ethical permissibility. These debates are characterized by a couple of features. First, a positive relationship is assumed to hold between these agency-related concepts and the ethical permissibility of moral bioenhancement. Second, these debates are centered around individualistic conceptions of agency, like free choice and authenticity, (...) which hail from an atomistic tradition of autonomy. My view is that emphasizing individualistic conceptions of autonomy do not provide particularly strong foundations on which to argue about the issue of the permissibility of moral bioenhancement. This is because individualistic autonomy is not the kind of agency-related consideration we ought to value. Instead, I propose that we investigate the relationship between moral bioenhancement and a more relational kind of autonomy. Focusing on this latter relationship, on my view, clarifies the potential for moral bioenhancement to support or enhance people’s autonomy. (shrink)

Deep Brain Stimulation (DBS) is an invasive therapeutic method involving the implantation of electrodes and the electrical stimulation of specific areas of the brain to modulate their activity. DBS brings therapeutic benefits, but can also have adverse side effects. Recently, neuroethicists have recognized that DBS poses a threat to the very fabric of human existence, namely, to the selves of patients. This article provides a review of the neuroethical literature examining this issue, and identifies the crucial dimensions related to the (...) self which DBS may endanger—personal identity, authenticity, and autonomy. The most influential theories accounting for these dimensions are analyzed herein, and it is argued that most of these theories require further refinement. This paper also demonstrates the interrelation between personal identity, authenticity, and autonomy, and concludes that one can only fully understand the impact of DBS on the self when all of these factors are taken into account. (shrink)

The abstract individual is a model that represents real human beings in moral and political philosophy. It occupies a central role in individualist theories such as political liberalism and mainstream Western medical ethics. This article presents two methodological standards for assessing competing models. Taken together, the standards form an objective yardstick against which different constructions of the abstract individual can be evaluated. Thereby, the article introduces a new level of abstraction, and a new set of normative principles, to individualist moral (...) and political philosophy which facilitates reliable moral judgments between different models of human beings. (shrink)

Nossa seleção de verbetes parte do interesse de cada pesquisador e os dispomos de maneira histórico-cronológica e, ao mesmo tempo, temática. O verbete de Melissa Lane, “Filosofia Política Antiga” vai da abrangência da política entre os gregos até a república e o império, às portas da cristianização. A “Filosofia Política Medieval”, de John Kilcullen e Jonathan Robinson, é o tópico que mais demanda espaço na nossa seleção em virtude das disputas intrínsecas ao período, da recepção de Aristóteles pelo medievo e (...) da tensão entre poder Papal e Civil. No verbete “Liberalismo”, de Gerald Gaus, Shane Courtland e David Schmidtz, vemos as fontes fundantes da Filosofia Política da modernidade. As ideias de liberdade negativa e positiva se coadunam com a Ética Liberal e sua influência sobre a abrangência do valor fundamental da liberdade individual diante das políticas públicas. O texto de Ian Carter, “Liberdade Positiva e Liberdade Negativa”, expõe o paradoxo da liberdade em suas concepções valorativas e neutra, muito úteis para compreender os problemas políticos que enfrentamos hoje. Por fim, Bas Van Der Vossen no texto “Libertarianismo” trata das noções tensas entre Estado e indivíduos. A concepção de “liberdade de si”, genuinamente negativa, ganha destaque justificatório. Jackie Scully, no verbete Bioética Feminista, exemplifica o valor da influência dessas correntes no âmago de todos os contemporâneos. Sua escrita homenageia postumamente Anne Donchin com um apanhado histórico da luta de inserção de políticas feministas na pesquisa acadêmica global. No verbete “Democracia”, os professores brasileiros Gustavo Dalaqua e Alberto Ribeiro Barros acrescentaram tópicos importantes ao tema geral, respectivamente: “Construtivismo Representativo vs. Representação Descritiva” e “Democracia Contestatória de Philip Pettit”. O texto de Thomas Christiano perpassa os principais argumentos de justificação política contra e a favor da democracia ocidental, com foco central nas concepções de liberdade e igualdade. Os verbetes dispostos nessa seleção de textos são tendenciosos na medida que expressam o interesse genuíno de cada pesquisador com os assuntos relevantes em suas pesquisas. Em virtude disso, a escolha “adota um lado” em detrimento de outros – mais especificamente: de outro que poderia ser mais “progressista”. Por si só, o livro já nasce reclamando um segundo volume, que será providenciado. Colocamos de lado qualquer exigência de “imparcialidade”, algo que não existe na Filosofia, muito menos na Filosofia Política. Sobressai, nesse aspecto, o caráter reflexivo que o assunto exige e a importância do assunto, sem o qual não teríamos a modernas concepções de representatividade, as teorias da justiça ou mesmo as ciências sociais. Um outro volume, portanto, se faz imperativo, por conta da abrangência da própria SEP e do respeito a seu projeto inicial, genuinamente um plano plural. (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)

