Name any valued human trait—intelligence, wit, charm, grace, strength—and you will find an inexhaustible variety and complexity in its expression among individuals. Yet we insist that such diversity does not provide grounds for differential treatment at the most basic level. Whatever merit, blame, praise, love, or hate we receive as beings with a particular past and a particular constitution, we are always and everywhere due equal respect merely as persons. -/- But why? Most who attempt to answer this question appeal (...) to the idea that all human beings possess an intrinsic dignity and worth—grounded in our capacities, for example, to reason, reflect, or love—that raises us up in the order of nature. Andrea Sangiovanni rejects this predominant view and offers a radical alternative. -/- To understand our commitment to basic equality, Humanity without Dignity argues that we must begin with a consideration not of equality but of inequality. Rather than search for a chimerical value-bestowing capacity possessed to an equal extent by each one of us, we ought to ask: Why and when is it wrong to treat others as inferior? Sangiovanni comes to the conclusion that our commitment to moral equality is best explained by a rejection of cruelty rather than a celebration of rational capacity. He traces the impact of this fundamental shift for our understanding of human rights and the norms of anti-discrimination that underlie it. (shrink)

The state regulates the way in which social power is exercised. It sometimes permits, enables, constrains, forbids how we may touch others, make offers, draw up contracts, use, alter, possess and destroy things that matter to people, manipulate, induce weakness of the will, coerce, engage in physical force, persuade, selectively divulge information, lie, enchant, coax, convince, … In each of these cases, we (sometimes unintentionally) get others to act in ways that serve our interests. Which such exercises of power should (...) the state forbid? Which should it permit? An intuitively appealing way to answer this question is, with Ripstein and Kant, to point to the role of freedom: exercises of social power can be legitimately prohibited when (and only when) they restrict people's freedom. But this raises a further question: How do we identify when such exercises of power make people unfree in the relevant sense? Ripstein, in defending Kant, draws a crucial distinction between actions that subject others’ wills to our choices (and which it would therefore be presumptively legitimate for the state to forbid) and actions that merely affect the contexts in which others act (and which it would therefore be presumptively illegitimate for the state to forbid). I query that distinction, and argue that the idea of independence cannot bear, on its own, the weight it is expected to bear within the Kantian framework. (shrink)

Political theorists aiming to articulate normative standards for the EU have almost entirely focused on whether or not the EU suffers from a ‘democratic deficit'. Almost nothing has been written, by contrast, on one of the central values underpinning European integration since at least the European Coal and Steel Community (ECSC), namely solidarity. What kinds of principles, policies, and ideals should an affirmation of solidarity commit us to? Put another way: what norms of socioeconomic justice ought to apply to the (...) EU? This is not an empirical or narrowly legal question. We are not trying to gauge the degree of attachment there currently is in the EU by, for example, citing the latest Eurobarometer poll. We are also not attempting to state the implicit rationale followed by the Court of Justice in its recent ‘solidarity’ jurisprudence, let alone trying to fix what the Commission might mean by it. In this article, I ask the more fundamental question underlying both the legal and the empirical questions: What principles of social solidarity ought to apply between states and citizens of the emerging European polity? This question has rarely been asked or answered by political theorists in an EU context, so we are entering largely uncharted territory. The article develops a tripartite model of EU solidarity in Section 2, and then applies it to the case of free movement of persons in Section 3. (shrink)

The demand for social justice, especially in the context of the welfare state, is often framed as a demand of solidarity. But it is not clear why: in what sense, if any, is social justice best understood as a demand of solidarity? This article explores that question. There are two reasons to do so. First, very little has been written on the concept of solidarity, and almost nothing on why and how solidarity can both give rise to and be the (...) target of a moral obligation. The first aim of the article is to fill this gap. The second aim of the article is to explore the normative implications of this account of solidarity for the commitment to social justice at the heart of the welfare state, and in so doing, to put into question the idea that shared experience or shared identity are either necessary or sufficient bases for social justice qua solidarity. (shrink)

