Virtually any appraisal of a person’s welfare, integrity, or moral status, as well as the moral and political theories built on such appraisals, will rely crucially on the presumption that her preferences and values are in some important sense her own. In particular, the nature and value of political freedom is intimately connected with the presupposition that actions one is left free to do flow from desires and values that are truly an expression of the ‘self-government’ of the agent. However, (...) we all know that no person is self-made in the sense of being a fully formed and intact ‘will’ blossoming out of nowhere. Our values and preferences are explained by essential reference to a variety of influences that have come to bear on our development throughout our personal histories. What is needed, then, is to establish an account of self-determination or autonomy that would help determine just when and if the values and preferences we find ourselves with deserve the centrality that moral and political theories place on them. (shrink)

Abortion has long been a central issue in the arena of applied ethics, but, the distinctive analysis of feminist ethics is generally overlooked in most philosophic discussions. Authors and readers commonly presume a familiarity with the feminist position and equate it with liberal defences of women's right to choose abortion, but, in fact, feminist ethics yields a different analysis of the moral questions surrounding abortion than that usually offered by the more familiar liberal defenders of abortion rights. Most feminists can (...) agree with some of the conclusions that arise from certain non-feminist arguments on abortion, but they often disagree about the way the issues are formulated and the sorts of reasons that are invoked in the mainstream literature. (shrink)

Women have historically been prevented from living autonomously by systematic injustice, subordination, and oppression. The lingering effects of these practices have prompted many feminists to view autonomy with suspicion. Here, Marilyn Friedman defends the ideal of feminist autonomy. In her eyes, behavior is autonomous if it accords with the wants, cares, values, or commitments that the actor has reaffirmed and is able to sustain in the face of opposition. By her account, autonomy is socially grounded yet also individualizing and sometimes (...) socially disruptive, qualities that can be ultimately advantageous for women. Friedman applies the concept of autonomy to domains of special interest to women. She defends the importance of autonomy in romantic love, considers how social institutions should respond to women who choose to remain in abusive relationships, and argues that liberal societies should tolerate minority cultural practices that violate women's rights so long as the women in question have chosen autonomously to live according to those practices. (shrink)

One of liberalism’s core commitments is to safeguarding individuals’ autonomy. And a central aspect of liberal social justice is the commitment to protecting the vulnerable. Taken together, and combined with an understanding of autonomy as an acquired set of capacities to lead one’s own life, these commitments suggest that liberal societies should be especially concerned to address vulnerabilities of individuals regarding the development and maintenance of their autonomy. In this chapter, we develop an account of what it would mean for (...) a society to take seriously the obligation to reduce individuals’ autonomy-related vulnerabilities to an acceptable minimum. In particular, we argue that standard liberal accounts underestimate the scope of this obligation because they fail to appreciate various threats to autonomy. (shrink)

In the subsequent pages, I want to develop a distinction between wanting and valuing which will enable the familiar view of freedom to make sense of the notion of an unfree action. The contention will be that, in the case of actions that are unfree, the agent is unable to get what he most wants, or values, and this inability is due to his own "motivational system." In this case the obstruction to the action that he most wants to do (...) is his own will. It is in this respect that the action is unfree: the agent is obstructed in and by the very performance of the action. (shrink)

It is my view that one essential difference between persons and other creatures is to be found in the structure of a person's will. Besides wanting and choosing and being moved to do this or that, men may also want to have certain desires and motives. They are capable of wanting to be different, in their preferences and purposes, from what they are. Many animals appear to have the capacity for what I shall call "first-order desires" or "desires of the (...) first order," which are simply desires to do or not to do one thing or another. No animal other than man, however, appears to have the capacity for reflective self-evaluation that is manifested in the formation of second-order desires. (shrink)

Autonomy has recently become one of the central concepts in contemporary moral philosophy and has generated much debate over its nature and value. This 2005 volume brings together essays that address the theoretical foundations of the concept of autonomy, as well as essays that investigate the relationship between autonomy and moral responsibility, freedom, political philosophy, and medical ethics. Written by some of the most prominent philosophers working in these areas, this book represents research on the nature and value of autonomy (...) that will be essential reading for a broad swathe of philosophers as well as many psychologists. (shrink)

A mugging can overwhelm our ability to apply moral principles. When words fail, we still need advice that allows us to remain moral in the face of an attack. Self-defense offers just such advice and can be supported by utilitarian, deontological, and virtue approaches to ethics. Self-defense increases safety and security that enhance our freedom and well-being, which, in turn, allow us to survive and flourish as moral agents. Self-defense must, however, itself be qualified because its violent treatment of muggers (...) may produce human time bombs that reduce the safety and security of society.The martial art of Aikido trains our hand to act morally in the face of a physical attack when our mind is otherwise occupied. Aikido teaches self-defense, but it goes beyond self-centeredness to also protect the attacker. Such concern helps build community because it reduces vectors of resentment that spread when violence is perpetuated. The defense-only nature of Aikido teaches virtues in an embodied form on the mat. It offers philosophers an experiential and kinesthetic view of moral conduct that supplements and complements an exclusively intellectual approach. Moral philosophy cannot demand that we learn a martial art since it is only one of many possibilities to assist us in living a moral life; nevertheless, a reasonable attention to those conditions necessary for freedom and well-being entails an awareness of self-defense. (shrink)

Prenatal screening, consisting of maternal serum screening and nuchal translucency screening, is on the verge of expansion, both by being offered to more pregnant women and by screening for more conditions. The Society of Obstetricians and Gynaecologists of Canada and the American College of Obstetricians and Gynecologists have each recently recommended that screening be extended to all pregnant women regardless of age, disease history, or risk status. This screening is commonly justified by appeal to the value of autonomy, or women's (...) choice. In this paper, I critically examine the value of autonomy in the context of prenatal screening to determine whether it justifies the routine offer of screening and the expansion of screening services. I argue that in the vast majority of cases the option of prenatal screening does not promote or protect women's autonomy. Both a narrow conception of choice as informed consent and a broad conception of choice as relational reveal difficulties in achieving adequate standards of free informed choice. While there are reasons to worry that women's autonomy is not being protected or promoted within the limited scope of current practice, we should hesitate before normalizing it as part of standard prenatal care for all. (shrink)

In recent years the concepts of individual autonomy and political liberalism have been the subjects of intense debate, but these discussions have occurred largely within separate academic disciplines. Autonomy and the Challenges to Liberalism contains essays devoted to foundational questions regarding both the notion of the autonomous self and the nature and justification of liberalism. Written by leading figures in moral, legal and political theory, the volume covers inter alia the following topics: the nature of the self and its relation (...) to autonomy, the social dimensions of autonomy and the political dynamics of respect and recognition, and the concept of autonomy underlying the principles of liberalism. (shrink)

Physicians make some medical decisions without disclosure to their patients. Nondisclosure is possible because these are silent decisions to refrain from screening, diagnostic or therapeutic interventions. Nondisclosure is ethically permissible when the usual presumption that the patient should be involved in decisions is defeated by considerations of clinical utility or patient emotional and physical well-being. Some silent decisions - not all - are ethically justified by this standard. Justified silent decisions are typically dependent on the physician's professional judgment, experience and (...) knowledge, and are not likely to be changed by patient preferences. We condemn the inappropriate exclusion of the patient from the decision-making process. However, if a test or treatment is unlikely to yield a net benefit, disclosure and discussion are at times unnecessary. Appropriate silent decisions are ethically justified by such considerations as patient benefit or economy of time. (shrink)

The third edition of Health Care Ethics in Canada builds on the commitment to Canadian content established in earlier editions without sacrificing breadth or rigor.