Inflicting harm is generally preferable to inflicting death. If you must choose between the two, you should generally choose to harm. But prenatal harm seems different. If a mother must choose between harming her fetus or aborting it, she may choose either, at least in many cases. So it seems that prenatal harm is particularly objectionable, sometimes on a par with death. This paper offers an explanation of why prenatal harm seems particularly objectionable by drawing an analogy to the all-or-nothing (...) problem. It then argues that this analogy offers independent support for the ‘voluntarist’ view that at least some parental role obligations are grounded in the choice to be a parent. (shrink)

Der Titel des Bandes greift eine Frage auf, die im alltäglichen Umgang aufkam: die Frage nach analytischer Philosophie, vom Rücksitz eines Autos gestellt. Dieser Kontext bot den Anlass, eine Herangehensweise zu wählen, die bislang nicht üblich war: auszuprobieren, was eine Einbeziehung des Alltags und Umgangs erbringen könnte, ohne auf Komplexität zu verzichten. -/- Diese Öffnung hat zu überraschenden Ergebnissen geführt, die eine Weiterentwicklung der analytischen Philosophie erlauben, auch und in besonderer Weise theoretisch: Die Beachtung von umgangsprachlichem Verhalten kann dabei behilflich (...) sein, Sprache besser zu verstehen, als dies eine traditionelle wissenschaftsphilosophische Ausrichtung ermöglichen würde. -/- Die Beiträge zu diesem Band haben Kathrina Talmi, Reinhard Matern und Kai Pege eingebracht. (shrink)

Bislang vernachlässigte man in der Forschung sowohl die Ansichten von Horkheimer und Adorno über Sprachgeschichte als auch Zusammenhänge mit jüdischen Theologien, die gemeinsam die Grundlage der Geschichtsphilosophien innerhalb der ‚Dialektik der Aufklärung‘ bilden; mit der vorliegenden Untersuchung werden die Versäumnisse nachgeholt. Matern bietet eine ausführliche, aber sehr konzentrierte Diskussion im Kontext von ethnographischen, philologischen und theologischen Forschungen. Der große Aufwand ist erforderlich, um (a) mögliche Bezüge von Horkheimer und Adorno herausstellen zu können, (b) eine Basis für angemessene Interpretationen zu erhalten. (...) Resultat der Forschung ist, dass beide Autoren unterscheidbare apokalyptisch messianische Theologien entwerfen, die nachweisbar im Kontext von messianischen Ausrichtungen innerhalb der jüdischen Kabbala stehen. (shrink)

Die Erörterung über Zivilisationen und die Goldenen Regeln ist zentral ein sprachliches Projekt, das dazu dienen soll, eine angemessene Bedeutung und mittels dieser einen möglichen Bezug zu finden. Reinhard Matern sucht und entwickelt ein Kriterium, um zivilisierte von unzivilisierten Gesellschaften zu differenzieren und nutzt dabei die weltweit entstandenen Goldenen Regeln, die er im Plural anführt, weil sich die überlieferten Formulierungen konkret unterscheiden. Es sind jedoch nicht die Unterschiede, sondern es ist das Gemeinsame, das ihn auf dem Weg zu einem allgemeinen (...) Kriterium interessiert. -/- Primär im ersten Jahrtausend vor unserer Zeitrechnung werden Spruchweisheiten notiert, über deren Ursprünge nichts bekannt ist. Die Goldenen Regel erlauben gegenüber dem formalisierten Vergeltungsrecht eine grundsätzlich andere Herangehenweise an menschliches Verhalten, ist auf Gleichbehandlung ausgerichtet. Diese vergleichsweise moderne Haltung ermöglicht es, ein allgemeines Kriterium zu bilden. Empirisch ist Gleichbehandlung in heutigen Gesellschaften jedoch immer noch nicht vollzogen, eine Zivilisation deshalb noch nicht erlangt. -/- Zum Abschluss findet sich ein Ausblick, der eine Erweiterung der Perspektive aufgrund zukünftiger Entwicklungen anstrebt: die Integration von humanoiden Robotern. (shrink)

In this open peer commentary, we concur with the three target articles’ analysis and positions on abortion in the special issue on Roe v. Wade as the exercise of reproductive liberty essential for the bioethical commitment to patient autonomy and self-determination. Our proposed OPC augments that analysis by explicating more fully the concept crucial to Roe of fetal personhood. We explain that the development and use of predictive reproductive technologies over the fifty years since Roe has changed the literal (...) image, and thereby the epistemological landscape, through which a prospective parent comes to know the fetus. The logic of Roe required a legal and ethical denial of fetal personhood to prioritize maternal autonomy over claims to fetal moral personhood. Our claim is that such a denial may be more complicated today. The fetal person genetic testing and reproductive imaging now presents to prospective parents has become an increasingly individualized, distinct medicalized picture of a developing person with which a parent can either identify or differentiate. In contrast, the fetal person of Roe was an abstract and vague figure stripped of most human particulars, a pregnancy rather than the specific individualized human entity reproductive technology now presents as a person to prospective parents. We discuss the implications of this shift and call for a more capacious analysis of reproductive ethics that works towards both reproductive and disability justice. (shrink)

