This collection of original essays explores the social and relational dimensions of individual autonomy. Rejecting the feminist charge that autonomy is inherently masculinist, the contributors draw on feminist critiques of autonomy to challenge and enrich contemporary philosophical debates about agency, identity, and moral responsibility. The essays analyze the complex ways in which oppression can impair an agent's capacity for autonomy, and investigate connections, neglected by standard accounts, between autonomy and other aspects of the (...) agent, including self-conception, self-worth, memory, and the imagination. (shrink)

Proponents of the ethic of care regard it as a personal ethic created by women which reveals the deficiencies of the male-defined ethic of justice. In contrast, feminist critics of the ethic of care hold that the ethic of care is parochial and renounces justice and therefore inconsistent with feminist goals. In my dissertation I resolve this debate by examining the concepts of care, justice, autonomy, and public and private spheres. ;Care and autonomy are often thought (...) to be mutually exclusive because care is based on a social conception of the self, while autonomy is based on an individualistic conception of the self. I challenge this dichotomy by showing that autonomy presupposes that we are socially constituted, and that care requires that we be able to individuate ourselves from others. I also examine the symbolic and institutional structures that construct care and autonomy in opposition to each other in our society. ;Moral theorists usually understand care and justice as having different domains, with their boundaries drawn along public-private lines. I challenge the traditional boundaries of care, showing that the expansion of care need not come at the expense of justice, but instead can serve to enrich our conception of justice. I also explore some of the moral issues that arise in attempts to apply the ethic of care to public questions of pacifism and welfare policy. ;The conflicts between the ethic of care and the ethic of justice need not lead us to accept one at the expense of the other, but can help us distinguish between better and worse versions of each ethic, providing the groundwork for a feminist ethic of care. However, despite the theoretical compatibility of the two ethics, I argue that given their present social contexts, integrating them into a comprehensive ethic brings the danger that the ethic of care will be subsumed by the ethic of justice. (shrink)

Because of his misogyny and disdain for the body, Kant has been a target of much feminist criticism. Moreover, as the epitome of eighteenth-century Enlightenment philosophy, his thought has been a focal point for feminist debate over the Enlightenment legacy—whether its conceptions of reason and progress offer tools for women's emancipation and empowerment or, rather, have contributed to the historical subordination of women in Western society. This volume presents radically divergent interpretations of Kant from feminist perspectives. (...) Some essays see Kant as having contributed significantly to theories of rationality and autonomy in ways that can further feminist projects. Other essays argue that Kant is a preeminent exponent of patriarchal views and that gender hierarchies are inscribed in the very structure of his theories of morality and aesthetic judgment. But both critics and sympathizers challenge the accepted topography of Kantian philosophy by which central philosophical concerns are defined as those that are abstract, universal, and transcendental. Instead, these feminist writers resituate Kantian questions in the politics of everyday life and emphasize the embodied nature of knowledge, morality, and aesthetics. They analyze dilemmas that face concrete subjects, involving issues of friendship, collective responsibility, xenophobia, and colonialism, among others. Contributors are Annette C. Baier, Marcia Baron, Monique David-Ménard, Kim Hall, Cornelia Klinger, Jane Kneller, Sarah Kofman, Marcia Moen, Herta Nagl-Docekal, Adrian M. S. Piper, Jean P. Rumsey, Robin May Schott, Hannelore Schröder, Sally Sedgwick, and Holly L. Wilson. (shrink)

The nature and role of the patient in biomedicine comprise issues central to bioethical inquiry. Given its developmental history grounded firmly in a backlash against 20th-century cases of egregious human subjects abuse, contemporary medical bioethics has come to rely on a fundamental assumption: the unit of care is the autonomous self-directing patient. In this article we examine first the structure of the feminist social critique of autonomy. Then we show that a parallel argument can be made against relational (...) autonomy as well, demonstrating how this second concept of autonomy fails to take sufficiently into account an array of biological determinants, particularly those from microbial biology. Finally, in light of this biological critique, we question whether or to what extent any relevant and meaningful view of autonomy can be recovered in the contemporary landscape of bioethics. (shrink)

In recent decades, the intertwining ideas of self-determination and well-being have received tremendous support in bioethics. Discussions regarding self-determination, or autonomy, often focus on two dimensions—the capacity of the patient and the freedom from external coercion. The practice of obtaining informed consent, for example, has become a standard procedure in therapeutic and research medicine. On the surface, it appears that patients now have more opportunities to exercise their self-determination than ever. Nonetheless, discussions of patient autonomy in the bioethics (...) literature, which focus on individual patients making particular decisions, neglect the social structure within which health-care decisions are made. Looking through the lens of disability and informed by the feminist conception of relational autonomy, this essay argues that the issue of autonomy is much more complex than the individualist model suggests. The social system and the ableist ideology impose various forms of pressure or oppressive power that can affect people’s ability to choose according to their value system. Even if such powers are not directly coercive, they influence potential parents’ decisions indirectly—they structure their alternatives in such a way that certain options are never considered as viable and other decisions must be made. This paper argues that, instead of only focusing on the individual act of decision-making, we need to pay attention to the social structure that frames people’s decision. (shrink)

