In late 2012, Hurricane Sandy hit the East Coast of the U.S., causing much suffering and devastation. Those who could have easily helped Sandy’s victims had a duty to do so. But was this a rightfully enforceable duty of justice, or a non-enforceable duty of beneficence? The answer to this question is often thought to depend on the kind of help offered: the provision of immediate bodily services is not enforceable; the transfer of material resources is. I argue that this (...) double standard is unjustified, and defend a version of what I call “Social Samaritanism.” On this view, within political communities, the duty to help the needy—whether via bodily services or resource transfers—is always an enforceable demand of justice, except when the needy are reckless; across independent political communities, it is always a matter of beneficence. I defend this alternative double standard, and consider its implications for the case of Sandy. (shrink)

Paternalistic interventions restrict individuals’ liberty or autonomy so as to guide their decisions towards options that are more beneficial for them than the ones they would choose in the absence of such interventions. Although some philosophers have emphasised that there is a case for justifiable paternalism in certain circumstances, much of contemporary moral and political philosophy works from a strong presumption against paternalistic interventions. However, Richard Arneson has argued that there are egalitarian reasons that support the case for paternalism: paternalistic (...) interventions can protect poor decision-makers from making ‘bad’ choices, thus preventing inequalities between them and those with better decision-making skills. This paper seeks to clarify and advance our understanding of the egalitarian argument for paternalism. Arneson’s argument adds an important and often neglected dimension to the debate about paternalism but also raises a number of questions about equality, paternalism and the relationship between the two. (shrink)

The question of how society should deal with social conflicts arising from cultural differences persists. Should we adopt an exclusivist approach by excluding reasons based on specific cultural traditions (culture-based reasons) from public debates about social policy, especially because these reasons do not appeal to the public at large? Or should we resort to an inclusivist approach by including reasons based on cultural traditions in public debate to give recognition to the diverse cultural identities of those who practice these traditions? (...) While these two approaches assign different roles to cultural traditions in public debate, both seem to welcome compromise between conflicting parties. This paper reviews contending normative approaches for dealing with conflicts in multicultural societies and explores the place of culture-based reasons in public debates designed to resolve conflicts. (shrink)

People often discriminate based on negative or positive stereotypes about others. Important examples of this are highlighted by the theory of ambivalent sexism. This theory distinguishes sexist stereotypes that are negative (hostile sexism) from those that are positive (benevolent sexism). While both forms of sexism are considered wrong towards women, hostile sexism seems intuitively worse than benevolent sexism. In this article, we ask whether the difference between discriminating based on positive vs. negative stereotypes in itself makes a morally relevant difference. (...) We suggest that it does not. By examining a number of prominent accounts of what makes discrimination wrong, we defend the Moral Irrelevance View according to which stereotype valence is irrelevant to the moral evaluation of discrimination, all else equal. (shrink)

In 2015 Robert Veatch published the second edition of his Transplantation ethics, this time together with Lainie Ross. The chapters on postmortem organ procurement distinguish between ‘giving’ and ‘taking’ systems, and argue that ‘taking’ systems may promise a greater yield of organs for transplantation, but inevitably violate a requirement of respect for the deceased's autonomy. That argument has been very influential, and is also representative of a way of thinking that is widespread in the literature and in public debate. In (...) this paper I contend that it is conceptually flawed in a number of important respects. These concern the understanding of both the concept of ‘consent’ and the requirement of respect for autonomy, the role of the relatives in any procurement system, and the factors that actually determine the extent to which a system respects autonomy, under any interpretation of that requirement. (shrink)

This paper investigates the relations between the concepts of moral harm and moral responsibility, arguing for a circularity between the two. On this basis the conceptual soundness of descriptivism, on which consequentialist and non-consequentialist arguments are often grounded, is questioned. In the last section a certain version of ascriptivism is defended: The circularity is relevant in order to understand how a restricted version of ascriptivism may in fact be well founded.

