Most recent accounts of personal autonomy acknowledge that the social environment a person lives in, and the personal relationships she entertains, have some impact on her autonomy. Two kinds of conceptualizing social conditions are traditionally distinguished in this regard: Causally relational accounts hold that certain relationships and social environments play a causal role for the development and on-going exercise of autonomy. Constitutively relational accounts, by contrast, claim that autonomy is at least partly constituted by a person’s social environment or standing. (...) The central aim of this paper is to raise the question how causally and constitutively relational approaches relate to the fact that we exercise our autonomy over time. I argue that once the temporal scope of autonomy is opened up, we need not only to think differently about the social dimension of autonomy. We also need to reconsider the very distinction between causally and constitutively relational accounts, because it is itself a synchronic (and not a diachronic) distinction. (shrink)

According to the interest theory of rights, the primary function of rights is the protection of fundamental interests. Since children undeniably have fundamental interests that merit protection, it is perfectly sensible to attribute rights, especially welfare rights, to them. The interest theory need not be hostile to the accommodation of rights that protect agency because, at least in the case of adults, there is a strong connection between the protection of agency and the promotion of welfare. Children have welfare rights (...) similar to those of adults. But children lack the agency rights adults have because children initially lack and only gradually develop the kinds of capacities for agency that are necessary for agency rights. Children's rights to culture, religion, and free expression are ill‐conceived. (shrink)

In his work on internality, identification, and caring, Harry Frankfurt attempts to delineate the organization of agency peculiar to human beings, while avoiding the traditional overintellectualized emphasis on the human capacity to reason about action. The focal point of Frankfurt’s alternative picture is our capacity to make our own motivation the object of reflection. Building upon the observation that marginal agents (such as young children and Alzheimer’s patients) are capable of caring, I show that neither caring nor internality need to (...) depend on the phenomena of reflectiveness. I develop alternative interlocking accounts of caring and internality that are independent of both reflectiveness and evaluation, but that can still do justice to the central role of carings in the organization of agency characteristic of human persons. (shrink)

Book reviewed in this article: Protecting The Vulnerable: A Reanalysis of Our Social Responsibilities. By Robert E. Goodin. Chicago: University of Chicago Press.

This article asks whether being a child is, all things considered, good or bad for children. I defend a predicament view of childhood, which regards childhood as bad overall for children. I argue that four features of childhood make it regrettable: impaired capacity for practical reasoning, lack of an established practical identity, a need to be dominated, and profound and asymmetric vulnerability. I consider recent claims in the literature that childhood is good for children since it allows them to enjoy (...) special goods that aren't available in adulthood, or which are harder to access in adulthood. I raise some difficulties for these claims. Then I argue that whatever version of these views survives my criticism will not establish that childhood is overall good for children. This is because the goods of childhood aren't significant enough to outweigh the bad features associated with being a child. I conclude by suggesting that the badness of childhood for children means that we are likely to owe more to children than to adults. (shrink)

Children's vulnerability gives rise to duties of justice towards children and determines when authority over them is legitimately exercised. I argue for two claims. First, children's general vulnerability to objectionable dependency on their caregivers entails that they have a right not to be subject to monopolies of care, and therefore determines the structure of legitimate authority over them. Second, children's vulnerability to the loss of some special goods of childhood determines the content of legitimate authority over them. My interest is (...) in the so-far little-discussed goods of engaging in world discovery, artistic creation, philosophical pursuits and experimentation with one's self. I call these ‘special goods of childhood’ because individuals, in general, only have full access to them during childhood and they make a distinctive and weighty contribution to wellbeing. Therefore, they are part of the metric of justice towards children. The overall conclusion is that we ought to make good institutional care part of every child's upbringing. (shrink)

This paper challenges the traditional account of vulnerability in healthcare which conceptualizes vulnerability as a list of identifiable subpopulations. This list of ‘usual suspects’, focusing on groups from lower resource settings, is a narrow account of vulnerability. In this article we argue that in certain circumstances middle-class individuals can be also rendered vulnerable. We propose a relational and layered account of vulnerability and explore this concept using the case study of cord blood (CB) banking. In the first section, two different (...) approaches to ‘vulnerability’ are contrasted: categorical versus layered. In the second section, we describe CB banking and present a case study of CB banking in Argentina. We examine the types of pressure that middle-class pregnant women feel when considering CB collection and storage. In section three, we use the CB banking case study to critique the categorical approach to vulnerability: this model is unable to account for the ways in which these women are vulnerable. A layered account of vulnerability identifies several ways in which middle-class women are vulnerable. Finally, by utilizing the layered approach, this paper suggests how public health policies could be designed to overcome vulnerabilities. (shrink)

