Given the explanatory stalemate between ‘embedded’ (EMB) and ‘extended’ (EXT) cognition, various authors have proposed normative and moral arguments in favour of EXT. According to what we call the “extended cognition moral narrative” (EXT-MN) (Cassinadri, 2022), we should embrace EXT and dismiss EMB, because the former leads to morally preferable consequences with respect to the latter. In this article we argue that two arguments following the EXT moral narrative are flawed. In Sect. 2.1 and 2.2, we present respectively King (2016) (...) and Vold’s (2018) ‘argument from assessment of capacities’ (AAC) and Clowes (2013), Farina and Lavazza’s (2022a) ‘cognitive diminishment argument’ (CDA). The AAC states that we should embrace EXT over EMB since the former is better at attributing cognitive credit to individuals with learning disabilities who use assistive tools to complete their learning tasks, thus avoiding their marginalisation. The CDA states that EMB implies a morally undesirable picture of the agent in terms of cognitive diminishment. In Sect. 3, we clarify and criticise the underlying assumptions of the AAC and CDA: the “cognitive credit assumption”, the “marginalisation assumption” and, more generally, an ableist conception of disabled agency. In Sect. 3.1, we discuss the role of moto-perceptual skills and metacognitive credit involved in complex cases of tool-use, to demonstrate that the EXT-MN is uninformative in addressing these cases. To conclude, in Sect. 4 we argue that AAC and CDA fail to present EXT as descriptively and normatively superior to EMB. (shrink)

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

Many popular artificial intelligence (AI) ethics frameworks center the principle of autonomy as necessary in order to mitigate the harms that might result from the use of AI within society. These harms often disproportionately affect the most marginalized within society. In this paper, we argue that the principle of autonomy, as currently formalized in AI ethics, is itself flawed, as it expresses only a mainstream mainly liberal notion of autonomy as rational self-determination, derived from Western traditional philosophy. In particular, we (...) claim that the adherence to such principle, as currently formalized, does not only fail to address many ways in which people’s autonomy can be violated, but also to grasp a broader range of AI-empowered harms profoundly tied to the legacy of colonization, and which particularly affect the already marginalized and most vulnerable on a global scale. To counter such a phenomenon, we advocate for the need of a relational turn in AI ethics, starting from a relational rethinking of the AI ethics principle of autonomy that we propose by drawing on theories on relational autonomy developed both in moral philosophy and Ubuntu ethics. (shrink)

Like the ‘thoughts and prayers’ so commonly offered by politicians in the aftermath of disaster, it is incredibly common to hear ‘autonomy and dignity’ invoked together in response to some threat to human wellbeing. As such, it seems natural to assume they must bear some kind of relation to one another. But are they merely two core human interests, that happen to be vulnerable to the same kinds of threat? Or are they interrelated in a deeper way? What I aim (...) to do in this chapter is draw on the philosophical literature on both concepts to consider how they might be connected, and explore whether certain ways of connecting them are more fruitful than others. I argue that the two most prominent connections drawn in the philosophical literature – that dignity is grounded in autonomy, and that respect for dignity is synonymous with respect for autonomy – are both highly problematic. Instead, I suggest we see autonomy and dignity as mutually supportive. Doing so has both practical and theoretical benefits: it can help us identify threats to both autonomy and dignity; and it exposes theoretical lacunae, especially within the autonomy literature. (shrink)

Can artificial entities be worthy of moral considerations? Can they be artificial moral agents (AMAs), capable of telling the difference between good and evil? In this essay, I explore both questions—i.e., whether and to what extent artificial entities can have a moral status (“the machine question”) and moral agency (“the AMA question”)—in light of Kazuo Ishiguro’s 2021 novel Klara and the Sun. I do so by juxtaposing two prominent approaches to machine morality that are central to the novel: the (1) (...) view “from within,” including the standard (or “metaphysical”) perspective on moral agency, and the (2) view “from outside,” which includes behaviorism, functionalism and the social-relational perspective. Importantly, while the story illustrates both views, it exposes the epistemological vulnerability of the first in relation to the practical and social reality imposed by the second. That is, regardless of what metaphysical properties the Artificial Friend Klara can be said to have (from within), her moral status as well as agency ultimately depend on the views of others (from outside), including the others’ own epistemic beliefs about the nature of consciousness and personhood. (shrink)