Beauvoir discusses various kinds of personal love in her work, including maternal love, lesbian love, friendship, and heterosexual love. In her portrayal of heterosexual love, she draws a distinction between two main types, inauthentic and authentic. Authentic love is “founded on mutual recognition of two liberties,” always freely chosen and sustained. It requires that the lovers maintain their individuality, while at the same time acknowledging each other’s differences. Inauthentic love is founded on inequality between the sexes, on submission and (...) domination. It prevents both women and men from experiencing freedom, comradeship and the joy of loving. This distinction is, I argue, applicable also to other types of love. Unlike Sartre, Beauvoir believes authentic love is possible. I contrast their respective views. Towards the end, I consider Beauvoir’s idea of authentic love in light of her concept of moral freedom, and argue that Beauvoir’s authentic love foreshadows feminist notion of “relational autonomy.”. (shrink)

A 2017 Nature report was widely touted as hailing the arrival of the artificial womb. But the scientists involved claim their technology is merely an improvement in neonatal care. This raises an under-considered question: what differentiates neonatal incubation from artificial womb technology? Considering the nature of gestation—or metaphysics of pregnancy—(a) identifies more profound differences between fetuses and neonates/babies than their location (in or outside the maternal body) alone: fetuses and neonates have different physiological and physical characteristics; (b) characterizes birth (...) as a physiological, mereological and topological transformation as well as a (morally relevant) change of location; and (c) delivers a clear distinction between neonatal incubation and ectogestation: the former supports neonatal physiology; the latter preserves fetal physiology. This allows a detailed conceptual classification of ectogenetive and ectogestative technologies according to which the 2017 system is not just improved neonatal incubation, but genuine ectogestation. But it is not an artificial womb, which is a term that is better put to rest. The analysis reveals that any ethical discussion involving ectogestation must always involve considerations of possible risks to the mother as well as her autonomy and rights. It also adds a third and potentially important dimension to debates in reproductive ethics: the physiological transition from fetus/gestateling to baby/neonate. (shrink)

Iris Marion Young’s classic paper on the phenomenology of pregnancy chronicles the alienating tendencies of technology-ridden maternal care, as the mother’s subjective knowledge of the pregnancy gets overridden by the objective knowledge provided by medical personnel and technological apparatuses. Following Fredrik Svenaeus, the authors argue that maternal care is not necessarily alienating by looking specifically at the proper attention paid by sonographers in maternal care when performing ultrasound examinations. Using Martin Heidegger’s philosophy as a theoretical lens, the (...) authors argue that sonographers who cultivate technical mastery, build patient rapport, explain the process and significance of the ultrasound, and understand the patient’s world are able to provide excellent patient care. The authors utilize Hans-Georg Gadamer’s hermeneutics to show how sonographers can frame the ultrasound in a way that acknowledges both the subjective knowledge of the mother and the objective data obtained by the sonographer through the use of technology. Ultimately, the authors argue that the common practice of framing the ultrasound as the chance to “meet the baby” is inappropriate, as it exacerbates the tendency to regard objective knowledge as the only legitimate knowledge in medical contexts. They recommend a more balanced approach that elicits a fusion of horizons between the patient’s subjective knowledge and the objective data that is obtained by the sonographer via the ultrasound, thus respecting and bolstering patient autonomy. (shrink)

The neo-liberal upsurge of the last twenty years and the neo-liberal case against the welfare state has gained much of its emotional force from a sub-text which is highly gendered. Whereas social liberalism had contained the promise of more autonomy within the private sphere and more caring values in the public sphere, neo-liberalism depicts the results of social liberalism as a loss of self reliance – through ‘over-protection’ by the state in the public sphere and usurpation of male roles (...) in the private sphere. The identification of the welfare state as female (the ‘nanny state’) helps fuel resentment on the part of those already confused by rapidly changing gender roles. This paper tracks the sex change which took place in the image of the liberal state as it evolved out of the night watchman state – the link between the women's suffrage movement and social regulation, maternal principles of distribution and demands for the public organization of caring. It examines the neo-liberal rejection of the breast and neo-liberal claims that the maternal state is incompatible with ‘self-reliance’ and a barrier to competitiveness in the world market. (shrink)

The recent spectacular progress in assisted reproductive technologies (ARTs) has resulted in new ethical dilemmas. Though women occupy a central role in the reproductive process, within the ART paradigm, the importance accorded to the embryo commonly surpasses that given to the mother. This commentary questions the increasing tendency to position the embryonic subject in an antagonistic relation with the mother. I examine how the mother’s reproductive autonomy is compromised in relation to that of her embryo and argue in favour (...) of doing away with the subject-object dyad between them, particularly in the contexts of surrogacy and abortion. I also engage with the Surrogacy (Regulation) Bill, 2016. A critical discussion of the privacy judgment passed by the Supreme Court of India helps examine how personal autonomy of the body and mind extends to include the reproductive autonomy of women as well. (shrink)

The philosophical significance of attitudinal autonomy—viz., the autonomy of attitudes such as beliefs—is widely discussed in the literature on moral responsibility and free will. Within this literature, a key debate centres around the following question: is the kind of attitudinal autonomy that’s relevant to moral responsibility at a given time determined entirely by a subject’s present mental structure at that time? Internalists say ‘yes’, externalists say ’no’. In this essay, I motivate a kind of distinctly epistemic attitudinal (...) autonomy, attitudinal autonomy that is relevant to knowledge. I argue that regardless of whether we are externalists or internalists about the kind of attitudinal autonomy that is relevant for moral responsibility, we should be externalists about the kind of autonomy that a belief must have to qualify as knowledge. (shrink)

