In this paper, I discuss a subset of preferences in which a person desires the fulfillment of a choice they have made, even if it involves the violation of their desires, as in rape fantasies. I argue that such cases provide us with a unique insight into personal autonomy from a proceduralist standpoint. In its first part, I analyze some examples in light of Frankfurt's endorsement theory and argue that even when we cannot endorse a practical decision that involves being (...) violated, we nonetheless regard those cases as instances of autonomy. Therefore, autonomy does not necessarily require endorsement. Instead, I propose that the nature of the relevant highest-order volition dictates the procedure that should be established in one’s desire structure for its fulfillment. In the second part, I discuss how an agent may effectively consent to the violation of their decision by another person. Ordinary consent typically refers to actions but fails to communicate one's higher-order desires or commitments. To address this limitation, I propose a practical tool that accomplishes this by signaling shifts in the normative context where the agents are interacting. (shrink)

What justifies political power? Most philosophers argue that consent or democracy are important, in other words, it matters how power is exercised. But this book argues that outcomes primarily matter to justifying power.

In a Ulysses contract, A gets B, at t1, to agree (i) to act at t2 in such a way that A is made to abide by her own earlier intentions and (ii) to ignore A’s later attempt to rescind the authorization. But why does A’s will at t2 lack the authority it had at t1? This article makes the case that a person has authority to enter a Ulysses contract only insofar as her expressed will at t1 is a (...) better expression of the values that remain attributable to her at t2 than is her expressed will at t2. (shrink)

Many believe that paternalism is less wrong in intimate relationships. In this paper, we argue that this view cannot be justified by appeal to (i) beneficence, (ii) shared projects, (iii) vulnerability, (iv) epistemic access, (v) expressivism, or (vi) autonomy as nonalienation. We finally provide an error theory for why many may have believed that paternalism is less wrong in intimate relations.

This paper defends the epistemic account of the normativity of requests. The epistemic account says that a request does not create any reasons and thus does not have any special normative power. Rather, a request gives reasons by revealing information which is normatively relevant. I argue that compared to competing accounts of request normativity, especially those of David Enoch and James H.P. Lewis, the epistemic account gives better answers to cases of insincere requests, is simpler, and does a better job (...) incorporating the importance of relationships. I also defend the epistemic account from three objections: that requests are important because they constitute consent, that requests and wishes must be normatively different, and that some requests do not provide any new information. (shrink)

Children conceived in order to donate biological material to save the life of an already existing child are known as 'saviour siblings'. The primary reasons that have been offered against the practice are: (i) creating a saviour sibling has negative impacts on the created child and (ii) creating a saviour child represents a wrongful procreative motivation of the parents. In this paper we examine to what extent the creation of saviour siblings actually presents a special case in procreative ethics. Although (...) we do not deny that there is a unique feature present in the saviour sibling case—namely, that the child was created to save their sibling’s life, we argue that the distinctive feature of being a saviour sibling does not make the procreative act wrong. Our claim is that the features that would make the creation of a particular saviour sibling (im)permissible are the same features that would make the creation of any child (im)permissible. Our conclusion is that saviour siblings—in relation to the reasons for the (im)permissibility of their creation—are not a special case for procreative ethics. (shrink)

I introduce a new distinction between two types of paternalism, which I call ‘internal’ and ‘external’ paternalism. The distinction pertains to the question of whether the paternalized subject’s current evaluative judgments are mistaken relative to a standard of correctness that is internal to her evaluative point of view—which includes her ‘true’ or ‘ideal’ self—as opposed to one that is wholly external. I argue that this distinction has important implications for (a) the distinction between weak and strong paternalism; (b) the distinction (...) between soft and hard paternalism; and (c) medical practice, where internal paternalism can, and probably often does, occur. (shrink)

