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 practices of using hostages to obtain concessions and using human shields to deter aggression share an important characteristic which warrants a univocal reference to both sorts of conduct: they both involve manipulating our commitment to morality, as a means to achieving wrongful ends. I call this type of conduct “moral coercion”. In this paper I (a) present an account of moral coercion by linking it to coercion more generally, (b) determine whether and to what degree the coerced agent is (...) liable for the harms resulting from acceding to moral coercion, and (c) investigate factors relevant to determining whether we ought to accede to moral coercion. In so doing, I provide grounds for the intuition that we “allow evil to succeed” when we accede to moral coercion. (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)

This article analyzes appropriate public policies for enhancement use of two most important stimulant drugs: Ritalin (methylphenidate) and Adderall (mixed amphetamine salts). The author argues that appropriate regulation of cognition enhancement drugs cannot be a result of a general discussion on cognitive enhancements as such, but has to be made on a case-by-case basis. Starting from the recently proposed taxation approach to cognition enhancement drugs, the author analyzes available, moderately permissive models of regulation. After a thorough analysis of relevant characteristics (...) of methylphenidate and amphetamine, the author concludes that a moderately liberal permissive regulation of enhancement use by healthy adults might be appropriate for extended release forms of methylphenidate. However, due to their danger profile, amphetamine and instant release forms of methylphenidate should not be made readily available to healthy adults and would need to be prohibited. (shrink)

It is usually thought that wrongful acts of threat-involving coercion are wrong because they involve a violation of the freedom or autonomy of the targets of those acts. I argue here that this cannot possibly be right, and that in fact the wrongness of wrongful coercion has nothing at all to do with the effect such actions have on their targets. This negative thesis is supported by pointing out that what we say about the ethics of threatening (and thus the (...) ethics of coercion) constrains what we can say about the ethics of warning and offering. Importantly, our favoured explanation of the wrongness of certain kinds of threatening should not commit us to condemning as wrong parallel cases of warning and offering. My positive project is to show how this can be done. I defend the claim that wrongful coercion is nothing more than the issuing of a conditional threat to do wrong, and that an agent's issuing of a conditional threat to do wrong is wrong because it constitutes motivation for that agent to adopt the announced intention to do wrong. The idea of explaining the wrongness of wrongful coercion in this way has gone unnoticed because we have thus far been mistaken about what a threat is. In this essay I present my moral analysis of coercion only after presenting a careful descriptive analysis of threats. On my view, it is essential to a threat that the announced intention is one that the agent does not possess before announcing it. This analysis makes it possible to elucidate the descriptive differences between threats, warnings and offers, which sets up the later project of elucidating the moral differences between them. (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)

Philosophers have talked to each other about moral issues concerning technology, but few of them have talked about issues of technology and the good life, and even fewer have talked about technology and the good life with the public in the form of recommendation. In effect, recommendations for various technologies are often left to technologists and gurus. Given the potential benefits of informing the public on their impacts on the good life, however, this is a curious state of affairs. In (...) the present paper, I will examine why philosophers are seemingly reluctant to offer recommendations to the public. While there are many reasons for philosophers to refrain from offering recommendations, I shall focus on a specific normative reason. More specifically, it appears that, according to a particular definition, offering recommendations can be viewed as paternalistic, and therefore is prima facie wrong to do so. I will provide an argument to show that the worry about paternalism is unfounded, because a form of paternalism engendered by technology is inevitable. Given the inevitability of paternalism, I note that philosophers should accept the duty to offer recommendations to the public. I will then briefly turn to design ethics, which has reconceptualised the role of philosophers and, in my mind, fitted well with the inevitability of paternalism. Finally, I shall argue that design ethics has to be supplemented by the practice of recommendation if it is to sustain its objective. (shrink)