This article discusses Luigi Caranti’s Kant’s Political Legacy, which argues, among other things, that a Kantian reconstruction of dignity can provide a foundation for human rights. Caranti’s book is one of the most powerful recent reconstructions of Kant’s political philosophy. Four main points are argued in response. First, to what extent can dignity understood as a value ground the essentially relational character of human rights claims? Second, does Caranti explain why our mere rational capacity to set moral ends has dignity (...) rather than the realization of that capacity in a morally righteous will? Third, how can the argument provided avoid the conclusion that, because people’s capacities vary, their dignity varies too? Fourth, is Kant’s political philosophy incompatible with our modern understanding of human rights and, in particular, their function in international law and practice? (shrink)

In his rich and stimulating book, Blake argues that comprehensive coercion triggers egalitarian obligations of distributive justice. I argue that coercion is not a necessary condition for egalitarian justice to apply; Blake’s use of a moralised conception of coercion is a mistake; coercion is a redundant member of any set of sufficient conditions that might explain why distributive justice applies; Blake’s emphasis on providing conditions for the exercise of autonomy might support a much more cosmopolitan theory of distributive justice.

Thousands of refugees die each year fleeing prosecution in their home state. But receiving states are often reluctant to admit, process and house refugees. This is in part because refugee protection is a public good, and so subject to free-riding. A promising, but controversial, solution is to set up markets in tradable refugee quotas (e.g., in the European Union). One of the main objections to such proposals is that they lead to the commodification and objectification of refugees. Another objection, less (...) often discussed, is that such markets seem to legitimate negative and prejudicial attitudes towards refugees. In this article, I defend markets in refugee quotas against such criticisms. Given how many die each year, we are more than ever in need of creative solutions. Tradable quotas provide a promising mechanism to increase the number of refugees processed and protected, especially in regional schemes like the EU. Ethical objections such as the ones canvassed here should not stand in our way. (shrink)

European Journal of Philosophy, Volume 30, Issue 2, Page 488-502, June 2022.

The Cameron government has recently negotiated a deal with the EU which permits the UK to restrict access to in-work benefits for recent EU migrants in the first four years of residence. Withdrawing access to in-work benefits will lead to significant inequalities in pay between British workers and their EU equivalents working at the same job, in the same general situation. The proposal has been widely decried as discriminatory. Is it? I do not, in this article, ask the legal question: (...) Does it violate anti-discrimination norms implicit in the treaties? Rather, I will ask the moral question underlying the legal one: Would, say, Polish citizens denied in-work benefits that British citizens receive be victims of wrongful discrimination? This question deserves consideration not simply because it will help us to evaluate some of the central concerns at stake in the Brexit debates but also because it will allow us to explore the role of norms against discrimination according to nationality within the EU, to address the nature of the European commitment to freedom of movement, and, in the reverse direction, to better understand our own moral commitment to anti-discrimination norms. (shrink)

RésuméLe livre ambitieux et nuancé de Sophia Moreau défend une vision pluraliste de la discrimination injuste. Je soutiens trois points. Premièrement, je soutiens que le compte rendu de Moreau sur la liberté délibérative ne fournit pas de motif distinct pour s'opposer à la discrimination. Deuxièmement, je soutiens qu'il n'y a pas, entre sa vision et l'expressivisme, un écart aussi important qu'elle le suggère. Troisièmement, j'avance qu'une lacune intrigante dans l'argument mérite une exploration plus poussée : Moreau ne nous fournit jamais (...) de description détaillée des situations où la subordination sociale est immorale ni des raisons qui expliquent pourquoi elle le devient. (shrink)