Digital media has become an integral part of people’s lives, and its ubiquity and pervasiveness in our everyday lives raise new ethical, social, cultural, political, economic and legal issues. Many of these issues have primarily been dealt with in terms of what is ‘right’ or ‘just’ with digital media and digitally-mediated practices, and questions about the relations between digital media and the good life are often left in the background. In short, what is often missing is an explicit discussion of (...) the relations between digital media and the good life. Under the label of ‘Net recommendation’, the present study aims to offer a balanced and constructive normative analysis of digital media, focusing on the relations between digital media and the good life. The project of Net recommendation aims to (re)assert the importance of actual discourses in our normative analysis of the relations between digital media and the good life. I pursue this project with a Walzerian approach to digital media and the good life that takes seriously (and, ideally, also interacts with) actual discourses. This approach allows us to have a better understanding of our normative judgements on the impacts of digital media has (or will have) on the good life and, at the same time, allows us to answer the question of ‘how should we live with digital media?’ more adequately. Moreover, the Walzerian approach is useful in both an intra-cultural and an inter¬cultural context. Using China’s Internet as a case study, I show that the relations between digital media and the good life in each culture should be examined in its own right. Together, I hope, this study provides an adequate illustration and defence of the project of Net recommendation that does not start with the assumption of digital media being a source of moral problem and strives to recommending specific ways to reform and/or transform digital media and digitally-mediated practices that allow us to have better relations with digital media and enable us to live better lives with them. (shrink)

This dissertation attempts to fill, in part, three lacunae in contemporary philosophical scholarship: first, the failure to identify the two distinct types of dialogism—psychological and interpersonal—that have been operative in discussions of the dialogical self; second, the lack of acknowledgement of the six most prominent features of interpersonal dialogism; and third, the unwillingness to recognize that interpersonal dialogism is a crucial feature of human ethical agency and identity. In Chapter One, I explain why dialogism has been relatively neglected—and certainly underappreciated—in (...) contemporary Western philosophy. In Chapter Two, I offer a picture of Mikhail Bakhtin’s conception of dialogism. I explain why and how Bakhtin focuses on the novel in his account of dialogism. I then offer an account of Bakhtin’s claim regarding the dialogism of the ‘inner’ speech of thought. In the second part of Chapter Two, I offer an account of Gadamer’s conception of dialogism. I begin my examination of Gadamer by discussing the event ontology that serves as the metaphysical framework for his account of “play” (Spiel) and dialogue. In doing so, I explain some of the most important ideas in this part of his thought, such as his notion of understanding, tradition, effective history, the fusion of horizons, and the text. I explain what Gadamer means by genuine conversation, or dialogue, and I then describe one of the most important ideas in Gadamer’s thought—his notion of “play.” In Chapter Three, I give a critical account of the most influential contemporary account of dialogism in psychology, offered by Hubert Hermans et al., specifically in terms of their establishment of dialogical self theory. My examination consists of several parts. First, I discuss the ways they conceptualize the self, temporally and spatially. Second, I offer a description of their account of I-positions within the dialogical self. Third, I examine their claims about the necessary features of the dialogical self, and argue against one of their claims, which says that dominance relations are intrinsic to dialogue. Fourth, I describe their account of the four kinds of relations that can emerge within the self (2010, 121). Fifth, I briefly discuss their view regarding the “[t]hree models of self and identity, associated with different historical phases” (4), that have predominated in Western history. Sixth, I consider their claim that there are “positions” within the self in addition to the “I-positions” noted above. And lastly, I evaluate their account of (what they call) the nine “features of good dialogue” (10). In Chapter Four, I offer a critical evaluation of the account of dialogue and dialogism developed by Dmitri Nikulin, arguably the leading contemporary philosopher on the subjects. While I address the features of his account that I think are correct, I ultimately argue that it is problematic for three main reasons: first, it fails to recognize the proper relationship between dialogue and agency; second, its elucidation of the necessary and sufficient conditions for dialogue contains conceptual inconsistencies; and third, its conception of the relation between dialogue and personhood has potentially disastrous ethical implications. In Chapter Five, I show how Heidegger’s notions of Dasein’s “Being-with” (Mitsein), “discourse” (Rede), and “solicitude” (Fursorge) help lay the groundwork for recognizing some important features of dialogism. I do three things in Chapter Six. First, I briefly discuss Charles Taylor’s work on dialogism. Second, I offer my account of the seven most prominent features of dialogism. And third, I argue that dialogism is a crucial feature of ethical agency and identity. To do so, I offer an example of a personal (and social) virtue, namely, empathy, which illustrates the important role dialogism plays in ethical agency. (shrink)

