The attention economy — the market where consumers’ attention is exchanged for goods and services — poses a variety of threats to individuals’ autonomy, which, at minimum, involves the ability to set and pursue ends for oneself. It has been argued that the threat wireless mobile devices pose to autonomy gives rise to a duty to oneself to be a digital minimalist, one whose interactions with digital technologies are intentional such that they do not conflict with their ends. In this (...) paper, we argue that there is a corresponding duty to others to be an attention ecologist, one who promotes digital minimalism in others. Although the moral reasons for being an attention ecologist are similar to those that motivate the duty to oneself, the arguments diverge in important ways. We explore the application of this duty in various domains where we have special obligations to promote autonomy in virtue of the different roles we play in the lives of others, such as parents and teachers. We also discuss the consequences of our arguments for employers, software developers, and policy makers. (shrink)

Critics of persuasive advertising argue that it undermines the autonomy of consumers by manipulating their desires in morally problematic ways. My aim is this paper is to refine that argument by employing a conception of autonomy that is not at odds with certain forms of manipulation. I argue that the charge of manipulation is not sufficient for condemning persuasive advertising. On my view, manipulation of an agent’s desires through advertising is justifiable in cases where the agent accepts the process through (...) which the desires were developed. I show how the standard manipulation objection proves too much as it would also condemn cases of that kind. I argue that this distinction is especially important when we consider the implications of “new media.” In addition to increasing vulnerability to manipulation, new media have considerable impacts on well-being. By siding with the traditional autonomy argument, we would be compelled to take an implausible stand against all forms of manipulation through advertising, but I suggest that only a proper subset of those cases are morally problematic. This conclusion opens up a space for persuasive advertising that is permissible while nevertheless condemning cases that violate consumers’ autonomy. (shrink)

Fears of alienation and anomie in liberal societies have driven many writers to emphasize care and commitment as essential ingredients of human well-being and as educational aims. Conceiving autonomy to be incompatible with these values, they have concluded that autonomy should be replaced with alternative conceptions of human well-being and of education that emphasize care and commitment. The claim I will try to defend in this paper is that, in contrast to these views, there is no contradiction between autonomy on (...) the one hand and care and commitment on the other; hence acknowledgment of the importance of the latter pair of values need not lead to the rejection of the ideal of autonomy. (shrink)

In recent years, several studies have advocated the need to expand the concept of patient autonomy beyond the capacity to deliberate and make decisions regarding a specific medical intervention or treatment (decision-making or decisional autonomy). Arguing along the same lines, this paper proposes a multidimensional concept of patient autonomy (decisional, executive, functional, informative and narrative) and argues that determining the specific aspect of autonomy affected is the first step towards protecting or promoting (and respecting) patient autonomy. These different manifestations of (...) autonomy are not mutually dependent; there may be patients who have problems in one dimension, while at the same time being fully autonomous in others. Nevertheless, a close interaction has been observed between the various dimensions and indeed, a phenomenological analysis shows that damage to or a reduction in one aspect of people’s capacity for self-government generally affects other aspects of their autonomy, which in turn disrupts their identity and the way in which they see themselves and are seen by others. In this paper, I shall examine some of these interactions and show how they may lie at the heart of the problem of poor treatment adherence (where adherence is defined as being the extent to which a patient’s behavior over time coincides with the recommendations made by and agreed with their health professional). One example given is that of psoriasis, a chronic skin disease with a very poor adherence record. In Spain, it is calculated that 85% of patients diagnosed with mild to moderate psoriasis fail to comply properly with their treatment, and figures from other parts of the world are similar. Although there are many possible causes for non-adherence among psoriasis patients, assessing their decisional, executive and narrative capacities and taking appropriate action based on the results may help increase adherence rates. (shrink)

This essay lays the groundwork for a novel conception of autonomy that may be called “effective autonomy”—a conception designed to be genuinely action guiding in bioethics. As empirical psychology research on the heuristics and biases approach shows, decision making commonly fails to correspond to people’s desires because of the biases arising from bounded cognition. People who are classified as autonomous on contemporary philosophical accounts may fail to be effectively autonomous because their decisions are uncoupled from their autonomous desires. Accordingly, continuing (...) attempts to value patient autonomy must go beyond existing philosophical conceptions of autonomy to consider the background conditions of human decision making. (shrink)

The aim of this article is to explore the impact of commercial marketing on personal autonomy. Several philosophers argue that marketing conflicts with ideals of autonomy or, at best, is neutral to these ideals. After qualifying our concept of marketing and introducing the distinctions between (i) divergent and convergent marketing and (ii) being autonomous and acting autonomously, we demonstrate the heretofore unnoticed positive impact of marketing on autonomy. Specifically, we argue that (i) convergent marketing has a significant potential to reinforce (...) autonomous action and (ii) divergent marketing has a significant potential to reinforce the state of being autonomous. (shrink)

