Clinical assessments of mental capacity have long been guided by four basic cognitive criteria (understanding, appreciation, ability to reason, communication of decision), distilled directly from widespread legal precedent in common law cases of informed consent and refusal. This article will challenge the sufficiency of these legal criteria at the bedside on the assertion that clinicians and bioethicists who evaluate decisional capacity face questions far deeper than the mere presence or absence of a patient’s informed consent. It will then present an (...) additional standard beyond the existing cognitive criteria – to be called the Narrative Coherence Standard – that may begin to bridge the gap between the existing legal standards and higher-order bioethical priorities. This standard will be treated with a philosophical argument for its use, as well as a detailed exploration of its technical components and conceptual underpinnings. (shrink)

Esta coletânea explora o papel desempenhado pelas emoções na teorização em ética e metaética. Inclui capítulos escritos por pesquisadores do Brasil e de outros países.

We haveconflictingpre-philosophical intuitions about what it means ‘to be true to ourselves.’ On the one hand, autonomy and authenticity seem closely connected to the lucidity of reflectiveness; on the other, they seem tightly interwoven with the immediacy of unreflectiveness. As opposed to a ‘Platonic’ intuition about the inferiority of the unexamined life, we have an equally strong ‘Nietzschean’ intuition about the corrosiveness of the examined life. Broadly speaking, the first intuition is more akin to the tradition of the Enlightenment, and (...) the second, more to that of Romanticism; the one is reminiscent of Descartes and Hume, the other of Rousseau and Herder.The use of the technical term ‘autonomy’ and the concomitant term ‘self’ is primarily limited to philosophy, while in daily life ‘freedom’ and ‘person,’ respectively, are used instead. Unfortunately, in their deployment of these technical terms philosophers have generally failed to acknowledge the two modes of ‘being true to ourselves’ associated with the Enlightenment and Romanticism, for they usually employ the concept of autonomy in a unitary way. (shrink)

We have conflicting pre-philosophical intuitions about what it means ‘to be true to ourselves.’ On the one hand, autonomy and authenticity seem closely connected to the lucidity of reflectiveness; on the other, they seem tightly interwoven with the immediacy of unreflectiveness. As opposed to a ‘Platonic’ intuition about the inferiority of the unexamined life, we have an equally strong ‘Nietzschean’ intuition about the corrosiveness of the examined life. Broadly speaking, the first intuition is more akin to the tradition of the (...) Enlightenment, and the second, more to that of Romanticism; the one is reminiscent of Descartes and Hume, the other of Rousseau and Herder.The use of the technical term ‘autonomy’ and the concomitant term ‘self’ is primarily limited to philosophy, while in daily life ‘freedom’ and ‘person,’ respectively, are used instead. Unfortunately, in their deployment of these technical terms philosophers have generally failed to acknowledge the two modes of ‘being true to ourselves’ associated with the Enlightenment and Romanticism, for they usually employ the concept of autonomy in a unitary way. (shrink)

How social media impacts the autonomy of its users is a topic of increasing focus. However, much of the literature that explores these impacts fails to engage in depth with the philosophical literature on autonomy. This has resulted in a failure to consider the full range of impacts that social media might have on autonomy. A deeper consideration of these impacts is thus needed, given the importance of both autonomy as a moral concept and social media as a feature of (...) contemporary life. By drawing on this philosophical literature, we argue that autonomy is broadly a matter of developing autonomy competencies, having authentic ends and control over key aspects of your own life, and not being manipulated, coerced, and controlled by others. We show how the autonomy of users of social media can be disrespected and harmed through the control that social media can have over its users’ data, attention, and behaviour. We conclude by discussing various recommendations to better regulate social media. (shrink)

Adaptive preference formation is the unconscious altering of our preferences in light of the options we have available. Jon Elster has argued that this is bad because it undermines our autonomy. I agree, but think that Elster's explanation of why is lacking. So, I draw on a richer account of autonomy to give the following answer. Preferences formed through adaptation are characterized by covert influence (that is, explanations of which an agent herself is necessarily unaware), and covert influence undermines our (...) autonomy because it undermines the extent to which an agent's preferences are ones that she has decided upon for herself. This answer fills the lacuna in Elster's argument. It also allows us to draw a principled distinction between adaptive preference formation and the closely related phenomenon of character planning. (shrink)