This article first describes a dilemma for liberalism: On the one hand restricting their own options is an important means for groups of people to shape their lives. On the other hand, group members are typically divided over whether or not to accept option-restricting solutions or policies. Should we restrict the options of all members of a group even though some consent and some do not? This dilemma is particularly relevant to public health policy, which typically target groups of people (...) with no possibility for individuals to opt out. The article then goes on to propose and discuss a series of aggregation rules for individual into group consent. Consideration of a number of scenarios shows that such rules cannot be formulated only in terms of fractions of consenters and non-consenters, but must incorporate their motives and how much they stand to win or lose. This raises further questions, including what is the appropriate impact of altruistic consenters and non-consenters, what should be the impact of costs and benefits and whether these should be understood as gross or net. All these issues are dealt with in a liberal, anti-paternalistic spirit, in order to explore whether group consent can contribute to the justification of option-restricting public health policy. (shrink)

My central thesis is that philosophers considering questions of epistemic value ought to devote greater attention to the enduring nature of beliefs. I begin by arguing that a commonly drawn analogy between beliefs and actions is flawed in important respects, and that a better, more fruitful analogue for belief would be desire, or a similarly enduring state of an agent. With this in hand, I argue that treating beliefs as enduring, constitutive states of agents allows us to capture the importance (...) of accessible, justified, and true beliefs to sustaining personal identity, autonomy, self-control, and authenticity. We thus arrive at a significant value to such beliefs through their crucial role in our personal, practical identities. (shrink)

Price gouging occurs when, in the wake of an emergency, sellers of a certain necessary goods sharply raise their prices beyond the level needed to cover increased costs. Most people think that price gouging is immoral, and most states have laws rendering the practice a civil or criminal offense. The purpose of this paper is to explore some of the philosophic issues surrounding price gouging, and to argue that the common moral condemnation of it is largely mistaken. I make this (...) argument in three steps, by rebutting three widely held beliefs about the ethics of price gouging: 1) that laws prohibiting price gouging are morally justified, 2) that price gouging is morally impermissible behavior, even if it ought not be illegal, and 3) that price gouging reflects poorly on the moral character of those who engage in it, even if the act itself is not morally impermissible. (shrink)

In this article, I argue that the state has a prima facie obligation to help its citizens satisfy their autonomous preferences. I argue that this obligation is grounded in the state's obligation to respect its citizens as persons, and that part of what is involved in respecting someone as a person is helping her satisfy her autonomous preferences. I argue that that which makes preferences autonomous is also that which makes them, and not their non-autonomous counterparts, worthy of respect. In (...) addition, I reject other views of what makes preferences worthy of respect, in particular Ronald Dworkin's view that only preferences for one's own enjoyment of some goods or opportunities deserve political consideration. Finally, I consider the state's obligation towards immoral autonomous preferences, and I argue that the state's prima facie obligation to promote the satisfaction of autonomous preferences is quite strong. (shrink)

In this paper, I examine two versions of the so-called “hierarchical” approach to personal autonomy, based on the notion of “second-order desires”. My primary concern will be with the question of whether these approaches provide an adequate basis for understanding the dynamics of autonomy-ascription. I begin by distinguishing two versions of the hierarchical approach, each representing a different response to the oft-discussed “regress” objection. I then argue that both “structural hierarchicalism” (e.g., Frankfurt, Bratman) and “procedural hierarchicalism” (e.g., Dworkin, Christman, Mele) (...) have difficulties accommodating the dynamics of how the attribution of autonomy to persons is claimed, disputed, and resolved. Although they differ in details, both shortcomings can be traced to viewing autonomy as a metaphysical rather than a normative, practical matter. I conclude by suggesting that these difficulties underscore the advantages of a more constructivist and pragmatist. (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)

What justifies differences in the acceptance of paternalism towards competent minors and older people? I propose two arguments. The first argument draws on the widely accepted view that paternalism is easier to justify the more good it promotes for the paternalizee. It argues that paternalism targeting young people generally promotes more good for the people interfered with than similar paternalism targeting older people. While promoting people's interests or well-being is essential to the justification of paternalism, the first argument has certain (...) unfair implications in that it disfavours paternalism towards the worse off. The second argument caters to such fairness concerns. It argues that priority or inequality aversion supports age-differentiated paternalism because young people, who act imprudently and thereby risk their interests or well-being, are worse off than older people who act in similar ways. I suggest that both arguments are pertinent in evaluating specific paternalistic acts and policies. (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.