The use of tanning beds has been identified as being among the most significant causes of melanoma and non-melanoma skin cancer. Accordingly, the activity is properly seen as one that involves profound harm to self. The article examines paternalistic reasons for restricting sunbed usage. We argue that both so-called soft and hard paternalistic arguments support prohibiting the use of sunbeds. We make the following three arguments: an argument from oppressive patterns of socialization suggesting that the autonomous nature of the conduct (...) in question is questionable; an argument from so-called evaluative delusions in which individuals attach incorrect weights to some of their values; a strictly hard paternalistic argument appealing to the harm in itself pertaining to the use of sunbeds. (shrink)

Like being able to drive a car, being autonomous is a socially attributed, claimed, and contested status. Normative debates about criteria for autonomy (and what autonomy entitles one to) are best understood, not as debates about what autonomy, at core, really is, but rather as debates about the relative merits of various possible packages of thresholds, entitlements, regulations, values, and institutions. Within different “regimes” of autonomy, different criteria for (degrees of) autonomy become authoritative. Neoliberal, solidaristic, and perfectionist regimes entail conflicting (...) understandings of what gets you autonomy and what autonomy gets you—for example, in relation to policies regarding physician-assisted suicide or financial support for senior citizens. In light of this, justifying a particular understanding of autonomy is inseparable from the task of arguing for the context-specific merits of a regime of autonomy as a whole and in relation to other ethical and political commitments. (shrink)

The spectacular progress in assisted reproduction technology that has been witnessed for the past thirty years resulted in emerging new ethical dilemmas as well as the revision of some perennial ones. The paper aims at a feminist approach to oocyte and spare embryo donation for research. First, referring to different concepts of autonomy and informed consent, we discuss whether the decision to donate oocyte/embryo can truly be an autonomous choice of a female patient. Secondly, we argue the commonly adopted language (...) of gift is misleading and that calling for altruism could put female patients at risk of exploitation. Finally, we point out that the presence of gender stereotypes in the procreative area casts doubt whether even a more robust notion of informed consent manages to overcome this risk. (shrink)

In this essay I critique two influential accounts of rational autonomy in common schooling that conceive liberalism as an ideal form of life, and I offer an alternative approach to democratic education that views liberal theory as concerned with coexistence among rival ways of living. This view places moral agency, not rational autonomy, at the heart of schooling in liberal societies—a moral agency grounded in initiation into dynamic traditions that enable self-definition and are accompanied by exposure to life-paths other than (...) one’s own. This alternative challenges the tendency in large diverse democracies (such as those of the US and the UK) to prefer common to particularistic schools, thereby placing many types of faith and secular schools on a more equal footing and providing moral justification for education in the national cultures of small liberal republics (such as Denmark, Israel and Lithuania) that maintain special relationships to particular groups while acknowledging the rights of all citizens. I call this approach the pedagogy of difference. (shrink)

Common-sense holds that morality requirespeople who know that they are infected with theHuman Immunodeficiency Virus (HIV) to disclosethis fact to their sexual partners. But manygay men who are HIV-positive do not disclose,and AIDS Service Organizations (ASOs) promotepublic-health policies based on safer sex byall, rather than disclosure by those who knowthat they are infected. The paper shows thatthe common-sense view follows from a minimalsexual morality based on consent. ASOs'seeming rejection of the view follows fromtheir need to take seriously widespreadweakness of will (...) in the realm of sexuality. The author argues that gay men take themselvesto follow the common sense view, but hold thatthe possibility of a partner's HIV infection isbackground information that need not bedisclosed for sexual consent. This suggestionis criticized. The paper concludes with aconsideration of HIV disclosure and sexualethics outside of the gay community and oflegal restrictions on the sexuality of theHIV-positive. (shrink)

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)

It is sometimes argued that autonomous decision-making requires that the decision-maker’s desires are authentic, i.e., “genuine,” “truly her own,” “not out of character,” or similar. In this article, it is argued that a method to reliably determine the authenticity (or inauthenticity) of a desire cannot be developed. A taxonomy of characteristics displayed by different theories of authenticity is introduced and applied to evaluate such theories categorically, in contrast to the prior approach of treating them individually. The conclusion is drawn that, (...) in practice, the authenticity of desires cannot be reliably determined. It is suggested that authenticity should therefore not be employed in informed consent practices in healthcare. (shrink)

