Respect for autonomy and beneficence are frequently regarded as the two essential principles of medical ethics, and the potential for these two principles to come into conflict is often emphasised as a fundamental problem. On the one hand, we have the value of beneficence, the driving force of medicine, which demands that medical professionals act to protect or promote the wellbeing of patients or research subjects. On the other, we have a principle of respect for autonomy, which demands that we (...) respect the self-regarding decisions of individuals. As well as routinely coming into opposition with the demands of beneficence in medicine, the principle of respect for autonomy in medical ethics is often seen as providing protection against beneficial coercion (i.e. paternalism) in medicine. However, these two values are not as straightforwardly opposed as they may appear on the surface. In fact, the way that we understand autonomy can lead us to implicitly sanction a great deal of paternalistic action, or can smuggle in paternalistic elements under the guise of respect for autonomy. -/- This paper is dedicated to outlining three ways in which the principle of respect for autonomy, depending on how we understand the concept of autonomy, can sanction or smuggle in paternalistic elements. As the specific relationship between respect for autonomy and beneficence will depend on how we conceive of autonomy, I begin by outlining two dominant conceptions of autonomy, both of which have great influence in medical ethics. I then turn to the three ways in which how we understand or employ autonomy can increase or support paternalism: firstly, when we equate respect for autonomy with respect for persons; secondly, when our judgements about what qualifies as an autonomous action contain intersubjective elements; and thirdly, when we expect autonomy to play an instrumental role, that is, when we expect people, when they are acting autonomously, to act in a way that promotes or protects their own wellbeing. I then provide a proposal for how we might work to avoid this. I will suggest that it may be impossible to fully separate paternalistic elements out from judgements about autonomy. Instead, we are better off looking at why we are motivated to use judgements about autonomy as a means of restricting the actions of patients or research subjects. I will argue that this is a result of discomfort about speaking directly about our beneficent motivations in medical ethics. Perhaps we can reduce the incentive to smuggle in these beneficent motivations under the guise of autonomy by talking directly about beneficent motivations in medicine. This will also force us to recognise paternalistic motivations in medicine when they appear, and to justify paternalism where it occurs. (shrink)

Since time immemorial, poverty reduction interventions in Sub‐Saharan Africa like everywhere in the South, have focused on the individual as the basic ingredient of a moral society (ethical individualism). According to this perspective, in order to lift human persons out of poverty, it is imperative to integrate poor persons into poverty eradication interventions irrespective of sex, social status and gender. Scholars and institutions that subscribed to this conception of poverty thought that individuals were poor because of personal weaknesses (case poverty).This (...) perspective has been greatly challenged due to the upsurge of gender and human rights scholarship in the 20th century. Gender scholars have painstakingly argued that in order to understand poverty, we need to look at society (ethical collectivism). They have rejected the Women in Development(WID) discourse that aims at integrating women into the development process in favour of the Gender and Development(GAD) approach to development and poverty reduction that aims at confronting power relations between men and women (empowerment).This GAD perspective looks at poverty in terms of the powerlessness speared head by prevailing structures in society (structural poverty) and hence the need to empower vulnerable persons such as women to challenge structures and strictures of oppression. The International Monetary fund (IMF) and World Bank as vehement promoters of economism in Sub‐Saharan Africa for decades have urged governments to include the perspectives of the poor in poverty polices through what they call participatory poverty assessments (PPAs). Despite its deceptive appearance, this PPAs stance of the IMF and World Bank tacitly looks at poverty as a case and not structural issue and that is why Uganda’s ambitious poverty reduction policy though greatly informed by Participatory Poverty Assessments greatly ignores structures and strictures that render women vulnerable to poverty. This paper critically assesses the obliviousness of Uganda’s Agricultural poverty policy to structures and how this has militated on the gender poverty production in Uganda. The paper contends that in order to realise engendered poverty eradication in Uganda, it is pertinent for the agricultural policy to ultimately make paradigm shift from focusing on the individual as the basic ingredient of a moral society (ethical individualism) to confronting structures and strictures that disempower and vulnerablelise individual moral agents (ethical collectivism). (shrink)

Humans often intervene in the wild for anthropocentric or environmental reasons. An example of such interventions is the reintroduction of wolves in places where they no longer live in order to create what has been called an “ecology of fear”, which is being currently discussed in places such as Scotland. In the first part of this paper I discuss the reasons for this measure and argue that they are not compatible with a nonspeciesist approach. Then, I claim that if we (...) abandon a speciesist viewpoint we should change completely the way in which we should intervene in nature. Rather than intervening for environmental or anthropocentric reasons, we should do it in order to reduce the harms that nonhuman animals suffer. This conflicts significantly with some fundamental environmental ideals whose defence is not compatible with the consideration of the interests of nonhuman animals. (shrink)

