The notion of respect for autonomy dominates bioethical discussion, though what qualifies precisely as autonomous action is notoriously elusive. In recent decades, the notion of autonomy in medical contexts has often been defined in opposition to the notion of autonomy favoured by theoretical philosophers. Where many contemporary theoretical accounts of autonomy place emphasis on a condition of “authenticity”, the special relation a desire must have to the self, bioethicists often regard such a focus as irrelevant to the concerns of medical (...) ethics, and too stringent for use in practical contexts. I argue, however, that the very condition of authenticity that forms a focus in theoretical philosophy is also essential to autonomy and competence in medical ethics. After tracing the contours of contemporary authenticity-based theories of autonomy, I consider and respond to objections against the incorporation of a notion of authenticity into accounts of autonomy designed for use in medical contexts. By looking at the typical problems that arise when making judgments concerning autonomy or competence in a medical setting, I reveal the need for a condition of authenticity—as a means of protecting choices, particularly high-stakes choices, from being restricted or overridden on the basis of intersubjective disagreement. I then turn to the treatment of false and contestable beliefs, arguing that it is only through reference to authenticity that we can make important distinctions in this domain. Finally, I consider a potential problem with my proposed approach; its ability to deal with anorexic and depressive desires. (shrink)

This dissertation studies the shift that occurs in German aesthetic theory between Kant's Critique of Judgment and Schopenhauer's The World as Will and Representation , with Schelling's System of Transcendental Idealism forming the pivot. This shift is actually part of a much larger movement, and I have chosen aesthetic theory because it mirrors so well the changing focus of the essence of the self which takes place as post-Enlightenment German philosophers delve deeper into the question of what it means to (...) be human. ;Kant remains firmly rooted in the rationalist tradition, and provides for his successors both a foundation and the means to undermine it. He gives an explanation for the individual's response to a great work of art which relies on an account of how the mind functions. Schelling and Schopenhauer are deeply influenced by Kant, but regard the human self as containing some inexplicable mystery, an unconscious mythic unity with all other selves, for Schelling, and an irrational desiring will, for Schopenhauer. Although Kant, too, unwillingly points to the evidence which suggests a non-rational basis for aesthetic response, as well as for an account of the self, he tries to avoid stating this result. By contrast, Schelling and Schopenhauer make this inexplicable aspect a basic premise of their respective works. ;In this work, I rely mainly on the three primary texts, with the intent of making the complex arguments, in particular those of Kant and Schelling, more accessible to the reader. I examine first the cognitive theory of each thinker, and then study each one's aesthetic theory in relation to their respective theory of mind. In this way, I show how a decisive shift in focus has occurred in the period under consideration. In addition, I refer to a cross-section of recent literature to clarify and support my position. ;The conclusion I draw is that philosophic self-understanding attains a completely new vantage point as the result of Schelling and Schopenhauer's work, a perspective which irrevocably changes the lines of debate about the nature of the self. (shrink)

The purpose of this dissertation is to identify some of the most pressing problems in the dominant contemporary approach to research ethics, and to devise an alternative approach that avoids these problems. I contend that the fundamental ethical values invoked in human research are often appealed to in contradictory or ambiguous ways, or in ways that do not adequately capture or do not show an adequate understanding of the specific ethical concerns of human research. One significant problem in this domain (...) is that values for ethical research are often unreflectively imported from medical therapy, producing ill-suited guidelines that cannot capture the different ethical situations that arise in the context of research. Furthermore, ethical guidelines in this area are often not developed with a sufficient understanding of the deep philosophical issues that they invoke. I suggest that we can address these problems through examining the fundamental ethical concerns of research on a philosophical level. This method will reveal severe problems with the approach to two of the ethical values underlying research; beneficence and respect for autonomy (or respect for persons). Once the nature of these problems has been revealed, and with reference to ethical problems that typically arise in the domain of research, I construct a coherent philosophical foundation for research ethics, which both avoids these deep-seated problems and better captures the ethical issues that arise in the domain of human research. I argue that we need to radically depart from the values of beneficence and autonomy/respect for persons as they are currently understood in the guidelines. We need an idea of beneficence that is clearly distinct from that which is used in the therapeutic medical context from which this notion is currently drawn. I also contend that we need to move away from autonomy as a central value in research ethics. I posit an alternative choice-based approach to informed consent which is concerned both with respecting agents’ freedom of choice, and also with their wellbeing, as providing a good means of protecting and promoting the interests of the individual research subject. Although these two imperatives are often thought to clash on a fundamental level, I will show that, in research ethics, they can be reconciled with minimal conflict. Though this represents a departure from the ethics of medical therapy, this approach is far more suited to the context of research. This theoretical basis for informed consent can help to clarify the ethical problems that are specific to this domain and provide us with relevant ethical guidance in research ethics. (shrink)