Respect for autonomy is a central moral principle in bioethics. The concept of autonomy can be construed in various ways. Under the non-ideal conceptualization proposed by Beauchamp and Childress, everyday choices of generally competent persons are autonomous to the extent that they are intentional and are made with understanding and without controlling influences. It is sometimes suggested that authenticity is important to personal autonomy, so that inauthenticity prevents otherwise autonomous persons from making autonomous decisions. Building from Beauchamp and Childress’s theory, (...) this article develops a non-ideal authenticity-based conceptualization of personal autonomy. Factors that indicate inauthentic decision-making are explicated, and the full concept is defended from three expected objections. The theory is then tested on a paradigm case which has concerned theorists and practitioners for some time, namely the possible inauthenticity of anorexia nervosa patients’ decision-making. It is concluded that the theory seems to be fruitful in analyses of the degree of autonomy of patients’ decision-making, and that it succeeds in providing reliable action-guidance in practical contexts. (shrink)

ABSTRACT I have two main theses. The first is that the inference from accepting an educational aim, especially an ideal aim such as self-realization or critical thinking, to a conclusion as to the content or structure of a curriculum is fallacious. The first thesis should not be controversial. But even if so, the aims-curricula fallacy is readily committed, and that calls for explanation. My second thesis is that the aims–curricula fallacy is often committed because the possibilities for realizing educational aims (...) through indirect methods or learning is ignored. (shrink)

Autonomy is often considered a core value of Western society that is deeply entrenched in moral, legal, and political practices. The development and deployment of artificial intelligence (AI) systems to perform a wide variety of tasks has raised new questions about how AI may affect human autonomy. Numerous guidelines on the responsible development of AI now emphasise the need for human autonomy to be protected. In some cases, this need is linked to the emergence of increasingly ‘autonomous’ AI systems that (...) can perform tasks without human control or supervision. Do such ‘autonomous’ systems pose a risk to our own human autonomy? In this article, I address the question of a trade-off between human autonomy and system ‘autonomy’. (shrink)

Mental capacity and autonomy are often understood to be normatively neutral? the only values or other norms they may presuppose are those the assessed person does or would accept. We show how mental disorder threatens normatively neutral accounts of autonomy. These accounts produce false positives, particularly in the case of disorders (such as depression, anorexia nervosa and schizophrenia) that affect evaluative abilities. Two normatively neutral strategies for handling autonomy-undermining disorder are explored and rejected: a blanket exclusion of mental disorder, and (...) functional tests requiring consistency, expression of identity, reflective non-alienation or lack of compulsion. Finally, we suggest ways in which substantivist alternatives to neutrality can be made more promising through increased transparency, democratic contestability of conditions for capacity and autonomy, and a historically sensitive caution concerning restrictions of liberty. (shrink)

According to a number of influential views in penal theory, 1 one of the primary goals of the criminal justice system is to rehabilitate offenders. Rehabilitativemeasures are commonly included as a part of a criminal sentence. For example, in some jurisdictions judges may order violent offenders to attend anger management classes or to undergo cognitive behavioural therapy as a part of their sentences. In a limited number of cases, neurointerventions — interventions that exert a direct biological effect on the brain (...) — have been used as aids to rehabilitation, typically being imposed as part of criminal sentences, separate treatment orders, or conditions of parole. Examples of such interventions include medications intended to attenuate addictive desires in substance-abusing offenders and agents intended to suppress libido in sex offenders.This chapter reviews some of the ethical issues raised by the use of neurointerventions as aids to rehabilitation. (shrink)

While it is intuitive to many that oppressive socialization undermines autonomy in virtue of its ability to shape the desires and values of the oppressed, it’s difficult to provide a plausible account of autonomy that can explain when and why socialization is autonomy undermining. I provide such an account, arguing that self-respect is a necessary condition for autonomous choice and that oppressive socialization functions in part by undermining the self-respect of the oppressed. On my account, our choices lack autonomy to (...) the degree that they are motivated by a failure to respect ourselves as beings whose plans and desires matter as much as anyone else’s; whose capacity for rational deliberation and practical reasoning are valuable; and whose particularities and interests contribute to our value. This theory of personal autonomy is able to account for the lack of autonomy in a wide range of cases, for example, a cult member being brainwashed by a cult leader, or a wife being subservient to her husband. I defend this account against objections which claim that it is disrespectful to the oppressed to claim that their autonomy is undermined by their oppression, and in the final chapter, I expand my theory to explain not only what our minds must be like for us to be autonomous, but also what the world outside of us must be like. (shrink)