Epistemic paternalism is the thesis that in some circumstances we are justified in interfering with the inquiry of others for their own epistemic good without consulting them on the issue. This paper addresses the issue of who is rationally entitled to undertake paternalistic interferences, and in virtue of which features one has this entitlement. First, it undermines the view according to which experts are the most apt people to act as paternalist interferers. Then it argues 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, it offers a virtue‐based account of paternalist interferers and shows how it can apply to cases in which the interferer is a group or an institution. (shrink)

Should officeholders be held individually responsible for submitting to systemically corrupt institutional practices? We draw a structural analogy between individual action under coercive threat and individual participation in systemic corruption, and we argue that officeholders who submit to corrupt institutional practices are not excused by the existence of a systemic coercive threat. Even when they have good personal reasons to accept the threat, they remain individually morally assessable and, in the circumstances, they are also individually blameworthy for actions performed in (...) their institutional capacity. (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)

Social robots are designed to perform intelligent, emotional, and autonomous behavior in order to establish intimate relationships with humans, for instance, in the context of elderly care. However, the imitation of qualities usually assumed to be necessary for human reciprocal interaction may impact our understanding of social interaction. Against this background, we compare the technical operations based on which social robots imitate human-like behavior with the concepts of emotionality, intelligence, and autonomy as usually attached to humans. In doing so, we (...) aim at making a conceptual contribution to the intuition that the technical imitation of emotional, intelligent, and autonomous behavior differs qualitatively from human forms of emotionality, intelligence, and autonomy. We conclude that the increasing tendency of social robots to imitate human characteristics and the thus increased human tendency of anthropomorphizing technical systems put forth new forms of human–machine interactions (HMI) that call for a critical examination. Thus, the emerging forms of interaction may lead, for instance, to false, reinforced, and perplexing assumptions regarding reciprocity. Therefore, studies are needed that critically examine the potential consequences and psychological effects that may be associated with the use of social robots, especially with regard to vulnerable groups such as children or the elderly. (shrink)

One’s constitution—whether one is generous or miserly, temperate or intemperate, kind or mean, etc.—is beyond one’s control in significant respects. Yet one’s constitution affects how one acts. And how one acts affects one’s moral standing. The counterintuitive inference—the so-called problem of constitutive moral luck—is that one’s moral standing is, to some significant extent, beyond one’s control. This article grants the premises but resists the inference. It argues that one’s constitution should have no net impact on one’s moral standing. While a (...) bad constitution lowers the chance that one will act morally, it offers significant gains to moral standing should that chance materialize. A good constitution increases one’s chance of performing good acts but for correspondingly more modest gains. This effect should smooth out, and possibly eliminate, the expected impact of constitution on moral standing. (shrink)

Journal of Political Philosophy, EarlyView.

Paternalism is widely viewed as presumptively justifiable for children but morally problematic for adults. The standard explanation for this distinction is that children lack capacities relevant to the justifiability of paternalism. I argue that this explanation is more difficult to defend than typically assumed. If paternalism is often justified when needed to keep children safe from the negative consequences of their poor choices, then when adults make choices leading to the same negative consequences, what makes paternalism less justified? It seems (...) true that ordinary adults have capacities enabling them to promote their interests in ways most children lack. This can explain why paternalism is more often justified towards children than adults. What is not explained, however, is why paternalism would be justifiable for children, but not adults, when neither possess the relevant interest-promoting capacities—exactly the cases when paternalism towards adults might be considered. I argue that this dilemma undercuts capacities-based explanations for the belief that childhood is distinctively relevant for the permissibility of paternalism. I then address defenses of both consequentialist and deontological versions of the capacities-based explanation. Absent this capacities-based explanation, I argue that the intuition that less demanding justificatory standards apply to paternalism when directed at children than when directed towards adults presents unresolved problems for egalitarians. (shrink)

