A ‘Ulysses arrangement’ (UA) is an agreement where a patient may arrange for psychiatric treatment or non-treatment to occur at a later stage when she expects to change her mind. In this article, I focus on ‘competence-insensitive’ UAs, which raise the question of the permissibility of overriding the patient’s subsequent decisionally competent change of mind on the authority of the patient’s own prior agreement. In “The Ethical Justification for Ulysses Arrangements”, I consider sceptical and supportive arguments concerning competence-insensitive UAs, and (...) argue that there are compelling reasons to give such UAs serious consideration. In “Decisional Competence and Legal Capacity in UAs”, I examine the nature of decisional competence and legal capacity as they arise in UAs, an issue neglected by previous research. Using the distinctions which emerge, I then identify the legal structure of a competence-insensitive UA in terms of the types of legal capacity it embodies and go on to explain how types of legal capacity might be shared between the patient and a trusted other to offer support to the patient in the creation and implementation of a competence-insensitive UA. This is significant because it suggests possibilities for building patient support mechanisms into models of legal UAs, which has not addressed in the literature to date. Drawing on this, in “Using Insights from the Competence/Capacity Distinction to Enhance Patient Support in UAs”, I offer two possible models to operationalize competence-insensitive UAs in law that allow for varying degrees of patient support through the involvement of a trusted other. Finally, I outline some potential obstacles implementing these models would face and highlight areas for further research. (shrink)

Criticism directed at neoclassical economics has failed to replace it with a similar grand theory. The author argues that one possible explanation may lie in the failure of economists to formulate an opinion as to the philosophical foundations of the author’s object of study. The paper aims to discuss this issue. The argument proceeds in two steps. First, the authors review the prevailing philosophical view of “the self-interest theory (S)”, which is one of the most powerful constituents of today’s economics, (...) and social theorizing in general. Second, the authors present a reasoning framework in which rationality becomes intelligible within a schema of integrating the self’s external and internal conditionalities into a unified view of human reasoning. (shrink)

Can a society be just if it ignores the plight of other societies? Does it matter whether those societies are contemporaries? Moral “purists” are likely to assume that the answer to these questions must be “no.” Relying on familiar claims about impartiality or universalizability, the purist is likely to assert that the dictates of justice have no bounds, that they extend with equal strength across space and time. On this view, if, for example, justice requires us to maximize the expectations (...) of the worst-off group in our society, it also requires us to maximize the expectations of the worst-off group in any society, at any time, so far as it is in our power to do so. Is such a position plausible? Is it more plausible than alternative positions? I am unsure about the answers to these questions, but both the questions, and the answers, are important. Clearly, the nature and extent of a just society's obligations will vary markedly depending on the scope of the correct principles of justice. (shrink)