On the standard view we assess a person’s competence by considering her relevant abilities without reference to the actual decision she is about to make. If she is deemed to satisfy certain threshold conditions of competence, it is still an open question whether her decision could ever be overruled on account of its harmful consequences for her (‘hard paternalism’). In practice, however, one normally uses a variable, risk dependent conception of competence, which really means that in considering whether or not (...) to respect a person’s decision-making authority we weigh her decision on several relevant dimensions at the same time: its harmful consequences, its importance in terms of the person’s own relevant values, the infringement of her autonomy involved in overruling it, and her decision-making abilities. I argue that we should openly recognize the multi-dimensional nature of this judgment. This implies rejecting both the threshold conception of competence and the categorical distinction between hard and soft paternalism. (shrink)

This article examines the normative force of consent, explaining how consent works its “moral magic” in transforming the moral quality of conduct that would otherwise constitute a wrong against the consenting person. Dempsey offers an original account of the normative force of consent, according to which consent (when valid) creates an exclusionary permission . When this permission is taken up, the moral quality of the consented-to conduct is transformed, such that it no longer constitutes a wrong against the consenting person. (...) Building on this account of how consent works, Dempsey identifies two sets of cases in which consent fails to transform the moral quality of one’s conduct: cases in which one is consent-insensitive to the rational force of another’s consent, and cases in which one acts for sadistic reasons. (shrink)

An ideal of education is to ensure that our children develop into autonomous critical thinkers. The ‘indoctrination objection’, however, calls into question whether education, aimed at cultivating autonomous critical thinkers, is possible. The core of the concern is that since the young child lacks even modest capacities for assessing reasons, the constituent components of critical thinking have to be indoctrinated if there is to be any hope of the child's attaining the ideal. Our primary objective is to defuse this objection. (...) We argue, first, that even if the indoctrination objection can be dealt with at the level of beliefs by an account that distinguishes between beliefs instilled in the child at the non‐rational stage that are indoctrinative and those that are non‐indoctrinative, there can be non‐autonomous ‘proto critical thinkers’ who lack autonomy with respect to the requisite motivational components. We then ask what must be added to the account to ensure that proto critical thinkers develop into autonomous ones. We suggest that motivational elements, even if instilled at a stage at which the child has insufficiently developed cognitive capacities, can be ‘truly the child's own’ only relationally: the autonomous motivational elements are ones with respect to which the future child is self‐governing. (shrink)

Autonomy is, among other things, an actual psychological condition, a capacity that can be developed, and an educational ideal. This paper contextualises, analyses, criticises and extends the theory of Richard S. Peters on these three aspects of autonomy.

What constraints should be imposed on individual liberty for the sake of protecting our collective security? A helpful approach to answering this question is offered by a theory that grounds political obligation and authority in a moral requirement of fair contribution to mutually beneficial cooperative schemes. This approach encourages us to split the opening question into two—a question of correctness and a question of legitimacy—and generates a detailed set of answers to both subsidiary questions, with a nuanced and plausible set (...) of implications. The plausibility of its treatment of the issues surrounding liberty and security, I argue, helps to confer credibility on the fairness-based theory that carries these implications. (shrink)

Some writers suggest that corporations should act in ways which reflect a broad concern for the well-being of others, as opposed to a more narrow (Libertarian) conception of responsibility. But this Broad View of moral responsibility puts us on a collision course with our considered intuitions about paternalistic acts. This paper discusses several aspects of this issue: the neutrality of the Standard View of Paternalism, the nature of the defenses of paternalistic interventions allowed by the Standard View of Paternalism and (...) their reliance on consent; and the sort of position on paternalism the Board View would have to endorse in order to justify the benevolence-motivated orientation required by its conception of moral responsibility.The conclusion is that unless we are prepared to take a different, non-standard view of paternalism the Board View of corporate moral responsibility will be untenable. (shrink)