The books’ goal is to answer the question: Do the weaknesses of value-free economics imply the need for a paradigm shift? The author synthesizes criticisms from different perspectives (descriptive and methodological). Special attention is paid to choices over time, because in this area value-free economics has the most problems. In that context, the enriched concept of multiple self is proposed and investigated. However, it is not enough to present the criticisms towards value-free economics. For scientists, a bad paradigm is better (...) than no paradigm. Therefore, the author considers whether value-based economics with normative approaches such as economics of happiness, capability approach, libertarian paternalism, and the concept of multiple self can be the alternative paradigm for value-free economics. This book is essential reading to everyone interested in the current state of economics as a discipline. (shrink)

Is it possible to construct a machine that can act of its own accord? There are a number of skeptical arguments which conclude that autonomous machine agency is impossible. Yet if autonomous machine agency is impossible, then serious doubt is cast on the possibility of autonomous human action, at least on the widely held assumption that some form of materialism is true. The purpose of this dissertation is to show that autonomous machine agency is possible, thereby showing that the autonomy (...) of human action is compatible with materialism. ;I proceed as follows. Chapter 1 casts the problem of autonomous machine agency. Chapter 2 sets out the skeptic's case against autonomous machine agency by canvassing arguments against the possibility of machine agency and arguments against the possibility of autonomous machine agency. Chapter 3 begins work on a theory of autonomous machine agency by developing and defending axioms of a theory of agency from thought experiments and examples. Chapter 4 expands the theory of agency to a theory of autonomous agency by adding axioms of autonomy. ;The axioms of autonomous agency contain the primitive terms 'belief', 'desire', and 'deliberation', which require further explication if the theory is to be of any use in arguing for the possibility of autonomous machine agency. Chapters 5 and 6 take up this challenge by developing mathematically tractable axioms of deliberation, belief, and desire. ;Chapter 7 completes the theory by developing axioms of mechanism derived from the substantial literature in the foundations of computer science. Chapter 8 employs the resulting theory of autonomous machine agency to show just how the functional prerequisites of autonomous agency can in principle be met by machines, thereby demonstrating the possibility of autonomous machine agency. ;Chapter 9 serves as a cautionary postscript. In spite of having shown that autonomous machine agency is possible, the implications are not always happy for current efforts in artificial intelligence or current philosophical theories of autonomous human agency. Nevertheless, the argument for autonomous machine agency suggests several research programs at the nexus of Philosophy of Mind and Artificial Intelligence. (shrink)

This thesis is an attempt to constructively interpret and critically evaluate the liberal doctrine that we may not limit a person’s liberty for her own good, and to discuss its implications and alternatives in some concrete areas of public health policy. The thesis starts theoretical and goes ever more practical. The first paper is devoted to positive interpretation of anti-paternalism with special focus on the reason component – personal good. A novel generic definition of paternalism is proposed, intended to capture, (...) in a generous fashion, the object of traditional liberal resistance to paternalism – the invocation of personal good reasons for limiting of or interfering with a person’s liberty. In the second paper, the normative aspect of this resistance is given a somewhat technical interpretation in terms of invalidation of reasons – the blocking of reasons from influencing the moral status of actions according to their strength. It is then argued that normative anti-paternalism so understood is unreasonable, on three grounds: 1) Since the doctrine only applies to sufficiently voluntary action, voluntariness determines validity of reasons, which is unwarranted and leads to wrong answers to moral questions. 2) Since voluntariness comes in degrees, a threshold must be set where personal good reasons are invalidated, leading to peculiar jumps in the justifiability of actions. 3) Anti-paternalism imposes an untenable and unhelpful distinction between the value of respecting choices that are sufficiently voluntary and choices that are not. The third paper adds to this critique the fourth argument that none of the action types typically proposed to specify the action component of paternalism is such that performing an action of that type out of benevolence is essentially morally problematic. The fourth paper ignores the critique in the second and third papers and proposes, in an anti-paternalistic spirit, a series of rules for the justification of option-restricting policies aimed at groups where some members consent to the policy and some do not. Such policies present the liberal with a dilemma where the value of not restricting people’s options without their consent conflicts with the value of allowing people to shape their lives according to their own wishes. The fifth paper applies the understanding of anti-paternalism developed in the earlier papers to product safety regulation, as an example of a public health policy area. The sixth paper explores in more detail a specific public health policy, namely that of mandatory alcohol interlocks in all cars, proposed by the former Swedish government and supported by the Swedish National Road Administration. The policy is evaluated for cost-effectiveness, for possible diffusion of individual responsibility, and for paternalistic treatment of drivers. The seventh paper argues for a liberal policy in the area of dissemination of information about uncertain threats to public health. The argument against paternalism is based on common sense consequentialist considerations, avoiding any appeal to the normative anti-paternalism rejected earlier in the thesis. (shrink)