What is it about a person's becoming an adult that makes it generally inappropriate to treat that person paternalistically any longer? The Standard View holds that a mere difference in age or stage of life cannot in itself be morally relevant, but only matters insofar as it is correlated with the development of capacities for mature practical reasoning. This paper defends the contrary view: two people can have all the same general psychological attributes and yet the mere fact that one (...) person is at the beginning of a life and another in the middle of one can justify treating the younger person more paternalistically than the older one. Recognising the moral relevance of age, moreover, is crucial if one is to accommodate both the liberal moral ideal of respect for autonomy and our demanding educational aims, given that these otherwise come into conflict with one another. (shrink)

In this article I examine several criticisms of the concept of vulnerability. Rather than rejecting the concept, however, I argue that a sufficiently rich understanding of vulnerability is essential to bioethics. The challenges of international research in developing countries require an understanding of how new vulnerabilities arise from conditions of economic, social and political exclusion. A serious shortcoming of current conceptions of vulnerability in research ethics is the tendency to treat vulnerability as a label fixed on a particular subpopulation. My (...) paper examines the role of this “label” metaphor in current statements of research ethics. In contrast to this prevailing “label” metaphor, my own positive account of vulnerability develops a dynamic way of understanding the structure of the concept of vulnerability based on the idea of “layers of vulnerability.” I examine several cases involving women, as they are sometimes labeled as a vulnerable population and sometimes not. My analysis demonstrates the essential role of this revised concept of vulnerability in bioethics and research ethics. (shrink)

Vulnerability has been extensively discussed in medical research, but less so in health care. Thus, who the vulnerable in this domain are still remains an open question. One difficulty in their identification is due to the general criticism that vulnerability is not a property of only some, but rather of everyone. By presenting a philosophical analysis of the conditions of vulnerability ascription, we show that these seemingly irreconcilable understandings of vulnerability are not contradictory. Rather, they are interdependent: they refer to (...) the same concept with different likelihoods of manifestation. We argue that the general vulnerability of living beings relies on their having certain types of interests. In health care, those individuals are particularly vulnerable who are more likely to have these interests unjustly considered. They should be afforded special protection in order to receive what is due to everyone, but which they are likely to fail to receive. (shrink)

This paper addresses the issue of paternalism in child-rearing. Since the parent–child relationship seems to be the linguistic source of the concept, one may be tempted to assume that raising a child represents a particularly appropriate sphere for paternalism. The parent–child relationship is generally understood as a relationship that is supposed to promote the development and autonomy-formation of the child, so that the apparent source of the concept is a form of autonomy-oriented paternalism. Far from taking paternalism to be overtly (...) unproblematic in such paradigmatic, pedagogical settings, this article analyzes how an effort should be made to understand a child’s capacities and which standards parents should be held to when deciding whether interference truly serves the child’s interests. (shrink)

Should society intervene to prevent the risky behavior of precocious teenagers even if it would be impermissible to intervene with adults who engage in the same risky behavior? The problem is well illustrated by the legal case of the 13-year-old Dutch girl Laura Dekker, who set out in 2009 to become the youngest person ever to sail around the world alone, succeeding in January 2012. In this paper we use her case as a point of entry for discussing the fundamental (...) question of how to demarcate childhood from adulthood. After summarizing the case, we identify a ‘demarcation dilemma’ that frames much of the public and expert debate. On the one hand, it seems morally imperative ‘to treat like alike’, which means that both children and adults should be allowed to undertake all actions for which they have the relevant competences. On the other hand, requiring proportional treatment of children and adults seems to neglect the special nature of childhood as a distinct stage in life that ends at a specific age. We introduce the notion of a ‘regime of childhood’ to deal with this problem. This regime includes several dimensions, including the limited liability for children, the supervisory responsibilities of parents, the role of age-based thresholds, and the overarching purpose of childhood as a context for developing autonomy. We argue that, all things considered, there are good reasons not to shift to a regime that offers individual children the option of qualifying for adulthood on the basis of age-neutral criteria. (shrink)