My aim in this paper is to move toward a relational moral theory of harm through examination of a common yet underexplored form of child maltreatment: childhood psychological abuse. I draw on relational theory to consider agential, intrapersonal, and interpersonal ways in which relational harms develop and evolve both in intimate relationships and in conditions of oppression. I set forth three distinctive yet interconnected forms of relational harm that childhood psychological abuse causes: harm to the relational agency of individuals, harm (...) to the relationships individuals hold with themselves, especially with regard to how they respect, know, and trust themselves, and harm to interpersonal relationships of both a direct and indirect nature in present and future timeframes. I close by noting that while relationships can be the site of human brutality that destroys the relational self, paradoxically and promisingly, they also can be a primary means of the relational reconstitution of the self. Ultimately, relational analyses of the harms of childhood psychological abuse reveal several key elements of a relational theory of harm and demonstrate the significance of relational harms for moral philosophy. (shrink)

Miller analyzes the relationship between consent and autonomy by offering three pictures. For autonomy, Miller distinguishes between procedural, substantive, and weak substantive autonomy. The corresponding views of consent are what Miller has termed as consensual minimalism, consensual idealism, and consensual realism. The requirements of sexual consent under consensual minimalism are a voluntary informed agreement. However, feminist critiques reveal the inadequacies of this simple position. Consensual idealism, which corresponds with substantive autonomy, offers a robust picture where consent and autonomy must be (...) based on non-oppression. However, this view is considered too ideal and it ignores context. Weak substantive autonomy takes into account the context in the sexual domain. Correspondingly, consensual realism takes into account the context and still fulfills the requirements of consent. (shrink)

This paper explores a distinctive form of social interaction—interpersonal inquiry—in which two or more people attempt to understand one another by engaging in conversation. Like many modes of inquiry into human beings, interpersonal inquiry partly shapes its own objects. How we conduct it thus affects who we become. I present an ethical ideal of conversation to which, I argue, at least some of our interpersonal inquiry ought to aspire. I then consider how this ideal might influence philosophical conceptions of the (...) self. (shrink)

This is an open-access textbook designed for introduction to philosophy courses that contain a section on ethics, or for introductory courses in moral theory. In this edited work, chapter authors explore both historical and contemporary approaches to understanding and justifying moral and ethical norms. The chapters cover a wide range of topics, including moral relativism, the relationship between ethics and religion, virtue ethics in the Western and Eastern traditions, the question of self-interest and ethics, utilitarianism, Kantian deontological ethics, and recent (...) work in feminist ethics and evolutionary ethics. -/- Introduction to Philosophy: Ethics, edited by George Matthews (Plymouth State University), is one of a series of open-access textbooks for introduction to philosophy courses edited by Christina Hendricks (University of British Columbia), published with the support of The Rebus Community. (shrink)

This chapter offers a fine-grained analysis of the relationship between autonomy and responsibility in order to address a challenge according to which considering autonomy and responsibility as closely related is misleading since these concepts serve different normative objectives. In response to this challenge, I first explore two criteria of ascription – rationality and control – that autonomy and responsibility seem to share. I then contrast and compare three pairs of autonomy and responsibility conceptions. Examining these pairs rescues the idea that (...) there are normatively significant connections between autonomy and responsibility, albeit that what that connection is and why it matters is highly sensitive to the different understandings of autonomy and responsibility one might adopt. The first pair, self-governance and accountability, posits a notion of core agency as irreducibly valuable. The second, authenticity and attributability, rests on a shared ideal of actively becoming a distinctive self. The third and final, relational autonomy and answerability, derives from the thought that unequal standing impacts heavily on whether and how the criteria of rationality and control are applied in specific cases. This analysis demonstrates that rationality and control are not independent criteria but always work in tandem. Failing to appreciate these conceptual interactions could obfuscate promising pathways for both supporting personal autonomy and challenging unwarranted responsibility ascriptions. (shrink)

The discipline of knowledge translation (KT) emerged as a way of systematically understanding and addressing the challenges of applying health and medical research in practice. In light of ongoing and emerging critique of KT from the medical humanities and social sciences disciplines, KT researchers have become increasingly aware of the complexity of the translational process, particularly the significance of culture, tradition and values in how scientific evidence is understood and received, and thus increasingly receptive to pluralistic notions of knowledge. Hence, (...) there is now an emerging view of KT as a highly complex, dynamic, and integrated sociological phenomenon, which neither assumes nor creates knowledge hierarchies and neither prescribes nor privileges scientific evidence. Such a view, however, does not guarantee that scientific evidence will be applied in practice and thus poses a significant dilemma for KT regarding its status as a scientific and practice-oriented discipline, particularly within the current sociopolitical climate. Therefore, in response to the ongoing and emerging critique of KT, we argue that KT must provide scope for relevant scientific evidence to occupy an appropriate position of epistemic primacy in public discourse. Such a view is not intended to uphold the privileged status of science nor affirm the “scientific logos” per se. It is proffered as a counterbalance to powerful social, cultural, political and market forces that are able to challenge scientific evidence and promote disinformation to the detriment of democratic outcomes and the public good. (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)