Gillian Brock’s compelling and richly textured new book aims to set out a human-rights-based framework for thinking about justice in migration. There is much to celebrate in these chapters, not least Brock’s masterful effort at weaving together her basic justificatory framework with real-world political concerns. In this article, I query the focus she places on self-determination in setting out the basic normative argument elaborated in Chapters 2, 3, and 9. In particular, I will wonder whether she gives the collective self-determination (...) of a people anything more than instrumental value, and so whether she is able to distance herself from so-called proponents of “open borders”. (shrink)

L’article analyse la représentation des ouvriers durant la seconde moitié du xxe siècle, et notamment de leur masculinité : il pointe la superposition des deux images de l’ouvrier et de l’homme, dans la mesure où la représentation du travailleur en tant qu’homme naît de la conviction que le travail est le principal outil de définition de la masculinité. Ces deux représentations sont étudiées en confrontant les images des espaces de travail et des travailleurs avec leurs propres autoreprésentations, à travers les (...) films, les photographies, les romans et les récits autobiographiques. L’article fait l’hypothèse d’une connexion entre la fin de la centralité du travail industriel depuis les années 1970 et les transformations de la masculinité, sous l’influence, tant du féminisme, que du changement des valeurs sociales, d’une manière plus générale. Pendant cette période, l’identité masculine se redéfinit : celle-ci n’est plus construite à partir du travail, mais plutôt, d’une nouvelle conscience de soi fondée sur le corps. (shrink)

Carol Gould's article offers a powerful argument against the sufficiency of informed consent in an age of surveillance capitalism. In this review, I assess the three main claims that Gould makes in her article, namely that (1) democratic control is required by the all‐affected principle; (2) democratic control is a means of ensuring that surveillance corporations and governments track public, rather than merely private, interests; and (3) democratic control is constitutive of freedom as self‐development and self‐transformation.

Introduction: Novel coronavirus is having a devastating psychological impact on patients, especially patients with cancer. This work aims to evaluate mood disorders of cancer patients undergoing radiation therapy during COVID-19 in comparison with cancer patients who underwent radiation therapy in 2019.Materials and Methods: We included all the patients undergoing radiation therapy at our department in two-time points and during the COVID-19 outbreak. All the patients were asked to fulfill a validated questionnaire, the Symptom Distress thermometer, and the Beck Depression Inventory (...) v.2. We took into account the COVID-19 outbreak and also sex, age, week of radiation treatment, and disease.Results: We included 458 patients, with a median age of 64 years. STAI-Y1 median score was 40, whereas the median score of SDT was five and BDI-2 median score was 11. STAI-Y1, SDT, and BDI-2 were significantly correlated with the COVID-19 outbreak, sex, week of treatment, and disease.Conclusions: The prevalence of mood disorders in patients undergoing radiation therapy is higher than expected and even higher during the COVID-19 outbreak. These measurements could be useful as a baseline to start medical humanities programs to decrease these scores. (shrink)

There are some premise-by-premise reconstructions in political philosophy which are flawed, because they omit at least one premise or misword at least one premise. This paper focuses on a reconstruction by Richard Child. The original argument is by Andrea Sangiovanni and is about whether egalitarian values of distributive justice apply both within a state and globally. Child’s reconstruction has been reproduced in a paper by Ian Davis, who approves of it. But I point out five logical problems with the (...) reconstruction. (shrink)

RésuméDans cette réponse à mes commentateurs, je réagis aux critiques de Alysia Blackham, Jessica Eisen, Pablo Gilabert, Andrea Sangiovanni, Dale Smith, Iyiola Solanke, et Daniel Viehoff incluses dans ce numéro spécial consacré à mon livre, Faces of Inequality. Parmi les sujets abordés, j'analyse les liens entre l’égalité et la discrimination, le rôle que joue la subordination dans ma théorie de la discrimination, et la méthodologie dans les théories de la discrimination.