This paper attempts to construct a concept of moral autonomy thai is compatible with a relationally-based or care-based ethical theory. After critiquing the traditional liberal identification of the ethical self with an abstract rational self detached from community and historical narrative, I argue that the ethical self emerges in a dialectical relation with the community itself. Essentially, I argue for a concept of autonomy that will be analyzed as a critical perspective from within a community rather than as (...) a privileged view from outside. Central to this argument is an understanding of the nature and role of moral conversation in the regeneration of community. The nature of that conversation is examined. (shrink)

Abstract This paper examines a convergence between Heidegger's reconceptualization of subjectivity and intersubjectivity and some recent work in feminist philosophy on relational autonomy. Both view the concept of autonomy to be misguided, given that our capacity to be self-directed is dependent upon our ability to enter into and sustain meaningful relationships. Both attempt to overturn the notion of a subject as an isolated, atomistic individual and to show that selfhood requires, and is based upon, one's relation to (...) and dependence upon others. The paper argues that Heidegger's notion of authentic Mitsein (being-with) rejects traditional notions of autonomy and subjectivity in favor of a relational model of selfhood. Ultimately, it provides a new point of entry into contemporary debates within feminist philosophy on Heidegger's thinking and defends Heidegger from certain feminist critiques. (shrink)

This dissertation is dedicated to developing a principle of autonomy that is suited to human rational agents situated in particular and contingent settings. In doing so, I start out by examining a very influential conception of autonomy which defines autonomy in terms of an agent's ability to "transcend" her particular and contingent life-situation. I call such a conception of autonomy deontological autonomy. I argue that there is an inherent inconsistency in the deontological approach since deontological (...) autonomy cannot accommodate the inescapable contingency in the concrete and particular life of each individual. I propose the notion of procedural autonomy as a more plausible conception of autonomy for humans, since it is achievable in one's particular and concrete setting. ;What makes us procedurally autonomous in contingent human conditions is the process of critical deliberation which consists of two stages: The first stage requires that an agent should examine hierarchically lower intentions and beliefs with her plan of life, the hierarchically most prior set of intentions and beliefs. In the second stage an agent must choose an adequate plan of life for herself, which can be chosen only when the agent is fully aware of various alternative life plans and has given each serious consideration for adoption. The injunction that an agent should be engaged in the two stages of critical deliberation in order to be procedurally autonomous is termed the Principle of Procedural Autonomy. This principle is an ethical principle that is hierarchically prior to moral principles, and it is a procedural principle which is primarily concerned with how one should act rather than what ends should be attained. ;I conclude by applying the Principle of Procedural Autonomy to the debate concerning moral maturity of rational agents in which certain feminist objections have been raised against the concept of autonomy; I argue that procedural autonomy escapes their criticism. ;In developing my position I consider Kant and Aristotle, and a number of contemporary thinkers including J. Rawls, M. Bratman, D. Parfit, B. Williams, C. Gilligan and N. Noddings, among others. (shrink)

Feminist socially constitutive conceptions of autonomy make the presence of idealized social conditions necessary for autonomy. I argue that such conceptions cannot, when applied under nonideal conditions, play two key feminist theoretical roles for autonomy: the roles of anti-oppressive character ideal and paternalism-limiting concept. Instead, they prescribe action that reinforces oppression. Treated as character ideals, socially constitutive conceptions of autonomy ask agents living under nonideal ones to engage in self-harm or self-subordination. (...) Moreover, conceptions of autonomy that make idealized social conditions a requirement of autonomy yield the conclusion that oppressed agents are appropriate objects of paternalism. (shrink)

A man with Alzheimer's who wanders around, a caregiver who disconnects the alarm, a daughter acting on het own, and a doctor who is not consulted set the stage for a feminist reflection on capacity/competence assessment. Feminist theory attempts to account for gender inequality in the political and in the epistemological realm. One of its tasks is to unravel the settings in which actual practices, i.c. capacity/competence assessment take place and offer an alternative. In this article the focus (...) will be on a feminist ethics of care in which relationality, care, vulnerability, and responsibility are privileged concepts and attitudes. The emphasis on these notions leads to a specific view of autonomy that has consequences for both carereceivers (patients, clients) and caregivers (professional and not professional). These concepts constitute a default setting that shapes the context for capacity/competence assessment. Whereas this notion is meant to distinguish between those who need to be taken care of and those who do not, reflection on what it means to say ‘those who need to be taken care of’ is also required. The feminist analysis presented here emphasizes the necessity of the contextualization of assessment of competence. It sketches the multifold and complex grid that comprehends capacity assessment. (shrink)