Epistemic paternalism is the thesis that in some circumstances we are justified in interfering with the inquiry of another for their own epistemic good without consulting them on the issue. In this paper, I address the issue of who is rationally entitled to undertake paternalistic interferences, and in virtue of which features one has this entitlement. First, I undermine the view according to which experts are the most apt people to act as paternalist interferers. Then, I argue that epistemic authorities (...) are in a better position to satisfy the requirements of justified epistemic paternalism, when conceived according to the service model of epistemic authority. Finally, I offer a virtue-based account of paternalist interferers and show how it can apply to cases in which the interferer is a group or an institution. (shrink)

This article presents philosophical-ethical arguments concerning the extent to which NCAA inter-collegiate football is a public good and some implausible implications of the claim that it constitutes a public good and ought to be publicly subsidized as part of a component of U.S. higher education generally as is currently the case. Underlying this main argument is one concerning who or what should have the responsibility for subsidizing the necessary costs of the sport, including its associated healthcare and medical costs.

I argue that it can be morally permissible to coerce people into doing what is good for their own health. I discuss recent initiatives in New York City that are designed to take away certain unhealthy options from local citizens, and argue that this does not impose on them in unjustifiable ways. Good paternalistic measures are designed to promote people's long-term goals, and to prevent them from making short-term decisions that interfere with reaching those, and New York's attempts to ban (...) the sale of sugary drinks larger than 16 ounces and the use of trans fats fall within those parameters. Given our tendency to cognitive bias, we need help in making choices that truly instantiate our values. (shrink)

Two normative principles of toleration are offered, one individual-regarding, the other group-regarding. The first is John Stuart Mill’s harm principle; the other is “Principle T,” meant to be the harm principle writ large. It is argued that the state should tolerate autonomous sacrifices of autonomy, including instances where an individual rationally chooses to be enslaved, lobotomized, or killed. Consistent with that, it is argued that the state should tolerate internal restrictions within minority groups even where these prevent autonomy promotion of (...) members of the group. Finally, it is argued that toleration excludes external protections of minority groups. (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)

According to rational will views of paternalism, the wrongmaking feature of paternalism is that paternalists disregard or fail to respect the rational will of the paternalized, in effect substituting their own presumably superior judgments about what ends the paternalized ought to pursue or how they ought to pursue them. Here I defend a version of the rational will view appealing to three rational powers that constitute rational agency, which I call recognition, discrimination, and satisfaction. By appealing to these powers, my (...) version of the rational will view can rank the wrongfulness of paternalistic acts in terms of the extent to which such acts (a) amount to supplanting the paternalized individual’s identity as a rational agent with that of the paternalist, and (b) the degree of mistrust the paternalistic act shows in the paternalized individual’s rational agency. My rational powers account thus provides a more complete account of why paternalism is a powerful, but not decisive or absolute, objection to an act or policy. My rational powers account also provides powerful explanations of why rational suasion deflects charges of paternalism; why consenting to intercessions in one’s rational agency negates paternalism; why we ordinarily believe that strong paternalism is more objectionable than weak paternalism; and why we ordinarily believe that hard paternalism is more objectionable than soft paternalism. (shrink)

Informed consent is normally understood as something that a patient gives prior to a medical intervention that can render it morally permissible. Whether or not it must be given prior to the intervention is debated. Some have argued that subsequent consent—that is, consent given after a medical intervention—can also render an otherwise impermissible act permissible. If so, then a patient may give her consent to an intervention that has already been performed and thereby justify a physician’s act retroactively. The purpose (...) of this paper is to argue that even if subsequent consent can render an otherwise impermissible act permissible, doctors are still blameworthy if they rely on it when prior consent could be given, because they would be banking on the justification of their interventions. Since doctors can only guess if patients will consent after the fact, they would be placing their patients at unreasonable risk of being disrespected as persons. (shrink)