According to many of its proponents, shared decision making ("SDM") is the right way to interpret the clinician-patient relationship because it respects patient autonomy in decision-making contexts. In particular, medical ethicists have claimed that SDM respects a patient's relational autonomy understood as a capacity that depends upon, and can only be sustained by, interpersonal relationships as well as broader health care and social conditions. This paper challenges that claim. By considering two primary approaches to relational autonomy, this paper argues that (...) standard accounts of SDM actually undermine patient autonomy. It also provides an overview of the obligations generated by the principle of respect for relational autonomy that have not been captured in standard accounts of SDM and which are necessary to ensure consistency between clinical practice and respect for patient autonomy. (shrink)

We study whether robots can satisfy the conditions of an agent fit to be held morally responsible, with a focus on autonomy and self-control. An analogy between robots and human groups enables us to modify arguments concerning collective responsibility for studying questions of robot responsibility. We employ Mele’s history-sensitive account of autonomy and responsibility to argue that even if robots were to have all the capacities required of moral agency, their history would deprive them from autonomy in a responsibility-undermining way. (...) We will also study whether humans and technological artifacts like robots can form hybrid collective agents that could be morally responsible for their actions and give an argument against such a possibility. (shrink)

When are we morally obligated as a society to help the homeless, and is coercive interference justified when help is not asked for, even refused? To answer this question, we propose a comprehensive taxonomy of different types of homelessness and argue that different levels of autonomy allow for interventions with varying degrees of pressure to accept help. There are only two categories, however, where paternalism proper is allowed, be it heavily qualified. The first case is the homeless person with severely (...) diminished autonomy as a result of mental illness, and the second case is the homeless person who runs a risk of serious and imminent harm to self. In the first case, namely, that of soft paternalism, we argue that coercive intervention in the case of a refusal to accept help should be focused on the provision of housing that meets basic needs—needs that we outline in the article. In the case of imminent and severe harm to self, the case of hard paternalism, we argue that forced intervention can only be allowed if it is temporary and local, namely focused on getting someone out of harm’s way. (shrink)

An analysis of the nature of good governance as it figures into the Royal Government of Bhutan's policy of Gross National Happiness.

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.

I first provide an analysis of Joel Feinberg’s anti-paternalism in terms of invalidation of reasons. Invalidation is the blocking of reasons from influencing the moral status of actions, in this case the blocking of personal good reasons from supporting liberty-limiting actions. Invalidation is shown to be distinct from moral side constraints and lexical ordering of values and reasons. I then go on to argue that anti-paternalism as invalidation is morally unreasonable on at least four grounds, none of which presuppose that (...) people can be mistaken about their own good: First, the doctrine entails that we should sometimes allow people to unintentionally severely harm or kill themselves though we could easily stop them. Second, it entails that we should sometimes allow perfectly informed and rational people to risk the lives of themselves and others, though they are in perfect agreement with us on what reasons we have to stop them for their own good. Third, the doctrine leaves unexplained why we may benevolently coerce less competent but substantially autonomous people, such as young teens, but not adults. Last, it entails that there are peculiar jumps in justifiability between very similar actions. I conclude that as liberals we should reject anti-paternalism and focus our efforts on explicating important liberal values, thereby showing why liberty reasons sometimes override strong personal good reasons, though never by making them invalid. (shrink)

Externalism is the view that facts about one's history or past in the external world that bear on the acquisition of one's responsibility-grounding psychological elements are pertinent to whether one's actions are free and, hence, pertinent to whether one can be morally responsible for them. Internalism is the thesis that the conditions of moral responsibility can be specified independently of facts about how the person acquired her responsibility-grounding psychological elements. In this paper we defend a position that navigates between externalism (...) and internalism: moral responsibility does not require that one have a past but it does require that one not have certain kinds of past. (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...

