This article focuses on the account of disrespect found in Honneth’s theory of recognition. In it, I am particularly interested in the form of misrecognition or disrespect which is the negation of respect , and which is clearly represented by statelessness. Respect, for Honneth, is closely connected to legal recognition. Guided by Honneth’s view of critical theory as ‘not entirely without a foundation in social reality’, the article puts together an analysis of the political dynamics of his model of disrespect. (...) This analysis is used to challenge certain aspects of Honneth’s political theory and in particular the implications of his conception of the state. The article argues that the way in which the state is used has the effect of obscuring significant political obstacles to recognition, and in particular, the way in which the state limits respect. (shrink)

In this paper, I give a reconstruction of the so‐called Reinhold–Sidgwick objection and show that Korsgaard‐style Kantian constructivists are committed to two key premises of the underlying argument. According to the Reinhold–Sidgwick objection, the Kantian conception of autonomy entails the absurd conclusion that no one is ever morally responsible for a morally wrong action. My reconstruction of the underlying argument reveals that the objection depends on a third premise, which says that freedom is a necessary condition for moral responsibility. After (...) mapping the common replies to the objection, I demonstrate that none of these replies is available to Kantian constructivists. But they need not be committed to the absurd conclusion that no one is ever morally blameworthy. Kantian constructivists who want to resist the Reinhold–Sidgwick objection are well advised to subject the third premise of the underlying argument to critical scrutiny. (shrink)

With the waves of reform occurring in mental health legislation in England and other jurisdictions, mental capacity is set to become a key medico-legal concept. The concept is central to the law of informed consent and is closely aligned to the philosophical concept of autonomy. It is also closely related to mental disorder. This paper explores the interdisciplinary terrain where mental capacity is located. Our aim is to identify core dilemmas and to suggest pathways for future interdisciplinary research. The terrain (...) can be separated into three types of discussion: philosophical, legal and psychiatric. Each discussion approaches mental capacity and judgmental autonomy from a different perspective yet each discussion struggles over two key dilemmas: whether mental capacity and autonomy is/should be a moral or a psychological notion and whether rationality is the key constitutive factor. We suggest that further theoretical work will have to be interdisciplinary and that this work offers an opportunity for the law to enrich its interpretation of mental capacity, for psychiatry to clarify the normative elements latent in its concepts and for philosophy to advance understanding of autonomy through the study of decisional dysfunction. The new pressures on medical and legal practice to be more explicit about mental capacity make this work a priority. (shrink)

The author reviews various conceptions of autonomy to show that humans are actually not autonomous, strictly speaking. He argues for a need to rethink the personal autonomy approaches to HIV testing in sub-Saharan Africa (SSA) countries. HIV/AIDS has remained a leading cause of disease burden in SSA. It is important to bring this disease burden under control, especially given the availability of current effective antiretroviral regimens in low- and middle-income countries. In most SSA countries the ethic or value of personal (...) autonomy or self-determination is promoted as primary in HIV testing decision-making. SSA policymakers have an ontological and moral duty to adopt HIV testing policies that reflect human and medical realities, relationships, local contexts, and respect human rights for both individuals and others who are affected by HIV in society. Without rethinking the value of autonomy in HIV testing decision-making, the article cautions that attainment of the Sustainable Development Goal (SDG) 3 and the UNAIDS fast-track strategy that explicitly call to end the epidemic by 2030 will not be feasible for SSA. (shrink)

Kantian deontology is one of three classic moral theories, among virtue ethics and consequentialism. Issues in medical ethics are frequently addressed within a Kantian paradigm, at least – although not exclusively – in European medical ethics. At the same time, critical voices have pointed to deficits of Kantian moral philosophy which must be examined and discussed. It is argued that taking concrete situations and complex relationships into account is of paramount importance in medical ethics. Encounters between medical or nursing staff (...) and patients are rarely symmetrical relationships between autonomous and rational agents. Kantian ethics, the criticism reads, builds on the lofty ideal of such a relationship. In addition to the charge of an individualist and rationalist focus on autonomy, Kantian ethics has been accused of excluding those not actually in possession of these properties or of its rigorism. It is said to be focussed on laws and imperatives to an extent that it cannot appreciate the complex nuances of real conflicts. As a more detailed analysis will show, these charges are inadequate in at least some regards. This will be demonstrated by drawing on the Kantian notion of autonomy, the role of maxims and judgment and the conception of duties, as well as the role of emotions. Nevertheless the objections brought forward against Kantian moral theory can help determine, with greater precision, its strengths and shortcomings as an approach to current problems in medical ethics. (shrink)