Consider three cases: -/- Turn: A trolley is about to kill five innocent strangers. You can turn the trolley onto me, saving the five and killing me. -/- Hurl: A trolley is about to kill five innocent strangers. You can hurl me at the trolley, saving the five and paralyzing me. -/- TurnHurl: A trolley is about to kill five innocent strangers. You can turn the trolley onto me, saving the five and killing me. You can instead hurl me at (...) the trolley, saving the five and paralyzing me. -/- Most find the following four claims intuitively plausible: -/- (1) It is permissible to turn the trolley onto me in Turn. (2) It is impermissible to hurl me at the trolley in Hurl. (3) It is impermissible to turn the trolley onto me in TurnHurl. (4) It is permissible to hurl me at the trolley in TurnHurl. -/- But how does turning go from permissible to impermissible, and hurling from impermissible to permissible, when both alternatives are available? I argue that such “secondary permissibility” claims are explained by contrastive consent. Even if I do not consent to being harmed, it is likely I’ll consent to being hurled at the trolley rather than being turned onto. (shrink)

Recent years have seen a proliferation of philosophical work on consent. Within this body of work, philosophers often appeal to an account of the interests, values, or functions that underpin the power of consent. By far the most commonly cited value realized by the power of consent is the promotion and protection of the power-holder’s autonomy. This focus on autonomy yields what I call the Gate Opener Model of consent, according to which the central valuable function of consent is to (...) give the power-holder control over whether other people can act in certain ways. In this article, I argue that the Gate Opener Model of consent is inadequate. I then defend an alternative Relational Model of consent, according to which a central valuable function of consent is to enable a non-instrumentally valuable form of interaction between people. (shrink)

This paper argues against the call to democratize artificial intelligence (AI). Several authors demand to reap purported benefits that rest in direct and broad participation: In the governance of AI, more people should be more involved in more decisions about AI—from development and design to deployment. This paper opposes this call. The paper presents five objections against broadening and deepening public participation in the governance of AI. The paper begins by reviewing the literature and carving out a set of claims (...) that are associated with the call to “democratize AI”. It then argues that such a democratization of AI (1) rests on weak grounds, because it does not answer to a demand of legitimization, (2) is redundant in that it overlaps with existing governance structures, (3) is resource intensive, which leads to injustices, (4) is morally myopic and thereby creates popular oversights and moral problems of its own, and finally, (5) is neither theoretically nor practically the right kind of response to the injustices that animate the call. The paper concludes by suggesting that AI should be democratized not by broadening and deepening participation but by increasing the democratic quality of the administrative and executive elements of collective decision making. In a slogan: The question is not so much whether AI should be democratized but how. (shrink)

Typical philosophical discussions of physician-assisted death have focused on whether the practice can be permissible. We address a different question: assuming that pad can be morally permissible, how far does that permission extend? We will argue that granting requests for pad may be permissible even when the pad recipient can no longer speak for themselves. In particular, we argue against the ‘competency requirement’ that constrains pad-eligibility to presently-competent patients in most countries that have legalized pad. We think pad on terminally (...) ill, incapacitated patients can be morally permissible in cases where advance directives or suitable surrogate decision-makers are available, and should be legally permissible in such cases as well. We argue that this view should be accepted on pain of inconsistency: by allowing surrogate decision-makers to request withdrawal of life-sustaining care on behalf of patients and by allowing patients to request pad, we rule out any plausible justification for imposing a competency requirement on pad. (shrink)

A number of criticisms of Utilitarianism – such as “nearest and dearest” objections, “demandingness” objections, and “altruistic” objections – arise because Utilitarianism doesn’t permit partially or wholly disregarding the utility of certain subjects. A number of authors, including Sider, Portmore and Vessel, have responded to these objections by suggesting we adopt “dual-maximizing” theories which provide a way to incorporate disregarding. And in response to “altruistic” objections in particular – objections noting that it seems permissible to make utility-decreasing sacrifices – these (...) authors have suggested adopting a dual-maximizing theory that permits disregarding one’s own utility. In this paper I’ll defend two claims. First, I’ll argue that dual-maximizing theories are a poor way to incorporate disregarding. Instead, I’ll suggest that “variable-disregarding” theories provide a more attractive way to incorporate disregarding. Second, I’ll argue that the right way to handle these “altruistic” objections isn’t to permit disregarding one’s own utility, it’s to permit disregarding the utility of those who consent. Together, these two claims entail that the best way to modify Utilitarianism to handle “altruistic” objections is to adopt a variable-disregarding view that disregards the utility of those who consent. (shrink)