Social robots are robots that can interact socially with humans. As social robots and the artificial intelligence that powers them becomes more advanced, they will likely take on more social and work roles. This has many important ethical implications. In this paper, we focus on one of the most central of these, the impacts that social robots can have on human autonomy. We argue that, due to their physical presence and social capacities, there is a strong potential for social robots (...) to enhance human autonomy as well as several ways they can inhibit and disrespect it. We argue that social robots could improve human autonomy by helping us to achieve more valuable ends, make more authentic choices, and improve our autonomy competencies. We also argue that social robots have the potential to harm human autonomy by instead leading us to achieve fewer valuable ends ourselves, make less authentic choices, decrease our autonomy competencies, make our autonomy more vulnerable, and disrespect our autonomy. Whether the impacts of social robots on human autonomy are positive or negative overall will depend on the design, regulation, and use we make of social robots in the future. (shrink)

Anger is often an appropriate reaction to harms and injustices, but is it a politically beneficial one? Martha Nussbaum (Journal of the American Philosophical Association 1 (1), 41–56, 2015, Anger and Forgiveness. Oxford University Press, 2016) has argued that, although anger is useful in initially recruiting agents for action, anger is typically counterproductive to securing the political aims of those harmed. After the initial shockwave of outrage, Nussbaum argues that to be effective at enacting positive social change, groups and individuals (...) alike, must move quickly out of the state of anger. Feminist theorists (Frye, The Politics of Reality. Crossing Press, 1983; Lorde, 1997; Narayan, Hypatia 3 (2): 31–48, 1988) on the other hand have for long highlighted the efficacy of anger, as well as its moral and epistemic value, in fighting against the oppressive status quo. It might be thought therefore that for political action to be effective, a continued state of anger is preferable. Protestors must after all create and sustain a sense of moral obligation and justice. A main way of doing so is to promote successive moral shocks that trigger outrage (Jasper, Emotion Review 6 (3): 208–213, 2014). I present a novel, empirically informed defense of anger’s efficacy in political action. Nussbaum holds a traditional view on the nature of anger, inherited from Aristotle and the Stoics, which holds that anger constitutively involves a desire for retribution. The view that anger is counterproductive falls out of this and is dominant in academic work as well as in our personal and political lives. Based on work in social psychology, I argue that we need to reconsider this. In doing so, I highlight anger’s aim for recognition, rather than retribution, as key. Furthermore, I uncover conditions for anger’s political efficacy, as well as reasons for why the traditional view of anger has been so pervasive. (shrink)

Outlaw emotions are emotions that stand in tension with one’s wider belief system, often allowing epistemic insight one may have otherwise lacked. Outlaw emotions are thought to play crucial epistemic roles under conditions of oppression. Although the crucial epistemic value of these emotions is widely acknowledged, specific accounts of their epistemic role(s) remain largely programmatic. There are two dominant accounts of the epistemic role of emotions: The Motivational View and the Justificatory View. Philosophers of emotion assume that these dominant ways (...) of accounting for the epistemic role(s) of emotions in general are equipped to account for the epistemic role(s) of outlaw emotions. I argue that this is not the case. I consider and dismiss two responses that could be made on behalf of the most promising account, the Justificatory View, in light of my argument, before sketching an alternative account that should be favoured. (shrink)

Our values change. What we value, want, desire, prefer, and how much; for nearly everyone, these will be different at different times in their life. These changes can be gradual or abrupt; they can be long-lasting or short-lived; and they can be induced by forces outside yourself or they can come from within or they can have no specific catalyst at all. Such preference change raises a number of questions for our theorising about rational choice, and these have been discussed (...) at length. In §2 and §3, I’ll outline two of these questions along with some of the putative solutions that have been proposed. But preference change also raises questions for our theorising about autonomy, and these have hardly been considered at all. In §4, I’ll outline three problems for personal autonomy; and in §5, I’ll outline one problem for political autonomy. In §6, I conclude. (shrink)