This paper concerns the relationship between two questions. The first is a question about inner freedom: What is it to be rendered unfree, not by external obstacles, but by aspects of oneself? The second is a question about agency: What is it to fail at being a thing that genuinely acts, and instead to be a thing that is merely acted upon, passive in relation to its own behaviour? It is widely believed that answers to the first question must rest (...) on or be partly explained by answers to the second. Here I argue that this is a mistake: losses of inner freedom are not, after all, explicable in terms of failures of agency. To establish this conclusion, I consider three familiar lines of thought that appear to tie ideas about inner freedom to ideas about agency, each relating to a different conception of inner freedom: absence of inner constraint, self-government, and absence of determination by external forces. I argue that, in each case, any apparent conceptual reliance on a special conception of agency is merely illusory, the result being that we must allow clear water between our theories of inner freedom and our theories of agency. This conclusion is of significance for contemporary theories of agency and personal autonomy, as well as for ‘positive’ conceptions of political liberty. (shrink)

Research with psychiatric patients raises frequently discussed, ethical questions, one of which is: Can psychiatric patients give consent to participation in research at all? To answer this and similar questions adequately, it is - according to our thesis - necessary to analyze first, which theoretical assumptions are made in established practice. -/- To solve the question after the possibility of consent, compatible understandings of ‘disease’, ‘illness’ and ‘autonomy’ are crucial, but there is no consensual use of these terms in philosophy. (...) Therefore we first are going to explain different concepts of ‘autonomy’ and ‘disease’. Subsequent to this we will test how the different conceptualizations of ‘autonomy’ and ‘disease’ can be related to each other and how the reasonable combinations shape possible answers to the opening question. It will become apparent that an adequate analysis of ‘autonomy’ and ‘disease’ raises ethical dilemma in psychiatry, for which we shall suggest possible solutions. (shrink)

The principle of respect for autonomy often dominates the bioethical discourse. Yet despite its prominence, the exact contours are not always well defined. Widespread disagreement about the nature of autonomy has led some to conclude that autonomy is hopelessly vague and therefore ought to be abandoned in contemporary bioethics. Despite calls to move beyond it, autonomy remains at the center of bioethical reflection. The challenge, then, if autonomy is to function as a bedrock of contemporary bioethics, is to define more (...) clearly the shape of autonomy, to mark more precisely its conceptual boundaries, and to delineate more carefully how best autonomy is put into practice in medical ethics. In this article, I raise questions about the ways autonomy is used in theory, as well as the ways that it is operationalized in practice. (shrink)

Kant's conception of autonomy presents the following problem. If, following Kant's explicit lead, we consider autonomy as the universal principle of morality and ground of the actions of rational beings (e.g. G 4:452), then self-legislation is best understood as a prescription by reason to itself. Applied to individual cases of willing, the term 'autonomy' describes the bringing of a set of practical attitudes under rational legislation. Agents may count as autonomous then, insofar as and only to the extent that they (...) are able to implement reason's prescription. This is the bare Kantian picture. The problem, as Schiller originally put it, is that this is also a picture of self-alienation, since parts of one's identity, feelings, emotions, and attachments, are kept at arm's length and treated with suspicion (e.g. AW XXb: 280). Schiller's point is that there must be something that makes autonomy different from mere rationomy. For Schiller this matters because he thinks that a rationalist prescriptive ethic is deeply unattractive and because, anticipating contemporary theories of personal autonomy, he wants to defend an integrative conception of autonomous agency. No such further commitments are needed, however, to see that the bare picture needs adding to it, to show how the principle of reason's self-legislation not only has a grip on individual agents, but also can express their autonomy. (shrink)

This paper argues that to understand the varieties of wrongs done in coercion, we should examine the dynamic normative relation that the coercer establishes with the coerced. The case rests on a critical examination of coercion by threat, which is proved irreducible to psychological inducement by overwhelming motives, obstruction of agency by impaired consent or deprivation of genuine choice. In contrast to physical coercion, coercion by threat requires the coercee’s participation in deliberation to succeed. For this kind of coercion to (...) be successful, there must be a normative relation established by the coercer and the coercee, in which they recognize each other as rational agents. In such cases, the coercee is wronged in the exercise of her deliberative powers. As a consequence, this form of coercion does not cancel the coercee’s moral responsibility for coerced action. Reclaiming the coercee’s responsibility for action under threat does not diminish the visibility and gravity of the coercer’s wrongdoing. On the contrary, it allows us to capture some features of the coercive relation that otherwise remain unfocused and thus identify the distinctive ways in which the coercee is wronged. (shrink)