This chapter sets out John Rawls’s conception of autonomy and considers the role that it plays in his thought across A Theory of Justice and Political Liberalism. I suggest that one distinctive but overlooked feature of this conception is that it takes seriously the threat to autonomy that arises from how individuals are shaped by their social and political institutions. After setting out this conception and tracing its connections to wider discussions of autonomy, I argue for two main conclusions. First, (...) that despite appearances to the contrary, Rawls’s autonomy-based commitments are broadly speaking consistent across his two main works. Second, that these autonomy-based commitments are not in fact disbarred from playing a grounding role in Political Liberalism. On the contrary, I suggest that Rawls’s conception of autonomy motivates his aim of finding principles of justice that can be stable, and that this in turn illuminates his later commitment to a political liberalism. (shrink)

Decision-making Capacity matters to whether a patient’s decision should determine her treatment. But why it matters in this way isn’t clear. The standard story is that dmc matters because autonomy matters. And this is thought to justify dmc as a gatekeeper for autonomy – whereby autonomy concerns arise if but only if a patient has dmc. But appeals to autonomy invoke two distinct concerns: concern for authenticity – concern that a choice is consistent with an individual’s commitments; and concern for (...) sovereignty – concern that an individual exercises control over that which is hers to control. Here, I argue, neither concern can alone explain why dmc matters. Instead, dmc matters because it indicates a harmony between the two concerns – the demands of each concern are more likely to agree if a patient has dmc. This vindicates the standard story, but also makes clear that dmc is an inappropriate gatekeeper for autonomy. (shrink)

Journal of Political Philosophy, EarlyView.

Uptake is typically understood as the hearer’s recognition of the speaker’s communicative intention. According to one theory of uptake, the hearer’s role is merely as a ratifier. The speaker, by expressing a particular communicative intention, predetermines what kind of illocutionary act she might perform. Her hearer can then render this act a success or a failure. Thus the hearer has no power over which act could be performed, but she does have some power over whether it is performed. Call this (...) the ratification theory of uptake. Several philosophers have recently endorsed an alternative theory of uptake, according to which the hearer can determine the nature of the act the speaker performs. According to this theory, if the hearer regards an utterance as illocutionary act y, then it is act y, even if the speaker intended to perform act x. Call this the constitution theory of uptake. The purported advantage of this theory is that it identifies a common but underanalysed way in which speakers can be silenced. I argue that despite its initial intuitive pull, the constitution theory of uptake should be rejected. It is incompatible with ordinary intuitions about speech, it entails a conceptual impossibility, and it has unsavoury political implications, entailing that marginalised speakers barely qualify as agents. (shrink)

It is widely accepted that consent is a normative power. For instance, consent can make an impermissible act permissible. In the words of Heidi Hurd, it “turns a trespass into a dinner party... an invasion of privacy into an intimate moment.” In this chapter, I argue against the assumption that consent has such robust powers for moral transformation. In particular, I argue that there is a wide range of sex that harms or wrongs victims despite being consensual. Moreover, these cases (...) are not limited to those where con- sent is vitiated by background conditions. I start by calling this category of consensual sex Bad Sex. I then distinguish subspecies of this category, including psychological pressure, social coercion, and epistemically unsafe sex. I end by responding to an objection on which we should treat at least some subspecies of Bad Sex as rape. Though this alternative proposal is often motivated by ameliorative and strategic considerations, I argue that such considerations actually count against collapsing the categories of Bad Sex and rape. (shrink)

The starting point regarding consent has to be that it is both extremely important, and that it is often suspicious. In this article, the author tries to make sense of both of these claims, from a largely liberal perspective, tying consent, predictably, to the value of autonomy and distinguishing between autonomy as sovereignty and autonomy as nonalienation. The author then discusses adaptive preferences, claiming that they suffer from a rationality flaw but that it's not clear that this flaw matters morally (...) or politically. What matters is whether they suffer from an autonomy flaw. To answer this question, the author develops an account of autonomy failure, according to which a preference is nonautonomous if an injustice played an appropriate role in its causal history. The author then discusses the moral implications—and in an initial way, the political ones as well—of proclaiming a preference, or consent based on it, nonautonomous in this way. (shrink)