ABSTRACT This paper discusses keys to the moral procurement, treatment and disposition of remains used for scientific research, specifically those donated to the University of Tennessee’s Anthropological Research Facility (ARF). The ARF is an outdoor laboratory dedicated to better understanding the fate of human remains in forensic contexts, and focuses its research on decomposition, time since death estimates, body location and recovery techniques, and skeletal analysis. Historically, many donations were unclaimed bodies received from medical examiners (although it will be shown (...) that this trend is changing), and it has been argued that the use of unclaimed bodies for medical or scientific purposes is a violation of autonomy since no consent was given by the individual. It is argued here, however, that the domain of autonomous choice extends to one’s own corpse only insofar as expressed wishes are made known prior to one’s death, and that in the absence of expressed intent toward final disposition, it is acceptable for institutions to receive donations from medical examiners or family members. This paper also discusses other philosophical issues related to donation, consent and autonomy, and the forensic benefits of research conducted at the Anthropological Research Facility. (shrink)

En los sectores políticos democráticos liberales, el principio del respeto a la autonomía es ampliamente aceptado —en teoría, si no siempre en la práctica— como un valor moral cardinal que debería guiar tanto la deliberación política, la política pública y las prácticas, como nuestras actitudes respecto a nuestros conciudadanos. En términos simples, respetar la autonomía es respetar los intereses de cada persona de vivir su vida según su propia concepción del bien. En la base del requisito normativo de respetar la (...) autonomía de otro está la presunción de que la autonomía confiere autoridad normativa sobre la propia vida; la autoridad para tomar decisiones de importancia práctica para la propia vida, por razones propias, cualesquiera que sean. Se asume que las personas autónomas tienen la capacidad, el derecho y la responsabilidad de ejercer esta autoridad, incluso si no siempre lo hacen sabiamente. (shrink)

Respect for autonomy is a central moral principle in bioethics. It is sometimes argued that authenticity, i.e., being “real,” “genuine,” “true to oneself,” or similar, is crucial to a person’s autonomy. Patients sometimes make what appears to be inauthentic decisions, such as when anorexia nervosa patients refuse treatment to avoid gaining weight, despite that the risk of harm is very high. If such decisions are inauthentic, and therefore non-autonomous, it may be the case they should be overridden for paternalist reasons. (...) However, it is not clear what justifies the judgment that someone or something is inauthentic. This article discusses one recent theory of what justifies judgments of inauthenticity. It is argued that the theory is seriously limited, as it only provides guidance in three out of nine identified cases. There are at least six authenticity-related problems to be solved, and autonomy theorists thus have reason to engage with the topic of authenticity in practical biomedicine. (shrink)

To be autonomous is to be a law to oneself; autonomous agents are self-governing agents. Most of us want to be autonomous because we want to be accountable for what we do, and because it seems that if we are not the ones calling the shots, then we cannot be accountable. More importantly, perhaps, the value of autonomy is tied to the value of self-integration. We don't want to be alien to, or at war with, ourselves; and it seems that (...) when our intentions are not under our own control, we suffer from self-alienation. What conditions must be satisfied in order to ensure that we govern ourselves when we act? Philosophers have offered a wide range of competing answers to this question. (shrink)

There are two extreme poles in the literature on akrasia. Internalists hold that it's impossible to act intentionally against your better judgment, because there's a necessary internal relation between judgment and intentional action. To the contrary, externalists maintain that we can act intentionally against our better judgment, because the will operates independently of judgment. Critics of internalism argue that it fails a realism test—most people seem to think that we can and do act intentionally against our better judgment. And critics (...) of externalism argue that it flirts with incoherence by severing the intimate link between judgment and action. Drawing on resources from phenomenology, the cognitive sciences, analytic action theory, and recent “hybrid models” of skilled action, I argue that one route beyond this theoretical impasse is to understand akrasia as a form of skillful pre-reflective intentional action. This strategy, I argue, preserves the internalist insight that there is indeed an intimate relation between judgment and intentional action; and it also confirms the externalist claim that this relation is defeasible, but it does so without falling into incoherence. (shrink)

Este texto tem como objetivo apresentar a principal motivação filosófica para se defender uma teoria causal da memória, que é explicar como pode um evento que se deu no passado estar relacionado a uma experiência mnêmica que se dá no presente. Para tanto, iniciaremos apresentando a noção de memória de maneira informal e geral, para depois apresentar elementos mais detalhados. Finalizamos apresentando uma teoria causal da memória que se beneficia da noção de veritação (truthmaking).