Mathias Risse, Andrea Sangiovanni, and Kok-Chor Tan have offered some subtle and powerful criticisms of the ideas given in my Justice and Foreign Policy. Three themes in particular recur in their critiques. The first is that the arguments I make in that book rest upon unjustified, arbitrary, or contradictory premises. The second is that the use of coercion in the analysis of distributive justice is a mistake. The third is that the global institutional set represents, contrary to my arguments, (...) an independent first-order site of justice. I address these criticisms, and try to vindicate the methodology of Justice and Foreign Policy in the face of these objections. (shrink)

This paper responds briefly to four reviews of Force and Freedom. Valentini and Sangiovanni criticize what they see as the excessive formalism of the Kantian enterprise, contending that the Kantian project is circular, because it defines rights and freedom together, and that this circularity renders it unable to say anything determinate about appropriate restrictions and permissions. I show that the appearance of circularity arises from a misconstrual of the Kantian idea of a right. Properly understood, Kantian rights are partially (...) indeterminate, but not in a way that causes problems for the account. Ronzoni and Williams seek to broaden the reach of public right, arguing that Kant's abstract approach overlooks pressing questions of social and political life, (Ronzoni) and that public right should allow for democratic deliberation about purposes that go beyond the requirement that a state provide a rightful condition for its members (Williams). I argue that the Kantian view makes room for these factors, but that each must be understood in relation to the formal constraints of right. (shrink)

This paper examines how the intercultural conception of human rights, fueled by the modes of reciprocal recognition associated with Hegel’s social philosophy, draws on traditional understandings of human dignity while avoiding the essentialism associated with those understandings. Part 1 summarizes core elements of an intercultural theory of human rights while addressing the general question of how that theory accommodates an understanding of the relationship of human dignity and human rights. Part 2 presents the intercultural approach as committed to a view (...) of human dignity focused on the intrinsic worth of individuals, but understood, not—with Kant—as an anthropologically inherent property, but as one forged in relations of intersubjective recognition. Part 3, critically engaging arguments of C Beitz and J Habermas, claims that an intercultural approach entails a status-based conception of human dignity, one that construes the latter, not as a metaphysically conceived inherent quality, but as a function of membership in a social order supportive of both liberal right claims and a republican commitment to rights systems generally. Drawing on the work of Hegel and critically engaging the position of A Sangiovanni, Part 4 construes human dignity in terms of a doctrine of human rights expressive of a common humanity, one understood, however, not as an essential attribute of human beings, but in terms of a globally realized legal-political order whose members are dispositionally committed to the worth of all members of the human community and the value of human community itself. Critically appropriating the work of H Arendt for the intercultural theory, Part 5 considers the centrality of actual politics to a dignitarian account of human rights. Part 6 construes human dignity, again with Kant, in terms of the principle of autonomy, but one understood, not abstractly, but—engaging Pico della Mirandola—as the fallibilistically conceived process of social learning on the part the members of the human community. Part 7 considers how the intercultural view, with the idea of social practice expressive of collective human agency, accommodates a concept of human dignity understood as the “foundation”—nuanced and variegated—of human rights. Part 8 details the specific normativity of an intercultural conception, asserting that despite and even because of its attention to the empirical realities of social, historical, and political life, that conception remains committed, as with essentialist views, to context-transcending norms capable of calling into question actual practices and policies. Here, recourse is had to a concept of recognition understood both as a principle of evaluation and as a social practice encompassing the activity of individuals and groups engaged in the discourse on human rights. (shrink)

In Andrea Sangiovanni’s words, practice-dependent theorists hold that “[t]he content, scope, and justification of a conception of [a given value] depends on the structure and form of the practices that the conception is intended to govern”. They have tended to present this as methodologically innovative, but here I point to the similarities between the methodological commitments of contemporary practice-dependent theorists and others, particularly P. F. Strawson in his Freedom and Resentment and Bernard Williams in general. I suggest that by (...) looking at what Strawson and Williams did, we can add to the reasons for adopting one form or another of practice-dependence. The internal complexity of the practices we hope our principles will govern may require it. However, this defence of practice-dependence also puts pressure on self-identified practice-dependence theorists, suggesting that they need to do more work to justify the interpretations of the practices their theories rely on. (shrink)

