Sex. Die meisten von uns haben ihn. Mal schlecht, mal gut, manchmal phänomenal. Die wenigsten denken lange drüber nach. Oder reden offen drüber. Dabei ist gar nicht so klar, was Sex eigentlich gut macht. Und wann ist Sex schlecht? Oder nicht nur schlecht, sondern sogar moralisch problematisch? Hilkje Hänel zeigt, dass es gar nicht so einfach ist, zwischen (moralisch) problematischem Sex und gutem Sex klar zu unterscheiden und dass es dabei häufig vor allem auf den Kontext und unsere Kommunikation ankommt. (...) Auf der Basis aktueller Wissenschaft und medialer Bewegungen wie #MeToo verteidigt Hänel ihre Ansichten gegen die wichtigsten Einwände und argumentiert für mehr Respekt im Bett. (shrink)

Experimental vaccines are being developed for the treatment of ‘unhealthy lifestyles’ and associated chronic illnesses. Policymakers and other stakeholders will have to deal with the ethical issues that this innovation path raises: are there morally justified reasons to integrate these innovative biotechnologies in future health policies? Should public money be invested in further research? Focusing on the case of an experimental nicotine vaccine, this article explores the ethical aspects of ‘lifestyle vaccines’ for public health. Based on findings from a qualitative (...) study into a vaccine for smoking cessation, the article articulates possible value conflicts related to nicotine vaccination as an intervention in tobacco control. The ‘vaccinization’ of lifestyle disease piggybacks on the achievements of classic vaccines. Contrary to expectations of simplicity and success, quitting smoking with a vaccine requires a complex supportive network. Social justice and public trust may become important ethical challenges when deciding whether to use further public funds for research or whether to implement these innovative vaccines in the future. (shrink)

Mary Kate McGowan’s Just Words offers an interesting account of exercitives. On McGowan’s view, one of the things we do with words is change what’s permitted, and we do this ubiquitously, without any special authority or specific intention. McGowan’s account of exercitives is meant to identify a mechanism by which ordinary speech is harmful, and which justifies the regulation of such speech. It is here that I part ways. I make three main arguments. First, McGowan’s focus on harm is misguided; (...) that ordinary speech is harmful is harder to support, and in turn does not less to support conclusions about whether it is wrong and warrants regulation, than Just Words suggests. Second, if the speech is harmful, McGowan’s account of exercitives is ill-suited to explain why; the relevant instances of ordinary speech seem to express speakers’ views about moral norms, not change social norms. Third, McGowan’s argument for why ordinary speech should be regulated because it is a form of discrimination presupposes a great deal that is controversial about what makes discrimination wrong and legally actionable, and even if it is right it may license the regulation of more speech than many, including McGowan, would deem acceptable. (shrink)

It is sometimes argued that practices such as organ-selling should be prohibited because they are demeaning to the individuals involved. In this article the plausibility of such an argument is questioned. I will examine what it means to demean or be demeaned, and suggest that the mere fact that an individual is demeaning themself does not provide sufficient justification for legal prohibition. On the contrary, such laws might be argued to be demeaning.

In a recent article, Ethan Bradley and Mark Navin (2021) argue that vaccine refusal is not akin to free riding. Here, I defend one connection between vaccine refusal and free riding and suggest that, when viewed in conjunction with their other arguments, this might constitute a reason to mandate Covid-19 vaccination.

This article evaluates the moral status of hominins, and obligations we may have towards them. In exploring these ethical considerations, I consider one of the most recent hominin finds: the ‘graveyard’ of Homo naledi in the Dinaledi caves at the Cradle of Humankind in South Africa. I argue that findings about H. naledi establish a pro tanto duty not to excavate their remains.

It is relatively uncontroversial that some public health policies are paternalistic. Furthermore, that they are paternalistic is often taken to show that they are morally wrong. In this article I challenge this position. The article starts by arguing that given standard definitions of paternalism it is unclear why such policies count as paternalistic. Whilst it might appear that they impose restrictions on what individuals can, or cannot, do for their own good, this is not the case. The reason for this (...) is that whilst public health policies focus on achieving benefits at a population or group level, the imposition is made at the level of the individual. If we are to retain the idea that such policies are paternalistic we must characterize them in such a way that both the benefit and imposition are at the same level: either that of the individual or that of the group. I argue that in many cases moving to the group level is the only plausible option. However, if we move to the group level, the features that make a policy paternalistic will not, unlike in those cases where paternalism is targeted at an individual, make the policy morally wrong. (shrink)