Instead of the question, ‘do we have an obligation to obey the law?,’ we should first ask the more modest question, ‘do we have reasons to obey the law?’ This paper offers a new account of the notion of the content-independence of legal reasons in terms of the grounding relation. That account is then used to mount a defense of the claim that we do indeed have content-independent moral reasons to obey the law (because it is the law), and that (...) these reasons, very plausibly, often amount to an obligation to so act. (shrink)

Preimplantation genetic diagnosis allows the detection of genetic abnormalities in embryos produced through in vitro fertilization. Current funding models in Australia provide governmental subsidies for couples undergoing IVF, but do not extend to PGD. There are strong reasons for publicly funding PGD that follow from the moral principles of autonomy, beneficence and justice for both parents and children. We examine the objections to our proposal, specifically concerns regarding designer babies and the harm of disabled individuals, and show why these are (...) substantially outweighed by arguments for subsidizing PGD. We argue that an acceptance of PGD is aligned with present attitudes towards procreative decision making and IVF use, and that it should therefore receive government funding. (shrink)

Many distributive egalitarians do not endorse strict equality of goods. Rather, they treat an equal division as having a special status such that departures from equality must be justified. They claim, then, that an equal division is “presumptively” just. Though the idea that equality is presumptively just and that departures from it may be just has intuitive appeal, making a case for this idea proves difficult. I argue, first, that extant “presumption arguments” are unsound. Second, I distill two general philosophical (...) morals: luck egalitarians have not adequately defended the presumption of equality and they face serious obstacles in doing so; Rawls has defended it, but only indirectly via the contract apparatus. This approach narrows the presumption’s appeal. Third, I consider and reject two alternative ways of understanding the presumption of equality that might avoid the problems revealed by my examination of extant views. The first appeals to the idea of value pluralism. The second treats the presumption as a view about the burden of proof. I conclude, ultimately, that it is misleading to think of distributive egalitarianism as typically having the form of a presumption argument. (shrink)

The normative power of consent plays a central role in enabling individuals to permissibly interact with one another. However, in the philosophical literature, the relationship between consent and permissible action is not always well understood. In this article I outline an account of the normative effect of valid consent, in order to clarify this relationship. I first argue that consent’s primary moral significance lies in its effect upon our interpersonal moral relationships. Specifically, I argue that valid consent serves to cancel (...) a directed duty owed to the consenter. Other things being equal, this equips the consentee with a directed permission: they will no longer wrong the consenter by acting in the consented to manner. However, this account does not yet explain how consent impacts upon the all things considered permissibility of an action. On the assumption that all things considered permissibility is a function of an agent’s reasons for action, we require an account of consent’s effect on those reasons. I consider, and then reject, Michelle Dempsey’s recent suggestion that consent affects a consentee’s reasons for action by granting them an exclusionary permission. I propose that we should instead understand consent to function as a cancelling permission. (shrink)

Children are treated differently to adults in liberal societies with respect to their right to bodily integrity. A commonly given justification for treating them differently is that they supposedly lack the sort of autonomy that is normally attributed to neurotypical adults. As such children fall through the cracks when it comes to protecting their bodily integrity: they are viewed as less than fully autonomous persons in philosophical, medical, and legal settings. With this editorial, we analyse current treatments of the concept (...) of the child's right to bodily integrity and how this relates to their (developing or future) autonomy on various conceptions. (shrink)

If Badguy threatens Goodguy with harm, and Goodguy consents to giving his money to Badguy (to avoid the harm), Goodguy’s consent is invalid because coerced. But if under Badguy’s coercive threat Goodguy proceeds to consent to paying someone else (or to hiring a bodyguard), the consent may very well be valid. The challenge is to explain this difference. In this paper I argue that the way forward is to recognize that the content of consent is contrastive – one doesn’t just (...) agree to giving the money; rather, one consents to giving-the-money-rather-than-some-alternative. And then the normative upshot of the relevant consent depends on what the morally relevant contrast is, which in turn depends on who is (before the relevant interaction) entitled to what against whom. We have, I think, independent reasons to understand consent contrastively, and once we do, we can solve the puzzle of third party coercion with ease. (shrink)