This pаpеr invеstigаtеs thе intеrgеnеrаtiоnаl еffеcts оf mаtеrnаl еducаtiоn оn child hеаlth in 68 dеvеlоping cоuntriеs аcrоss fivе cоntinеnts оvеr nеаrly thrее dеcаdеs. Еxplоiting thе bеtwееn-sistеrs vаriаtiоn in thе еducаtiоnаl аttаinmеnt оf thе mоthеrs, wе find thаt mоthеr’s еducаtiоn is pоsitivеly аssоciаtеd with child hеаlth mеаsurеd by thе thrее mоst cоmmоnly usеd indicеs, nаmеly hеight-fоr-аgе, wеight-fоr-hеight, аnd wеight-fоr-аgе. Оur mеchаnism аnаlysеs furthеr shоw thаt thеsе fаvоrаblе еffеcts cоuld bе, аt lеаst in pаrt, аttributеd tо fеrtility bеhаviоr, аssоrtаtivе mаtching, hеаlth cаrе (...) utilizаtiоn, аccеss tо infоrmаtiоn, hеаlth knоwlеdgе, аnd lаbоr mаrkеt оutcоmе. Givеn thе lоng-lаsting impаcts оf еаrly-lifе hеаlth оvеr thе lifе cyclе, оur findings undеrlinе thе impоrtаncе оf mаtеrnаl еducаtiоn in imprоving еcоnоmic аnd sоciаl cоnditiоns in dеvеlоping cоuntriеs. (shrink)

Pauline Kleingeld and Marcus Willaschek, in a co-authored article, declare that their purportedly new interpretation of Immanuel Kant’s writings on autonomy reveals that his moral philosophy is neither realist nor constructivist. However, as I explain here, John Rawls already occupies the area of intellectual territory to which Kleingeld and Willaschek attempt to lay claim: Rawls interprets Kant’s moral philosophy as neither realist, as Kleingeld and Willaschek evidently construe this term, nor constructivist, as they evidently construe this term. Contra Kleingeld (...) and Willaschek, the moral constructivism attributed to Kant by Rawls is not voluntarist, and Rawls’s account of Kant’s concept of autonomy is not paradoxical. In order to understand autonomy, it is necessary to understand Kant’s complex conception of the will, which structures his moral philosophy (as Rawls, unlike Kleingeld and Willaschek, explains). Rawls, like Kant, but unlike Kleingeld and Willaschek, clearly distinguishes between certain importantly different questions about normativity and obligation. Kant’s moral philosophy, according to Rawls’s insightful interpretation, is a form of objective moral constructivism. (shrink)

There seems to be a deep tension between two aspects of aesthetic appreciation. On the one hand, we care about getting things right. On the other hand, we demand autonomy. We want appreciators to arrive at their aesthetic judgments through their own cognitive efforts, rather than deferring to experts. These two demands seem to be in tension; after all, if we want to get the right judgments, we should defer to the judgments of experts. The best explanation, I suggest, (...) is that aesthetic appreciation is something like a game. When we play a game, we try to win. But often, winning isn’t the point; playing is. Aesthetic appreciation involves the same flipped motivational structure: we aim at the goal of correctness, but having correct judgments isn’t the point. The point is the engaged process of interpreting, investigating, and exploring the aesthetic object. Deferring to aesthetic testimony, then, makes the same mistake as looking up the answer to a puzzle, rather than solving it for oneself. The shortcut defeats the whole point. This suggests a new account of aesthetic value: the engagement account. The primary value of the activity of aesthetic appreciation lies in the process of trying to generate correct judgments, and not in having correct judgments. -/- *There is an audio version available: look for the Soundcloud link, below.*. (shrink)

From the outset, critical social theory has sought to diagnose people’s participation in their own oppression, by revealing the roots of irrational and self-undermining choices in the complex interplay between human nature, social structures, and cultural beliefs. As part of this project, Ideologiekritik has aimed to expose faulty conceptions of this interplay, so that the objectively pathological character of what people are “freely” choosing could come more clearly into view. The challenge, however, has always been to find a way of (...) doing this without arrogantly assuming special access to what is good for people. And this danger of paternalism is one to which social theorists have all too often fallen prey. In this brief essay, I focus on contemporary instances of clearly self-defeating behavior in contexts of complex choices. I begin by discussing a recent attempt to diagnose and solve these failures of choices, namely the public policy recommendations of behavioral economist Richard Thaler and reform-minded legal theorist Cass Sunstein. Their influential “libertarian paternalist” approach is particularly interesting, both in what it includes (attention to the socially constructed nature of choice situations and the roots of the problems in human nature) and in what it leaves out (an understanding of the social construction of human nature and an adequate appreciation of the value of autonomy). After discussing it, I consider a broadly perfectionist alternative, to the effect that the problem lies in a failure to adequately appreciate the importance of developing autonomy. I then turn to sketching the outlines of a new approach, based on the concept of “autonomy gaps,” which approaches overly demanding policies in relational and action-theoretical terms. In the final section, I show how this provides the basis for an analysis both in terms of a critique of ideology and of social pathology. (shrink)

This article assesses how autonomy and machine learning impact the existential risk of nuclear war. It situates the problem of cyber security, which proceeds by stealth, within the larger context of nuclear deterrence, which is effective when it functions with transparency and credibility. Cyber vulnerabilities poses new weaknesses to the strategic stability provided by nuclear deterrence. This article offers best practices for the use of computer and information technologies integrated into nuclear weapons systems. Focusing on nuclear command and control, (...) avoiding autonomy and machine learning is recommended as one means to reduce the existential risk of unintended nuclear conflict. (shrink)