Sex work’s governance throughout the Commonwealth has historically been animated by the objective of rendering the sale of sex, and those who engage in such transactions, invisible. To achieve this end, lawmakers have characterized public, viewable sex work as a nuisance meriting criminalization. Although prohibition results in unequivocal perils for sex workers, governance strategies in this domain remain centred on criminalization. A new law in Canada, Bill C-36: the Protection of Communities and Exploited Persons Act, exemplifies this point. While Bill (...) C-36 purports to shift criminal law’s focus from sex workers to their clients and profiteers, it continues to expose sex workers who work in public view to criminal prosecution. It thereby preserves sex work’s characterization as a nuisance, offensive to a community’s senses and deserving of proscription. Although Bill C-36 proclaims to promote dignity and equality rights, it prioritizes the interests of communities over those of sex workers. In the result, this new law will revoke sex workers’ social and political citizenship and thwart their personal security. (shrink)

Ms. Johnson’s case highlights a number of the ethical challenges that can arise when treating anorexia nervosa, including uncertainty about a patient’s decisional capacity, the limitations of treat...

Normative powers like promising allow agents to effect changes to their reasons, permissions and rights by the means of communicative actions whose function is to effect just those changes. An attractive view of the normativity of such powers combines a non-reductive account of their bindingness with a value-based grounding story of why we have them. This value-based view of normative powers however invites a charge of wishful thinking: Is it not bad reasoning to think that we have a given power (...) because it would be good? In this article, I offer a defence of the value-based view of normative powers against this surprisingly under-discussed objection. First, I clarify the challenge by distinguishing between two components of normative powers, which I call the material and normative components, respectively. Secondly, I defend the form of normative explanation involved, showing that it is needed to give convincing value-based explanations for other important normative phenomena, especially rights of autonomy. (shrink)

The American Journal of Bioethics, Volume 12, Issue 3, Page 35-36, March 2012.

The current ethical and regulatory framework for research is often charged with burdening investigators and impeding socially valuable research. To address these concerns, a growing number of research ethicists argue that informed consent should be adapted to the risks of research participation. This would require less rigorous consent standards in low-risk research than in high-risk research. However, the current discussion is restricted to cases of research in which the risks of research participation are outweighed by the potential clinical benefits for (...) the individual research participant. Furthermore, current proposals do not address the worry that risk-adapted informed consent may result in enrolling participants into research without their autonomous authorization. In this paper, we show how the standard view of informed consent – consent as autonomous authorization – can be adapted to risk even when the research does not have a favourable risk-benefit profile for the participant. Our argument has two important implications: first, it implies that current and proposed consent standards are not adequately calibrated to risk and, second, that consent standards also need to be adapted to factors other than risk. (shrink)

Some recent arguments for paternalist government interventions have been based in empirical results in psychology and behavioral economics that would seem to show that adult human beings are far removed from the ideals of rationality presupposed by much of philosophical and economic theory. In this paper it is argued that we need to move to a different conception of human decision-making competence than the one that lies behind that common line of philosophical and economic thinking, and which actually still lies (...) in the background of some of these recent approaches to paternalist interventions. An alternative picture of human decision-making competence is outlined and four criteria for identifying areas where paternalist interventions have a basic moral and political legitimacy are then identified on the basis of this picture. (shrink)

The clinical introduction of medical devices often occurs with relatively little oversight, regulation and (long-term) follow-up. Some recent controversies underscore the weaknesses of the current regime, such as the complications surrounding the metal-on-metal hip implants and the scandal surrounding the global breast implant scare of silicone implants made by France's Poly Implant Prothese (PIP) Company. The absence of national registries hampered the collection of reliable information on the risks and harms of the PIP breast implants. To warrant long-term safety, a (...) case can be made for mandatory post-marketing surveillance by means of the establishment of compulsory registries. In this edition of Public Health Ethics, Schofield calls for debate on how such a registry system should be initiated and maintained and how it would relate to the ethical requirement of consent. Here we use breast implant registries as a case to discuss whether and when a so-called ‘thick opt-out’ would be an appropriate method to include people in medical device registries. We conclude that a thick opt-out procedure for medical device registries is only justifiable in cases where inclusion does not involve burdens (or very low), when it does not involve a sensitive subject and when the data are stored anonymously (or at least not directly linked to the medical record). Otherwise, inclusion should be sought by means of an opt-in. (shrink)