Political philosophy should focus not on uplifting ideals, but rather, so I argue, on minimizing serious suffering. This is so not because other things do not ultimately matter (they do), but rather because in the political context, the stakes in terms of suffering are usually extremely high, so that any other considerations are almost always outweighed. Put in moderately deontological terms: the high stakes carry most political decisions across the thresholds of the relevant deontological constraints. While the argument is substantive (...) rather than exegetical, I engage in detail Judith Shklar's “Liberalism of Fear”. I share with Shklar her pessimistic starting point, but I also show how a focus on suffering (rather than cruelty and fear) is what plausibly follows from such a starting point. I then pursue the implications of this difference—they are theoretically profound, but perhaps less significant practically. (shrink)

Decision-making capacity (DMC) plays an important role in clinical practice—determining, on the basis of a patient’s decisional abilities, whether they are entitled to make their own medical decisions or whether a surrogate must be secured to participate in decisions on their behalf. As a result, it’s critical that we get things right—that our conceptual framework be well-suited to the task of helping practitioners systematically sort through the relevant ethical considerations in a way that reliably and transparently delivers correct verdicts about (...) who should and should not have the authority to make their own medical decisions. Unfortunately, however, the standard approach to DMC does not get things right. It is of virtually no help in identifying and clarifying the relevant ethical considerations. And, embedded in the prevailing anti-paternalist paradigm, DMC assessments obfuscate and distort the underlying ethical justification for granting or withholding decisional authority. Here, we describe the core commitments of the standard approach to DMC and then highlight three problems with it. We then argue that these problems are significant enough that they call for more than merely tinkering and fine tuning—variations of the standard approach cannot adequately address them. Instead, we should ditch DMC. (shrink)

This article investigates the hitherto under-examined relations between affirmative action, paternalism and respect. We provide three main arguments. First, we argue that affirmative action initiatives are typically paternalistic and thus disrespectful towards those intended beneficiaries who oppose the initiatives in question. Second, we argue that not introducing affirmative action can also be disrespectful towards these potential beneficiaries because such inaction involves a failure to adequately recognize their moral worth. Third, we argue that the paternalistic disrespect involved in affirmative action is (...) alleviated when the potential beneficiaries’ preferences against such initiatives are adaptive. We conclude that although there is a relevant sense in which paternalistic affirmative action is disrespectful, it may well be more disrespectful not to pursue such policies. (shrink)

The law of contracts, at least in its orthodox expression, concerns voluntary, or chosen, legal obligations. When Brody accepts Susan’s offer to sell him a canoe for a set price, the parties’ choices alter their legal rights and duties. Their success at changing the legal landscape depends on a background system of rules that specify when and how contractual acts have legal effects, rules that give the offer and acceptance of a bargain-exchange a central role in generating obligations. Contract law (...) conceived as a body of rules empowering individuals to shape their own rights and responsibilities presents an object of philosophical study. The philosophy of contract includes two broad sets of projects. One set, the focus of the first part of this entry, targets the basic structure and normative justification of the law of contracts. The aim is to subsume a salient body of contract law rules under general principles in order to clarify contract law’s conceptual categories, distinguish it from other areas of law, and specify criteria relevant to its normative appraisal. This kind of philosophical work presupposes detailed knowledge of the law in existing legal regimes, and the entry begins by outlining the common law of contracts. A second set of projects draws on resources from the philosophy of language, philosophy of action, and moral and political philosophy to address debates within contract law. Questions about the nature of meaning and interpretation, intentionality, freedom in contract, and distributive justice drive contemporary legal debates concerning contract formation, interpretation, and enforcement. Philosophical work on these topics has attracted significant commentary which serves as the focus of the second part of this entry. (shrink)

