University of Utrecht, Department of Philosophy, Heidelberglaan 6, 3584 CS Utrecht, The Netherlands. Tel.: +31 30 253 28 74, Email: Thomas.Nys{at}phil.uu.nl ' + u + '@' + d + ' '//-->Measures in public health care seem vulnerable to charges of paternalism: their aim is to protect, restore, or promote people's health, but the public character of these measures seems to leave insufficient room for respect for individual autonomy. This paper wants to explore three challenges to these charges: Measures in PHC (...) are aimed to protect, restore or promote ‘deep autonomy’, Measures in PHC are directed at the public and, as such, they do show respect for autonomy, and Some measures in PHC can be justified on grounds of justice and need not be defended as cases of ‘justified paternalism’. Although charges of unjustified paternalism in PHC might still be relevant, we should at least face these different challenges. CiteULike Connotea Del.icio.us What's this? (shrink)

The aim of this article is to compare the theories of Isaiah Berlin and Charles Taylor with regard to the topic of freedom. I will argue that Berlin’s famous positive-negative distinction still serves an important purpose by maintaining a crucial tension within the concept of liberty. This tension allows ethical pluralism to be taken seriously instead of being covered up by ideological retorics. Berlin held that the implementation of positive liberty – defining the boundaries of true liberty – is always (...) problematic. Taylor, however, tries to by-pass the gap between negative and positive liberty by means of his concept of authenticity. I will argue that this notion is a sound descriptive term for an individual’s entrenchment in community, but that the normative appeal from authenticity amounts to a project of ‘re-sourcing the self’ which is ultimately rooted in an optimist perspective on pluralism and multiculturalism. However, to the extent that there are indeed different communities with different values and different ways of being authentic, it is worthwhile to repeat the Berlinian Grundgedanke that human beings should cope with the inexorable and irreducible tragedy in moral life. (shrink)

We argue that contemporary psychiatry adopts a defensive strategy vis-à-vis various external sources of pressure. We will identify two of these sources – the plea for individual autonomy and the idea of Managed Care – and explain how they have promoted a strict biomedical conception of disease. The demand for objectivity, however, does not take into account the complexity of mental illness. It ignores that the psychiatrist’s profession is essentially characterized by fragility: fluctuating between scientific reduction and the irreducible complexity (...) of reality. Therefore, the psychiatrist is not in need of hard and fast rules, but of judgment. At the end, we suggest that philosophy could inject some healthy uncertainty within psychiatry in order to restore its fragile identity. Our examples are drawn from the Dutch situation but we are confident that they apply to other countries as well. (shrink)