In this paper, I critically analyze Andrea Sangiovanni’s approach to international justice in the EU that he labels Reciprocity-based Internationalism (RBI). I aim to show that the type of reciprocity RBI operates with is not a morally attractive ground for distributive justice because it cannot cope with the case of member states’ inability to reciprocate the production of collective goods at the EU level. I illustrate this with the case of disability. I contrast RBI’s understanding of reciprocity with Christie (...) Hartley’s ‘relationship model’. I argue that the relationship model of reciprocity should characterize the EU, whose two core normative features are fraternity and equal status. The advantage of the relationship model is that it calls for a stronger type of solidarity than RBI does. That not only entails the willingness to support those worse-off members that cannot productively reciprocate other member states’ efforts at the EU level but also calls for a higher redistribution rate within the EU. In the paper, I make three comparisons between RBI’s ‘productive reciprocity’ and the relationship model. The first concerns non-EU-integration-related disadvantages; the second concerns membership cases, such as accession to federations and supranational unions, while the third comparison examines EU-integration-related disadvantages. I argue that the relationship model is a better alternative to RBI in both integration-related and non-integration-related disadvantages. Also, the relationship model can justify accession cases where previous historical ties are relevant, which are outside of the purview of RBI. (shrink)

This introduction provides a very brief sketch of the fundamental claims of Arthur Ripstein's Force and Freedom before locating the criticisms of his interlocutors in relation to those claims. Valentini and Sangiovanni are situated as critics of the Kantian frame, while Ronzoni and Williams are critics situated within that frame.

This paper defends an egalitarian conception of global justice against two kinds of criticism. Many who defend egalitarian principles of justice do so on the basis that all humans are part of a common 'association' of some kind. In this paper I defend the humanity-centred approach which holds that persons should be included within the scope of distributive justice simply because they are fellow human beings. The paper has four substantive sections - the first addresses Andrea Sangiovanni's reciprocity-based argument (...) for the claim that egalitarian principles apply only within the state. The second responds to Michael Blake's coercion-based argument for the thesis that egalitarian principles apply only within the state. A third section draws attention to a general problem with associational accounts of distributive justice. Finally, I seek to show how a humanity-centred cosmopolitanism can accommodate the insights associated with an associational approach. (shrink)

In his recent book, Andrea Sangiovanni raises various objections against what he calls the “aristocratic” conception of dignity – the idea that dignity represents a kind of high- ranking social status. In this short article, I suggest that Sangiovanni gives the aristocrats less credit than they deserve. Not only do his objections target an uncharitably narrow version of the view, Sangiovanni surreptitiously incorporates aspects of the aristocratic conception of dignity into his own (supposedly non-dignitarian) theory of moral (...) equality. (shrink)

Over the past 15 years, Rainer Forst has developed a fundamental research programme within the tradition of Frankfurt School Critical Theory. The core of this programme is a moral account of the basic right of justification that humans owe to one another as rational beings. This account is put to work by Forst in articulating - both historically and philosophically - the contexts and form of justice and of toleration. The result is a powerful theoretical framework within which to address (...) issues such as transnational justice and multicultural toleration. In this volume, Forst sets out his ideas in an extended essay, which is responded to be influential interlocutors including: Andrea Sangiovanni, Amy Allen, Kevin Olson, Anthony Laden, Eva Erman and Simon Caney. The volume concludes with Forst's response to his interlocutors. (shrink)

Dignity underlies much philosophical debate, but the concept and its place in a broader theory of justice have received renewed analytic attention of late. In this article, I examine several recent books on dignity: Human Dignity and Political Criticism, by Colin Bird; Human Dignity and Human Rights, and Human Dignity and Social Justice, both by Pablo Gilabert; Contours of Dignity by Suzanne Killmister; and Humanity Without Dignity: Moral Equality, Respect, and Human Rights, by Andrea Sangiovanni. As I outline, each (...) book develops and defends a position in an established disagreement between so-called ‘Naturalistic’ views, which hold that dignity inheres in natural properties, and ‘Conventionalist’ perspectives, which hold that dignity is socially defined. With these contemporary accounts in mind, I expose the contours of this disagreement and suggest that further work should focus on developing a hybrid conception of dignity consistent with Naturalism and Conventionalism. (shrink)