Although health and disease occupy opposite ends of a spectrum, distinguishing between them can be difficult. This is the “line-drawing” problem. The papers in this special issue engage with this challenge of delineating the boundaries of disease. The authors explore different views as to where the boundary between disease and nondisease lies, and related questions, such as how we can identify, or decide, what counts as a disease and what does not; the nature of the boundary between the two categories; (...) and what sorts of considerations could justify the location of that boundary. In exploring these questions, the papers draw on detailed clinical examples, provide theoretical critiques of existing approaches to disease definition, and offer new ways to conceptualize key features in debates about disease, including harm and biological dysfunction. (shrink)

It has been suggested that, in addition to individual level decision-making, informed consent procedures could be used in collective decision-making too. One of the main criticisms directed at this suggestion concerns decision-making power. It is maintained that consent is a veto power concept and that, as such, it is not appropriate for collective decision-making. This paper examines this objection to collective informed consent. It argues that veto power informed consent can have some uses in the collective level and that when (...) it is not appropriate the decision power a concerned party ought to have in connection with an arrangement should be made relative to the interest she has at stake in it. It concludes that the objection examined does not undermine collective informed consent. (shrink)

In the Social Contract Rousseau gives what could be called a philosophical rule of recognition for law in Modernity: a law is law if and only if 'the whole people rules over the whole people'. Thus, he defines self-legislation as, at bottom, collective intentional action. I will first map out the speech act structure [LEX] underlying self-legislation on this account. In particular, I argue for a first person plural counterpart of the reflexive structure inherent to intentions generally: the notion of (...) a collective self. Then I take issue with Bratman's analysis of shared intentional activity in terms of mutuality, submitting that it misses out on the specifically political presupposition involved in 'doing something together'. I will show why 'mutuality' requires representation of the unity of a polity, and how this representation can take form without either external authority or mutual responsiveness. (shrink)

An increasing number of older patients have to decide on a treatment plan for advanced chronic kidney disease, involving dialysis or conservative care. Shared decision-making is recommended as the model for decision-making in such preference-sensitive decisions. The aim of SDM is to come to decisions that are consistent with the patient’s values and preferences and made by the patient and healthcare professional working together. In clinical practice, however, SDM appears to be not yet routine and needs further implementation. A shift (...) from a biomedical to a person-centered conception might help to make the process more shared. Shared should, therefore, be interpreted as two persons bringing two perspectives to the table, that both need to be explored during the decision-making process. Starting from the patient’s perspective will enable to determine the mutual goals of care first and, subsequently, determine the best way for achieving those goals. To perform such SDM, the healthcare professional needs to become a skilled companion, being part of the patient’s relational context, and start asking the right questions about what matters to the patient as person. In this article, we describe the need for a person-centered conception of SDM for the setting of older patients with advanced CKD. (shrink)

This essay examines contemporary liberal theory in light of the 12 cartoons of the Prophet Muhammad, first published in the Danish newspaper Jyllands-Posten. The objective is both to show the limits of liberal theory, in particular with regard to constituents who do not share liberalism's view of acceptable harm, and to discuss how these limits give us reason to supplement liberal theory with other recourses from critical theory and phenomenology. The essay warns against a bifurcation of law and harm, and (...) instead argues for a pluralization of the possible links between them. To this end, the essay foregrounds what T.M. Scanlon dubs a certain ‘creative instability’, which works to energize liberalism's practice of free speech. The essay tracks this possibility in relation to the plurality and energy intrinsic to the 12 Jyllands-Posten cartoons, and suggests that liberal theory can learn from thinkers such as Merleau-Ponty and Deleuze who focus on the variable impacts and framings of free speech. The upshot is a self-critical theory of free expression, one that links harmful speech to the affirmation of mutual contestation, social equality and respect for difference. (shrink)

One of the most important assumptions in liberal societies is that citizens should be tolerant of a diversity of values. We are challenged by this assumption to justify restraint when we confront what we oppose, disapprove of, or perceive to be immoral, even if we have the power to suppress perceived immoralities. Based on the work of Elliot Turiel, Jonathan Haidt, and Gerald Gaus, the argument developed in this article is that the best way to address the challenge is to (...) distinguish between public morality and other normative categories such as convention and private morality. Public morality circumscribes what should not be publicly tolerated. Conventional and private immoralities that are not prohibited by public morality should be tolerated. (shrink)