As the use of nudges by governmental agencies becomes more common, the need for normative guidelines regarding the processes by which decisions about the implementation of specific nudges are taken becomes more acute. In order to find a justified set of such guidelines one must meet several theoretical challenges to Libertarian Paternalism that arise at the foundational level. In this paper, I identify three central challenges to Libertarian Paternalism, and suggest that Susan Hurley's political philosophy as presented in her Natural (...) Reasons (1989) can be viewed as offering powerful responses to them. (shrink)

The phenomenon of weakness of will – not doing what we perceive as the best action – is not recognized by neoclassical economics due to the axiomatic assumptions of the revealed preference theory (RPT) that people do what is best for them. However, present bias shows that people have different preferences over time. As they cannot be compared by the utility measurements, economists need to normatively decide between selves (short- versus long-term preferences). A problem is that neoclassical economists perceive RPT (...) as value-free and incorporate present bias within the economic framework. The axiomatic assumption that people do what is best for them leads to theoretical and practical dilemmas. This work examines weakness of will to resolve some shortcomings of RPT. The concept of intention is used to provide multiple self conception with the framework to decide between selves, which had not been done before. The paper concludes that individuals should not always follow their revealed preferences (desires) but the intentions (reason) because the latter indicates what people really want. (shrink)

Ordinary Language Philosophy has largely fallen out of favour, and with it the belief in the primary importance of analyses of ordinary language for philosophical purposes. Still, in their various endeavours, philosophers not only from analytic but also from other backgrounds refer to the use and meaning of terms of interest in ordinary parlance. In doing so, they most commonly appeal to their own linguistic intuitions. Often, the appeal to individual intuitions is supplemented by reference to dictionaries. In recent times, (...) Internet search engine queries for expressions of interest have become quite popular. Apparently, philosophers attempt to surpass the limits of their own linguistic intuitions by appealing to experts or to factual uses of language. I argue that this attempt is commendable but that its execution is wanting. Instead of appealing to dictionaries or Internet queries, philosophers should employ computer-based linguistic corpora in order to confirm or falsify hypotheses about the factual use of language. This approach also has some advantages over methods employed by experimental philosophers. If the importance of ordinary language is stressed, the use of linguistic corpora is hardly avoidable. (shrink)

This thesis explores the relationship between the capability approach to justice and liberal philosophy. I argue that the most compelling articulation of the capability approach—one given by Martha Nussbaum—suffers from an unattractive kind of inconsistency. On the one hand, Nussbaum is committed to formulating a robust account of a dignified human life which can give rise to a range of individual entitlements which ought to be guaranteed to all individuals. On the other hand, Nussbaum is committed to political liberalism which (...) requires state institutions to uphold strict neutrality between a variety of reasonable conceptions of the good. Nussbaum’s first commitment results in the formulation of a list of ten central human capabilities. However, I argue that the content and justification of this list cannot be successfully established in a way that is consistent with Nussbaum’s second commitment. Therefore, in this thesis, I propose a novel capability approach: a two-step approach which consists of two principles arranged in lexical priority. First, governments have a moral obligation to secure individuals with a meta-capability of autonomy. That is to say, governments must provide the conditions which are conducive to individuals exercising a range of agentic competencies which are constitutive of autonomous judgement. Second, governments have a moral obligation to provide opportunities for individuals to exercise this meta-capability in six domains of well-being: health, politics, knowledge, relationships, self-expression, and work. I argue that exercising autonomous choice in the pursuit of welfare is necessary for a good life, regardless of the specific choices individuals eventually make, and even if they choose to forgo some supposedly valuable choices altogether. My proposal has two striking features which set it apart from other articulations of the capability approach. First, my proposal is comprehensive in that it relies on a particular view about what is a valuable way of life. In my view, a way of life is valuable if it is pursued autonomously, that is to say, if it involves an individual exercising a set of agentic competencies and standing in appropriate relations with other people. And second, by virtue of being based in this particular comprehensive claim, my account of justice is anti-perfectionist. That is to say, my proposal does not aim to compel people to make valuable choices. Rather, it aims to equip people with the means to live the kind of life they find valuable and worth living. I then apply this capability approach to the domain of education, and I argue it can be useful in formulating an ambitious and transformative approach to education. In particular, I develop a program of civic education aimed at responding to the problems associated with disinformation and ‘post-truth’ trends in politics. (shrink)