This paper aims to provide autonomy-based reasons in favour of limitarianism. Limitarianism affirms it is of primary moral importance that no one gets too much. The paper challenges the standard assumption that having more material resources always increases autonomy. It expounds five mechanisms through which having too much material wealth might undermine autonomy. If these hypotheses are true, a theory of justice guided by a concern for autonomy will support a limitarian distribution of wealth. Finally, the paper discusses two issues (...) autonomy-based limitarianism would raise. First, insofar as coercion invades autonomy, do autonomy-based reasons legitimate coercive measures to secure a limitarian distribution of wealth? Second, is a limitarian ethos consistent with the incentive to produce enough wealth to secure distributive justice? (shrink)

The paper addresses the problem of authenticity from a point of view that diverges from the more usual social, political, or moral approaches, by focusing very explicitly on the internal psychological make-up of human agents in an attempt to identify the conditions that would enable us to use the colloquial phrase 'being true to ourselves' in a way that is philosophically tenable. First, it is argued that the most important and problematic condition is the requirement that agents can be the (...) source of normative constraints which they themselves should attempt to respect. In the main part of the paper an argument is developed against a more or less Humean interpretation of this crucial requirement, according to which agents can be the source of normative constraints because they have desires , and a more or less Kantian interpretation, according to which agents can be the source of normative constraints because they have the capacity to judge . The Humean account is unsatisfactory, because it fails to make sense of the normativity of the content of desires, and because it cannot account on its own for what makes a person's desires her own . The Kantian account is also unsatisfactory, because, although it can account for the difference between being true to someone else and being true to certain principles, it is unable to account for the difference between being true to oneself and being true to principles. In the final part I shall suggest a way out of this impasse by claiming that the intelligibility of the phenomenon of being true to oneself crucially depends on the, yet to be explored, possibility of developing an account of self-respect that involves both de se attitudes and the idea of ourselves being valuable entities. (shrink)

The aim of this paper is to suggest that a necessary condition of autonomy has not been sufficiently recognized in the literature: the capacity to critically reflect on one’s practical attitudes (desires, preferences, values, etc.) in the light of new experiences . It will be argued that most prominent accounts of autonomy—ahistorical as well as history-sensitive—have either altogether failed to recognize this condition or at least failed to give an explicit account of it.

Ethicists differ considerably in their reasons for using empirical data. This paper presents a brief overview of four traditional approaches to the use of empirical data: “the prescriptive applied ethicists,” “the theorists,” “the critical applied ethicists,” and “the particularists.” The main aim of this paper is to introduce a fifth approach of more recent date (i.e. “integrated empirical ethics”) and to offer some methodological directives for research in integrated empirical ethics. All five approaches are presented in a table for heuristic (...) purposes. The table consists of eight columns: “view on distinction descriptive-prescriptive sciences,” “location of moral authority,” “central goal(s),” “types of normativity,” “use of empirical data,” “method,” “interaction empirical data and moral theory,” and “cooperation with descriptive sciences.” Ethicists can use the table in order to identify their own approach. Reflection on these issues prior to starting research in empirical ethics should lead to harmonization of the different scientific disciplines and effective planning of the final research design. Integrated empirical ethics (IEE) refers to studies in which ethicists and descriptive scientists cooperate together continuously and intensively. Both disciplines try to integrate moral theory and empirical data in order to reach a normative conclusion with respect to a specific social practice. IEE is not wholly prescriptive or wholly descriptive since IEE assumes an interdepence between facts and values and between the empirical and the normative. The paper ends with three suggestions for consideration on some of the future challenges of integrated empirical ethics. (shrink)

This essay suggests that common themes in recent feminist ethical thought can dislodge the guiding assumptions of traditional theories of free agency and thereby foster an account of freedom which might be more fruitful for feminist discussion of moral and political agency. The essay proposes constructing that account around a condition of normative-competence. It argues that this view permits insight into why women's labor of reclaiming and augmenting their agency is both difficult and possible in a sexist society.