What weight should we place on self-determination, democracy, human rights and equality in an account of migration justice? Anna Stilz and Andrea Sangiovanni offer insightful comments that prompt us to consider such questions. In addressing their welcome critiques I aim to show how my account can help reduce migration injustice in our contemporary world. As I argue, there is no right to free movement across state borders. However, migrants do have rights to a fair process for determining their rights. (...) Democratic communities should have scope to make many migration decisions, although there are constraints on that self-determination. The migration governance oversight arrangements I favor are compatible with core requirements of agency and responsiveness that are operative in mature democracies. In responding to concerns about objectionable power inequalities that often characterize temporary worker programs, I show why addressing these issues requires various institutional protections that are well enforced. Robust migration governance arrangements can assist in formulating defensible migration policies that we can implement here and now as we aim to reduce migration injustices in our current world. (shrink)

In this paper I argue that the attempt to develop practice dependence as a middle path between cosmopolitanism and social liberalism ultimately fails. In particular, I contend that the only type of practice dependence that can coherently be defended collapses into cosmopolitanism. I trace the origin of practice dependence theory from Cohen and Sabel’s work through Sangiovanni and Valentini. After discussing the various different types of practice dependence, I argue that the only type of practice dependence that stands up (...) to scrutiny is functionalism, but that if functionalism is true, it commits us to cosmopolitanism. (shrink)

John Rawls famously claims that ‘justice is the first virtue of social institutions’. On one of its readings, this remark seems to suggest that social institutions are essential for obligations of justice to arise. The spirit of this interpretation has recently sparked a new debate about the grounds of justice. What are the conditions that generate principles of distributive justice? I am interested in a specific version of this question. What conditions generate egalitarian principles of distributive justice and give rise (...) to equality as a demand of justice? My paper focuses on relationalist answers to this question. Advocates of relationalism assume that ‘principles of distributive justice have a relational basis’, in the sense that ‘practice mediated relations in which individuals stand condition the content, scope and justification of those principles’. To say that principles of justice are ‘based’ on and ‘conditioned’ by practice mediated relations is ambiguous. I will here be concerned with advocates of what I call the relationalist requirement , viz. positions which assume that ‘practice mediated relations’ constitute a necessary existence condition for principles of egalitarian distributive justice. Relationalists who endorse this view come in different varieties. My focus is on relationalists that view social and political institutions as the relevant ‘practice mediated relation’. The question at stake, then, is this: Are institutionally mediated relations a necessary condition for equality to arise as a demand of justice? Strong relationalists of the institutionalist cast, call them advocates of the institutionalist requirement , differ in important respects. They argue about what set of institutions is foundationally significant, and they disagree on why only that institutional relation gives rise to egalitarian obligations of justice. My paper engages two ways of arguing for the institutionalist requirement : Julius’s framing argument and Andrea Sangiovanni’s reciprocity argument . The issue at stake are the grounds of egalitarian justice and I will argue that the institutionalist requirement is mistaken. It is not the case that egalitarian obligations of distributive justice arise only between and solely in virtue of individuals sharing a common institution. (shrink)