Several authors have recently advocated a so-called new case for paternalism, according to which empirical findings from distinct decision sciences provide compelling reasons in favour of paternalistic interference. In their view, the available behavioural and neuro-psychological findings enable paternalists to address traditional anti-paternalistic objections and reliably enhance the well-being of their target agents. In this paper, I combine insights from decision-making research, moral philosophy and evidence-based policy evaluation to assess the merits of this case. In particular, I articulate and defend (...) three complementary arguments that, I claim, challenge even the best available calls for such case. In doing so, I identify the main justificatory challenges faced by the new paternalists and explicate the implications of these challenges for the ongoing philosophical debate about the justifiability of paternalistic interference. (shrink)

Philosophical work on free will, contemporary as well as historical, is inevitably framed by the problem of free will and determinism. One of my goals in what follows is to give a feel for the main lines of that debate in philosophy today. I will also be outlining a particular perspective on free will. Many working philosophers consider themselves Compatibilists; the perspective outlined, building on a number of arguments in the recent literature, is a contemporary form of such a view. (...) It cannot, however, claim to be the contemporary philosophical perspective. There is no such thing. Against a background of the perennial problem of free will and determinism, through ongoing argument and debate, philosophers continue to try to work toward an understanding of precisely what it means for an action to be free. (shrink)

Being autonomous depends on the kind of relations we enjoy in the different domains of our lives, but the impact of decision-making and the power exercise that takes place in the political sphere, makes political relations crucial to our development and enjoyment of autonomy. This dissertation develops a novel view of political participation by interrogating its connection to our personal autonomy. According to this view, our political relations are partially constitutive of our personal autonomy, which in other words means there (...) is a political aspect of our autonomy. The kind of political relations we should hold to fully enjoy our autonomy is what I call Relations of Mutual Recognition. It is the mutual recognition of each agent’s autonomous standing—translated into a proper distribution of political power— that will face dominating political relations. The basis for that domination comes from our democracies’ power imbalances that condition influence over political decision-making to each individual’s economic, social or cultural standing. Consequently, there are political conditions for our autonomy to thrive. Relations of Mutual Recognition require two main conditions: non-domination and control. I take these two neo-republican ideals and redefine them to shape what a proper distribution of political power amounts to. Political participation comes in precisely to identify a way to challenge power imbalances. Therefore, my definition of political participation, which I call Collective Self-Government, requires a particular sort of implementation. Accordingly, I suggest a deliberative and inclusive arrangement that involves direct and innovative forms of decision-making, and more importantly, grants relevant shares of authority to all actors, i.e., common citizens, legislators, technocrats, etcetera. This project could rightly belong to both a relational approach to autonomy and be labelled as a version of deliberative democracy. However, relational accounts focus on our social relations, whilst I claim that we cannot be “less” or non-autonomous in the political sphere and still enjoy an autonomous life. Likewise, the participatory focus—in the sense of inclusion of all actors—of this proposal more accurately turn it into either a participatory version of deliberative democracy or a deliberative version of participatory democracy. (shrink)

Do non-human animals have an interest in sociopolitical freedom? Cochrane has recently taken up this important yet largely neglected quest ion. He argues that animal freedom is not a relevant moral concern in itself, because animals have a merely instrumental but not an intrinsic interest in freedom (Cochrane 2009a, 2012). This paper will argue that even if animals have a merely instrumental interest in freedom, animal freedom should nonetheless be an important goal for our relationships with animals. Drawing on recent (...) work on the value of freedom, it will be argued that freedom is non-specifically instrumentally valuable. Accordingly, freedom is a means to other goods, but often it is not possible to identify those goods in advance or aim for them directly. Some of the reasons that make freedom non-specifically valuable for human relationships, it will be argued, also apply to relationships between humans and animals. Amongst other implications, it will be shown how this argument provides a response to those who fear that stricter animal protection policies might undermine people’s freedom: A concern for freedom actually requires stricter protection policies rather than speak against them. (shrink)

Amartya Sen, the initiator of the Capability Approach, rejects perfectionism and the idea that theorists can, or ought to, predefine what capabilities we have reason to value. Instead he insists that the route to social justice stay true to the liberal ideal of value pluralism and human diversity and demands a content-neutral procedure of reflective scrutiny. This paper investigates the theoretical underpinnings assumed in such a procedural account. Can it avoid perfectionistic assumptions? I think it cannot for two reasons. First, (...) it is clear that a deliberative process is taken to be valuable without it being a product of such a process. It is thus taken to be a priori valuable. Consequently, the capabilities that enable citizens to successfully partake in such a process are taken to be what we have reason to value. Second, I argue, Sen’s procedural approach is primarily aimed at enhancing freedom understood as personal autonomy. I then ask if Sen successfully can deflect perfectionistic allegations by referring to a formal and content-neutral account of autonomy. Again, I conclude he cannot. This suggests that Sen’s rejection of perfectionism is untenable. (shrink)