This paper sheds light on Kant’s notion of autonomy in his moral philosophy by considering Kant’s critique of the rationalist theories of morality that Kant discussed in his lectures on practical philosophy from the 1760s to the time of the Groundwork. The paper first explains Kant’s taxonomy of moral theories and his perspective on the history of ethics. Second, it considers Kant's arguments against the two main variants of ‘rationalism’ as he construes it, that is, perfectionism and theological voluntarism, (...) pointing out the similarities to previous criticisms. Third, the paper argues that Kant’s discussion of the 'rationalist' views does not amount to an unqualified dismissal, but to an attempt at working out a novel rationalist position. Kant’s criticisms of rationalist views suggest that his project emerges from the failures of previous rationalism, with the aim to work out a rationalist view that can account for moral obligation by integrating insights from the theological conception. The combination of perfectionism and theological views yields the basic outline of the idea of autonomy, consisting in the lawgiving function of a rational will as a key to the legislation of a necessary law. (shrink)

According to Marshall et al. (2024), some of the patients who refuse to stay in observation after being resuscitated following an opioid overdose are likely not making an autonomous choice. While I do not intend to dispute this claim, it merits discussion what is the concept of autonomy at play in making this assessment. I contend that the concept at work is more substantive than Marshall et al. acknowledge—and more substantive, too, than the form of autonomy usually thought (...) to underpin the moral justification of the requirement of informed consent . (shrink)

Sometimes neuroscientists discover distinct realizations for a single psychological property. In considering such cases, some philosophers have maintained that scientists will abandon the single multiply realized psychological property in favor of one or more uniquely realized psychological properties. In this paper, we build on the Dimensioned theory of realization and a companion theory of multiple realization to argue that this is not the case. Whether scientists postulate unique realizations or multiple realizations is not determined by the neuroscience alone, but by (...) the psychological theory under examination. Thus, one might say that, in the splitting or non-splitting of properties, psychology enjoys a kind of autonomy from neuroscience. (shrink)

Current AI policy recommendations differ on what the risks to human autonomy are. To systematically address risks to autonomy, we need to confront the complexity of the concept itself and adapt governance solutions accordingly.

Since 2016, when the Facebook/Cambridge Analytica scandal began to emerge, public concern has grown around the threat of “online manipulation”. While these worries are familiar to privacy researchers, this paper aims to make them more salient to policymakers — first, by defining “online manipulation”, thus enabling identification of manipulative practices; and second, by drawing attention to the specific harms online manipulation threatens. We argue that online manipulation is the use of information technology to covertly influence another person’s decision-making, by targeting (...) and exploiting their decision-making vulnerabilities. Engaging in such practices can harm individuals by diminishing their economic interests, but its deeper, more insidious harm is its challenge to individual autonomy. We explore this autonomy harm, emphasising its implications for both individuals and society, and we briefly outline some strategies for combating online manipulation and strengthening autonomy in an increasingly digital world. (shrink)

Social robots are robots that can interact socially with humans. As social robots and the artificial intelligence that powers them becomes more advanced, they will likely take on more social and work roles. This has many important ethical implications. In this paper, we focus on one of the most central of these, the impacts that social robots can have on human autonomy. We argue that, due to their physical presence and social capacities, there is a strong potential for social (...) robots to enhance human autonomy as well as several ways they can inhibit and disrespect it. We argue that social robots could improve human autonomy by helping us to achieve more valuable ends, make more authentic choices, and improve our autonomy competencies. We also argue that social robots have the potential to harm human autonomy by instead leading us to achieve fewer valuable ends ourselves, make less authentic choices, decrease our autonomy competencies, make our autonomy more vulnerable, and disrespect our autonomy. Whether the impacts of social robots on human autonomy are positive or negative overall will depend on the design, regulation, and use we make of social robots in the future. (shrink)

In order to achieve the World Health Organization’s Millennium Development Goal of reducing maternal mortality by three quarters by 2015, a strong global commitment is needed to address this issue in low-income nations where the risk to women is greatest. A comprehensive international effort must include provision of obstetric and general medical care as well as community-based interventions, with an emphasis on the latter in nations where the majority of women deliver babies at home without a trained attendant. Methods: (...) This systematic analysis evaluates interventions published in Medline and CINAHL whose outcome measure is maternal mortality. Analysis includes components of the intervention, nation and maternal death rates. Results: Nine studies documented the effectiveness of various clinical and community-based interventions, including specific drug regimens and procedures, in reducing the risk of maternal death. Six studies reported interventions that did not significantly alter maternal mortality outcomes, and the intervention in one study demonstrated increased risk of maternal death. Conclusion: The dearth of evidence highlights the need for increased focus on translational research that bridges the gap between medical advances and community-based interventions that are feasible in low-income nations. This cannot be accomplished without a stronger commitment to reducing maternal mortality by global health practitioners and researchers. (shrink)

A pronatalist perspective on maternal bodies renders the adoptive maternal body queer. In this essay, I argue that the queerness of the adoptive maternal body makes it a useful epistemic standpoint from which to critique dominant views of mothering. In particular, exploring motherhood through the lens of adoption reveals the discursive mediation and social regulation of all maternal bodies, as well as the normalizing assumptions of heteronormativity, “reprosexuality,” and family homogeneity that frame a traditional view of (...) the biological family. As participants in motherhood who resist “repro-narrativity,”“reprosexuality,” and essentialism, adoptive maternal bodies have the potential to both queer our notions of normal mothering and normalize our notions of queer mothering. (shrink)