Criminal offenders may be offered to participate in voluntary rehabilitation programs aiming at correcting undesirable behaviour, as a condition of early release. Behavioural treatment may include direct intervention into the central nervous system (CNS). This article discusses under which circumstances voluntary rehabilitation by CNS intervention is justified. It is argued that although the context of voluntary rehabilitation is a coercive circumstance, consent may still be effective, in the sense that it can meet formal criteria for informed consent. Further, for a (...) consent to be normatively valid (“take the wronging out of the act”) under a coercive circumstance, the subject to be treated must (1) have the sovereign authority to consent, and (2) the offer-giver must be in the right normative position to make the offer. While I argue that subjects do have the sovereign authority to consent to treatment, I also argue that inappropriate offers yield invalid consents. Considerations on inappropriate offers should therefore inform which kinds of CNS intervention-based rehabilitation schemes the state may propose as part of the criminal justice system. Yet as I conclude in this paper, while there are some intrinsic constraints on voluntary rehabilitation programs, the main constraints on voluntary rehabilitation are likely to be contingent overriders. However, CNS intervention is not ruled out as such in the context of voluntary rehabilitation. (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)

Wherever a government or state is concerned with the welfare of its citizens, there will probably also exist policies which compel the individual citizen to undertake or abstain from activities which affect that citizen alone. The set of theories behind such policies is collectively known as ‘paternalism’. It is not hard to understand why this term has developed strong pejorative overtones. Policies of this type appear to offend a fundamental tenet of liberal societies: namely, that the individual is best placed (...) to know what is in his or her interests. Paternalistic policies imply, and are concerned with correcting, failures of precisely this kind of judgement. And yet, at the same time, there is a popular consensus that compelling people to wear a seat belt when driving a car is a reasonable restriction of personal liberty. Paternalism may be difficult to accept in principle, but it is equally difficult to avoid in practice. Not surprisingly, the literature reveals a long heritage of debate in a wide range of academic disciplines. This debate reveals a failure to make progress in two areas in particular. First, analyses of paternalism often confuse policies which are actually concerned with correcting failures of market exchange — in particular, those concerned with insufficient or imperfect information — with those which are genuinely paternalistic. One objective of this paper will be to clarify the difference between these two kinds of policy. (shrink)

A ‘Ulysses arrangement’ (UA) is an agreement where a patient may arrange for psychiatric treatment or non-treatment to occur at a later stage when she expects to change her mind. In this article, I focus on ‘competence-insensitive’ UAs, which raise the question of the permissibility of overriding the patient’s subsequent decisionally competent change of mind on the authority of the patient’s own prior agreement. In “The Ethical Justification for Ulysses Arrangements”, I consider sceptical and supportive arguments concerning competence-insensitive UAs, and (...) argue that there are compelling reasons to give such UAs serious consideration. In “Decisional Competence and Legal Capacity in UAs”, I examine the nature of decisional competence and legal capacity as they arise in UAs, an issue neglected by previous research. Using the distinctions which emerge, I then identify the legal structure of a competence-insensitive UA in terms of the types of legal capacity it embodies and go on to explain how types of legal capacity might be shared between the patient and a trusted other to offer support to the patient in the creation and implementation of a competence-insensitive UA. This is significant because it suggests possibilities for building patient support mechanisms into models of legal UAs, which has not addressed in the literature to date. Drawing on this, in “Using Insights from the Competence/Capacity Distinction to Enhance Patient Support in UAs”, I offer two possible models to operationalize competence-insensitive UAs in law that allow for varying degrees of patient support through the involvement of a trusted other. Finally, I outline some potential obstacles implementing these models would face and highlight areas for further research. (shrink)