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)

The nature and role of the patient in biomedicine comprise issues central to bioethical inquiry. Given its developmental history grounded firmly in a backlash against 20th-century cases of egregious human subjects abuse, contemporary medical bioethics has come to rely on a fundamental assumption: the unit of care is the autonomous self-directing patient. In this article we examine first the structure of the feminist social critique of autonomy. Then we show that a parallel argument can be made against relational autonomy as (...) well, demonstrating how this second concept of autonomy fails to take sufficiently into account an array of biological determinants, particularly those from microbial biology. Finally, in light of this biological critique, we question whether or to what extent any relevant and meaningful view of autonomy can be recovered in the contemporary landscape of bioethics. (shrink)

I defend my pure social account of global autonomy from Steven Weimer's recent criticisms. In particular, I argue that it does not implicitly rely upon the very kind of nonsocial conception of autonomy that it hopes to replace.

Recent work on diachronic agency has challenged the predominantly structural or synchronic approach to agency that is characteristic of much of the literature in contemporary philosophical moral psychology. However, the embodied dimensions of diachronic agency continue to be neglected in the literature. This article draws on phenomenological perspectives on embodiment and narrative conceptions of the self to argue that diachronic agency and selfhood are anchored in embodiment. In doing so, the article also responds to Diana Meyers' recent work on corporeal (...) selfhood. (shrink)

Theories of autonomy commonly make reference to some form of endorsement: an action is autonomous insofar as the agent has a second-order desire towards the motivating desire, or takes it to be a reason for action, or is not alienated from it. In this paper I argue that all such theories have difficulty accounting for certain kinds of agents, what I call ‘Woody Allen cases’. In order to make sense of such cases, I suggest, it is necessary to disambiguate two (...) distinct forms of endorsement, both of which contribute to autonomy. (shrink)

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)

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)

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)

In this paper I look at various ways that interpersonal and social relations can be seen as required for autonomy. I then consider cases where those dynamics might play out or not in potentially paternalistic situations. In particular, I consider cases of especially vulnerable persons who are attempting to reconstruct a sense of practical identity required for their autonomy and need the potential paternalist’s aid in doing so. I then draw out the implications for standard liberal principles of paternalism, specifically (...) in clinical or therapeutic situations. The picture of potential paternalism that emerges here is much more of a dynamic, interpersonal scenario rather than a case of two separate individuals making decisions independent of each other. (shrink)