Recent studies in psychosocial oncology that seek to address the social, psychological, emotional, spiritual, quality of life, and functional impacts of cancer, report positive findings for meaning-making interventions designed to help cancer patients cope with their illness experience. These interventions are successful in decreasing depression among cancer patients and increasing life satisfaction, self-esteem, coping, physical functioning, and optimism. Yet, despite these positive findings meaning-making interventions and, more generally psychosocial care, are not well integrated into hospital or healthcare organization routine cancer (...) patient care.This thesis explores practical, theoretical, and bioethical barriers to integrating psychosocial care, focusing primarily on the latter considerations. I will argue that meaning-making interventions fall within the bounds of healthcare professionals’ capacities and duty to care, more to the point, as necessary for quality cancer patient care. The bioethical principle of respect for autonomy, when reconsidered from a feminist standpoint, morally requires the intervention’s inclusion in routine care. (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)

It has been argued - most prominently in Harry Frankfurt's recent work - that the normative authority of personal commitments derives not from their intrinsic worth but from the way in which one's will is invested in what one cares about. In this essay, I argue that even if this approach is construed broadly and supplemented in various ways, its intrasubjective character leaves it ill-prepared to explain the normative grip of commitments in cases of purported self-betrayal. As an alternative, I (...) sketch a view that focuses on intersubjective constraints of intelligibility built into social practices and on the pragmatics of how those norms are contested in an ongoing fashion. (shrink)

According to Heidegger's Being and Time, social relations are constitutive of the core features of human agency. On this view, which I call a ‘strong conception’ of sociality, the core features of human agency cannot obtain in an individual subject independently of social relations to others. I explain the strong conception of sociality captured by Heidegger's underdeveloped notion of ‘being-with’ by reconstructing Heidegger's critique of the ‘weak conception’ of sociality characteristic of Kant's theory of agency. According to a weak conception, (...) sociality is a mere aggregation of individual subjects and the core features of human agency are built into each individual mind. The weak conception of sociality remains today widely taken for granted. I show that Christine Korsgaard, one of the most creative contemporary appropriators of Kant, operates with a weak conception of sociality and that this produces a problematic explanatory deficiency in her view: she is unable to explain the peculiar motivational efficacy of shared social norms. Heidegger's view is tailor made to explain this phenomenon. I end by sketching how Heidegger provides a social explanation of a major systematic concern animating Korsgaard, the concern with the importance of individual autonomy and answerability in human life. (shrink)

Controversial and provocative, To Be Real is a blueprint for the creation of a new political force.

A strong distinction is often made between personal autonomy and moral autonomy. Personal autonomy involves governing yourself in the pursuit of your own conception of the good. Moral autonomy involves legislating the moral law for yourself. Viewed in this way personal autonomy seems at best marginal and at worst a positive hindrance to moral autonomy, since personal autonomy can conflict with moral autonomy. Given that Kantian approaches to morality are closely aligned with moral autonomy, does that mean that the Kantian (...) must view personal autonomy as a moral hindrance? Can there be a legitimate role for personal autonomy within Kant’s ethical framework? This paper will seek to argue: that personal and moral autonomy need not be seen as in tension or at odds with one another; that Kant defends an attractive weak substantive theory of personal autonomy; that socialisation plays an important role (both positive and negative) in the development of autonomy competences in Kant’s theory; and that personal autonomy (properly understood) has an essential role to play in Kant’s ethical framework. (shrink)

