This articles assesses the arguments that bioethicists have presented for the view that patient’ autonomy has value over and beyond its instrumental value in promoting the patients’ wellbeing. It argues that this view should be rejected and concludes that patients’ autonomy should be taken to have only instrumental value in medicine.

This paper defends the claim that there are — at least — two kinds of normativity in technological practice. The first concerns what engineers ought to do and the second concerns normative statements about artifacts. The claim is controversial, since the standard approach to normativity, namely normative realism, actually denies artifacts any kind of normativity; according to the normative realist, normativity applies exclusively to human agents. In other words, normative realists hold that only “human agent normativity” is a genuine form (...) of normativity.I will argue that normative realism is mistaken on this point. I will mainly draw on material of Daniel Dennett and Philip Pettit to show that it makes sense to talk about artifactual normativity. We claim that this approach can also make sense of human agent normativity — or more specifically “engineer normativity”. Moreover, it avoids some of the problems formulated by opponents of normative realism. Thus I will develop a strategy which: (i) makes sense of artifactual normativity; and (ii) makes sense of “human agent normativity”, specifically “engineer normativity”. (shrink)

This paper argues that, with certain provisos, predicting one's future actions is incompatible with rationally deliberating about whether to perform those actions. It follows that fully rational omniscient agents are impossible, since an omniscient being could never rationally deliberate about what to do. Consequently, theories that explain practical reasons in terms of the choices of a perfectly rational omniscient agent must fail. The paper considers several ways of defending the possibility of an omniscient agent, and concludes that while some of (...) these may work, they are inconsistent with the aim of explaining practical normativity by appeal to such an agent. (shrink)

Individual autonomy is a prominent value in Western medicine and medical ethics, and there it is often accepted that the only way to pay proper respect to autonomy is to let the patients themselves determine what is good for them. Adopting this approach has, however, given rise to some unwanted results, thus motivating a quest for an objective conception of health. Unfortunately, the purportedly objective conceptions of health have failed in objectivity, and if a conception of health is not acceptable (...) for all agents, the threat of offending the patients’ autonomy arises. This article sketches an objective conception of health that is able to respect individual autonomy. (shrink)