This article joins in and extends the contemporary debate on the right to privacy. We bring together two strands of the contemporary discourse on privacy. While we endorse the prevailing claim that norms of informational privacy protect the autonomy of individual subjects, we supplement it with an argument demonstrating that privacy is an integral element of the dynamics of all social relationships. This latter claim is developed in terms of the social role theory and substantiated by an analysis of the (...) role of privacy in intimate relationships, in professional relationships and in social interactions between strangers in public. We conclude by arguing that it is not always reasonable to assume a conflict between individual privacy on the one hand and society on the other. Legislators and participants in public debate also have to take into account the consequences of limiting privacy on social interaction and the integration of the society. (shrink)

In recent work, Peter Railton, Julia Annas, and David Velleman aim to reconcile the phenomenon of “flow”—broadly understood as describing the “unreflective” aspect of skilled action—with one or another familiar conception of agency. While there are important differences between their arguments, Railton, Annas, and Velleman all make, or are committed to, at least one similar pivotal claim. Each argues, directly or indirectly, that agents who perform skilled unreflective actions can, in principle, accurately answer “Anscombean” questions—”what” and “why” questions— about what (...) they do. I argue against this claim and explore the ramifications for theories of skilled action and agency. (shrink)

In this paper I propose and develop a social account of global autonomy. On this view, a person is autonomous simply to the extent to which it is difficult for others to subject her to their wills. I argue that many properties commonly thought necessary for autonomy are in fact properties that tend to increase an agent’s immunity to such interpersonal subjection, and that the proposed account is therefore capable of providing theoretical unity to many of the otherwise heterogeneous requirements (...) of autonomy familiar from recent discussions. Specifically, I discuss three such requirements: (i) possession of legally protected status, (ii) a sense of one’s own self-worth, and (iii) a capacity for critical reflection. I argue that the proposed account is not only theoretically satisfying but also yields a rich and attractive conception of autonomy. (shrink)

(2013). Autonomy and the Normativity Question: Framing Considerations. International Journal of Philosophical Studies. ???aop.label???. doi: 10.1080/09672559.2012.727014.

It has been argued that voluntary euthanasia (VE) and physician-assisted suicide (PAS) are morally wrong. Yet, a gravely suffering patient might insist that he has a moral right to the procedures even if they were morally wrong. There are also philosophers who maintain that an agent can have a moral right to do something that is morally wrong. In this article, I assess the view that a suffering patient can have a moral right to VE and PAS despite the moral (...) wrongness of the procedures in light of the main argument for a moral right to do wrong found in recent philosophical literature. I maintain that the argument does not provide adequate support for such a right to VE and PAS. (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)

Many philosophers believe that agents are self-ruled only when ruled by their (authentic) selves. Though this view is rarely argued for explicitly, one tempting line of thought suggests that self-rule is just obviously equivalent to rule by the self . However, the plausibility of this thought evaporates upon close examination of the logic of ‘self-rule’ and similar reflexives. Moreover, attempts to rescue the account by recasting it in negative terms are unpromising. In light of these problems, this paper instead proposes (...) that agents are self-ruled only when not ruled by others. One reason for favouring this negative social view is its ability to yield plausible conclusions concerning various manipulation cases that are notoriously problematic for nonsocial accounts of self-rule. A second reason is that the account conforms with ordinary usage. It is concluded that self-rule may be best thought of as an essentially social concept. (shrink)

When philosophers consider factors compromising autonomy in consent, they often focus solely on the consent-giver’s agential capacities, overlooking the impact of the consent-receiver’s conduct on the consensual character of the activity. In this paper, I argue that valid consent requires justified trust in the consent-receiver to act only within the scope of consent. I call this the Trust Condition (TC), drawing on Katherine Hawley’s commitment account of trust. TC constitutes a belief that the consent-receiver is capable and willing to act (...) as we expect from them. If such trust is not warranted, I argue, consent lacks the appropriate normative grounds. After establishing TC, I explore its application in the sexual arena, asserting that due to the non-contractual dimensions of sexual activity — such as the dynamic nature of sexual desires and the absence of external factors effectively binding sexual partners to the terms of consent—trust is warranted in sexual consent by means of care. I define care as a special sensitivity and attention toward the partner’s will and discuss how this approach leads to safer intimate relationships in practice. (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)

