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)

In the 1990s, Dutch nature policy adopted a new policy concept, ‘nature development', whereas, until then, ‘nature preservation’ had largely dominated both the discourses and practices of nature policy-making. Nature development can be regarded as the Dutch counterpart of concepts such as ecological restoration, emerging simultaneously in other national nature policies. This paper argues that the rise of the nature development concept in the Netherlands is mainly due to the entrepreneurial strategies of a relatively small group of individuals. To study (...) the impact of the latter's entrepreneurial strategies on the adoption and implementation of the new concept, we first made a content analysis of nature-policy documents issued between 1977, when the concept of nature development was coined for the first time, and 2012. Next, we analysed newspaper articles covering the debate on Dutch nature policy. Third, we conducted semi-structured interviews with the key individuals involved. This article deliberately takes an agency perspective, emphasising the complementary roles that policy entrepreneurs played in the different phases of the policy change process, with concept developers, early adopters and translators, and early implementers. Their success is to be attributed to a smart combination of discursive and network strategies. (shrink)