In the debates regarding the ethics of human enhancement, proponents have found it difficult to refute the concern, voiced by certain bioconservatives, that cognitive enhancement violates the autonomy of the enhanced. However, G. Owen Schaefer, Guy Kahane and Julian Savulescu have attempted not only to avoid autonomy-based bioconservative objections, but to argue that cognition-enhancing biomedical interventions can actually enhance autonomy. In response, this paper has two aims: firstly, to explore the limits of their argument; secondly, and more (...) importantly, to develop a more complete understanding of autonomy and its relation to cognitive enhancement. By drawing a distinction between the capacity for autonomy and the exercise and achievement of autonomy and by exploring the possible effects of cognitive enhancement on both competence and authenticity conditions for autonomy, the paper identifies and explains which dimensions of autonomy can and cannot, in principle, be enhanced via direct cognitive interventions. This allows us to draw conclusions regarding the limits of cognitive enhancement as a means for enhancing autonomy. (shrink)

Autonomy has been central to moral and political philosophy for millenia, and has been positioned as a critical aspect of both justice and wellbeing. Research in psychology supports this position, providing empirical evidence that autonomy is critical to motivation, personal growth and psychological wellness. Responsible AI will require an understanding of, and ability to effectively design for, human autonomy (rather than just machine autonomy) if it is to genuinely benefit humanity. Yet the effects on human (...) class='Hi'>autonomy of digital experiences are neither straightforward nor consistent, and are complicated by commercial interests and tensions around compulsive overuse. This multi-layered reality requires an analysis that is itself multidimensional and that takes into account human experience at various levels of resolution. We borrow from HCI and psychological research to apply a model (“METUX”) that identifies six distinct spheres of technology experience. We demonstrate the value of the model for understanding human autonomy in a technology ethics context at multiple levels by applying it to the real-world case study of an AI-enhanced video recommender system. In the process we argue for the following three claims: 1) There are autonomy-related consequences to algorithms representing the interests of third parties, and they are not impartial and rational extensions of the self, as is often perceived; 2) Designing for autonomy is an ethical imperative critical to the future design of responsible AI; and 3) Autonomy-support must be analysed from at least six spheres of experience in order to approriately capture contradictory and downstream effects. (shrink)

Clinical evidence has shown that physical exercise during pregnancy may alter brain devel- opment and improve cognitive function of offspring. However, the mechanisms through which maternal exercise might promote such effects are not well understood. The present study examined levels of brain-derived neurotrophic factor (BDNF) and absolute cell num- bers in the hippocampal formation and cerebral cortex of rat pups born from mothers exer- cised during pregnancy. Additionally, we evaluated the cognitive abilities of adult offspring in different behavioral paradigms (...) (exploratory activity and habituation in open field tests, spatial memory in a water maze test, and aversive memory in a step-down inhibitory avoid- ance task). Results showed that maternal exercise during pregnancy increased BDNF lev- els and absolute numbers of neuronal and non-neuronal cells in the hippocampal formation of offspring. No differences in BDNF levels or cell numbers were detected in the cerebral cortex. It was also observed that offspring from exercised mothers exhibited better cognitive performance in nonassociative (habituation) and associative (spatial learning) mnemonic tasks than did offspring from sedentary mothers. Our findings indicate that maternal exer- cise during pregnancy enhances offspring cognitive function (habituation behavior and spa- tial learning) and increases BDNF levels and cell numbers in the hippocampal formation of offspring. (shrink)

Accounts of aesthetic valuing emphasize two constraints on the formation of aesthetic belief. We must form our own aesthetic beliefs by engaging with aesthetic value first-hand (the acquaintance principle) and by using our own capacities (the autonomy principle). But why? C. Thi Nguyen’s proposal is that aesthetic valuing has an inverted structure. We often care about inquiry and engagement for the sake of having true beliefs, but in aesthetic engagement this is flipped: we care about arriving at good aesthetic (...) beliefs for the sake of the values that arise in the process of doing so. The engagement is the point, so we must use our own capacities in first-hand encounters. Here I challenge Nguyen’s account. I argue that it misconstrues the value of aesthetic belief; it conflicts with restrictions on aesthetic testimony; and it has trouble harnessing engagement-value for a theory of aesthetic value. A better approach emphasizes the social character of aesthetic valuing. On this view, aesthetic valuing is a social practice structured around the collaborative exercise and improvement of certain special capacities. The autonomy and acquaintance principles tell us to engage these capacities in forming our aesthetic beliefs. Understood aright, and contrary to consensus, these rules are identical. (shrink)

Some have objected to human enhancement on the grounds that it violates the autonomy of the enhanced. These objections, however, overlook the interesting possibility that autonomy itself could be enhanced. How, exactly, to enhance autonomy is a difficult problem due to the numerous and diverse accounts of autonomy in the literature. Existing accounts of autonomy enhancement rely on narrow and controversial conceptions of autonomy. However, we identify one feature of autonomy common to many (...) mainstream accounts: reasoning ability. Autonomy can then be enhanced by improving people’s reasoning ability, in particular through cognitive enhancement; given how valuable autonomy is usually taken to be, this gives us extra reason to pursue such cognitive enhancements. Moreover, autonomy-based objections will be especially weak against such enhancements. As we will argue, those who are worried that enhancements will inhibit people’s autonomy should actually embrace those enhancements that will improve autonomy. (shrink)