The purpose of this introduction is two-fold. First, it is to provide readers unfamiliar with the debates on practice-dependence with the insight necessary to fully comprehend the different contributions to this volume. Second, it is to make readers already well versed in practice-dependence more sensible to the substantive nature of this view and to provide them with a workable typology. After establishing a first distinction between metaphysical, relational and practice-dependent conceptions of justice, I draw a line, among practice-dependent views, between (...) institutionalism and cultural conventionalism. I complete the typology by differentiating between three forms of institutionalism according to how they regard the institutional fact, namely the fact that individuals are always already placed in a state of submission to existing institutions. Whereas de facto institutionalism describes this fact as a mere factual reality which imposes itself upon human beings, de jure institutionalism regards it as a practical necessity that stands in need of justification to each and every individual. Finally, moral institutionalism accounts for the institutional fact in terms of moral duty , namely the duty to contribute to the emergence of a state of affairs in which everyone’s freedom of choice is respected. (shrink)

La filosofía de la historia se ha debatido durante siglos en una estéril lucha entre idealistas y materialistas. El libro de Ignacio Ellacuría es un intento de superar esa dicotomía clásica. Tomando como punto de partida algunos conceptos fundamentales de la filosofía de Zubiri, Ellacuría cree posible asumir y a la vez criticar ambos extremos, desde una actitud más realista. De ahí el título del libro. Es importante destacar que la historia, para Ignacio Ellacuría, es el lugar de realización de (...) la ética. La historia no está hecha, se construye, es un proceso de creación de posibilidades humanas, y, en tanto que tal, una labor ética. La tesis de Zubiri de que el hombre tiene que hacerse cargo de la realidad, en Ellacuría se transforma en esta otra: el ser humano está obligado a encargarse de la realidad, y a cargar con ella. Este es el imperativo ético. Imperativo que, por otra parte, no sólo le obliga individualmente al hombre, en el reducto de la propia conciencia, al modo del idealismo, ni tampoco sólo en tanto que miembro de una clase social, como en el marxismo, sino como sujeto a la vez individual y específico, como miembro a la vez solitario y solidario de la especie humana. La obra póstuma de Ignacio Ellacuría constituye sin duda su más ingente trabajo intelectual en el campo de la filosofía, y representa, por su calidad y contenido, una pieza clave para comprender no solamente su producción estrictamente filosófica, sino también su pensamiento teológico y socio-político. (shrink)

Brendel and Miller (2008) take the most distinctive commitment in their pragmatic approach to be treating ethical principles as having a hypothetical status. I am sympathetic to a pragmatic approac...

Objectives: Evidence based patient choice seems based on a strong liberal individualist interpretation of patient autonomy; however, not all patients are in favour of such an interpretation. The authors wished to assess whether ideals of autonomy in clinical practice are more in accordance with alternative concepts of autonomy from the ethics literature. This paper describes the development of a questionnaire to assess such concepts of autonomy.Methods: A questionnaire, based on six moral concepts from the ethics literature, was sent to aneurysm (...) patients and their surgeons. The structure of the questionnaire was assessed by factor analysis, and item reduction was based on reliability.Results: Ninety six patients and 58 surgeons participated. The questionnaire consisted of four scales. Two of the scales reflected the paternalistic and consumerist poles of the liberal individualist model, one scale reflected concepts of Socratic autonomy and of procedural independence, and the fourth scale reflected ideals of risk disclosure.Discussion: The Ideal Patient Autonomy Scale is a 14 item normative instrument. It is clearly distinct from the generally used psychological preference questionnaires that assess preferences for physician-patient roles. (shrink)

In The Idea of a Social Science Winch, argues that, sociology is more properly conceived as a branch of philosophy than of empirical science. Winch falls victim here to the Humean assimilation of the empirical to the generalizable. He notes that much of our talk about social practice is in terms of conventions, so that explanations of social action can be given without recourse to statistical or experimental findings. But such talk depends nonetheless on the accuracy and detail with which (...) the situations in which actions occur are? recorded, and this is surely an empirical enterprise. It is the misleading conception of sociology as a discipline, characterized by common procedures, that leads Winch to espouse the assimilation of sociology to conceptual inquiry. We need to see instead that sociology embraces a group of questions and subjects so loosely connected that it would be mistaken to speak of, and idle to project, a procedure common to all of them. (shrink)