In recent times, informed consent has been adopted worldwide as a cornerstone to ensure autonomy during HIV testing. However, there are still ongoing debates on whether the edifice on which informed consent requirements are grounded, that is, personal autonomy, is philosophically, morally, and practically sound, especially in countries where HIV is an epidemic and/or may have a different ontological perspective or lived reality. This study explores the views of participants from Zambia. In-depth and focus group discussions were conducted at various (...) locations in Lusaka and Chongwe, Zambia. Participants came from various demographics, including people living with HIV, healthcare professionals and workers, policymakers, pregnant women, churchgoers, teachers, rural-based persons, and police officers. Data were manually analysed by conducting inductive and deductive thematic analyses. Results show that participants were not in favour of HIV policies that promote personal autonomy at the expense of pursuit of the common good. Participants viewed interdependence, not autonomy, as an essential characteristic of being human. The participants’ views have a realistic potential to provide a contextual and appropriate ethical, respectful, and realistic foundation for HIV testing policies. (shrink)

This article investigates how human life is conceptualized in the design and use of digital assistants and how this conceptualization feeds back into the life really lived. It suggests that a specific way of conceptualizing human life — namely as a set of tasks to be optimized — is responsible for the much-criticized information hunger of these digital assistants. The data collection of digital assistants raises not just several issues of privacy, but also the potential for improving people’s degree of (...) self-determination, because the optimization model of daily activity is genuinely suited to a certain mode of self-determination, namely the explicit and reflective setting, pursuing, and monitoring of goals. Furthermore, optimization systems’ need for generation and analysis of data overcomes one of the core weaknesses in human capacities for self-determination, namely problems with objective and quantitative self-assessment. It will be argued that critiques according to which digital assistants threaten to reduce their users’ autonomy tend to ignore that the risks to autonomy are derivative to potential gains in autonomy. These critiques are based on an overemphasis of a success conception of autonomy. Counter to this conception, being autonomous does not require a choice environment that exclusively supports a person’s “true” preferences, but the opportunity to engage with external influences, supportive as well as adverse. In conclusion, it will be argued that ethical evaluations of digital assistants should consider potential gains as well as potential risks for autonomy caused by the use of digital assistants. (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)

The aims of this paper are to: (1) identify the best framework for comprehending multidimensional impact of deep brain stimulation on the self; (2) identify weaknesses of this framework; (3) propose refinements to it; (4) in pursuing (3), show why and how this framework should be extended with additional moral aspects and demonstrate their interrelations; (5) define how moral aspects relate to the framework; (6) show the potential consequences of including moral aspects on evaluating DBS’s impact on patients’ selves. Regarding (...) (1), I argue that the pattern theory of self can be regarded as such a framework. In realizing (2) and (3), I indicate that most relevant issues concerning PTS that require resolutions are ontological issues, including the persistence question, the “specificity problem”, and finding lacking relevant aspects of the self. In realizing (4), I identify aspects of the self not included in PTS which are desperately needed to investigate the full range of potentially relevant DBS-induced changes—authenticity, autonomy, and responsibility, and conclude that how we define authenticity will have implications for our concept of autonomy, which in turn will determine how we think about responsibility. Concerning (5), I discuss a complex relation between moral aspects and PTS—on one hand, they serve as the lens through which a particular self-pattern can be evaluated; on the other, they are, themselves, products of dynamical interactions of various self-aspects. Finally, I discuss (6), demonstrating novel way of understanding the effects of DBS on patients’ selves. (shrink)

Since the automation revolution of our technological era, diverse machines or robots have gradually begun to reconfigure our lives. With this expansion, it seems that those machines are now faced with a new challenge: more autonomous decision-making involving life or death consequences. This paper explores the philosophical possibility of artificial moral agency through the following question: could a machine obtain the cognitive capacities needed to be a moral agent? In this regard, I propose to expose, under a normative-cognitive perspective, the (...) minimum criteria through which we could recognize an artificial entity as a genuine moral entity. Although my proposal should be considered from a reasonable level of abstraction, I will critically analyze and identify how an artificial agent could integrate those cognitive features. Finally, I intend to discuss their limitations or possibilities. (shrink)