Suppose that we think it important that people have the chance to enjoy autonomous lives. An obvious corollary of this thought is that people should, if they want it, have control over the time and manner of their deaths, either ending their own lives, or by securing the help of others in doing so. So, generally, and even if we overall think that the practice should not be legalized on other grounds, it looks like common sense to think that considerations (...) of autonomy tell at least somewhat in favour of legalizing at least some acts of suicide and voluntary euthanasia. In this paper, I argue that, in fact, when we scrutinize the reasons for most end of life decisions, it turns out that they are seriously problematic from the point of view of autonomy. Full autonomy requires that we are responsible for the consequences of our decisions, and responsibility is precluded by non-voluntariness, which is to say decisions made because there are no acceptable alternatives. Since most end of life decisions are made for precisely this reason, it looks as though most such decisions are non-voluntary, and therefore undermine our autonomy: a discomforting and paradoxical claim. I argue that we should respond by taking the paradox to illuminate the context required by an autonomy-respecting framework for legalizing assisted suicide and euthanasia. People should have a legal right to a reasonable choice about when and how to die. However, this must go hand in hand with institutions that ensure, as far as possible, that such choices are made against a background which ensures, as far as possible, that people choose death clear-sightedly and not because nothing else is acceptable. (shrink)

Shared decision-making involves health professionals and patients/clients working together to achieve true person-centred health care. However, this goal is infrequently realized, and most barriers are unknown. Discussion between philosophers, clinicians, and researchers can assist in confronting the epistemic and moral basis of health care, with benefits to all. The aim of this paper is to describe what shared decision-making is, discuss its necessary conditions, and develop a definition that can be used in practice to support excellence in maternity care. Discussion (...) between the authors, with backgrounds in philosophy, clinical maternity care, health care management, and maternity care research, assisted the team to confront established norms in maternity care and challenge the epistemic and moral basis of decision-making for caesarean section. The team concluded that shared decision-making must start in pregnancy and continue throughout labour and birth, with equality in discourse facilitated by the clinician. Clinicians have a duty of care for the adequacy of women's knowledge, which can only be fulfilled when relevant knowledge is offered freely and when personal beliefs and biases that may impinge on decision-making (defeaters) are disclosed. Informed consent is not shared decision-making. Key barriers include existing cultural norms of “the doctor knows best” and “patient acquiescence” that prevent defeaters being acknowledged and discussed and can lead to legal challenges, overuse of medical intervention and, in some areas, obstetric violence. Shared decision-making in maternity care can thus be defined as an enquiry by clinician and expectant woman aimed at deciding upon a course of care or none, which takes the form of a dialogue within which the clinician fulfils their duty of care to the client's knowledge by making available their complete knowledge (based on all types of evidence) and expertise, including an exposition of any relevant and recognized potential defeaters. Research to develop measurement tools is required. (shrink)

In recent years there has been an explosion of interest in Artificial Intelligence (AI) both in health care and academic philosophy. This has been due mainly to the rise of effective machine learning and deep learning algorithms, together with increases in data collection and processing power, which have made rapid progress in many areas. However, use of this technology has brought with it philosophical issues and practical problems, in particular, epistemic and ethical. In this paper the authors, with backgrounds in (...) philosophy, maternity care practice and clinical research, draw upon and extend a recent framework for shared decision-making (SDM) that identified a duty of care to the client's knowledge as a necessary condition for SDM. This duty entails the responsibility to acknowledge and overcome epistemic defeaters. This framework is applied to the use of AI in maternity care, in particular, the use of machine learning and deep learning technology to attempt to enhance electronic fetal monitoring (EFM). In doing so, various sub-kinds of epistemic defeater, namely, transparent, opaque, underdetermined, and inherited defeaters are taxonomized and discussed. The authors argue that, although effective current or future AI-enhanced EFM may impose an epistemic obligation on the part of clinicians to rely on such systems' predictions or diagnoses as input to SDM, such obligations may be overridden by inherited defeaters, caused by a form of algorithmic bias. The existence of inherited defeaters implies that the duty of care to the client's knowledge extends to any situation in which a clinician (or anyone else) is involved in producing training data for a system that will be used in SDM. Any future AI must be capable of assessing women individually, taking into account a wide range of factors including women's preferences, to provide a holistic range of evidence for clinical decision-making. (shrink)

More and more researchers argue that online technologies manipulate human users and, therefore, undermine their autonomy. We call this the MAL view on online technology because it argues from Manipulation to Autonomy-Loss. MAL enjoys public visibility and will shape the academic discussion to come. This view of online technology, however, fails conceptually. MAL presupposes that manipulation equals autonomy loss, and that autonomy is the absence of manipulation. That is mistaken. In short, an individual can be manipulated (...) while being fully personally autonomous. Internet policy researchers should be aware of this point to avoid looking in the wrong place in future research on manipulative and harmful online technology. (shrink)

'Autonomy' is originally a political notion. In this chapter, I argue that the political theory Kant defended while he was writing the _Groundwork_ sheds light on the difficulties that are commonly associated with his account of moral autonomy. I argue that Kant's account of the two-tiered structure of political legislation, in his _Feyerabend Lectures on Natural Law_, parallels his distinction between two levels of moral legislation, and that this helps to explain why Kant could regard the notion of (...) 'autonomy' as apt to express the principle of morality---at least in the mid 1780s. (shrink)