People with gut issues are often constrained in the foods they are able to eat. The choices they are able to make about food, however, are shaped not merely by specific medical and dietary needs but also by social, relational, and environmental factors such as the presence of trusted and supportive others who take their needs seriously. Drawing on work in disability theory and relational autonomy, as well as interviews undertaken in summer 2019, the paper explores the ways that choices (...) are enabled or undermined, and argues that these should be taken into account in work on the ethics and politics of food. (shrink)

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

COVID-19 has turned many ethical principles and presuppositions upside down. More precisely, the principle of respect for autonomy has been shown to be ill suited to face the ethical challenges posed by the current health crisis. Individual wishes and choices have been subordinated to public interests. Patients have received trial therapies under extraordinary procedures of informed consent. The principle of respect for autonomy, at least in its mainstream interpretation, has been particularly questioned during this pandemic. Further reflection on the nature (...) and value of autonomy is urgently needed. Relational autonomy has been proposed as an alternative account of autonomy that can more adequately respond to contemporary ethical issues in general and to a pandemic such as the one we are currently facing in particular. As relational autonomy is an emerging notion in current bioethics, it requires further consideration and development to be properly operationalized. This paper aims to show how six different philosophical branches––namely, philosophy of nature, philosophical anthropology, existential phenomenology, discourse ethics, hermeneutics, and cultural anthropology––have incorporated the category of relation throughout the twentieth century. We first delve into primary philosophical sources and then apply their insights to the specific field of medical ethics. Learning from the historical developments of other philosophical fields may provide illumination that will enable bioethics to experience a successful “relational turn”, which has been partially initiated in contemporary bioethics but not yet achieved. (shrink)

This paper offers a critical phenomenological view of the concept of access intimacy, a term coined by disability justice advocate Mia Mingus. Access intimacy refers to a mode of relation between disabled people or between disabled and non-disabled people that can be born of concerted cultivation or instantly intimated and centrally concerns the feeling of someone genuinely understanding and anticipating another’s access needs. Putting in conversation this notion of intimacy with Kym Maclaren’s critical phenomenological account of intimacy, I show how (...) accessibility is not about what one person or institution can do for another but involves an ongoing, interpersonal process of relating and taking responsibility for our inevitable encroachment on one another in ways that enhance one another’s freedom. (shrink)

Nossa seleção de verbetes parte do interesse de cada pesquisador e os dispomos de maneira histórico-cronológica e, ao mesmo tempo, temática. O verbete de Melissa Lane, “Filosofia Política Antiga” vai da abrangência da política entre os gregos até a república e o império, às portas da cristianização. A “Filosofia Política Medieval”, de John Kilcullen e Jonathan Robinson, é o tópico que mais demanda espaço na nossa seleção em virtude das disputas intrínsecas ao período, da recepção de Aristóteles pelo medievo e (...) da tensão entre poder Papal e Civil. No verbete “Liberalismo”, de Gerald Gaus, Shane Courtland e David Schmidtz, vemos as fontes fundantes da Filosofia Política da modernidade. As ideias de liberdade negativa e positiva se coadunam com a Ética Liberal e sua influência sobre a abrangência do valor fundamental da liberdade individual diante das políticas públicas. O texto de Ian Carter, “Liberdade Positiva e Liberdade Negativa”, expõe o paradoxo da liberdade em suas concepções valorativas e neutra, muito úteis para compreender os problemas políticos que enfrentamos hoje. Por fim, Bas Van Der Vossen no texto “Libertarianismo” trata das noções tensas entre Estado e indivíduos. A concepção de “liberdade de si”, genuinamente negativa, ganha destaque justificatório. Jackie Scully, no verbete Bioética Feminista, exemplifica o valor da influência dessas correntes no âmago de todos os contemporâneos. Sua escrita homenageia postumamente Anne Donchin com um apanhado histórico da luta de inserção de políticas feministas na pesquisa acadêmica global. No verbete “Democracia”, os professores brasileiros Gustavo Dalaqua e Alberto Ribeiro Barros acrescentaram tópicos importantes ao tema geral, respectivamente: “Construtivismo Representativo vs. Representação Descritiva” e “Democracia Contestatória de Philip Pettit”. O texto de Thomas Christiano perpassa os principais argumentos de justificação política contra e a favor da democracia ocidental, com foco central nas concepções de liberdade e igualdade. Os verbetes dispostos nessa seleção de textos são tendenciosos na medida que expressam o interesse genuíno de cada pesquisador com os assuntos relevantes em suas pesquisas. Em virtude disso, a escolha “adota um lado” em detrimento de outros – mais especificamente: de outro que poderia ser mais “progressista”. Por si só, o livro já nasce reclamando um segundo volume, que será providenciado. Colocamos de lado qualquer exigência de “imparcialidade”, algo que não existe na Filosofia, muito menos na Filosofia Política. Sobressai, nesse aspecto, o caráter reflexivo que o assunto exige e a importância do assunto, sem o qual não teríamos a modernas concepções de representatividade, as teorias da justiça ou mesmo as ciências sociais. Um outro volume, portanto, se faz imperativo, por conta da abrangência da própria SEP e do respeito a seu projeto inicial, genuinamente um plano plural. (shrink)