Traditionally, most philosophers saw childhood as a state of deficiency and thought that its value was entirely dependent on how successfully it prepares individuals for adulthood. Yet, there are good reasons to think that childhood also has intrinsic value. Children possess certain intrinsically valuable abilities to a higher degree than adults. Moreover, going through a phase when one does not yet have a “self of one’s own,” and experimenting one’s way to a stable self, seems intrinsically valuable. I argue that (...) children can have good lives, on several understandings of well-being – as a pleasurable state, as the satisfaction of simple desires or as the realization of certain objective goods. In reply to the likely objection that only individuals capable of morality can have intrinsic value, I explain why it is plausible that children have sufficient moral agency to be as deserving of respect as adults. (shrink)

Too often, we as individuals do things that harm us, that seriously interfere with our being able to live in the way that we want. We eat food that makes us obese, that promotes diabetes, heart failure and other serious illness, while at the same time, we want to live long and healthy lives. Too many of us smoke cigarettes, even while acknowledging we wish we had never begun. We behave in ways that undercut our ability to reach some of (...) our most valued goals, despite education and despite incentives to choose the right thing. What should be done?If I were to try to harm someone else in a way that alters his future seriously and perhaps irrevocably for the worse, I would be stopped. When it comes to hurting myself, though, we have a common belief that it is wrong to interfere, even if I foresee that I will very much regret what I have done, often when it is too late to fix what I have let happen. I think this makes no sense. If it is permissible, even obligatory, to stop me when I do something that seriously interferes with someone else's chances of achieving the life he wants, I think …. (shrink)

In this paper I look at various ways that interpersonal and social relations can be seen as required for autonomy. I then consider cases where those dynamics might play out or not in potentially paternalistic situations. In particular, I consider cases of especially vulnerable persons who are attempting to reconstruct a sense of practical identity required for their autonomy and need the potential paternalist’s aid in doing so. I then draw out the implications for standard liberal principles of paternalism, specifically (...) in clinical or therapeutic situations. The picture of potential paternalism that emerges here is much more of a dynamic, interpersonal scenario rather than a case of two separate individuals making decisions independent of each other. (shrink)

In the early 1700s the Flemish explorer Sicnarf Garhcs discovered a society, the Namuh, which he described in his two-volume compendium of primitive societies. As this society bears on my present topic, I begin with a summary of its salient features: It consists of two classes of people, the Tluda and the Dlihc, whom I shall hereafter refer to as the T's and the D's. Relative to the D's, the T's are strong, intelligent and knowledgeable about the world. The D's (...) are weak, ignorant and dim-witted. (shrink)

The concept of vulnerability has been subject to numerous different interpretations but accounts are still beset with significant problems as to their adequacy, such as their contentious application or the lack of genuine explanatory role for the concept. The constant failure to provide a compelling conceptual analysis and satisfactory definition leaves the concept open to an eliminativist move whereby we can question whether we need the concept at all. I highlight problems with various kinds of approach and explain why a (...) satisfactory account of vulnerability is unlikely ever to be offered if we wish the concept to play a genuinely explanatory role in bioethical contexts. I outline why an eliminativist position should be taken with regard to this concept in light of these concerns but mitigate some of the severity of this position by arguing that we can still make sense of retaining our widespread use of the term by viewing it as nothing more than a useful pragmatic linguistic device that acts as a marker to draw attention to certain kinds of issue. These issues will be entirely governed by other, better understood ethical concepts and theories. (shrink)

To what extent does the common claim that childhood is ‘socially constructed’ affect the ethical debate on the ‘intrinsic’ and ‘special’ goods of childhood? Philosophers have referred to this kind of goods in their critique of overly adult-centred and future-oriented conceptions of childhood. The view that some goods are child-specific, in the sense that they are only good for children, not for adults, seems to presuppose an understanding of what children ‘are’, and how they differ from adults. However, if the (...) social-constructionist view is accepted, it cannot be assumed that childhood is a given. This essay claims that the social-constructionist understanding of childhood does not undermine the debate on the moral status and the goods of childhood, but that nevertheless important lessons can be drawn from the insight that childhood, as we know it, is not a natural and universal phenomenon. (shrink)