The author reviews various conceptions of autonomy to show that humans are actually not autonomous, strictly speaking. He argues for a need to rethink the personal autonomy approaches to HIV testing in sub-Saharan Africa (SSA) countries. HIV/AIDS has remained a leading cause of disease burden in SSA. It is important to bring this disease burden under control, especially given the availability of current effective antiretroviral regimens in low- and middle-income countries. In most SSA countries the ethic or value of personal (...) autonomy or self-determination is promoted as primary in HIV testing decision-making. SSA policymakers have an ontological and moral duty to adopt HIV testing policies that reflect human and medical realities, relationships, local contexts, and respect human rights for both individuals and others who are affected by HIV in society. Without rethinking the value of autonomy in HIV testing decision-making, the article cautions that attainment of the Sustainable Development Goal (SDG) 3 and the UNAIDS fast-track strategy that explicitly call to end the epidemic by 2030 will not be feasible for SSA. (shrink)

In this article, I develop a tension in the capabilities approach between committing to political liberalism and ensuring full capability for all persons. In particular, I argue that the capabiliti...

The notion of authenticity, i.e., being “genuine,” “real,” or “true to oneself,” is sometimes held as critical to a person’s autonomy, so that inauthenticity prevents the person from making autonomous decisions or leading an autonomous life. It has been pointed out that authenticity is difficult to observe in others. Therefore, judgments of inauthenticity have been found inadequate to underpin paternalistic interventions, among other things. This article delineates what justifies judgments of inauthenticity. It is argued that for persons who wish to (...) live according to the prevailing social and moral standards and desires that are seriously undesirable according to those standards, it is justified to judge that a desire is inauthentic to the extent that it is due to causal factors that are alien to the person and to the extent that it deviates from the person’s practical identity. The article contributes to a tradition of thinking about authenticity which is known mainly from Frankfurt and Dworkin, and bridges the gap between theoretical ideals of authenticity and real authenticity-related problems in practical biomedical settings. (shrink)

Questions about the nature of self and self-consciousness are closely aligned with questions about the nature of autonomy. These concepts have deep roots in traditional philosophical discussions that concern metaphysics, epistemology and ethics. They also have direct relevance to practical considerations about informed consent in medical contexts. In this paper, with reference to understanding specific side effects of deep brain stimulation treatment in cases of, for example, Parkinson’s Disease, Obsessive Compulsive Disorder, and Major Depressive Disorder, I’ll argue that it is (...) best to frame discussions of informed consent in terms of relational autonomy and a pattern theory of self. (shrink)

Cognitive scientists have identified a wide range of biases and heuristics in human decision making over the past few decades. Only recently have bioethicists begun to think seriously about the implications of these findings for topics such as agency, autonomy, and consent. This article aims to provide an overview of biases and heuristics that have been identified and a framework in which to think comprehensively about the impact of them on the exercise of autonomous decision making. I analyze the impact (...) that these biases and heuristics have on the following dimensions of autonomy: understanding, intentionality, absence of alienating or controlling influence, and match between formally autonomous preferences or decisions and actual choices or actions. (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)

Drawing on the built environment concept of “inclusive design” and its emphasis on creating accessible environments for all persons regardless of ability, I suggest that a central task for feminist disability theory is to redesign foundational philosophical concepts to present opportunities rather than barriers to inclusion for people with disability. Accounts of autonomy within liberal philosophy stress self-determination and the dignity of all individual persons, but have excluded people with intellectual disability from moral and political theories by denying their capacity (...) for individual autonomy, seen as a chief marker of moral personhood. This paper modifies and extends feminist theories of relational autonomy by arguing for the need to view autonomy as a feature of persons that is manifested only through relations of support, advocacy, and enablement. An “inclusively designed,” relational account negotiates the tensions encountered in attempts to apply autonomy to people with high support needs, and politicizes the concept as an advocacy tool for people with intellectual disability and their allies. (shrink)