Feminist strong substantive autonomy (FSSA), as presented by Natalie Stoljar and Anita Superson, pronounces judgment on the autonomy status of certain women living under oppression. These women act on deformed desires, Superson explains, and as deformed desires cannot be the agent's own, the women are heteronomous. Stoljar argues that some women's choices violate the Feminist Intuition; by acting on false and oppressive values, these women render themselves heteronomous. I argue against Stoljar and Superson on epistemological grounds. I present six different (...) ways in which agents' choices can be related to deformed desires, with varying results for their autonomy statuses. I show that Stoljar and Superson are not able to distinguish properly among the differing autonomy statuses in these six cases, because doing so requires attention to agents' inner processes of decision-making, as those processes are enacted in the agents' social and temporal contexts. Stoljar and Superson judge others' autonomy statuses based on abstract generalizations rather than via empirical attention to agents' actual decision-making processes. Consequently, their judgments are not adequate to the lived self-direction of real persons. Assessing others' autonomy status requires consideration of agents' inner choice-making in sociotemporal context, which favors a procedural or weak substantive account of autonomy. (shrink)

Advance directives for psychiatric care are the subject of debate in a number of Western societies. By using psychiatric advance directives , it would be possible for mentally ill persons who are competent and with their disease in remission, and who want timely intervention in case of future mental crisis, to give prior authorisation to treatment at a later time when they are incompetent, have become non-compliant, and are refusing care. Thus the devastating consequences of recurrent psychosis could be minimised.Ulysses (...) contracts raise a number of ethical questions. In this article the central issues of concern and debate are discussed from a narrative perspective. Ulysses contracts are viewed as elements of an ongoing narrative in which patient and doctor try to make sense of and get a hold on the recurrent crises inherent in the patient's psychiatric condition. (shrink)

In recent decades, the intertwining ideas of self-determination and well-being have received tremendous support in bioethics. Discussions regarding self-determination, or autonomy, often focus on two dimensions—the capacity of the patient and the freedom from external coercion. The practice of obtaining informed consent, for example, has become a standard procedure in therapeutic and research medicine. On the surface, it appears that patients now have more opportunities to exercise their self-determination than ever. Nonetheless, discussions of patient autonomy in the bioethics literature, which (...) focus on individual patients making particular decisions, neglect the social structure within which health-care decisions are made. Looking through the lens of disability and informed by the feminist conception of relational autonomy, this essay argues that the issue of autonomy is much more complex than the individualist model suggests. The social system and the ableist ideology impose various forms of pressure or oppressive power that can affect people’s ability to choose according to their value system. Even if such powers are not directly coercive, they influence potential parents’ decisions indirectly—they structure their alternatives in such a way that certain options are never considered as viable and other decisions must be made. This paper argues that, instead of only focusing on the individual act of decision-making, we need to pay attention to the social structure that frames people’s decision. (shrink)

Drawing on recent cognitive theories of the emotions, this article develops an account of critical reflection as requiring emotional flexibility and involving the ability to envisage alternative reasons for action. The focus on the role of emotions in critical reflection, and in agents' resistance to reflection, suggests the need to move beyond an introspective to a more social and relational conception of the process of reflection. It also casts new light on the intractable problem of explaining how oppressive socialisation impairs (...) the capacity for autonomy. (shrink)

Cognitive Theories of emotions have enjoyed great popularity in recent times. Allegedly, the so-called Perceptual Theory constitutes the most attractive version of this approach. However, the Perceptual Theory has come under increasing pressure. There are at least two ways to deal with the barrage of objections, which have been mounted against the Perceptual Theory. One is to argue that the objections work only if one assumes an overly narrow conception of what perception consists in. On a better and more liberal (...) understanding of perception, the objections lose their force. The other is to stress that the differences between emotions and sensory perceptions can be explained by focusing on a new analogy. As I will argue, emotions have interesting similarities with magnitude representations, such as the representation of distance. Such representations are plausibly thought to be analog and non-conceptual, but by contrast to sensory perceptions, such as colour perceptions, they do not lie at the sensory periphery. This new analogy makes room for a novel and attractive theory of emotions, the Receptive Theory, which allows for a positive and epistemologically fruitful characterization of emotions. (shrink)

Self-control is normally, if only tacitly, viewed as an inherently practical capacity or achievement: as exercised only in the domain of action. Questioning this assumption, we wish to motivate the...