This article seeks to intervene in what I perceive to be a problematic opposition in feminist theory between ontological and epistemological accounts of existence and politics, by proposing an approach that weaves together Elspeth Probyn’s conceptualisation of ‘feminist reflexivity’ with a re-reading of feminist standpoint through affect. In so doing, I develop the concept of affective solidarity as necessary for sustainable feminist politics of transformation. This approach is proposed as a way of moving away from rooting feminist transformation in the (...) politics of identity and towards modes of engagement that start from the affective dissonance experience can produce. Moving beyond empathy as a privileged way of connecting with others, I argue that the difference between ‘womanhood’ and ‘feminism’ is critical for a universal yet non-essential understanding of what motivates gendered change. (shrink)

The aim of the article is to further assess and develop feminist standpoint theory by introducing the notion of the `situated imagination' as constituting an important part of this theory as well as that of `situated knowledge'. The article argues that the faculty of the imagination constructs as well as transforms, challenges and supersedes both existing knowledge and social reality. However, like knowledge, it is crucial to theorize the imagination as situated, that is, as shaped and conditioned (although not determined) (...) by social positioning. (shrink)

In this article the relevance of the feminist ethic of care for current Dutch social policies is elaborated. It starts from the observation that Dutch society is witnessing two intertwined processes: the relocation of politics and the relocation of care. Together these processes result in the need for new normative frameworks for social policy. Care has to become part of the practices of active citizenship, which should be based on notions of relationality and interdependence. Basic moral concepts of the ethic (...) of care, like attentiveness, responsibility, competence, responsiveness, trust and asymmetrical reciprocity are introduced. In the final part, the ethic of care is applied to two topical issues: policies on combining paid labour and care and generation-sensitive policies. Finally some norms are proposed to guide social policymaking. (shrink)

I give an account of the structure of “oppressive double binds,” the double binds that exist in virtue of oppression. I explain how these double binds both are a product of and serve to reinforce o...

This paper offers a defense of the practice of mindless eating. Popular accounts of the practice suggest that it is non-autonomous and to blame for many of society’s food related problems, including the so-called obesity epidemic and the prevalence of diet related illnesses like diabetes. I use Maureen Sie’s “traffic participation” account of agency to argue that some mindless eating is autonomous, or more specifically, agential. Insofar as we value autonomous eating, then, it should be valued. I also argue that (...) mindless eating can be substantively good: it can help us achieve valuable ends, like creating and maintaining community. Acknowledging the agency and value in mindless eating has both practical and ethical benefits. I contend that it can help us preserve the value in mindless eating while suggesting more effective ways to change it, and, by offering a new narrative about mindless eaters, may be less damaging to agency than popular narratives. (shrink)

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

In this paper, I outline the cumulative network model of the self. This model articulates the self as relational, recognizing social relations as constitutive of the self. The theory arises out of concerns about the individualistic paradigms of two main frameworks in the analytic philosophical literature on personal identity, namely, the psychological and the animalist approaches to personhood and is explicitly inspired by feminist theories on relational autonomy and self. I argue that “relationality” is not only social, but that the (...) self is relational throughout, psychologically, physically, biologically, culturally, semantically, as well as socially. Hence, the self is a network of relations. The model also aims to recognize that temporality or historicity is constitutive of the self, that the self is a process, not a static three-dimensional thing. Hence, the self is a cumulative network. (shrink)

This chapter first introduces naturalistic approaches to ethics more generally and distinguishes methodological ethical naturalism (the focus of this chapter), from metaphysical ethical naturalism. The second part then discusses evolutionary ethics as a specific variant of methodological ethical naturalism. After introducing the concepts of evolutionary theory that are relevant for evolutionary ethics, I will sketch the history of evolutionary ethics, which offers an interesting lesson about why it became a controversial topic, and then focus on four central questions about ethics (...) that can be approached from within the framework of evolutionary ethics: 1. What should we do? 2. Why are we moral? 3. Are there moral facts? 4. Can we have justified moral beliefs and moral knowledge? (shrink)