Concern for human vulnerability seems to be at the heart of bioethical inquiry, but the concept of vulnerability is under-theorized in the bioethical literature. The aim of this article is to show why bioethics needs an adequately theorized and nuanced conception of vulnerability. We first review approaches to vulnerability in research ethics and public health ethics, and show that the bioethical literature associates vulnerability with risk of harm and exploitation, and limited capacity for autonomy. We identify some of the (...) challenges emerging from this literature: in particular, how to reconcile universal human vulnerability with a context-sensitive analysis of specific kinds and sources of vulnerability; and how to reconcile obligations to protect vulnerable persons with obligations to respect autonomy. We then briefly survey some of the theoretical resources available within the philosophical literature to address these challenges, and to assist in understanding the conceptual connections between vulnerability and related concepts such as harm, exploitation, needs, and autonomy. We also sketch out a taxonomy of sources and kinds of vulnerability. Finally, we consider the implications for policy evaluation of making vulnerability an explicit and central focus of bioethics. Our investigation is in the form of a broad survey motivating a research agenda rather than a detailed analysis. (shrink)

It is one of the main allegations impelled by feminist theorists against Kant's philosophy that the subject Kant placed at the base of his understanding of rationality is masculine, a Westerner and belongs to upper/middle class. In fact, there is considerable supporting evidence to promote this claim for mainstream Western philosophy in general and Kant's philosophy in particular. On the other hand, while reckoning with the history of philosophy, and examining whether it is possible to break away from philosophical (...) concepts and categories or not, is another matter of discussion. In this article, I try to focus on various possibilities that can reconcile Kant's philosophy with the demands of liberal feminism and an inclusive democratic participation principle. It is important that to discuss whether it is possible to make a new reading that can be reconciled with feminist demands by ignoring the misogynistic discourses in Kant's works, especially starting from the concepts of autonomy and personality. Today, many factors like traditions, prejudices, oppressive forms of government, etc. prevent women from taking part in public life as free agents and autonomously, and from being considered as “subjects with the status of rights”. Therefore, I argue that Kant's concepts such as autonomy, becoming a person and having the conditions for free action, do have something in common with feminist demands. (shrink)

Recent criticism of the role of respect for autonomy in bioethics has focused on that principle's status as ‘dogma’ or ‘ideology’. I suggest that lying beneath many applications of respect for autonomy in medical ethics are some influential dogmas — propositions accepted, not as explicit premises or as a consequence of reasoned argument, but simply because moral problems are so frequently framed in such terms. Furthermore, I will argue that rejecting these dogmas is vital to secure and protect (...) an autonomy worthy of respect. The concept of autonomy that is widely applied in clinical ethics emphasises decision-making competence, at the expense of considering the authenticity of those decisions. Respect for such autonomy is interpreted in largely synchronic and individual terms — concerned with the isolated decisions of individual agents — and thus neglects the diachronic and social dimensions of many moral dilemmas arising in the health care context. I will examine how these unwritten rules lead to an impoverished understanding of respect and a systematic neglect in bioethics of certain kinds of ethical consideration, and draw on insights from feminist and communitarian work on autonomy to sketch an alternative approach to understanding respect, modelled on the norms of respectful conversation — a respect that is firstly concerned with engaging with the another as a potential giver and bearer or reasons, and working with them to promote both individual and social flourishing. (shrink)

This chapter surveys prominent feminist writings that call for a relational conception of autonomy and that criticize the philosophical mainstream for lacking such an account. It shows that prominent mainstream accounts of autonomy do acknowledge the importance of social relationships, thus tending to converge on this point with the prevalent feminist view. Feminists' objections to mainstream conceptions of autonomy are considered, focusing on the charge that mainstream accounts do not take account of social relationships.

