Advances in psychology and neuroscience have elucidated the social aspects of human agency, leading to a broad shift in our thinking about fundamental concepts such as autonomy and responsibility. Here, we address a critical aspect of this inquiry by investigating how people consider the socio-relational nature of their own agency, particularly the influence of others on their perceived control over their decisions and actions. Specifically, in a series of studies using contrastive vignettes, we examine public attitudes about when external influences (...) on everyday decisions are perceived as " undue " – that is, as undermining the control conditions for these decisions to be considered autonomous – vs. when they are perceived as appropriate and even supportive of autonomous decision-making. We found that the influence of preauthorized agents – individuals and institutions with whom we share a worldview – was judged to be less undue than non-preauthorized agents, even after controlling for the familiarity of the agent. These effects persisted irrespective of the extent to which respondents identified as communitarian or individualistic, and were consistent across two distinct scenarios. We also found that external influences that were rational were perceived as less undue than those that were arational. Our study opens new avenues of inquiry into the " folk conception " of autonomy, and we discuss the implications of our findings for the ethics of public policies designed to influence decisions and for information sharing in social networks. (shrink)

The shape and function of ethical imperatives may vary if the context is an interaction between strangers, or those who are well acquainted. This idea, taken up from Stephen Toulmin’s distinction between an “ethics of strangers” and an “ethics of intimacy”, can be applied to encounters in healthcare. There are situations where healthcare personnel (HCP) know their patients (corresponding to an “ethics of intimacy”) and situations where HCP do not know their patients (corresponding to “an ethics of strangers”). Does it (...) make a difference for normative imperatives that follow from central concepts and principles in medical ethics whether HCP know their patients or not? In our view, this question has not yet been answered satisfactorily. Once we have clarified what is meant by “knowing the patient”, we will show that the distinction is particularly relevant with regard to some thorny questions of autonomy in healthcare (e.g., regarding advance directives or paternalism in the name of autonomy), whereas the differences with regard to imperatives following from the principles of justice and beneficence seem to be smaller. We provide a detailed argument for why knowing the patient is ethically valuable in encounters in healthcare. Consequently, healthcare systems should provide fertile ground for HCP to get to know their patients, and structures that foster therapeutic continuity. For this to succeed, a number of questions still need to be clarified, which is an important task for medical ethics. (shrink)

Care theorists have yet to outline an account of how the concept of toleration should function in their normative framework. This lack of outline is a notable gap in the literature, particularly for demonstrating whether care ethics can appropriately address cases of moral disagreement within contemporary pluralistic societies; in other words, does care ethics have the conceptual resources to recognize the disapproval that is inherent in an act of toleration while simultaneously upholding the positive values of care without contradiction? By (...) engaging care ethics with John Locke’s influential corpus on toleration, I answer the above question by building the bases for a novel theory of toleration as care. Specifically, I argue that care theorists can home in on an oft-overlooked aspect of Locke’s later thought: that the possibility of a tolerant society is dependent on a societal ethos of trustworthiness and civility, to the point where Locke sets out positive ethical demands on both persons and the state to ensure this ethos can grow and be sustained. By leveraging and augmenting Locke’s thought within the care ethical framework, I clarify how care ethics can provide meaningful solutions to moral disagreement within contemporary pluralistic societies in ways preferable to the capability of a liberal state. (shrink)

A relational, feminist ethics of pregnancy sees the fetus as valuable both relationally and biologically, rather than minimized or ignored. Women are always at the center of ethical concern. To avoid gender-based discrimination, women’s bodily integrity, consent (to pregnancy), and physical “nestedness” (containment of the fetus within a person’s body) must be considered primary ethical concerns. This relational approach accounts for the significance of pregnancy and the grief of pregnancy loss while concurrently providing an ethical justification for abortion. This refined (...) framework has significant benefits because it can address a spectrum of ethical issues that arise around pregnancy. (shrink)

Definition of the problem Assistive technologies, including “smart” instruments and artificial intelligence (AI), are increasingly arriving in older adults’ living spaces. Various research has explored risks (“surveillance technology”) and potentials (“independent living”) to people’s self-determination from technology itself and from the increasing complexity of sociotechnical interactions. However, the point at which self-determination of the individual is overridden by external influences has not yet been sufficiently studied. This article aims to shed light on this point of transition and its implications. Arguments (...) The identification of this “tipping point” could contribute to analysis of familiar issues of conflict between the ethical principles of beneficence and respect for autonomy. When using technology in the living spaces of older adults, relationships, among other factors, may play a crucial role in older adult’s self-determination. We find the tipping point to occur subjectively and variably. To this end, the article combines theoretical ethical considerations with two examples from a qualitative study illustrating the perspective of older adults aged 65–85 years. Conclusion The study of the tipping point underscores the importance of perceiving an older person’s perspective. Particularly at the tipping point, this might be the only way to effectively identify whether the individual concerned perceives their self-determination as externally overridden. In conceptualizing the tipping point itself as well as its variability, we might create the basis for a normative call to shift the tipping point to promote self-determination and prevent overriding the will of older adults. We highlight individual, relational, and societal implications of our findings. (shrink)

Persuasive design draws on our basic psychological makeup to build products that make our engagement with them habitual. It uses variable rewards, creates Fear of Missing Out, and leverages social approval to incrementally increase and maintain user engagement. Social media and networking platforms, video games, and slot machines are all examples of persuasive technologies. Recent attention has focused on the dangers of PD: It can deceptively prod users into forming habits that help the company’s bottom line but not the user’s (...) wellbeing. But PD is not inherently immoral. We can take advantage of our psychological biases to make beneficial changes in ways that enhance our agency rather than limit it. Knowing that a tool is persuasively designed is a consideration in favor of using it when we are trying to break bad habits, such as smoking. How are we to conceptually distinguish between ethical and unethical uses of PD? In this paper, I argue that unethical uses of PD betray or erode our trust. Annette Baier offers a moral test for trust: If gaining knowledge about what other parties do with our trust in them would lead us to stop trusting, then that trusting relationship is immoral. I apply this test to the case of PD. Using trust as a litmus test for ferreting out unethical PD has several advantages, one of which is that it reveals how the harm of unethical PD extends beyond the individual to her wider social network. I close the paper by investigating these cascading effects. (shrink)