The development of personal technologies has recently shifted from devices that seek to capture user attention to those that aim to improve user well-being. Digital wellness technologies use the same attractive qualities of other persuasive apps to motivate users towards behaviors that are personally and socially valuable, such as exercise, wealth-management, and meaningful communication. While these aims are certainly an improvement over the market-driven motivations of earlier technologies, they retain their predecessors’ focus on influencing user behavior as a primary metric (...) of success. Digital wellness technologies are still persuasive technologies, and they do not evade concerns over whether their influence on users is ethically justified. In this paper, we describe several ethical frameworks with which to assess the justification of digital wellness technologies’ influence on users. We propose that while some technologies help users to complete tasks and satisfy immediate preferences, other technologies encourage users to reflect on the values underlying their habits and teach them to evaluate their lives’ competing demands. While the former approach to digital wellness technology is not unethical, we propose that the latter approach is more likely to lead to skillful user engagement with technology. (shrink)

An important part of what it means for agents to be situated in the everyday world of human affairs includes their engagement with economic practices. In this paper we employ the concept of cognitive institutions in order to provide an enactive and interactive interpretation of market and economic reasoning. We challenge traditional views that understand markets in terms of market structures or as processors of distributed information. The alternative conception builds upon the notion of the market as a ‘scaffolding institution’. (...) Introducing the concept of market as a ‘socially extended’ cognitive institution we go beyond the notion of scaffolding to provide an enactive view of economic reasoning that understands the market participant in terms of social interactive processes and relational autonomy. Markets are more than inert devices for information processing; they can be viewed as ‘highly scaffolded’, where strong constraints and incentives predictably direct agents’ behavior. Building on this idea we argue that markets emerge from (a) the economic interaction of both supply and demand sides, in continual and mutual interplay, and (b) more basic social interactions. Consumer behavior in the marketplace is complex, not only determining the market price, but also extending the consumer’s cognitive processes to reliably attain a correct evaluation of the good. Moreover, this economic reasoning is socially situated and not something done in isolation from other consumers From a socially situated, interactive point of view buying or not buying a good is something that enacts the market. This shifts the status of markets from external institutions that merely causally affect participants’ cognitive processes to social institutions that constitutively extend these cognitive processes. On this view the constraints imposed by social interactions, as well as the possibilities enabled by such interactions, are such that economic reasoning is never just an individual process carried out by an autonomous individual, classically understood. In this regard, understanding the concept of relational autonomy allows us to see how economic reasoning is always embodied, embedded in, and scaffolded by intersubjective interactions, and how such interactions make the market what it is. (shrink)

ZusammenfassungDie Uterustransplantation ermöglicht Frauen mit einer absoluten uterinen Infertilität eine Schwangerschaft mit biologisch eigenem Kind. Das neuartige experimentelle Verfahren wirft eine Reihe von ethischen Fragen auf. Ziel dieses Artikels ist es, relevante ethische Problemkonstellationen im Kontext der Uterustransplantation überblickshaft darzulegen und kritisch zu diskutieren. Als systematischer Rahmen der Darstellung dienen die vier Prinzipien der Medizinethik Autonomie, Nicht-Schaden, Wohltun und Gerechtigkeit nach Beauchamp und Childress. Nach eingehender ethischer Betrachtung plädieren die Autorinnen mit Blick auf die Akkumulation schwerwiegender ethischer Probleme für die (...) Notwendigkeit einer grundlegenden und umfassenden ethischen Debatte über Uterustransplantation. Ausgangspunkt einer solchen Debatte muss eine kritische Reflexion des normativen Stellenwerts des Leidens an einem unerfüllten Kinderwunsch sein. (shrink)

Deep brain stimulation (DBS) is an effective treatment for the debilitating motor symptoms of Parkinson’s disease and other neurological disorders. However, clinicians and commentators have noted that DBS recipients have not necessarily experienced the improvements in quality of life that would be expected, due in large part to what have been described as the ‘psychosocial’ impacts of DBS. The premise of this paper is that, in order to realise the full potential of DBS and similar interventions, clinical services need to (...) be arranged in such a way that these psychosocial dimensions are recognised and managed. Our starting point is that the psychosocial effects of DBS ‘in the field’ present us with analytically-useful disruptions: they disturb and foreground deeply held assumptions relating to the individual, health and its treatment, and which in a crude form manifest as the myth of technological solutionism within health care. Drawing on scholarship in medical sociology and science and technology studies (STS), we argue that DBS brings to the fore the relational dimensions of personhood, and demonstrates the emotional and social turmoil that can result if the relational dimensions of personhood are ignored by clinical services. In light of this, we argue that DBS should be implemented within a regime of care. Drawing on ethnographic research of a paediatric DBS clinical service, we provide an example of a regime of care, and conclude by reflecting on what other DBS services might learn from this paediatric service. (shrink)