ABSTRACTThis paper begins with the assumption that it is morally problematic when people in need are offered money in exchange for research participation if the amount offered is unfair. Such offers are called ‘coercive’, and the degree of coerciveness is determined by the offer's potential to cause exploitation and its irresistibility. Depending on what view we take on the possibility to compensate for the sacrifices made by research participants, a wish to avoid ‘coercive offers’ leads to policy recommendations concerning payment (...) for participation. For sacrifices considered compensable, we ought to offer either no payment or payment at a level deemed fair, while for sacrifices deemed incompensable, we always ought to offer no payment because as compensation appears and increases, so too does coercion. This article provides a model for thinking of the way in which degrees of exploitativeness, irresistibility, and coerciveness interact with the size of the reward for compensable and incompensable cases. T... (shrink)

Bioethicists tend to focus on the individual as the relevant moral subject. Yet, in highly complex and socially differentiated healthcare systems a number of social groups, each committed to a common cause, are involved in medical decisions and sometimes even try to influence bioethical discourses according to their own agenda. We argue that the significance of these collective actors is unjustifiably neglected in bioethics. The growing influence of collective actors in the fields of biopolitics and bioethics leads us to pursue (...) the question as to how collective moral claims can be characterized and justified. We pay particular attention to elaborating the circumstances under which collective actors can claim ‘collective agency.’ Specifically, we develop four normative-practical criteria for collective agency in order to determine the conditions that must be given to reasonably speak of ‘collective autonomy’. For this purpose, we analyze patient organizations and families, which represent two quite different kinds of groups and can both be conceived as collective actors of high relevance for bioethical practice. Finally, we discuss some practical implications and explain why the existence of a shared practice of trust is of immediate normative relevance in this respect. (shrink)

Literature on the mental capacities and cognitive mechanisms of the great apes has been silent about whether they can act autonomously. This paper provides a philosophical theory of autonomy supported by psychological studies of the cognitive mechanisms that underlie chimpanzee behavior to argue that chimpanzees can act autonomously even though their psychological mechanisms differ from those of humans. Chimpanzees satisfy the two basic conditions of autonomy: (1) liberty (the absence of controlling influences) and (2) agency (self-initiated intentional action), each of (...) which is specified here in terms of conditions of understanding, intention, and self-control. In this account, chimpanzees make knowledge-based choices reflecting a richly information-based and socially sophisticated understanding of the world. Finally, two major theories of autonomy (Kantian theory and two-level theory) are rejected as too narrow to adequately address these issues, necessitating the modifications made in the present approach. (shrink)

The body and bodily experience make little appearance in analytic moral philosophy. This is true even of analytic sexual ethics—the one area of ethical inquiry we might have expected to give a starring role to bodily experience. I take a small step toward remedying that by identifying one way in which the bodily experience of sex is ethically significant: some of the physical actions of sex have a default expressive significance, conveying trust, affection, care, sensitivity, enjoyment, and pleasure. When people (...) having sex don't in fact have these feelings, the sex can be misleading, even if they've antecedently communicated that they don't have these feelings. This account of how sex can mislead is inspired by a perhaps surprising source, Catholic sexual morality. Analytic sexual ethicists could benefit from emulating Catholic sexual morality's attentiveness to the bodily nature of sex and its ethical significance. (shrink)

An examination of case law on forced marriage reveals that in addition to physical force, the role of emotional pressure is now taken into consideration. However, in both legal and policy discourse, the difference between arranged and forced marriage continues to be framed in binary terms and hinges on the concept of consent: the context in which consent is constructed largely remains unexplored. By examining the socio-cultural construction of personhood, especially womanhood, and the intersecting structural inequalities that constrain particular groups (...) of South Asian women in the UK, we argue that consent and coercion in relation to marriage can be better understood as two ends of a continuum, between which lie degrees of socio-cultural expectation, control, persuasion, pressure, threat and force. Women who face these constraints exercise their agency in complex and contradictory ways that are not always recognised by the existing exit-centred state initiatives designed to tackle this problem. (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)