A pressing and difficult practical problem concerns the general issue of the right social response to offenders classified as having antisocial personality disorder. This paper approaches this general problem by focusing, from a philosophical perspective, on the still relevant but more approachable question whether psychopathic offenders are morally responsible. In particular, I investigate whether psychopaths possess moral understanding. A plausible way to approach the last question requires a satisfactory philosophical interpretation of the empirical evidence that appears to show that psychopaths (...) fail to draw the distinction between conventional and moral norms. Specifically, I will consider a recent philosophical debate polarized between supporters of rationalist and sentimentalist accounts of moral understanding. These opponents have discussed whether the case of psychopathy offers empirical support for their account and undermine the rival view. I will argue that the available empirical data leave the outcome of this discussion indeterminate. However, this implies that both these principal theories of moral understanding, if independently motivated, would imply that psychopaths have certain deficits that might affect their moral understanding and, consequently, their moral responsibility. (shrink)

Does a coherentist version of rationality issue requirements on states? Or does it issue requirements on processes? This paper evalu- ates the possibility of process-requirements. It argues that there are two possible definitions of state- and process-requirements: a satisfaction- based definition and a content-based definition. I demonstrate that the satisfaction-based definition is inappropriate. It does not allow us to uphold a clear-cut distinction between state- and process-requirements. We should therefore use a content-based definition of state- and pro- cess-requirements. However, a (...) content-based definition entails that ra- tionality does not issue process-requirements. Content-based process- requirements violate the principle that ‘rationality requires’ implies ‘can satisfy’. The conclusion of this paper therefore amounts to a radical re- jection of process-requirements of rationality. (shrink)

Climate change is ‘a complex problem raising issues across and between a large number of disciplines, including physical and life sciences, political science, economics, and psychology, to name just a few’ (Gardiner 2006: 397). It is also a moral problem. Therefore, in this chapter, I will consider what kind of a contribution an ethical theory called ‘contractualism’ can make to the climate change debates. This chapter first introduces contractualism. It then describes a simple climate change scenario. The third section explains (...) what kind of moral obligations we would have in that situation according to contractualism. Finally, the last section discusses some of the advantages and problems of the sketched view. These discussions should help us to better understand contractualism and illustrate how contractualism could perhaps enable us to come to grips with some of the more difficult moral aspects of climate change. (shrink)

Que los grandes sistemas filosóficos gozan de una vigorosa mala salud es algo tan aceptado que constituye casi un tópico constatar que nos encontramos lejos de las grandes propuestas que caracterizaron otra época. Quizás tampoco nuestra sensibilidad como lectores nos predisponga a mantener una opinión contraria. Si alguien nos adelanta su intención de desarrollar una teoría general acerca de cualquier fenómeno nuestra reacción más comprensible, según esa peculiar sensibilidad, será reprochar de modo inmediato lo arrogante de ese proceder disponiéndonos, con (...) más escepticismo que otra cosa, a constatar con satisfacción nuestro prejuicio inicial. El libro que comentaré es doblemente ambicioso en relación a lo que señalo. En ese añejo sentido al que aludo arriba, el filósofo americano Robert Audi presenta un amplio acercamiento al fenómeno de la racionalidad, mostrando los paralelismos existentes entre el ámbito epistémico y el práctico. En otro sentido menos evidente, de un calado quizás metafilosófico, Audi nos invita a ser un poco menos escépticos sobre el propio alcance de la indagación que tiene por objeto las grandes preguntas filosóficas. Aunque el libro de Audi muestre muchos problemas controvertidos, presentando con esmero y claridad una enorme variedad de temas, sus páginas sobre todo demuestran, con un proceder paciente, que no siempre es imposible comunicar una concepción sobre un asunto tan general como nuestra razón y su estructura. El éxito de esa quimérica empresa se apoyará, más que en la fuerza de argumentos explícitos, en la habilidad que tengamos para dibujar un mapa general que perfile y delimite algunos contornos en ese vasto territorio. En los dos sentidos en los que me refiero a este libro como ambicioso su intento es fructífero y merece ser discutido. (shrink)

It is widely held that instrumental reasoning to a practical conclusion is parasitic on non-instrumental practical reasoning. This conclusion is based on the claim that when there is no reason to adopt a certain end, there is no reason to take the means (qua means) to that end. But, as will be argued, while there is a sense of reason according to which the previous statement is true, there is another sense according to which it is false. Furthermore, in both (...) of the relevant senses of reason, it is true that reasons are considerations that ground correct conclusions of practical deliberation and correct advice. It follows that instrumental reasoning to a practical conclusion is not invariably parasitic on non-instrumental practical reasoning. The view that it is results from combining the idea that when there is no reason to adopt a certain end, there is no reason to take the means (qua means) to that end, with the common but faulty assumption that considerations that ground correct conclusions of practical deliberation and correct advice are all reasons in a single sense (sometimes referred to as the normative sense of reason). The assumption in question is implicit in, for example, the work of John Broome, T. M. Scanlon, Christine Korsgaard, and Stephen Darwall.1 Given the common identification of normative reasons with considerations that ground correct conclusions of practical deliberation and correct advice, the position that will be defended in this paper can be expressed by saying that there is not one but two senses of reason for which it is true that reasons are normative.. (shrink)