This pathbreaking work pursues two interwoven themes. Firstly, it engages in a deconstruction of Ancient philosopher's texts--mainly from Plato, but also from Homer and Parmenides--in order to free four Greek female figures from the patriarchal discourse which for centuries had imprisoned them in a particular role. Secondly, it attempts to construct a symbolic female order, reinterpreting these figures from a new perspective. Building on the theory of sexual difference, Cavarero shows that death is the central category on which the whole (...) edifice of traditional philosophy is based. By contrast, the category of birth provides the thread with which new concepts of feminist criticism can be woven together to establish a fresh way of thinking. Cavarero develops a philosophical narrative which, by re-interpreting each of the four figures of ancient thought, uncovers several images of the female desire for self-representation. Plato himself had not forseen that one day female subjectivity would assert its autonomy, plundering and throwing into confusion the patriarchal text in order to tell another story. (shrink)

Principle-based formulations of bioethical theory have recently come under increasing scrutiny, particularly insofar as they give prominence to personal autonomy. This essay critiques the dominant conceptualization of autonomy and urges an alternative formulation freed from the individualistic assumptions that pervade the prevailing framework. Drawing on feminist perspectives, I discuss the need for a vision of patient autonomy that joins relational experiences to individuality and acknowledges the influence of patterns of power and authority on the exercise of (...) patient agency. Deficiencies in the current models of science and social relations guiding medical practice are analyzed, particularly (1) the tendency to disregard the patients self-knowledge and (2) failure to recognize limitations on the generalizability of medical knowledge. Models of social relations such as mothering and friendship are explored to advance a conception of autonomy better suited to the practical activities of medicine. In conclusion, I consider how acknowledgement of the specificity and complexity of social relations can contribute to reconfiguration of other principles comprising the standard framework of bioethics, particularly beneficence, justice, and equality. (shrink)

Freedom is intrinsic to a good life. An account of the Confucian conception of the good life must include a reasonable conception of freedom. Studies in Chinese ideas of freedom, however, have been focused mostly on Daoism. A quick survey of some fine books on Chinese philosophy shows little result on Confucian freedom.1 In this essay, I argue that attributing a notion of “free will” to Confucian philosophy has serious limitations; it will be more fruitful to draw on contemporary (...) class='Hi'>feminist theories of freedom and autonomy, particularly the notion of autonomy competency, in explicating Confucian freedom. Thus, I articulate the Confucian notion of freedom in terms of choosing , and advance a Confucian .. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 35.1 (2002) 1-21 [Access article in PDF] Turning Kant Against the Priority of Autonomy: Communication Ethics and the Duty to Community Pat J. Gehrke Communication ethics scholars afford Immanuel Kant significantly less attention than one might expect. This may be because, as Robert Dostal notes, Kant argues that rhetoric merits no respect whatsoever (223). This rejection of rhetoric, Dostal writes, is grounded in the significant (...) emphasis given to Kant's concept of autonomy (232). The focus on autonomy and, hence, rhetoricians' relative neglect of Kant's ethical theory are both connected to the separation of Kant's Critique of Pure Reason (hereinafter CPuR) from his subsequent ethical and moral philosophy. Kenneth Burke writes that Kant's first critique has no ethical implications, "no 'wills,' 'oughts,' 'shoulds,' or 'thou shalt nots'... nothing but an inevitable is, a description of conditions as they necessarily are for human experience" (191; emphasis in original). Such readings lose much of the richness and complexity of Kant's thought and tend instead to produce simple moral duties, such as Mike Markel's assertion that technical communicators must be truthful.Perhaps the most critical element of Kant's work lost in our focus on autonomy is his articulation of a ground for a duty to community. While Kant makes clear the importance of community for his metaphysics in the first critique (CPuR), the importance of community in Kant's moral philosophy often is overlooked. Some scholars claim that an ethical duty to community is either rejected by Kant's emphasis on the autonomy of will or simply ignored. This article combines a reading of Kant's metaphysics of experience with his moral philosophy to articulate a communication ethic grounded in community. This argument is made in three parts: first, the community of objects in experience—the Third Analogy of Experience—is an organizing principle of and a necessary condition for the possibility of all experience; second, this metaphysical principle of community is relevant [End Page 1] to community as developed in Kant's ethical writings; and finally, Kant's own work undermines the primacy of autonomy and better supports a communication ethic grounded in a duty to community.Scholars interested in Jurgen Habermas's theory of communicative action have special reason to take note of Kant's work. Kant is not only a figure that Habermas sees reflected in his own work, 1 but a constant point of contrast. Craig Calhoun writes that much of Habermas's own philosophy emerges by rejecting Kant's epistemology and elements of his metaphysics while still giving credence to Kantian moral philosophy (2). However, like most communication scholars and philosophers, Habermas believes that autonomy governs Kantian ethics: "Formalistic ethics (Kant) binds the criterion of generality of norms to the further criterion of autonomy, that is, independence from contingent motives" (Habermas, Legitimation 89). Since autonomy excludes or represses the contingent, if our readings of Kant give primacy to autonomy we leave little room for any notion of community as manifest in experience. In no small part, it is the criticism of Kant for privileging autonomy that has given Habermasians their break from Kantian ethics. However, if we turn to the first critique to guide our reading of the moral philosophy, there is another way to understand the role of autonomy and community in Kant's thought. By linking Kant's metaphysics with his moral philosophy, this article turns Kant away from the primacy of autonomy and uses Kant's own works to argue that autonomy is but one half of an antinomy that is organized under the principle of community. Thus, this article recuperates the possibility of deploying Kantian metaphysics and moral philosophy together as grounds for a communication ethic that privileges community and recovers the value of rhetoric.For rhetorical scholars, the resistance to the priority of autonomy may be related to the frequent expression of community through appeal to commonality, sameness, or identification. Today, feminist, race, postmodern, and poststructural communication scholars are questioning the value of commonality as a ground for ethics (e... (shrink)