Phenomenology gives rise to certain ontological considerations that have far-reaching implications for standard conceptions of patient autonomy in medical ethics, and, as a result, the obligations of and to patients in clinical decision-making contexts. One such consideration is the phenomenological reduction in classical phenomenology, a core feature of which is the characterisation of our primary experiences as immediately and inherently meaningful. This paper builds on and extends the analyses of the phenomenological reduction in the works of Husserl, Heidegger, and (...) Merleau-Ponty in order to identify and explain its implications for our current understanding of the principle of respect for patient autonomy and the norms of clinical decision making. (shrink)

In this chapter, I articulate the structure of a general concept of autonomy and then reply to possible objections with reference to Ulysses arrangements in psychiatry. The line of argument is as follows. Firstly, I examine three alternative conceptions of autonomy: value-neutral, value-laden, and relational. Secondly, I identify two paradigm cases of autonomy and offer a sketch of its concept as opposed to the closely related freedom of action and intentional agency. Finally, I explain away the (...) class='Hi'>autonomy paradox, to which the previously identified pair of paradigm cases seems to give rise in the context of mental disorder. By addressing this paradox, we learn two valuable lessons. The first is about the relationships between the three conceptions of autonomy above. The second is about the relationship between autonomy and mental disorder. (shrink)

Our values change. What we value, want, desire, prefer, and how much; for nearly everyone, these will be different at different times in their life. These changes can be gradual or abrupt; they can be long-lasting or short-lived; and they can be induced by forces outside yourself or they can come from within or they can have no specific catalyst at all. Such preference change raises a number of questions for our theorising about rational choice, and these have been discussed (...) at length. In §2 and §3, I’ll outline two of these questions along with some of the putative solutions that have been proposed. But preference change also raises questions for our theorising about autonomy, and these have hardly been considered at all. In §4, I’ll outline three problems for personal autonomy; and in §5, I’ll outline one problem for political autonomy. In §6, I conclude. (shrink)

: A pronatalist perspective on maternal bodies renders the adoptive maternal body queer. In this essay, I argue that the queerness of the adoptive maternal body makes it a useful epistemic standpoint from which to critique dominant views of mothering. In particular, exploring motherhood through the lens of adoption reveals the discursive mediation and social regulation of all maternal bodies, as well as the normalizing assumptions of heteronormativity, "reprosexuality," and family homogeneity that frame a traditional view (...) of the biological family. As participants in motherhood who resist "repro-narrativity," " reprosexuality," and essentialism, adoptive maternal bodies have the potential to both queer our notions of normal mothering and normalize our notions of queer mothering. (shrink)

In contemporary bioethics, the autonomy of the patient has assumed considerable importance. Progressing from a more limited notion of informed consent, shared decision making calls upon patients to voice the desires and preferences of their authentic self, engaging in choice among alternatives as a way to exercise deeply held values. One influential opinion in Jewish bioethics holds that Jewish law, in contradistinction to secular bioethics, limits the patient's exercise of autonomy only in those instances in which treatment choices (...) are sensitive to preferences. Here, we analyze a discussion in the Mishna, a foundational text of rabbinic Judaism, regarding patient autonomy in the setting of religiously mandated fasting, and commentaries in the Babylonian and Palestinian Talmuds, finding both a more expansive notion of such autonomy and a potential metaphysical grounding for it in the importance of patient self-knowledge. (shrink)

Recently, more attention has been paid to the nature and value of the intellectual virtue of epistemic autonomy. One underexplored issue concerns how epistemic autonomy is related to other intellectual virtues. Plausibly, epistemic autonomy is closely related to a number of intellectual virtues like curiosity, inquisitiveness, intellectual perseverance, and intellectual courage to name just a few. Here, however, I will examine the relation between epistemic autonomy and intellectual humility. I will argue that epistemic autonomy and (...) intellectual humility bear an interesting relationship to one another in that they are interconnected and mutually supporting intellectual virtues. In sections 2 and 3 I will provide a brief overview of the predominant accounts of intellectual humility (section 2) and epistemic autonomy (section 3) in the literature. With an understanding of these intellectual virtues in hand, we will examine their relationship of mutual support in section 4. Section 5 will explore a challenge to this relationship coming from the epistemology of disagreement, and section 6 concludes. (shrink)

In this Introduction, I situate the underlying project “Autonomy and Mental Disorder” with reference to current debates on autonomy in moral and political philosophy, and the philosophy of action. I then offer an overview of the individual contributions. More specifically, I begin by identifying three points of convergence in the debates at issue, stating that autonomy is: 1) a fundamentally liberal concept; 2) an agency concept and; 3) incompatible with (severe) mental disorder. Next, I explore, in the (...) context of decisional capacity assessments, the difficulties to reconcile 1) and 2) with 3) which they at the same time seem to imply. Having clarified the centrality of a cogent notion of mental disorder for addressing these difficulties, I comment on three promising lines of inquiry about the nature and scope of autonomy that emerge from the following chapters. (shrink)

Jurgen Habermas has argued that carrying out pre-natal germline enhancements would be inimical to the future child's autonomy. In this article, I suggest that many of the objections that have been made against Habermas' arguments by liberals in the enhancement debate misconstrue his claims. To explain why, I begin by explaining how Habermas' view of personal autonomy confers particular importance to the agent's embodiment and social environment. In view of this, I explain that it is possible to draw (...) two arguments against germline enhancements from Habermas' thought. I call these arguments ‘the argument from negative freedom’ and ‘the argument from natality’. Although I argue that many of the common liberal objections to Habermas are not applicable when his arguments are properly understood, I go on to suggest ways in which supporters of enhancement might appropriately respond to Habermas' arguments. (shrink)