Some say that consent is essentially just a state of mind. Others say it is essentially just a communication. Many say it is both. I say it is neither. Instead it is an act, or rather a pair of acts—an internal mental act in the first instance, an external performative act in the second. Each of those acts is an act of commitment, intrapersonally in the first case and interpersonally in the second. The content of the commitment is, familiarly enough, (...) to give permission to someone else to do something that it would be wrong for them to do without your permission. The novelty lies in seeing consent as an act of commitment in those two dimensions and in seeing those as commitments that persist until and unless undone by an act of a similar sort. (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)

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

Recent observations associate naturally occurring trace levels of Lithium in ground water with significantly lower suicide rates. It has been suggested that adding trace Lithium to drinking water could be a safe and effective way to reduce suicide. This article discusses the many ethical implications of such population-wide Lithium medication. It compares this policy to more targeted solutions that introduce trace amounts of Lithium to groups at higher risk of suicide or lower risk of adverse effects. The question of mass (...) treatment with Lithium recalls other choices in public health between population-wide and more targeted interventions. The framework we propose could be relevant to some of these other dilemmas. (shrink)

In this article, we seek to contribute to the debate on the requirement of disclosure in the context of informed consent for research. We defend the subjective standard of disclosure and describe ways to implement this standard in research practice. We claim that the researcher should make an effort to find out what kinds of information are likely to be relevant for those consenting to research. This invites researchers to take empirical survey information seriously, attempt to understand the cultural context, (...) talk to patients to be better able to understand what can be potentially different concerns and interests prevalent in the target population. The subjective standard of disclosure should be seen as a moral ideal that perhaps can never be perfectly implemented but still can and should be used as a normative ideal guiding research practice. In the light of these discussions, we call for more empirical research on what considerations are likely to be perceived as relevant by potential research participants recruited from different socio-economic and cultural groups. (shrink)

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)

Given that many people with disabilities have been excluded from political deliberation and subjected to infantilizing and degrading treatment from others, many members of the disability rights movement are understandably critical of policies and practices that speak on behalf of people with disabilities and presume to know what is really in their best interest. Yet, this analysis argues that a general principle of anti-paternalism is not desirable for disability politics. In particular, people with cognitive disabilities are sometimes unable to make (...) important decisions by themselves, and may require assistance from family members or more cognitively able and verbally fluent citizens to make their political voices and choices heard. Drawing from John Locke and Alasdair MacIntyre, this article reconsiders the relationship between paternalism and autonomy, suggesting that autonomous decisionmaking and expression are best thought of as collaborative processes undertaken between people with a range of capacities. (shrink)

Occasional reports in the literature suggest that biological samples collected and stored for scientific research are sometimes accessed and used for a variety of forensic purposes. However, donors are almost never informed about this possibility. In this paper we argue that the possibility of forensic access may constitute a relevant consideration at least to some potential research subjects in deciding whether to participate in research. We make the suggestion that if some type of forensic access to research collections is likely (...) to be perceived by the subjects as a reason against donating their biological materials, there are good ethical reasons to make this type of access impossible or at least severely restricted. We also provide an ethical argument for the claim that, if a total ban on this type of forensic access cannot be achieved, potential research subjects should be informed about the extent to which this type of forensic access is possible. (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)

The idea that research with human participants should benefit society has become firmly entrenched in various regulations, policies, and guidelines, but there has been little in-depth analysis of this ethical principle in the bioethics literature. In this paper, I distinguish between strong and weak versions and the social benefits principle and examine six arguments for it. I argue that while it is always ethically desirable for research with human subjects to offer important benefits to society, the reasonable expectation of substantial (...) public benefit should be a necessary condition for regarding research as ethical only when it imposes more than minimal risks on non-consenting subjects; or it is supported by public resources. (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)