The High Court continues to exercise its inherent jurisdiction to make declarations about interventions into the lives of situationally vulnerable adults with mental capacity. In light of protective responses of health care providers and the courts to decision-making situations involving capacitous vulnerable adults, this paper has two aims. The first is diagnostic. The second is normative. The first aim is to identify the harms to a capacitous vulnerable adult’s autonomy that arise on the basis of the characterisation of situational (...) vulnerability and autonomy as fundamentally opposed concepts or the failure to adequately acknowledge the conceptual relationship between them at common law. The second part of this aim is to draw upon developments in analytic feminist philosophy to illustrate how standard approaches to autonomy are ill-equipped to capture the autonomy issues of capacitous vulnerable adults when their decisions regarding care and treatment are at stake. The second (normative) aim is to develop an account of self-authorised, intersubjective autonomy on the basis of analytic feminist insights into the relational practices of recognition. This account not only attempts to capture the autonomy of capacitous vulnerable adults and account for the necessary harms to their autonomy that arise from standard common law responses to their situational vulnerability, it is also predicated on the distinctions between mental capacity, the satisfaction of conditions for informed consent and the exercise of autonomy, meaning that it is better placed to fulfil the primary aim of the inherent jurisdiction – to facilitate the autonomy of vulnerable adults with capacity. (shrink)

Recent research on patient decision-making reveals a disconnect between theories of autonomy, agency, and decision-making and their practice in contemporary clinical encounters. This study examines these concepts in the context of female patients making oncofertility decisions in the United Kingdom in light of the phenomenon of “being guided.” Patients experience being guided as a way to cope with, understand, and defer difficult treatment decisions. Previous discussions condemn guided decision-making, but this research suggests that patients make an informed, autonomous decision (...) to be guided by doctors. Thus, bioethicists must consider the multifaceted ways that patients enact their autonomy in medical encounters. (shrink)

This paper advances a Millian concept of care by re-evaluating his defense of the “common arrangement,” or a gendered division of labor in marriage, in connection with his views about traditionally feminine capacities, time use, and societal expectations. Informed by contemporary care ethics and liberal feminism, I explicate the best argument Mill could have provided in defense of the common arrangement, and I show that it is grounded in a valuable concept of care for care-givers. This dual-sided concept of care (...) theorizes care-giving both as a domain of human excellence and as labor with accompanying burdens. Liberal feminists should adopt this Millian concept of care, which can then inform principled thinking about distributive arrangements. (shrink)

This book explores, in rich and rigorous ways, the possibilities and limitations of “thick” autonomy in light of contemporary debates in philosophy, ethics, and bioethics. Many standard ethical theories and practices, particularly in domains such as biomedical ethics, incorporate minimal, formal, procedural concepts of personal autonomy and autonomous decisions and actions. Over the last three decades, concerns about the problems and limitations of these “thin” concepts have led to the formulation of “thick” concepts that highlight the mental, corporeal, (...) biographical and social conditions of what it means to be a human person and that enrich concepts of autonomy, with direct implications for the ethical requirement to respect autonomy. The chapters in this book offer a wide range of perspectives on both the elements of and the relations between “thin” and “thick” concepts of autonomy as well as their relative roles and importance in ethics and bioethics. This book offers valuable and illuminating examinations of autonomy and respect for autonomy, relevant for audiences in philosophy, ethics, and bioethics. (shrink)

In both theoretical and applied contexts the concept of autonomy has assumed increasing importance in recent normative philosophical discussion. Given various problems to be clarified or resolved the author characterizes the concept by first setting out conditions of adequacy. The author then links the notion of autonomy to the identification and critical reflection of an agent upon his first-order motivations. It is only when a person identifies with the influences that motivate him, assimilates them to himself, that he (...) is autonomous. In addition this process of identification must itself meet certain procedural constraints. (shrink)