The ethical debate about neurotechnologies—including both drugs and implanted devices—has been largely framed around the questions of whether and when these technologies could damage or promote authenticity. Patients can experience changes in mood, behavior, emotion, or preferences—seemingly, changes in character or personality. Some describe such changes by saying they feel like different people; that they have become either more or less themselves; or that they feel as though some of their moods, behaviors, emotions or preferences are not their own. These (...) kinds of statements are used to describe both changes that a drug or device is... (shrink)

This paper takes as its starting point a debate between Harry Frankfurt and J. David Velleman. Frankfurt argues that we need to resolve ambivalence since it necessarily threatens autonomy. Velleman challenges this claim, arguing that a desire to resolve ambivalence threatens autonomy when it prompts repression. I argue that the relationship between ambivalence and autonomy is more ambiguous than either theorist tends to acknowledge. In doing so, I recommend three features relevant for assessing whether or not ambivalence threatens autonomy.

This paper is a theoretical and empirical investigation into whether persons in subordinate social contexts possess agency and if they do, how do we recognise and recover their agency given the oppressive conditions of their lives. It aims to achieve this through forging closer links between the philosophical arguments and the ethnographic evidence of women's agency. Through such an exercise, this paper hopes to bridge the existing gap between feminist theoretical interventions and feminist politics as well as to increase 'sociological (...) awareness' within feminist philosophical arguments. In order to think about women's agency in oppressive social contexts, the paper evaluates the suitability of existing theoretical frameworks for examining, describing and capturing the autonomy of persons and concludes that a new and a more complex thinking is required to facilitate thinking about human agency within oppressive transcultural contexts. The social context of subordination, the exhibition of agency within and oppressive context and the application of the new theoretical framework is illustrated in an extensive empirical study of the contact with modernity and its accompanying ideas of autonomy and individual rights of rural women belonging to two districts in Rajasthan, North western India. (shrink)

In a recent article in this journal, Rolf Ahlzén treats a moral problem related to physician-assisted suicide and the notion of authenticity. The problem is whether considerations of a patient’s “true self” should be included in judgments of PAS. In this short commentary, it is argued that Ahlzén neglects to attend to central contributions to the philosophy of authenticity, provides an internally inconsistent theory thereof, and conflates crucial distinctions in the debate.

This collection of new essays examines philosophical issues at the intersection of feminism and autonomy studies. Are autonomy and independence useful goals for women and subordinate persons? Is autonomy possible in contexts of social subordination? Is the pursuit of desires that issue from patriarchal norms consistent with autonomous agency? How do emotions and caring relate to autonomous deliberation? Contributors to this collection answer these questions and others, advancing central debates in autonomy theory by examining basic components, normative commitments, and applications (...) of conceptions of autonomy. Several chapters look at the conditions necessary for autonomous agency and at the role that values and norms -- such as independence, equality, inclusivity, self-respect, care and femininity -- play in feminist theories of autonomy. Whereas some contributing authors focus on dimensions of autonomy that are internal to the mind -- such as deliberative reflection, desires, cares, emotions, self-identities and feelings of self-worth -- several authors address social conditions and practices that support or stifle autonomous agency, often answering questions of practical import. These include such questions as: What type of gender socialization best supports autonomous agency and feminist goals? When does adapting to severely oppressive circumstances, such as those in human trafficking, turn into a loss of autonomy? How are ideals of autonomy affected by capitalism? and How do conceptions of autonomy inform issues in bioethics, such as end-of-life decisions, or rights to bodily self-determination? (shrink)

Theories of collective intentionality and theories of relational autonomy share a common interest in analyzing the social dynamics of agency. However, whereas theories of collective intentionality conceive of social groups primarily as intentional and voluntarily willed, theories of relational autonomy claim that autonomous agency is both scaffolded and constrained by social forces and structures, including the constraints imposed by nonvoluntary group membership. The question raised by this difference in view is whether social theorizing that overlooks the effects of nonvoluntary social (...) group membership on individual and joint agency overlooks crucial aspects of the social dynamics of agency. To explore this question, this article first evaluates Michael Bratman's planning analysis of individual agency from the perspective of relational autonomy theory and compares it with a narrative self‐constitution account of temporally extended agency. It then evaluates Bratman's analysis of shared agency and discusses Shaun Gallagher and Deborah Tollefsen's concept of we‐narratives, which extends the notion of narrative construction to shared agency. Overall, the argument aims to show that if we are interested in understanding the social dynamics of agency, it is critical to attend to the way that agents exercise their intentional agency in relation to internalized and external social constraints. (shrink)

Thesis (Ph. D.)--University of Hawaii at Manoa, 1995.