Kantian ethics is based on a metaphysical conception of autonomy that may seem difficult to reconcile with the empirically-based science of psychology. I argue that, although not formally developed, a Self-Determination Theory (SDT) perspective of ethics can broaden the field of Kantian-based moral psychology and specify what it means, motivationally, to have autonomy in the application of a moral norm. More specifically, I argue that this is possible when a moral norm is fully endorsed by the self through (...) a process of internalization that is energized by intrinsic motivation and is facilitated by the fulfillment of the basic needs for autonomy, competence and relatedness. The conditions of the fulfillment of these needs may even implicitly reveal which norms will be integrated and treated as moral norms. I conclude that SDT offers a motivational approach that is useful in understanding the development of moral norms. (shrink)

A widely held picture in political science emphasizes the cognitive shortcomings of us citizens. We’re ignorant. We don’t know much about politics. We’re irrational. We bend the evidence to show our side in the best possible light. And we’re malleable. We let political elites determine our political opinions. This paper is about why these shortcomings matter to democratic values. Some think that democracy’s value consists entirely in its connection to equality. But the import of these shortcomings, I argue, cannot be (...) explained in purely egalitarian terms. To explain it, we must instead think of democracy’s value partly in terms of collective autonomy. Our ignorance and irrationality undermine the epistemic conditions for realizing this kind of autonomy. They stop us knowing the outcomes of our political choices. Our irrationality and malleability undermine the independence conditions for realizing such autonomy. They mean our political choices are subject to problematic kinds of interpersonal influence. Thus, at root, the import of the widely held picture is that, if accurate, it closes off this critical aspect of democracy’s value. (shrink)

Adaptive preference formation is the unconscious altering of our preferences in light of the options we have available. Jon Elster has argued that this is bad because it undermines our autonomy. I agree, but think that Elster's explanation of why is lacking. So, I draw on a richer account of autonomy to give the following answer. Preferences formed through adaptation are characterized by covert influence (that is, explanations of which an agent herself is necessarily unaware), and covert influence (...) undermines our autonomy because it undermines the extent to which an agent's preferences are ones that she has decided upon for herself. This answer fills the lacuna in Elster's argument. It also allows us to draw a principled distinction between adaptive preference formation and the closely related phenomenon of character planning. (shrink)

In this paper, I offer a theory of autonomous agency that relies on the re-sources of a strongly cognitivist theory of intention and intentional action. On the proposed account, intentional action is a graded notion that is ex-plained via the agent’s degree of practical knowledge. In turn, autonomous agency is also a graded notion that is explained via the agent’s degree of practical understanding. The resulting theory can synthesize insights from both the hierarchical and the cognitivist theories of autonomy (...) with at least some aspects of the reason-responsiveness theories. Moreover, by treating practical knowledge and practical understanding as gradable no-tions, the paper offers a strategy to respond to enduring objections against cognitivism about intention, control, and autonomy. (shrink)

In this paper we will demonstrate that a computational system can meet the criteria for autonomy laid down by classical enactivism. The two criteria that we will focus on are operational closure and structural determinism, and we will show that both can be applied to a basic example of a physically instantiated Turing machine. We will also address the question of precariousness, and briefly suggest that a precarious Turing machine could be designed. Our aim in this paper is to (...) challenge the assumption that computational systems are necessarily heteronomous systems, to try and motivate in enactivism a more nuanced and less rigid conception of computational systems, and to demonstrate to computational theorists that they might find some interesting material within the enactivist tradition, despite its historical hostility towards computationalism. (shrink)

The phenomenology of a priori intuition is explored at length (where a priori intuition is taken to be not a form of belief but rather a form of seeming, specifically intellectual as opposed to sensory seeming). Various reductive accounts of intuition are criticized, and Humean empiricism (which, unlike radical empiricism, does admit analyticity intuitions as evidence) is shown to be epistemically self-defeating. This paper also recapitulates the defense of the thesis of the Autonomy and Authority of Philosophy given in (...) the author’s “A Priori Knowledge and the Scope of Philosophy” (Philosophical Studies, 1996). (shrink)

Disclosure in clinical practice is aimed at promoting patient autonomy, usually culminating in patient choice (e.g., to consent to an operation or not, or between different medications). In medical ethics, there is an implicit background assumption that knowing more about (X) automatically translates to greater, or more genuine, autonomy with respect to one's choices involving (X). I challenge this assumption by arguing that in rare cases, withholding information can promote a patient's autonomy (understood as the capacity for (...) rational choice in alignment with one's values and goals). (shrink)

In this paper, I argue that the principle of respect for autonomy can serve as the basis for laws that significantly limit conduct, including orders mandating isolation and quarantine. This thesis is fundamentally at odds with an overwhelming consensus in contemporary bioethics that the principle of respect for autonomy, while important in everyday clinical encounters, must be 'curtailed', 'constrained', or 'overridden' by other principles in times of crisis. I contend that bioethicists have embraced an indefensibly 'thin' notion of (...) autonomy that uproots the concept from its foundations in Kantian ethics. According to this thin conception, respect for autonomy, if unconditioned by competing principles (beneficence, justice, non-maleficence) would give competent adults the right to do anything they desired to do so long as they satisfied certain baseline psychological conditions. I argue that the dominant 'principlist' model of bioethical reasoning depends on this thin view of autonomy and show how it deprives us of powerful analytical tools that would help us to think seriously about the foundations of human rights, justice, and law. Then, I offer a brief sketch of a 'thick', historically grounded notion of autonomy and show what we could gain by taking it seriously. (shrink)