The paper is devoted to the analysis of Kant’s approach to the ideas of universality and autonomy as the constitutive features of morality. The paper shows that Kant’s findings concerning these ideas were anticipated by the previous history of moral philosophy, mainly by the modern moral philosophers, who focused specifically on the elaboration of the philosophical concept of morality. Kant’s peculiar role was that, firstly, he conceptualized the ideas of universality and autonomy and formulated corresponding principles; secondly, Kant integrated both (...) principles into the concept of moral law and revealed the way by which the formula of universality and the formula of autonomy together with formula of humanity constitute the supreme principle of morality and essentially express the sense of morality itself. Kant believed that the reason for the failure of the previous attempts to explicate the supreme principle of morality was inability to understand that the moral agent is subject not only to universal but at the same time his own legislation. Thirdly, Kant, unlike his predecessors, in his examination of universality didn’t appeal to the human nature or nature of things. Fourthly, he underlined that the principle of universality and the principle of autonomy were not only interconnected but also shaped each other: the determination of will may be identified as a universal principle only if it is given through a moral agent’s rational will. And a moral agent may be identified as autonomous only if in his decisions and actions he is guided by principles that are universalizable. (shrink)

Sometimes it is not us but those to whom we stand in special relations that face transformative choices: our friends, family, or beloved. A focus upon first-personal rational choice and agency has left crucial ethical questions regarding what we owe to those who face transformative choices largely unexplored. In this paper, I ask: under what conditions, if any, is it morally permissible to interfere with to try to prevent another from making a transformative choice? Some seemingly plausible answers to this (...) question fail precisely because they concern transformative experiences. I argue that we have a distinctive moral right to revelatory autonomy grounded in the value of autonomous self-making. If this right is outweighed then, I argue, interfering to prevent another making a transformative choice is permissible. This conditional answer lays the groundwork for a promising ethics of transformative experience. (shrink)

Sometimes it is not us but those to whom we stand in special relations that face transformative choices: our friends, family or beloved. A focus upon first-personal rational choice and agency has left crucial ethical questions regarding what we owe to those who face transformative choices largely unexplored. In this paper I ask: under what conditions, if any, is it morally permissible to interfere to try to prevent another from making a transformative choice? Some seemingly plausible answers to this question (...) fail precisely because they concern transformative experiences. I argue that we have a distinctive moral right to revelatory autonomy grounded in the value of autonomous self-making. If this right is outweighed then, I argue, interfering to prevent another making a transformative choice is permissible. This conditional answer lays the groundwork for a promising ethics of transformative experience. (shrink)

In recent decades politicians and policy-makers have emphasised the need to shift from a “passive” to an “active” welfare state. This has resulted in policies that reduce compensation rates in social insurance or make compensation conditional on different requirements such as participation in rehabilitation or vocational training. This article argues that such policies are justified if they tend to ensure an adequate level of personal autonomy. To that effect, a ‘thick’ conception of personal autonomy is spelled out based on Norman (...) Daniels’ extension of the principle of fair equality of opportunity. Some objections to policies limiting entitlement to social insurance are discussed. It is argued that although the objections fail to show that limited entitlement to social insurance is always unjustified, they identify considerations that must be taken into account for an overall assessment of such policies. (shrink)

Helen Frowe has recently offered what she calls a “practical” account of self-defense. Her account is supposed to be practical by being subjectivist about permissibility and objectivist about liability. I shall argue here that Frowe first makes up a problem that does not exist and then fails to solve it. To wit, her claim that objectivist accounts of permissibility cannot be action-guiding is wrong; and her own account of permissibility actually retains an objectivist (in the relevant sense) element. In addition, (...) her attempt to restrict subjectivism primarily to “urgent” situations like self-defense contradicts her own point of departure and is either incoherent or futile. Finally, the only actual whole-heartedly objectivist account she criticizes is an easy target; while those objectivist accounts one finds in certain Western European jurisdictions are immune to her criticisms. Those accounts are also clearly superior to hers in terms of action-guidingness. (shrink)