In recent decades politicians and policy-makers have emphasised the need to shift from a “passive” to an “active” welfare state. This has resulted in policies that reduce compensation rates in social insurance or make compensation conditional on different requirements such as participation in rehabilitation or vocational training. This article argues that such policies are justified if they tend to ensure an adequate level of personal autonomy. To that effect, a ‘thick’ conception of personal autonomy is spelled out based on Norman (...) Daniels’ extension of the principle of fair equality of opportunity. Some objections to policies limiting entitlement to social insurance are discussed. It is argued that although the objections fail to show that limited entitlement to social insurance is always unjustified, they identify considerations that must be taken into account for an overall assessment of such policies. (shrink)

Drawing on empirical evidence in medicine, economics, law, and anthropology, I argue that a market is uniquely capable of meeting the demand for transplantable kidneys, and that it may be arranged so as to operate safely. The welfare gains, expected to accrue to both vendors and recipients, are sufficient to justify sales. Having spelled out the considerations recommending a kidney market, I address the most forceful objections facing the proposal. Despite its currency, the claim that incentives will crowd out altruistic (...) donors and result in a decrease in supply is empirically unsupported and predicated on an implausible view of donorsâ motives. A host of objections claim vendorsâ will not give informed consent. Many such objections identify easily remediable problems, or impose unreasonable standards â standards that would rule out morally permissible kidney donation. And all presuppose a model of morally transformative consent that, I argue, is deficient. Two further challenges point to harms inflicted on those who do not participate in the market. Some claim that those in poverty will be subject to harmful social and legal pressure to vend. This objection fails to distinguish between being pressured to perform a specific act, and being under general economic pressure and having the option to perform an act. It, moreover, presupposes vending more common than is possible. Others worry that the market will give rise to unfair pecuniary externalities. This objection also presupposes that kidney sales will occur more often than is possible. But more importantly, the normative consideration that is supposed to make such externalities especially objectionable, in fact, recommends allowing sales. I also make a political case for kidney sales. I offer an account of the stateâs proper role in the market. I begin with a conception of democratic equality according to which the state is responsible to secure for its citizens the preconditions for democratic participation. I then show that this end would be promoted were the state to end the current prohibition on sales. (shrink)

In Axel Honneths Recht der Freiheit (RF) dienen persönliche Beziehungen, zu welchen Honneth neben Familien- und Liebesbeziehungen auch die Freundschaft zählt, der Verwirklichung einer „besondere[n], schwer zu charakterisierende[n] Form von Freiheit“ (RF 233). Diese Behauptung fügt sich ein in die Kernthese des Rechts der Freiheit. Demnach vermochte es die „Freiheit im Sinne der Autonomie des Einzelnen“ innerhalb unzähliger „Vorstellung[en] vom Guten“ als einzige, die moderne Gesellschaft nachhaltig zu prägen, wohingegen alle anderen Werte, die in der Moderne wirkmächtig geworden sind, als (...) „Facette[n] der konstitutive[n] Idee der individuellen Autonomie“ (RF 35) verstanden werden müssen. Wir argumentieren, dass Honneths Erörterung des Werts von Freundschaft in dreierlei Hinsicht sein Ziel verfehlt: Erstens zwingt sie Honneth zu einer radikalen Beschneidung des Freundschaftsbegriffs, indem er einen überzogenen Kontrast zwischen antiken und modernen Konzeptionen von Freundschaft zeichnet. Zweitens marginalisiert Honneth mit seiner Betrachtung andere Axiologien der Freundschaft, welche dieser gewichtige instrumentelle, konstitutive und finale Werte zuweisen. Drittens scheint selbst eine schwächer angelegte These, die den Wert, den Freundschaften für die individuelle Freiheit haben, auf die Stellung eines primus inter pares zurückstuft, immer noch den zentralen Wert, den Freundschaften für uns haben sollten, zu verfehlen. Dadurch wird Honneths Kernthese von der Exklusivität des Wertes der Freiheit für unsere Gesellschaft in Frage gestellt. (shrink)

Any ethical argument involving the problems of access to assisted reproductive technologies should entail the discussion of the decision protocol and consider the individual deliberating on the appropriateness of these remedies from the point of view of self and community. Yet, arguments based on patients' own moral calculations are rare in the bioethics literature. The moral voice behind most discourses concerning ARTs is that of an outwardly independent spectator, who nonetheless proceeds to justify a personally significant worldview in the utilization (...) of these resources. Investigators grounded in social and legal sciences have offered relevant arguments in this regard, but because their discourses are derived from research protocols specific to their respective disciplines, they fail to provide a general rationale applicable to moral deliberation. (shrink)