In spite of its everyday connotations, the term independence as republicans understand it is not a celebration of individualism or self-reliance but embodies an acknowledgement of the importance of personal and social relationships in people’s lives. It reflects our connectedness rather than separateness and is in this regard a relational ideal. Properly understood, independence is a useful concept in addressing a fundamental problem in social philosophy that has preoccupied theorists of relational autonomy, namely how to reconcile the idea of individual (...) human agency with the inevitable and necessary influence of other people, both directly and indirectly. I derive my account from the work of Mary Wollstonecraft and Catharine Macaulay, whose contributions have remained largely overlooked by current republican theorists. I have three purposes in this chapter. First, I set out the relational character of independence. Secondly, I outline a republican approach to the problem of structural social threats to agency. Finally, I hope to establish the basis for a fruitful dialogue between republicans and relational autonomy theorists on the requirements and dynamics of individual agency and freedom in oppressive social situations. I identify three distinctive features of the internal logic of freedom as independence that give it a relational character: it always locates the person within a community; there is a mediating role played by the notion of arbitrariness in connecting individual and collective perspectives; a causal relationship exists linking each person’s freedom as independence such that that the dependence of one class of persons jeopardizes the independence of the whole community. (shrink)

John Harris recently argues that the moral bioenhancement proposed by Persson and Savulescu can damage moral agency by depriving the recipients of their freedom to fall (freedom to make wrongful choices) and therefore should not be pursued. The link Harris makes between moral agency and the freedom to fall, however, implies that all forms of moral enhancement, including moral education, that aim to make the enhancement recipients less likely to “fall” are detrimental to moral agency. In this paper, I present (...) a new moral agency-based critique against the moral bioenhancement program envisaged by Persson and Savulescu. I argue that the irresistible influences exerted by the bioenhancement program harms our capabilities for conducting accurate self-reflection and forming decisions that truly express our will, which subsequently undermine our moral agency. (shrink)

This paper explores early Australasian philosophy in some detail. Two approaches have dominated Western philosophy in Australia: idealism and materialism. Idealism was prevalent between the 1880s and the 1930s, but dissipated thereafter. Idealism in Australia often reflected Kantian themes, but it also reflected the revival of interest in Hegel through the work of ‘absolute idealists’ such as T. H. Green, F. H. Bradley, and Henry Jones. A number of the early New Zealand philosophers were also educated in the idealist tradition (...) and were influential in their communities, but produced relatively little. In Australia, materialism gained prominence through the work of John Anderson, who arrived in Australia in 1927, and continues to be influential. John Anderson had been a student of Henry Jones, who might therefore be said to have influenced both main strands of Australian philosophical thought. (shrink)

In this article I seek a more complete understanding of evil action. To this end, in the first half of the article I assess the conceptual strengths and weaknesses of the most compelling theories of evil action found in the contemporary philosophical literature. I conclude that the theories that fall under the category I call ‘‘Nuanced Harm Accounts’’ successfully identify the necessary and sufficient conditions of the concept. However, necessary and sufficient conditions are not coextensive with significant features, and Nuanced (...) Harm Accounts are incomplete even if they are correct. In order to supplement them, in the second half of the article I examine the normative relation that obtains between perpetrators and victims of evil and find them to be parties to a relation of asymmetrical power in which the vulnerability of the weaker party is exploited by the stronger party for its advantage, pleasure, or otherwise to achieve its aims. Moreover, the parties in the relation reciprocally enable each other’s role relative to one another. The strength of the more powerful party emerges out of the states of vulnerability of the victims, and the victims are vulnerable relative to the power(s) of the perpetrator. (shrink)

Sigmund Freud famously described three existential insults to humanity stemming from heliocentrism, evolution, and psychoanalysis. In recent years we are, perhaps, beginning to see the emergence of a fourth: interdependency. Over the last several centuries, Anglo-American culture has modelled itself on a vision of the independent individual – strong, autonomous, and self-sufficient. Yet from feminist theory, communitarianism, disability theory, institutionalist economics, and elsewhere, the evidence mounts that independence is, in most contexts, a myth. We are, in fact, fundamentally social beings: (...) fragile, vulnerable, variously disabled, and intrinsically dependent. In their time, each of the existential insults had profound effects; they forced a re-examination of the self, which rippled throughout the culture and uprooted old practices. This article argues that taking interdependency seriously would similarly lead to profound changes in our culture, our central political concepts, and even our major institutions. (shrink)