Currently held conceptions of autonomy that inform biomedicine are inadequate and oppressive. Liberal notions of individualism are anti-humanist and constitute pernicious socialization, which leads to internalized oppression and dehumanization, especially among already oppressed groups. Women in recovery from addiction and other mental illnesses are especially affected by anti-humanist conceptions of autonomy. I argue that these women need to receive treatment that supports autonomy through supplementing psychiatric and rehabilitative therapy with humanistic education and group therapy. Treatment (...) must encourage the construction of healthy social interaction that augments a sense of supported autonomy. (shrink)

In both theoretical and applied contexts the concept of autonomy has assumed increasing importance in recent normative philosophical discussion. Given various problems to be clarified or resolved the author characterizes the concept by first setting out conditions of adequacy. The author then links the notion of autonomy to the identification and critical reflection of an agent upon his first-order motivations. It is only when a person identifies with the influences that motivate him, assimilates them to himself, that he (...) is autonomous. In addition this process of identification must itself meet certain procedural constraints. (shrink)

This chapter presents the author's basic account of autonomy, considering its social context and dimensions. It then explores the difference between a substantive and a content-neutral conception of autonomy, opting for the latter. This is followed by some thoughts about the prospects for autonomy under dangerous or oppressive conditions. The chapter concludes with some remarks about possible counterexamples to the conception of autonomy presented.

The relationship between community and individual is the key issue in contemporary political philosophy and ethics. The concept of self seems very important for individualism, communitarianism and feminism when they respond to relationships, particularly when we have to situate selfhood in the conditions of modernity. Consequently, this paper can be divided into seven parts. First it introduces the debate about the concept of the self between individualism and communitarianism. Second, it discusses the feminist critique of this issue and analyses (...) the feminist concept of self, and then addresses modernity as the condition of women. Next it attempts to analyze how women situate themselves in the conditions of modernity. Then it discusses how Chinese women are reshaping their selfhood under the conditions of modernity, and finally draws some brief conclusions claiming that neither communitarian nor individualist self is adequate in contemporary society. Chinese women, it is argued, are expected to reshape their own selfhood resting on the positive side of Confucian ethics and a feminist concept of self. (shrink)

The feminist literature against the commodification of embryos in human embryo research includes an argument to the effect that embryos are “intimately connected” to persons, or morally inalienable from them. We explore why embryos might be inalienable to persons and why feminists might find this view appealing. But, ultimately, as feminists, we reject this view because it is inconsistent with full respect for women's reproductive autonomy and with a feminist conception of persons as relational, embodied beings. Overall, (...) feminists should avoid claims about embryos’ being inalienable to persons in arguments for or against the commodification of human embryos. (shrink)

ABSTRACT In recent years, the medical establishment has been speaking in favor of women's autonomy in childbirth by advocating cesarean delivery on maternal request (CDMR). This paper offers to look at the ethical dimension of CDMR through a feminist critique of the medicalization of childbirth and its influence on present‐day medical ethics. I claim that the medicalization of childbirth reflects a sexist bias with regard to conceptions of the body and needs to be used with caution when (...) applied to women's reproductive health. I then use this perspective to critically analyze the position of the American College of Obstetricians and Gynecologists (ACOG) on the ethics of decision‐making in patient‐choice surgery. I claim that informed consent cannot be meaningfully exercised unless women are made aware of the sexist underpinnings of the medical model of childbirth and its influence on the ethical reasoning of the American College of Obstetricians and Gynecologists. I also express concern about the effects of normalizing patient‐choice cesarean sections on the choices available to pregnant women using as examples the institutional rules on mandatory cesarean sections for women with a previous cesarean delivery or breech presentation. I conclude with a call for more research into the real cost of convenience in CDMR, particularly as our increasingly strained publicly funded healthcare system would greatly benefit from the de‐medicalization of normal body functions rather than an increased dependence on costly surgical technology. (shrink)

The case of Rees v. Darlington Memorial Hospital N.H.S. Trustarises from a lower court backlash against the a prior decision of the British House of Lords in McFarlane v. Tayside Health Board. McFarlane holding that healthy children brought about by negligence in family planning procedures are blessings, and parents should therefore be denied the costs of child maintenance. But, would the House agree with the Court of Appeal in Reesthat the factual variation in that case of a disabled parent with (...) a healthy child should form an exception? In tracing the appeal of Reesto the House of Lords, this note explores their Lordships’ refusal in principle to depart from McFarlane, as well as the invocation of an autonomy-based approach to address the harm of unsolicited parenthood. In reflecting on the extent to which the wrongful conception action can be said to reinforce the value of reproductive autonomy, this note argues, nevertheless, that Reesillustrates in another way a significant departure from McFarlane, but that this is still a turn in the wrong direction. Far from resonating with women’s diverse experiences of reproduction, the law of negligence continues to illustrate little respect for reproductive choice. Therefore, this note calls for a deeper understanding of autonomy, one that recognises and embraces the diversity of individuals’ reproductive lives. (shrink)