Resumen: Este artículo analiza la fundamentación normativa de un tipo de políticas de alivio contra la pobreza comunes durante los últimos años en Latinoamérica, a saber, las transferencias monetarias condicionadas. Se mostrará que la justificación típica de las transferencias monetarias condicionadas es ilegítima en una comunidad política democrática. A través de la indagación de las razones por las que la carga de la prueba se coloca del lado de las transferencias incondicionadas, se mostrará que se apela a una noción controvertida (...) de responsabilidad individual que cristaliza relaciones desiguales y que se basa en un diagnóstico empírico cuestionable.: This paper analyzes the normative foundations of conditional cash transfers, a kind of poverty relief policy which has been massively implemented during recent years in Latin America. I intend to show that the conditional cash transfer’s typical justification is illegitimate for a democratic political community. After reviewing the reasons why the burden of proof falls on unconditional transfers, I argue that the typical justification appeals to a controversial conception of individual responsibility that crystallizes unequal interpersonal relations and is based on a shaky empirical diagnosis. (shrink)

Many epistemologists treat rationality and justification as the same thing. Those who don’t lack detailed accounts of the difference, leading their opponents to suspect that the distinction is an ad hoc attempt to safeguard their theories of justification. In this paper, I offer a new and detailed account of the distinction. The account is inspired by no particular views in epistemology, but rather by insights from the literature on reasons and rationality outside of epistemology. Specifically, it turns on a version (...) of the familiar distinction in meta-ethics between possessing apparent normative reasons (which may be merely apparent) and possessing objective normative reasons. The paper proceeds as follows. In §1, I discuss the history of indifference to the distinction between rationality and justification in epistemology and the striking contrast with meta-ethics. I introduced the distinction between apparent reasons and possessed objective reasons in §2 and provide a deeper basis for it in §3. I explain how the ideas extend to epistemology in §4 and explore the upshots for some central issues in §5. (shrink)

While contractualism seems to solve some of the more pressing concerns of other moral theories, it does not conclusively address the moral status of non-human animals. Peter Carruthers claims that contractualism excludes animals from having full moral status. I argue that Carruthers’ arguments are fatally flawed due to his reliance on contradictory claims, unlikely assumptions, and flagrant violations of the contractualist method. However, Carruthers also claims that we can treat animals wrongly and that it deserves moral criticism. This claim is (...) based in indirect moral significance. However, this position makes it impossible for Carruthers to avoid endorsing two extremely counter-intuitive claims. The work of C. Tucker and C. MacDonald allows us to demonstrate that contractualism does give animals full moral standing. They ground the criteria for a contracting agent in three characteristics that animals possess. A look at some possible objections reveals nothing devastating to their proposal. (shrink)

Gorući i težak praktički problem vezan je uz opće pitanje ispravnog društvenog odgovora na prijestupnike klasificirane kao osobe s antisocijalnim poremećajem ličnosti. Članak prilazi ovom općem problemu fokusirajući se, iz filozofske perspektive, na još uvijek važno ali lakše dohvatljivo pitanje jesu li psihopatski prijestupnici moralno odgovorni. Posebno se istražuje imaju li psihopati mogućnost moralnog razumijevanja. Vjerodostojni pristup posljednjem pitanju zahtijeva zadovoljavajuću filozofsku interpretaciju empirijskog dokaza koji pokazuje da psihopati ne uspijevaju naći razliku između konvencionalnih i moralnih normi. Preciznije, uzet ću (...) u obzir nedavnu filozofsku raspravu polariziranu između pobornika racionalističkog i sentimentalističkog objašnjenja moralnog razumijevanja. Ovi su suparnici otvorili raspravu nudi li slučaj psihopatije empirijsku potporu za njihovo objašnjenje i potkopava suparnički pogled. U radu tvrdim da dostupni empirijski podaci ostavljaju ishod ove rasprave neodlučenim. To implicira da bi obje teorije moralnog razumijevanja, ako su neovisno motivirane, uzele u obzir psihopate kao osobe koje imaju određene nedostatke koje bi mogle utjecati na njihovo moralno razumijevanje a stoga i na njihovu moralnu odgovornost. (shrink)