Key legislations in many countries emphasize the importance of involving children in decisions regarding their own health at a level commensurate with their age and capacities. Research is engaged in developing tools to assess capacity in children in order to facilitate their responsible involvement. These instruments, however, are usually based on the cognitive criteria for capacity assessment as defined by Appelbaum and Grisso and thus ill adapted to address the life-situation of children. The aim of this paper is to revisit (...) and critically reflect upon the current definitions of decision-making capacity. For this purpose, we propose to see capacity through the lens of essential contestability as it warns us against any reification of what it means to have capacity. Currently, capacity is often perceived of as a mental or cognitive ability which somehow resides within the person, obscuring the fact that capacity is not just an objective property which can be assessed, but always operates within a dominant cultural framework that “creates” that same capacity and defines the threshold between capable and incapable in a specific situation. Defining capacity as an essentially contested concept means using it in a questioning mode and giving space to alternative interpretations that might inform and advance the debate surrounding decision-making. (shrink)

Because no single person or group holds knowledge about all aspects of research, mechanisms are needed to support knowledge exchange and engagement. Expertise in the research setting necessarily includes scientific and methodological expertise, but also expertise gained through the experience of participating in research and/or being a recipient of research outcomes. Engagement is, by its nature, reciprocal and relational: the process of engaging research participants, patients, citizens and others brings them closer to the research but also brings the research closer (...) to them. When translating research into practice, engaging the public and other stakeholders is explicitly intended to make the outcomes of translation relevant to its constituency of users. In practice, engagement faces numerous challenges and is often time-consuming, expensive and ‘thorny’ work. We explore the epistemic and ontological considerations and implications of four common critiques of engagement methodologies that contest: representativeness, communication and articulation, impacts and outcome, and democracy. The ECOUTER methodology addresses problems of representation and epistemic foundationalism using a methodology that asks, “How could it be otherwise?” ECOUTER affords the possibility of engagement where spatial and temporal constraints are present, relying on saturation as a method of ‘keeping open’ the possible considerations that might emerge and including reflexive use of qualitative analytic methods. This paper describes the ECOUTER process, focusing on one worked example and detailing lessons learned from four other pilots. ECOUTER uses mind-mapping techniques to ‘open up’ engagement, iteratively and organically. ECOUTER aims to balance the breadth, accessibility and user-determination of the scope of engagement. An ECOUTER exercise comprises four stages: engagement and knowledge exchange; analysis of mindmap contributions; development of a conceptual schema ; and feedback, refinement and development of recommendations. ECOUTER refuses fixed truths but also refuses a fixed nature. Its promise lies in its flexibility, adaptability and openness. ECOUTER will be formed and re-formed by the needs and creativity of those who use it. (shrink)

This article examines the case of Insite, North America’s only supervised injection facility, to consider the relationship between dependence, relational autonomy, and vulnerability. At state-funded Insite, users inject illicit drugs under medical supervision. By conceiving of Insite as a health-care facility and addiction as disease, advocates evoke a shared sense of vulnerability among the nonusing public and users, garnering considerable support for the site. Through Insite, the state responds to vulnerability by reshaping the meaning of dependence and conferring recognition upon (...) users, in turn fostering users’ autonomy. However, the medicalized discourse surrounding Insite may obscure drug users’ vulnerabilities emerging not from “disease,” but from stigma and criminalization. Vulnerability analysis must emphasize not merely a naturalized conception of vulnerability, but the socially constructed nature of human beings’ experiences of vulnerability. (shrink)

This paper examines eight publicly available critical care triage protocols intended for use during an influenza pandemic. These protocols place an emphasis on objective measures of survivability as the primary criterion for assigning priority for lifesaving critical care during a pandemic. Triage would then be undertaken without consideration of the relational or social characteristics of patients who need critical care. We argue that enacting these protocols could result in the denial of lifesaving care to oppressed and disadvantaged groups. The lens (...) of relational theory reveals this ethical flaw in the triage protocols we examine, and suggests ways of improving these protocols. (shrink)

Deliberative democracy’s approach with its emphasis on a multidimensional conception of freedom is very well suited to offer a sophisticated and critical account of freedom of speech in the democratic public sphere. Nevertheless, it has rarely engaged other competing free speech theories in order to offer a valuable social critique of other ways of thinking about freedom of expression. This article tries to fill this gap by critically engaging Robert Post’s theory of freedom of speech based on democratic self-government. On (...) Post’s account, the key to effective democratic self-government is political autonomy, which he reduces to negative liberty and formal equality. I argue that this reduction creates serious problems. A purely procedural account of democracy makes it difficult to politicize new issues in the public sphere and also makes a dominant discourse resistant to contestation. Further, given his theory, Post does not have enough normative resources to offer an account of public justification, which would expand effective political liberty. (shrink)