Es wurde für die These argumentiert, dass der Begriff der Würde in der Medizinethik nutzlos sei und in den Fällen, in denen er verständlich verwendet wird, nichts anderes meint als den Respekt vor der Autonomie von Personen. In diesem Aufsatz soll gezeigt werden, dass diese These falsch ist. Es wird ein Begriff von Würde vorgestellt, der sich nicht auf den Begriff des Respekts vor der Autonomie von Personen reduzieren lässt. Anhand der Diskussion um ein Sterben in Würde soll auch deutlich (...) werden, dass auf den Begriff der Würde auch in der Medizinethik nicht verzichtet werden kann. (shrink)

Nothing can kill a promising research program in ethics more quickly than a plausible argument to the effect that it is committed to a morally repellent consequence. It is especially troubling when a theory one favors is jeopardized in this way. I have this worry about Harry Frankfurt's theory of free will, autonomous agency and moral responsibility, for there is a very plausible argument to the effect that aspects of his view commit him to a version of the late Stoic (...) thesis that acting freely is a matter of ‘making do,’ that is, of bringing oneself to be motivated to act in accordance with the feasible, so that personal liberation can be achieved by resigning and adapting oneself to necessity. In this paper I try to determine whether the theory does in fact commit Frankfurt (and adherents like me) to this result and, if so, what can be done to prevent it. (shrink)

The recent increased prevalence of diseases related to unhealthy lifestyles raises difficulties for healthcare insurance systems traditionally based on the principles of risk-management, solidarity, and selective altruism: since these diseases are, to some extent, predictable and avoidable, patients seem to bear some responsibility for their condition and may not deserve full access to social medical services. Here, we investigate with objective criteria to what extent it is warranted to hold patients responsible for their illness and to sanction them accordingly. We (...) ground our analysis on a series of minimal conditions for ‘practical’ and for ‘moral’ responsibility attribution. By applying these criteria consistently, we highlight that individual responsibility applies to risk-taking life choices rather than stigmatized sickness. We explain that responsibility is a matter of degree, that it varies across life-history, and can be affected by factors beyond the patients’ grasp. We point out that scientific knowledge about the effect of these factors generates responsibilities for other parties such as public health agencies and private industry. The upshot of our analysis is that health policies targeting the ‘liable’ undeserving sick are mostly unwarranted, and tend to increase unequal treatment of already vulnerable groups: the unlucky sick. (shrink)

Peter-Paul Verbeek elaborates on the concept of “relational freedom” in Moralizing Technology (2011). In this paper, I propose to extend and reinterpret it as a concept of personal autonomy. Generally, studies of autonomy do not examine the use of technology thoroughly, because these studies mainly focus on an individual’s mental process regarding reasons or motives. Consequently, these studies fail to understand technological aspects that contribute to the agent’s actions and decisions. When we take into consideration that our autonomous behaviors and (...) lives are highly intertwined with technologies, it becomes necessary to clarify the aspect of autonomy that relates to the use of technology. This is where Verbeek’s relational freedom comes into play. This is because it refers to the set of capacities to constitute one’s subjectivity in the process of deliberately using technological means. However, some conceptual analysis and critical discussion are necessary. The former includes whether it is a procedural or substantive notion. The latter consists of the problem concerning the correspondence between human participant(s) and a hybrid agent, and the difference between the hybrid agent and a moral subject. (shrink)

This paper discusses the volenti non fit injuria maxim. The volenti maxim states that a person is not wronged by that to which she consents, provided her consent is valid. I will argue, however, that the volenti maxim does not apply to all instances of valid consent. In some cases the consenter is wronged even if his consent is valid. Valid consent can only release others from consent-sensitive duties, not from consent-insensitive duties. If the consentee flouts a consent-insensitive duty the (...) consentee wrongs the consenter and thereby commits a wrong. (shrink)