A central reason to worry that managers should not use nudges to influence employees is that doing so fails to treat employees as _rational_ and/or _autonomous_ (RA). Recent nudge defenders have marshaled a powerful line of response against this worry: in general, nudges treat us as the kind of RA agents we are, because nudges are apt to enhance our limited capacities for RA agency by improving our decision-making environments. Applied to managerial nudges, this would mean that when managers nudge (...) their employees, they generally bolster their employees’ limited RA agency and, thus, treat employees as the kinds of RA agents they are. My aim is to vindicate a qualified version of the initial worry from the nudge-defender response and, as a result, provide a clearer, more plausible framework for evaluating managerial nudges than what nudge critics have previously given. I do this, first, by showing how nudge defenders rely on equivocation between two different senses of “treating someone as RA.” The _value-preserving_ notion that supports the nudge-defender prescription to protect and enhance RA capacities is different from the _authority-recognizing_ notion that underwrites the initial worry about nudging. Second, I argue that the authority-recognizing notion of treating someone as RA implies that managerial nudges treat employees as RA just when the nudges are compatible with relating to employees as equals. Third, I explain how, to determine when managerial nudges are compatible with relating to employees as equals, we need to consider how employees surrender aspects of their equal, agency-grounded authority to managers. (shrink)

Journal of Political Philosophy, Volume 30, Issue 2, Page 143-165, June 2022.

The idea that experts (especially scientific experts) play a privileged role in determining the meanings of our words and the contents of our concepts has become commonplace since the work of Hilary Putnam, Tyler Burge, and others in the 1970s. But if experts have the power to determine what our words mean, they can do so responsibly or irresponsibly, from good motivations or bad, justly or unjustly, with good or bad effects. This paper distinguishes three families of metasemantic views based (...) on their attitudes towards bad behaviour by meaning-fixing experts, and draws a series of distinctions relevant for the normative evaluation of meaning-determining actions. (shrink)

The topic of moral diversity is not only prevalent in contemporary moral and political philosophy, it is also practically relevant. Moral diversity, however, poses a significant challenge for moral theory building. John Thrasher, in his discussion of public reason theory, which includes social contract theory, argues that if one seriously considers the goal of moral constructivism and considerations of representation and stability, then moral diversity poses an insurmountable problem for most public reason theories. I agree with Thrasher that moral diversity (...) poses a significant challenge for orthodox multistage social contract theories. In fact, I even add a further problem for such theories under the assumption of deep moral diversity. Nevertheless, I argue that my recently developed multilevel social contract theory overcomes these problems. I focus on some of the underexplored features of this theory to show that multilevel social contract theory offers one conceptually coherent and plausible way to render social contract theory viable and relevant for modern diverse societies. (shrink)

In The Birth of Ethics, Philip Pettit carefully argues that Erewhonians would develop concepts that closely resemble our normative concepts – including our moral concepts – and that this reveals a great deal about the nature of normativity in general and morality in particular. The purported revelations about morality include: Thesis #1: Moral concepts ascribe natural properties. Thesis #2 “Full-scale” moral realism is true. Thesis #3: There is a sufficiently good answer to the question, “Why be moral?”In this paper, I (...) do not question Pettit's ingenious argument that the Erewhonians' conceptual repertoire would expand in the way described in his narrative. I instead question whether this narrative supports these metaethical theses. I argue that if our moral concepts were expressively equivalent to Erewhonian moral concepts, that would not ground a “full-scale” moral realism, nor would it give us a sufficiently compelling answer to the question “Why be moral?” Furthermore, I argue that our moral concepts are not expressively equivalent to Erewhonian moral concepts, which puts pressure on the argument that our moral concepts ascribe natural properties. Finally, contra Pettit, I argue that moral concepts do not play the same function in our lives as the analogous concepts play in Erewhonians' lives. (shrink)

Formal views of autonomy rule out substantive rational capacities (reasons-responsiveness) as a condition of autonomous agency. I argue that such views face a number of underappreciated problems: they have trouble making sense of how autonomous agents could be robustly responsible for their choices, face the burden of explaining why there should be a stark distinction between the importance of factual and evaluative information within autonomous agency, and leave it mysterious why autonomy is the sort of thing that has value and (...) ought to be promoted. Moreover, I argue that the alternative view that includes substantive rational capacities need not have the unacceptable political implications it is sometimes thought to have. (shrink)