This paper explores the impacts of neurological intervention on selfhood with reference to recipients’ claims about changes to their self-understanding following Deep Brain Stimulation for treatment of Parkinson’s Disease. In the neuroethics literature, patients’ claims such as: “I don’t feel like myself anymore” and “I feel like a machine”, are often understood as expressing threats to identity. In this paper I argue that framing debates in terms of a possible threat to identity—whether for or against the proposition, is mistaken and (...) occludes what is ethically salient in changes from DBS. Rather, by adopting a relational narrative approach to identity and autonomy, I show that the ethically salient issue from DBS is impacts on autonomous agency—whether one’s actions and beliefs are one’s own, and how DBS may hinder, or foster, embodied, relational autonomy competences. This approach recognizes that if sufficiently significant, impacts on autonomy competences may pose a threat to one’s ability to contribute to the process of authoring one’s own life and so pose a threat to identity formation. I argue this approach resolves the confusion in the literature about whether and how DBS threatens identity and provides a complex picture of how DBS may affect selfhood by disrupting narrative identity formation and revision, distorting agency and/or undermining autonomy. (shrink)

Research on the status and experience of women in academia in the last 30 years has challenged conventional explanations of persistent gender inequality, bringing into sharp focus the cumulative impact of small scale, often unintentional differences in recognition and response: the patterns of 'post-civil rights era' dis­crimination made famous by the 1999 report on the status of women in the MIT School of Science. I argue that feminist standpoint theory is a useful resource for understanding how this sea change in (...) understanding gender inequity was realized. At the same time, close attention to activist research on workplace environment issues suggests ways in which our understanding of standpoint theory can fruitfully be refined. I focus on the implications of two sets of distinctions: between types of epistemic injustice (and correlative advantage) that may affect marginalized knowers; and between the resources of situated knowledge and those of a critical standpoint on knowledge production. (shrink)

This article looks at how and why addiction should be understood as a ‘sociorelational’ disorder, and what this implies on a policy level in terms of the treatment and prevention of addiction. In light of scientific research, we argue that the neurobiological changes that underlie addiction are heavily influenced by sociorelational processes. We thereby advocate for a conceptual approach in which autonomy in addiction is a sociorelational concept, and social environments are considered autonomy undermining or autonomy promoting. We then discuss (...) the various implications this should have on policies. (shrink)

There is a view that what we owe to other people is explained by the fact that they are human beings who share in a common human life. There are many ways of construing this explanatory idea, and I explore a few of these here; the aim is to look for constructions that contribute to an understanding of what we owe to people with profound and multiple learning difficulties and disabilities. In exploring the idea of sharing in a common life (...) I construe ‘sharing’ as ‘participating in’, and ‘common life’ as the social life characteristic of the environment that someone lives in. My principal purpose is to render the idea of sharing in a common life in terms that help explain its eligibility as a ground for establishing the moral status of people with PMLD. The participatory options I examine each make some call on agency, if only as something hoped for in the future, including when hope flies in the face of expectation. Accordingly I look at conceptions of actual and potential participation in social life, and at the idea of treating people as if they have the potential to participate, even when the existence of any such potential is unlikely. I conclude with some thoughts on the relation between participation and the moral status of profoundly disabled people, and about how much, and how little, the argument has achieved. (shrink)

Many activities formerly not in the market are being “marketized,” and women's labor is increasingly in the market. I consider the grounds on which to decide what should and what should not be “in” the market. I distinguish work that is paid from work done under “market norms,” and argue that market values should not have priority in education, childcare, healthcare, and many other activities. I suggest that a feminist ethics of care is more promising than Kantian ethics or utilitarianism (...) for recommending social decisions concerning limits on markets. (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.

This article seeks to explore and analyze the relationship between autonomy and trust, and to show how these findings could be relevant to medical ethics. First, I will argue that the way in which so-called “relational autonomy theories” tie the notions of autonomy and trust together is not entirely satisfying Then, I will introduce the so-called Encapsulated Interest Account as developed by Russell Hardin. This will bring out the importance of the reasons for trust. What good reasons do we have (...) for trusting someone? I will criticize Hardin’s business model as insufficiently robust, especially in the context of health care, and then turn to another source of trust, namely, love. It may seem that trust-through-love is much better suited for the vulnerability that is often involved in health care, but I will also show that it has its own deficiencies. Good health care should therefore pay attention to both models of trust, and I will offer some tentative remarks on how to do this. (shrink)

This essay defends a strong right against displacement as part of a basic individual right to secure access to one’s home. The analysis is purposefully situated within the difficult context of climate change adaptation policies. Under increasing environmental pressures, especially regarding water security, there are weighty reasons motivating the forced displacement of persons—to safeguard water resources or prevent water-related disasters. Even in these pressing circumstances, I argue, individuals have weighty rights to secure access to their homes. I explain how the (...) home provides a functional context for conditions of autonomous agency. Being coerced from the home disrupts and subverts the conditions necessary for autonomous processes. I conclude by suggesting that the right to the home could be a foundational element of territorial rights. (shrink)