Integrity is one of the leading normative concepts employed in our society. We frequently talk about the degree of integrity of community leaders and famous historical figures, and we highly value integrity in our elected public officials. But philosophers have had a difficult time arriving at consensus about what integrity consists in. Some claim that it is a purely formal relation of consistency, others that it has to do primarily with one‟s identity, and still others that it involves subjective or (...) objective moral requirements. The primarily goal here is to outline the leading facets of integrity in the contemporary philosophical literature. (shrink)

Helen Frowe has recently offered what she calls a “practical” account of self-defense. Her account is supposed to be practical by being subjectivist about permissibility and objectivist about liability. I shall argue here that Frowe first makes up a problem that does not exist and then fails to solve it. To wit, her claim that objectivist accounts of permissibility cannot be action-guiding is wrong; and her own account of permissibility actually retains an objectivist (in the relevant sense) element. In addition, (...) her attempt to restrict subjectivism primarily to “urgent” situations like self-defense contradicts her own point of departure and is either incoherent or futile. Finally, the only actual whole-heartedly objectivist account she criticizes is an easy target; while those objectivist accounts one finds in certain Western European jurisdictions are immune to her criticisms. Those accounts are also clearly superior to hers in terms of action-guidingness. (shrink)

This study is a contribution to the bioethical debate about new and possibly emerging reproductive technologies. Its point of departure is the intuition, which many people seem to share, that using such technologies to select non-disease traits – like sex and emotional stability - in yet unborn children is morally problematic, at least more so than using the technologies to avoid giving birth to children with severe genetic diseases, or attempting to shape the non-disease traits of already existing children by (...) environmental means, like education. The study employs philosophical analysis for the purpose of making this intuition intelligible and judging whether it is justified. Different ways in which the moral problems posed by reproductive technologies are often framed in bioethical debates are criticised as inadequate for this task. In particular, it is argued that the intuition cannot fully be made sense of in terms of harm to the children that such technologies help create. The study attempts to elaborate an alternative to that broadly consequentialist approach, by drawing on Martin Heidegger’s philosophy of technology, Hans Jonas’s ethics, and Aristotle’s practical philosophy, as it has been received and developed in the hermeneutical tradition. It is suggested that reproductive choices, unlike decisions for already born children, are characterised by a peculiar one-sidedness: the future child appears to the parents as something wholly theirs to decide about, not as a concrete other with whom they must interact in a responsive and attuned way. This is problematic because it means that such choices cannot call upon the particularised moral understanding only gained in interpersonal encounters. In particular, it makes them easily shaped by various tendencies, to which parents are always susceptible, to relate to children in instrumentalising ways, and at risk of reinforcing such tendencies. However, this does not mean that all uses of reproductive technologies are equally troubling. When selecting against severe disease the parents can rely on a widely shared illness experience to escape the dangers that one-sidedness involves. It is concluded that the intuition under discussion, thus explicated and in some ways qualified, makes sense morally. (shrink)

Paternalism is not acceptable in dentistry today because it eliminates the patients’ right to choose the treatment they feel is right for them, even if their choice is not what the doctor feels is best. Paternalism violates the patient’s autonomy and self-determination. Dentists accept the ethical principle of non-maleficence and in many countries, are also recognizing the right to informed consent. Most people trust health professionals who serve them. Dentists are among the trusted professionals, and the paper will investigate the (...) attitudes to dentists in several different countries as examples. When patients request inappropriate dental treatment, the dentist must decide how to balance a concern with patients' wellbeing with respect for their choices. It is important for a dentist to keep this in mind and to reflect of its implications, especially when dental practice seems to be changing so much under the influence of the malpractice crises, the changing economic scene, the changing regulatory environment, and so on. A dentist must consider the patient’s values and personal preferences, and must involve the patient in the decision-making process. It is the dentist’s responsibility to determine the decision-making capacity of each patient with the help of appropriate surrogates. For example, patients may be given choices about which type of tooth repair they will choose, given that there are often choices between what an insurance will cover and what an insurance will not cover. Are dental implants only for the rich, and dentures for the poor? Is there a class divide between a silver, gold or white smile? Ethics affect virtually every decision made in a dental office, encompassing activities of both judging and choosing, relationship with patients, the public, office staff, and other professionals. This paper gives an overview of bioethical issues in dental practice and explains the fact that dental ethics cannot support paternalism even in prevention. (shrink)