Thomas Hurka has put forth a powerful account of virtue. The account rests on a specification of intrinsically good mental states and then explains what unifies them. On his account, virtue and desert also share the same structure. His theory of virtue has some difficulties that threaten the structure that unifies it. First, Hurka's account cannot provide a principled account of virtue and vice when they are constituted by attitudes toward things are not intrinsically good (e.g., nonexistent state of affairs). (...) Second, Hurka's account does not have room for an important factor in determining the degree to which an attitude is virtuous or vicious: agent-relative goods. Hurka is thus faced with a abandoning the basic structure that makes his theory attractive or adopting counterintuitive positions. (shrink)

When women become perpetrators of suicide bombing, their agency – their ability to act upon and affect the world – is often denied. There are a number of reasons for this and one this thesis considers is that – as females – they are not expected to be violent. Accordingly, such women are judged to be coerced or incompetent, and so unable to rule themselves sufficiently as agents. Models of autonomy propose various frameworks for assessing whether acts or persons are (...) self-governing, and the relational approach in particular has garnered much support recently. However, some aspects of the relational account remain under-theorised, including how autonomy might be measured. In this thesis, I aim to bring these two elements together by examining whether an extension of the relational model may offer a way in which to estimate the autonomy of the bombers in a more nuanced fashion. I make two claims. First, that the relational conception of the agent and autonomy ‘fits’ the bombers. Second, that my spectrum view, which is rooted in the relational approach, maps the bomber’s autonomy approximately but in detail. As such, my spectrum view is a befitting notion of autonomy and allows a graded and comparative representation of the bomber’s autonomy. (shrink)

In this paper I argue that Mill’s ‘Doctrine of Philosophical Necessity’ regarding the human will and action cannot apply on all cases, and that the human mind has potentially the capacity to create freely a will or action that, no matter what kind of knowledge we possess, cannot be predicted. More precisely, I argue against Mill’s attempt of conjunction between the freedom of the will and the ‘Doctrine of Philosophical Necessity’ while I attempt a comparison with the relevant Kantian approach. (...) I then claim that a will cannot be free and be predicted at the same time, as both the elements of freedom and unpredictability of the will are founded on the very process of its formulation as an outcome of genuine creativity. I, thus, attempt to propose a more substantially free view of free will and action than the ones presented by the prominent conceptions. (shrink)

John Christman has argued that constitutively relational accounts of autonomy, as defended by some feminist theorists, are problematically perfectionist about the human good. I argue that autonomy is constitutively relational, but not in a way that implies perfectionism: autonomy depends on a dialogical disposition to hold oneself answerable to external, critical perspectives on one's action-guiding commitments. This type of relationality carries no substantive value commitments, yet it does answer to core feminist concerns about autonomy.

Debates over how to conceptualize the nursing role were prominent in the nursing literature during the latter part of the twentieth century. There were, broadly, two schools of thought. Writers likeHenderson andOrem used the idea of a self‐care deficit to understand the nurse as doing for the patient what he or she could not do alone. Later writers found this paternalistic and emphasized the importance of the patient's free will. This essay uses the ideas of positive and negative freedom to (...) explore the differing conceptions of autonomy which are implicit in this debate. The notion of positive freedom has often been criticized as paternalistic, and the criticisms of self‐care in the nursing literature echo criticisms from political philosophy. Recent work on relational autonomy and on the relationship between autonomy and identity are used to address these objections. This essay argues for a more nuanced conception of the obligation to support autonomy that includes both positive (freedomto) and negative (freedomfrom) dimensions. This conception of autonomy provides a moral foundation for conceptualizing nursing in something like Henderson's terms: as involving the duty to expand the patient's capacities. The essay concludes by generalizing the lesson. Respect for autonomy on the part of any health care provider requires both respect for the patient's choices and a commitment to expand the patient's ability to actualize their choices. (shrink)