Should society intervene to prevent the risky behavior of precocious teenagers even if it would be impermissible to intervene with adults who engage in the same risky behavior? The problem is well illustrated by the legal case of the 13-year-old Dutch girl Laura Dekker, who set out in 2009 to become the youngest person ever to sail around the world alone, succeeding in January 2012. In this paper we use her case as a point of entry for discussing the fundamental (...) question of how to demarcate childhood from adulthood. After summarizing the case, we identify a ‘demarcation dilemma’ that frames much of the public and expert debate. On the one hand, it seems morally imperative ‘to treat like alike’, which means that both children and adults should be allowed to undertake all actions for which they have the relevant competences. On the other hand, requiring proportional treatment of children and adults seems to neglect the special nature of childhood as a distinct stage in life that ends at a specific age. We introduce the notion of a ‘regime of childhood’ to deal with this problem. This regime includes several dimensions, including the limited liability for children, the supervisory responsibilities of parents, the role of age-based thresholds, and the overarching purpose of childhood as a context for developing autonomy. We argue that, all things considered, there are good reasons not to shift to a regime that offers individual children the option of qualifying for adulthood on the basis of age-neutral criteria. (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 idea that people’s numerical identity may sometimes be discontinuous over time initially appears to provide useful material for defending restrictions on putatively self-harming behaviour in a non-paternalistic manner. According to this line of thinking, sometimes a putatively self-harming act is, in fact, a matter of ‘harm to others’. Yet, in this paper I argue that if we, as we ought to do, take into consideration the non-identity problem, this challenges the notion that the agent at T1 is in fact (...) imposing harm on anyone, even when we accept that he or she is numerically different from the agent at T2. If the life of the agent at T2 is still worth living, the agent is not worse off than he or she would have been in spite of the consequences pertaining to the putatively self-harming act since he or she would otherwise never have come into existence. In this way, the argument I put forward in this paper calls in question the ability of the shifting identity argument to actually justify imposing restrictions on self-harming behaviour. (shrink)

Athletes who wish to compete in spite of high risk of injury can prove a challenge for sports doctors. Overriding an athlete's choices could be considered to be unnecessarily overbearing or paternalistic. However simply accepting all risk-taking as the voluntary choice of an individual fails to acknowledge the context of high-level sport and the circumstances in which an athlete may be being coerced or in some other way be making a less than voluntary choice. Restricting the voluntary choices of an (...) athlete may still be possible but under very limited circumstances. This article explores the ways a sports doctor might respond in ensuring a choice is indeed voluntary and, if so, under what circumstances limits might be placed. Responding to such risk-taking by, for example, limiting the actions of an athlete or assisting them to compete, involves attempting to balance the athlete's aims against some set of ideals of good health or medical ends. (shrink)

Current International Criminal Law suffers from at least four theoretical shortcomings regarding its ‘concept and meaning’, ‘ius puniendi’, ‘overall function’ and ‘purposes of punishment’. These issues are intimately interrelated; in particular, any reflection upon the last two issues without having first clarified the ius puniendi would not make sense. As argued elsewhere, in an initial contribution towards a consistent theory of ICL, the ius puniendi can be inferred from a combination of the incipient supranationality of the value-based world order and (...) the world citizens’ fundamental human rights predicated upon a Kantian concept of human dignity. On this basis, it is now possible to examine the overall function of ICL. Given the fact that ICL has not yet achieved the status of an autonomous discipline, the inquiry must start with a discussion of national theories of criminalisation. The article focuses on the two most important theories of criminalisation, namely the theories of protection of Rechtsgüter and the prevention of harm. Next, it examines whether and how these national theories can be transferred to ICL. (shrink)

There is widespread opinion that, notwithstanding deviations, the political life of humanity on a large scale is on the path of progress, and humans are becoming freer and more enlightened with time. I am going to contend with this opinion, namely, with a part of it telling that the prevailing mass of the people strives to achieve more freedom and enlightenment. On the opposite, freedom, individual independence, and political rights are of minor importance to the mass. The ideology of liberalism (...) in its classical form, as created by John Locke, Immanuel Kant, John Stuart Mill and others, yields to the pressure of the ideology of state paternalism. The pressure comes not only from above ; the people also welcome more paternalism. They appear not to value their individual freedom and independence, and they are inclined to give them up voluntarily to some mighty organization such as the state in exchange for care, protection and leadership. Liberalism has played an important role in the development of human civilization and the formation of the Western world, but new ideologies and political practices are pushing it out of people’s minds. For the author, as adherent of classical liberalism, this is unfortunate. However, I wish to treat this issue realistically, even if the facts conflict with my own convictions and desires. (shrink)