In this article, I assess the position that voluntary euthanasia and physician-assisted suicide ought not to be accepted in the cases of persons who suffer existentially but who have no medical condition, because existential questions do not fall within the domain of physicians’ professional expertise. I maintain that VE and PAS based on suffering arising from medical conditions involves existential issues relevantly similar to those confronted in connection with existential suffering. On that basis I conclude that if VE and PAS (...) based on suffering arising from medical conditions is taken to fall within the domain of medical expertise, it is not consistent to use the view that physicians’ professional expertise does not extend to existential questions as a reason for denying requests for VE and PAS from persons who suffer existentially but have no medical condition. (shrink)

It is plausible to think that part of what it is to be an autonomous agent is to adequately respond to important changes in one’s circumstances. The agent who has set her own course in life, but is unable to recognize and respond appropriately when evidence arises indicating the need to reconsider and perhaps adjust her plan, lacks an important form of personal autonomy. However, this “evidence-responsiveness” aspect of autonomy has not yet been adequately analyzed. Most autonomy theorists ignore it (...) altogether and the few who have addressed it have failed to give a satisfactory account. In this paper, I first examine an evidence-responsiveness condition proposed by Arneson. I argue there that while Arneson’s condition provides a valuable framework in which to examine evidence-responsiveness, there are several crucial issues that it either fails to address at all or else fails to adequately resolve. That condition is therefore in need of further elaboration and refinement. I then examine a recent article in this journal by Blöser, Schöpf, and Willaschek which develops an account of autonomy that I argue can usefully be understood as employing and elaborating upon the general framework offered by Arneson. I argue that while the elaboration Blöser and her co-authors provide Arneson’s condition is instructive, it is inadequate in several important ways which indicate the form a more satisfactory evidence-responsiveness condition will take. I go on to develop such a condition and conclude by highlighting the advantages to be gained by including that condition in a complete theory of autonomy. (shrink)

The majority of current attention on the question of autonomy has focused on the internal reflection of the agent. The quality of an agent’s reflection on her potential action (or motivating desire or value) is taken to determine whether or not that action is autonomous. In this paper, I argue that there is something missing in most of these contemporary accounts of autonomy. By focusing overwhelmingly on the way in which the agent reflects, such accounts overlook the importance of what (...) the agent is reflecting upon. Whichever of these current formulations of autonomy we accept, reflection could be undertaken in full accordance with the conditions set, and yet the action fail to be autonomous. This will occur, I argue, if the agent is mistaken about the object of her reflection. More precisely, if she has a particular kind of false belief about the action she is contemplating undertaking, then no amount of reflection can render that action autonomous. This suggests the need for externalist conditions to be incorporated into an account of autonomy. (shrink)

MacKay and Robinson (2016) claim that some legal procedures that regulate organ donations (VAC, opt-in, opt-out) bypass people's rational capacities and thus are “potentially morally worse than MAC”, which only employs a very mild form of coercion. We provide a critique of their argumentation and defend the opposite thesis: MAC is potentially morally worse than the three other options.

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)

In the past three decades a number of narrative self-concepts have appeared in the philosophical literature. A central question posed in recent literature concerns the embodiment of the narrative self. Though one of the best-known narrative self-concepts is a non-embodied one, namely Dennett’s self as ‘a center of narrative gravity’, others argue that the narrative self should include a role for embodiment. Several arguments have been made in support of the latter claim, but these can be summarized in two main (...) points. Firstly, a logical one: without taking the body into account Dennett’s theory becomes self-refuting. Secondly, a more practical/phenomenological point: a disembodied self-concept overlooks how personal the body is, and as such should be considered part of the self. In this paper I endorse these criticisms of non-embodied narrative self-concepts, but I argue that the relationship between the narrative self and the body is far from sufficiently fleshed out. I claim that the narrative self and the body are much more interwoven than the above criticisms suggest. What I aim to show in this paper is that the relationship between the body and the narrative self is interactive rather than unidirectional: not only does our body shape our narrative self, but our narrative self also shapes our body. The upshot of this is a better conception of the self is as a dynamic interaction between its various aspects. (shrink)