Respect for autonomy is a central moral principle in bioethics. It is sometimes argued that authenticity, i.e., being “real,” “genuine,” “true to oneself,” or similar, is crucial to a person’s autonomy. Patients sometimes make what appears to be inauthentic decisions, such as when anorexia nervosa patients refuse treatment to avoid gaining weight, despite that the risk of harm is very high. If such decisions are inauthentic, and therefore non-autonomous, it may be the case they should be overridden for paternalist reasons. (...) However, it is not clear what justifies the judgment that someone or something is inauthentic. This article discusses one recent theory of what justifies judgments of inauthenticity. It is argued that the theory is seriously limited, as it only provides guidance in three out of nine identified cases. There are at least six authenticity-related problems to be solved, and autonomy theorists thus have reason to engage with the topic of authenticity in practical biomedicine. (shrink)

Value conflicts between individualism and collectivism are common. In philosophy, such conflicts have been conceptualized as conflicts between individuality and conformity, among other things. This article develops a more detailed conceptual framework by combining philosophical analysis with empirical observations. The focus is on value conflicts pertaining to LGBT (lesbian, gay, bisexual, and transgender) factors in a non-individualist society (Georgia). Conservative or traditional norms sometimes constrain LGBT individuals by influencing them to adapt to social expectations. The phenomenon is intuitively clear and (...) has been reported on in numerous quantitative investigations. A qualitative study has been conducted on how LGBT individuals in Georgia experience the constraining influence of such norms. Deep interviews (n=8) have clarified how, more precisely, the effects of those influences should be conceptualized. The results indicate that important distinctions between different types of influences, as well as different objects of influence, have been overlooked in previous philosophical inquiries about value conflicts in this context. The conceptual framework developed throughout the article should be of use to philosophers and social scientists studying individualism and collectivism, and to policymakers working with LGBT issues. (shrink)

Many libertarians assume that there is a close relation between an individual’s self-ownership and her freedom. That relation needs questioning. In this article it is argued that, even in a pre-property state, self-ownership is insufficient to protect freedom. Therefore, libertarians who believe in self-ownership should either offer a defense of freedom that is independent from their defense of self-ownership, make it explicit that they hold freedom as second to self-ownership (and defend that position), or reconsider the moral basis of their (...) political views. (shrink)

The aim of this doctoral thesis is to bridge the gap between theoretical ideals of authenticity and practical authenticity-related problems in healthcare. In this context, authenticity means being "genuine," "real," "true to oneself," or similar, and is assumed to be closely connected to the autonomy of persons. The thesis includes an introduction and four articles related to authenticity. The first article collects various theories intended to explain the distinction between authenticity and inauthenticity in a taxonomy that enables oversight and analysis. (...) It is argued that (in-)authenticity is difficult to observe in others. The second article offers a solution to this difficulty in one theory of authenticity. It is proposed that under certain circumstances, it is morally justified to judge that the desires underlying a person's decisions are inauthentic. The third article incorporates this proposition into an already established theory of personal autonomy. It is argued that the resulting conceptualization of autonomy is fruitful for action-guidance in authenticity-related problems in healthcare. The fourth article collects nine cases of possible authenticity-related problems in healthcare. The theory developed in the third article is applied to the problems, when this is allowed by the case-description, to provide guidance with regard to them. It is argued that there is not one universal authenticity-related problem but many different problems, and that there is thus likely not one universal solution to such problems but various particular solutions. (shrink)