This discussion responds to two recent articles defending a child-centered view of parenting. Anca Gheaus and James Dwyer argue that children should be reared by the best available parent, who, in turn, should make choices based only on children’s welfare. They claim that love and respect require this fiduciary stance. However, love and respect do not justify child-centered norms. If children were competent, they would embrace norms that accommodate parental interests because they benefit from nonfiduciary rules, are grateful to their (...) parents, and reject discrimination produced by child-centered principles. Furthermore, child-centered accounts imply unreasonably broad obligations to children. (shrink)

The WHO, American Academy of Pediatrics and other Western medical bodies currently maintain that all medically unnecessary female genital cutting of minors is categorically a human rights violation, while either tolerating or actively endorsing medically unnecessary male genital cutting of minors, especially in the form of penile circumcision. Given that some forms of female genital cutting, such as ritual pricking or nicking of the clitoral hood, are less severe than penile circumcision, yet are often performed within the same families for (...) similar reasons, it may seem that there is an unjust double standard. Against this view, it is sometimes claimed that while female genital cutting has ‘no health benefits’, male genital cutting has at least some. Is that really the case? And if it is the case, can it justify the disparate treatment of children with different sex characteristics when it comes to protecting their genital integrity? I argue that, even if one accepts the health claims that are sometimes raised in this context, they cannot justify such disparate treatment. Rather, children of all sexes and genders have an equal right to bodily autonomy. This includes the right to decide whether their own ‘private’ anatomy should be exposed to surgical risk, much less permanently altered, for reasons they themselves endorse when they are sufficiently mature. (shrink)

The patient preference predictor is a proposed computer-based algorithm that would predict the treatment preferences of decisionally incapacitated patients. Incorporation of a PPP into the decision-making process has the potential to improve implementation of the substituted judgement standard by providing more accurate predictions of patients’ treatment preferences than reliance on surrogates alone. Yet, critics argue that methods for making treatment decisions for incapacitated patients should be judged on a number of factors beyond simply providing them with the treatments they would (...) have chosen for themselves. These factors include the extent to which the decision-making process recognises patients’ freedom to choose and relies on evidence the patient themselves would take into account when making treatment decisions. These critics conclude that use of a PPP should be rejected on the grounds that it is inconsistent with these factors, especially as they relate to proper respect for patient autonomy. In this paper, we review and evaluate these criticisms. We argue that they do not provide reason to reject use of a PPP, thus supporting efforts to develop a full-scale PPP and to evaluate it in practice. There are no data in this work. (shrink)

A Patient Preference Predictor (PPP)—an algorithm capable of predicting, on the basis of demographic or more personalized data, what an incapacitated patient would prefer were they capacitated—is a...

ABSTRACT:Many ethicists argue that contract theory offers the most promising strategy for regulating risks. I challenge the adequacy of the contractualist approach for evaluating the complicated, novel risks associated with some structured financial products, particularly focusing on risks to third parties. Structured financial products like collateralized debt obligations (CDOs) divide a pool of financial assets into risk “tranches” organized from least to most risky. Investors purchase various tranches based on their individual risk-and-return preferences. Whereas contract theory holds that investment risks (...) are ethically permitted (roughly) when everyone—including both parties directly involved in the investments and third parties—consents to them, structured financial products like CDOs show that even risks to which everyone consents are ethically problematic when they involve systemic risks of ruin. (shrink)

This paper explores the extent to which behavioral public policies can be both efficient and democratic by reflecting on the conditions under which individuals could rationally consent to them. Consent refers to a moral requirement that a behavioral public policy should respect what I call a person’s value autonomy and conception of the good. Behavioral public policies can take many forms. Based on a social choice framework, I argue that fully paternalistic and prudential behavioral public policies are unlikely to trigger (...) a hypothetical form of rational consent. Non-fully paternalistic behavioral public policies with partially non-prudential motivations are less problematic in this perspective. In any case, a public deliberative stage preceding the implementation of policies seems to be the best democratic way to justify them. (shrink)