For the purpose of advancing the feminist commitment to inclusion and nonliberal articulations of pluralism, in this essay I conceptualize the Native account of individual autonomy that itself evolves from a commitment to pluralism. I demonstrate that Native individual autonomy is concurrently strong and feminist in nature—what I call “radical-cum-relational.” That is, Native autonomy is more radical than the traditional liberal conception and is simultaneously grounded in relationality, which is the basis of much of (...) class='Hi'>feminist ethics. I demonstrate that the Native conception of autonomy is radical and promotes the highest degree of individual self-determination and independence qua individuality and particularity. Yet this radical self-determination depends on intense social interdependency. The grounding metaphysics and epistemology of the Native framework are conceived entirely in terms of ethical relationships between and responsibilities to other individuals, animals, and the Earth. That is, no part of the Native paradigm can be understood outside of the ethical connections persons have by virtue of their primary position as community members. It is by situating radical autonomy against a background of ethical social interdependence, together with thebackground condition of gender equality of Native practices, that the radical construal of Native individual freedom is feminist. To shore up and illustrate the connection between Native autonomy and feminism, I argue that an identification between the Native social practice of gifting and feminist reciprocity can be made, specifically Iris Marion Young’s notion of asymmetrical reciprocity. Finally, I argue that this connection avoids the problem of incommensurability and so is theoretically possible, responsible, and fits the criterion of respectfulness also at the foundation of the Native framework. Broadly speaking, the problem of incommensurability is concerned with theorists’ inability to recognize foundational incompatibilities between paradigms and their forced attempts to mergethem, often at the price of ignoring inconsistencies, inaccuracies, and contradictions that result from impossible translations and conversions. Historically and to the present day, Western philosophy has been egregiously guilty of distorting Native theories and practices. In this essay I argue that since translation takes place at the level of praxis rather than at the level of language, my argument circumvents problems that arise from failed attempts to map cultural concepts onto others that do not share similar foundations. (shrink)

Among bioethicists, and perhaps ethicists generally, the idea that we are obliged to respect autonomy is something of a shibboleth. Appeals to autonomy are commonly put to work to support legal and moral claims about the importance of consent, but they also feed a wider discourse in which the patient’s desires are granted a very high importance and medical paternalism is regarded as almost self-evidently indefensible.

The received view in medical contexts is that informed consent is both necessary and sufficient for patient autonomy. This paper argues that informed consent is not sufficient for patient autonomy, at least when autonomy is understood as a "relational" concept. Relational conceptions of autonomy, which have become prominent in the contemporary literature, draw on themes in the thought of Charles Taylor. I first identify four themes in Taylor's work that together constitute a picture of human (...) agency corresponding to the notion of agency implicit in relational accounts of autonomy. Drawing on these themes, I sketch two arguments against the position that informed consent secures autonomy. The first is that informed consent is an "opportunity" concept whereas autonomy is an "exercise" concept; the second is that informed consent requires merely weak evaluation and not strong evaluation. On Taylor's analysis of agency, strong evaluation is required for agency and for autonomy. (shrink)

This paper argues for a conception of autonomy that takes social oppression seriously without sapping autonomy of its valuable focus on individual self-direction. Building on recent work in relational accounts of autonomy, the paper argues that current conceptions of autonomy from liberal, feminist and critical theorists do not adequately account for the social features of belief formation. The paper then develops an alternative conception of relational autonomy that focuses on how autonomy contains (...) both individualistic and social epistemic features. Rather than consider autonomy to reside in an impenetrable inner citadel, a place immune from external influences, the paper argues that we must acknowledge the hermeneutic relationship between individual and social processes of belief adjudication. Taking such an argument seriously results in the need to alter our conception of autonomy and the schooling needed to foster its growth. (shrink)

The concept of self - respect is often invoked in feminist theorizing. But both women's too-common experiences of struggling to have self - respect and the results of feminist critiques of related moral concepts suggest the need for feminist critique and reconceptualization of self - respect. I argue that a familiar conception of self - respect is masculinist, thus less accessible to women and less than conducive to liberation. Emancipatory theory and practice require a suitably feminist (...) conception of self - respect ; I propose one such conception. (shrink)