In the luck egalitarian literature, one influential formulation of luck egalitarianism does not specify whether equalities that do not reflect people’s equivalent exercises of responsibility are bad with regard to inequality. This equivocation gives rise to two competing versions of luck egalitarianism: asymmetrical and symmetrical luck egalitarianism. According to the former, while inequalities due to luck are unjust, equalities due to luck are not necessarily so. The latter view, by contrast, affirms the undesirability of equalities as well as inequalities insofar (...) as they are due to luck. The symmetrical view, we argue, is by far the more compelling, both by internal luck egalitarian standards and in light of the external rightist emphasis on choice and responsibility to which luck egalitarianism may partly be seen as a response. Our main case for the symmetrical view is that when some people, against a background of equal opportunities, do not exercise their responsibility to the same degree as others, they cannot justifiably call for equalizing measures to be put in place. Indeed, such measures would be positively unfair. The symmetrical view, accordingly, rejects compensation in such cases, whereas the asymmetrical view, implausibly, enjoins it. We also examine two objections to this argument. First, that this view fails to qualify as genuinely egalitarian, instead collapsing the notion of equality into the notion of desert. Second, that the opposing asymmetrical view, in contrast to the symmetrical view, can draw support from its compatibility with sufficientarian concerns. Both objections are rebutted. We conclude that luck egalitarians are best served by endorsing the symmetrical, luck-neutralizing stance. (shrink)

Informed consent is considered by many to be a moral imperative in medical research. However, it is increasingly acknowledged that in many actual instances of consent to participation in medical research, participants do not employ the provided information in their decision to consent, but rather consent based on the trust they hold in the researcher or research enterprise. In this article we explore whether trust-based consent is morally inferior to information-based consent. We analyse the moral values essential to valid consent (...) – autonomy, voluntariness, non-manipulation, and non-exploitation – and assess whether these values are less protected and promoted by consent based on trust than they are by consent based on information. We find that this is not the case, and thus conclude that trust-based consent if not morally inferior to information-based consent. (shrink)

Immanuel Kants Metaphysische Anfangsgründe der Rechtslehre, 1797 als erster Teil der Metaphysik der Sitten erschienen, stellen einen Beitrag zur neuzeitlichen Rechts- und Staatsphilosophie dar. Hinsichtlich der normativen Prinzipien von Recht und Staat entwickelt Kant eine erfahrungsunabhängige, insofern metaphysische Theorie. Sie beginnt mit einem angeborenen und unveräußerlichen Menschenrecht und geht dann zu den Institutionen des Eigentums und des Rechtsstaates über. Besonders aktuell ist die Formulierung eines rechts- und friedensfunktionalen Völkerrechts und eines Weltbürgerrechts. Darüber hinaus behandelt Kant auch das Ehe und Familienrecht, (...) das Verhältnis von Staat und Kirche und das Straf- und Begnadigungsrecht. Durch den thematischen Reichtum und die begriffliche Genauigkeit, vor allem jedoch durch die Radikalität seiner Fragen und die Originalität der Antworten ist Kants Rechtsdenken bis heute von hohem systematischem Rang. Die elf Beiträger dieses kooperativen Kommentars, der anlässlich des 300. Kant-Jubiläums in einer 3., überarbeiteten Auflage erscheint, nehmen die bleibend gültigen Provokationen der „Metaphysischen Anfangsgründe" ernst. Mit Beiträgen von Hans Friedrich Fulda, Otfried Höffe, Peter König, Kristian Kühl, Bernd Ludwig, Jean-Christophe Merle, Jörg Paul Müller, Terry Pinkard, Alessandro Pinzani, Robert B. Pippin, Allen W. Wood. (shrink)