Voluntary acts are preceded by electrophysiological (RPs). With spontaneous acts involving no preplanning, the main negative RP shift begins at about200 ms. Control experiments, in which a skin stimulus was timed (S), helped evaluate each subject's error in reporting the clock times for awareness of any perceived event.

This paper offers a phenomenological analysis of the relationship between regret and episodic memory, the temporal structure of ‘regretful memory’, the affective and evaluative dimension of regretful memory and the counterfactual dimension of regretful memory. Based on Husserl’s phenomenology, I offer an analysis of regret’s complex structures of intentionality and time-consciousness. Husserl held that episodic memory requires two temporal orientations on one’s own experience: the past now that one relives and the present now in which one does the reliving. If (...) memory generally entails two temporal perspectives, regretful memory brings in a third point of temporal reference: that now that could have been. Drawing on Hoerl and McCormack, I give an account of regret as a mnemic and counterfactual form of intentional consciousness that confronts an alternative past and attempts to negotiate between two essential yet conflicting features of its actual past: its contingency and its irreversibility. On this basis, I then draw on Bagnoli to offer a phenomenological theory of regretful memory as an emotional mode of valuing possibilities that belong to the past. (shrink)

ABSTRACT It is accepted that treatment of previously competent, now incompetent patients can be limited if that is what the patient would desire, if she were now competent. Expressed past preferences or an advance directive are often taken to constitute sufficient evidence of what a patient would now desire. I distinguish between desires and rational desires. I argue that for a desire to be an expression of a person's autonomy, it must be or satisfy that person's rational desires. A person (...) rationally desires a course of action if that person desires it while being in possession of all available relevant facts, without committing relevant error of logic, and “vividly imagining” what its consequences would be like for her. I argue that some competent, expressed desires obstruct autonomy. I show that several psychological mechanisms operate to prevent a person rationally evaluating what future life in a disabled state would be like. Rational evaluation is difficult. However, treatment limitation, if it is to respect autonomy, must be in accord with a patient's rational desires, and not merely her expressed desires. I illustrate the implications of these arguments for the use of advance directives and for the treatment of competent patients. (shrink)

I contrast Robert Veatch's recent liberal vision of medical decision‐making with a more rationalist liberal model. According to Veatch, physicians are biased in their determination of what is in their patient's overall interests in favour of their medical interests. Because of the extent of this bias, we should abandon the practice of physicians offering what they guess to be the best treatment option. Patients should buddy up with physicians who share the same values —‘deep value pairing’. The goal of choice (...) is maximal promotion of patient values. I argue that if subjectivism about value and valuing is true, this move is plausible. However, if objectivism about value is true — that there really are states which are good for people regardless of whether they desire to be in them — then we should accept a more rationalist liberal alternative. According to this alternative, what is required to decide which course is best is rational dialogue between physicians and patients, both about the patient's circumstances and her values, and not the seeking out of people, physicians or others, who share the same values. Rational discussion requires that physicians be reasonable and empathic. I describe one possible account of a reasonable physician. (shrink)

The prelims comprise: Introduction Controversial Choices Kinds of Normative Reasons for Action Limits on Respect for Autonomy Children and Controversial Choice Controversial Choices and the Duty to Strive Toward Perfection and Full Autonomy Acknowledgments Notes References.