ABSTRACT When one thinks about the ethics of abortion, one inevitably thinks about rights, since it is in terms of the concept of rights that much of the debate has been conducted. This is true of overtly feminist as well as non‐feminist accounts. Indeed, some early feminist writers – Judith Jarvis Thomson and Mary Ann Warren, for example – employ a model of rights that is indistinguishable, or virtually indistinguishable, from that of their non‐feminist counterparts. However, (...) more recent feminist writers have developed a different understanding of ‘a woman's right to choose.’ In this paper, I will begin by outlining the non‐feminist debate over the moral permissibility of abortion. I will suggest that this debate is irresolvable, since at its heart is an ‘essentially contested concept’, that of personhood. I will then consider the way in which some feminist writers have attempted to reconceive the terms of the abortion debate and suggest an expanded account of women's right to abortion, drawing on the work of Susan Sherwin. Finally, I will argue that there is a further element to a ‘woman's right to choose’ that expands on and provides a conceptual link between the feminist and non‐feminist understanding of abortion. (shrink)

This survey of the Supreme Court of Canada’s pivotal anti-discrimination rulings over a 30-year period assesses the extent to which the shifting nature of the grounds approach and the Court’s conceptions of dignity together form part of a gendered system of enunciation at the intersection of autonomy, identity and affect. This article is written as a corrective to some of the author’s early optimism about the possibilities that dignity may offer in the context of constitutional equality rights cases (...) and as a cautionary tale for those who would attempt to use it as a vehicle for rights claiming through the courts. These cases reveal that in the context of Canadian anti-discrimination law, the concept of dignity is most often used to circumscribe agency, limit subjectivity and curtail possibilities for redress by reducing large scale structural problems to the individual in ways that reproduce law’s originary violence. (shrink)

Relational autonomy theorists attempt to accommodate social embeddedness within a conception of autonomy. These attempts are conceptually messy, at best, and category errors, at worst. Rejecting the liberal conception of autonomy due to feminist concerns is more helpfully answered by the neorepublican notion of freedom as nondomination. The conception of freedom as nondomination captures the values that motivate the relational turn in moral and political theory and does so in a conceptually neater way than attempting to (...) accommodate those concerns in our accounts of autonomy. (shrink)

Autonomy has risen in esteem, then fallen, only to rise again in recent theorizing about women in society and culture. In this paper, I further bolster the renewed feminist interest in autonomy. I characterize feminist social aspirations in terms of three very abstract goals and then argue that women’s individual autonomy promotes at least two of them in crucial ways. Women’s autonomy will improve the quality of the close personal relationships that pervade women’s traditional (...) moral concems (the first goal) and it will enable women the better to resist traditional, gender-based constraints on their lives (the second goal). My conclusion is tempered, however, by the view that individual autonomy interferes to a significant degree with the solidarity and collective action by women needed to effect feminist social change (the third goal). In passing, I gesture toward a conception of autonomy as a certain kind of narrative of self-development. (shrink)

Autonomy has risen in esteem, then fallen, only to rise again in recent theorizing about women in society and culture. In this paper, I further bolster the renewed feminist interest in autonomy. I characterize feminist social aspirations in terms of three very abstract goals and then argue that women’s individual autonomy promotes at least two of them in crucial ways. Women’s autonomy will improve the quality of the close personal relationships that pervade women’s traditional (...) moral concems (the first goal) and it will enable women the better to resist traditional, gender-based constraints on their lives (the second goal). My conclusion is tempered, however, by the view that individual autonomy interferes to a significant degree with the solidarity and collective action by women needed to effect feminist social change (the third goal). In passing, I gesture toward a conception of autonomy as a certain kind of narrative of self-development. (shrink)

Despite enthusiasm for patient-centered care, the practice of patient-centered care is proving challenging. Further, it is curious that the literature about this subject does not explicitly address patient autonomy, since patients guide care in patient-centered care, and respect for patient autonomy is a prominent health-care value. We argue that by explicitly adopting a relational conception of autonomy as an essential component, patient-centered care becomes more coherent, is strengthened, and could help practitioners to make better use of a (...) principle of respect for autonomy. Hence, its use appears promising to narrow the theory–practice gap. (shrink)

Women have historically been prevented from living autonomously by systematic injustice, subordination, and oppression. The lingering effects of these practices have prompted many feminists to view autonomy with suspicion. Here, Marilyn Friedman defends the ideal of feminist autonomy. In her eyes, behavior is autonomous if it accords with the wants, cares, values, or commitments that the actor has reaffirmed and is able to sustain in the face of opposition. By her account, autonomy is socially grounded yet (...) also individualizing and sometimes socially disruptive, qualities that can be ultimately advantageous for women. Friedman applies the concept of autonomy to domains of special interest to women. She defends the importance of autonomy in romantic love, considers how social institutions should respond to women who choose to remain in abusive relationships, and argues that liberal societies should tolerate minority cultural practices that violate women's rights so long as the women in question have chosen autonomously to live according to those practices. (shrink)