McGowan argues “that ordinary utterances routinely enact norms without the speaker having or exercising any special authority” and thereby not “merely cause” but “constitute” harm if harm results from adherence to the enacted norms. The discovery of this “previously overlooked mechanism,” she claims, provides a potential justification for “further speech regulation.” Her argument is unsuccessful. She merely redefines concepts like “harm constitution” and “norm enactment” and fails to explain why speech that “constitutes” harm is legally or morally problematic and thus (...) an initially more plausible target for speech regulation than speech that “merely causes” harm. Even if she could explain that, however, her account would still be incapable of identifying cases where utterances “constitute harm.” This is so for two reasons. First, she provides neither analytical nor empirical criteria for deciding which so-called “s-norms” have been enacted by an “ordinary utterance.” Second, even if such criteria could be provided, there is no epistemically available means to distinguish whether harm has ensued due to adherence to the enacted s-norms or through other mechanisms. Given this lack of criteria and practical applicability, there is no way that this account could serve as a principled basis for speech regulation – it could only serve as a pretext for arbitrary censorship. (shrink)

This article describes how a small but vocal group of biomedical scientists propagates the views that either HIV is not the cause of AIDS, or that it does not exist at all. When these views were rejected by mainstream science, this group took its views and arguments into the public domain, actively campaigning via newspapers, radio, and television to make its views known to the lay public. I describe some of the harmful consequences of the group's activities, and ask two (...) distinct ethical questions: what moral obligations do scientists who hold such minority views have with regard to a scientifically untrained lay audience, and what moral obligations do mainstream newspapers and government politicians have when it comes to such views. The latter question will be asked because the 'dissidents' succeeded for a number of years in convincing the South African government of the soundness of their views. The consequences of their stance affected millions of HIV infected South Africans severely. (shrink)

In his latest book, Criminalizing Sex (2020), Stuart P. Green, professor of philosophy of law at Rutgers, develops a unified liberal theory of the criminalization of sexual offenses. The exercise he undertakes is not an easy. Nevertheless, through the use of accessible language, rigorous reasoning and sometimes amusing examples, Green succeeds in offering both a state of the art of knowledge on the subject and in elaborating a legal system that allows for the advancement of thinking in the area of (...) sexual offenses according to the liberal ethics of harms and wrongs. The author starts from the observation that in recent years, criminal legislation on sexual offenses has undergone profound transformations: it has generally become more repressive with regard to non-consensual relationships (rape, sexual assault, etc.) but also more flexible with regard to mutually consensual relationships (homosexuality, adultery, etc.). This apparent double movement invites him to explore conceptual and normative implications of these divergent tendencies, starting from the premise that an ideal liberal criminal justice system should only punish situations where a perpetrator would impose a non-consensual sexual relationship on another. Such a vision of law, which emphasizes individual autonomy while preventing harm to others, follows in the footsteps of those promoted by John Stuart Mill (On Liberty), Herbert L.A. Hart (The Morality of the Criminal Law), and Joel Feinberg (The Moral Limits of the Criminal Law, 4 vols.). (shrink)

Non-beneficial paediatric research is vital to improving paediatric healthcare. Nevertheless, it is also ethically controversial. By definition, subjects of such studies are unable to give consent and they are exposed to risks only for the benefit of others, without obtaining any clinical benefits which could compensate those risks. This raises ethical concern that children participating in non-beneficial research are treated instrumentally; that they are reduced to mere instruments for the benefit of science and society. But this would make the research (...) incompatible with the widely endorsed principle of the primacy of the human subject, which stipulates that the interests of the participating individual should prevail over the interests of science and society. This paper deals with this conflict. It analyses solutions to this problem developed in the literature, and shows that they are unsuccessful. Finally, it offers a new idea of how to reconcile the conduct of non-beneficial paediatric research with the PP. The paper argues for a new formula of the PP, and shows that it implies a specific non-comparative definition of the minimal risk threshold. (shrink)

'Brainjacking’ refers to the exercise of unauthorized control of another’s electronic brain implant. Whilst the possibility of hacking a Brain–Computer Interface (BCI) has already been proven in both experimental and real-life settings, there is reason to believe that it will soon be possible to interfere with the software settings of the Implanted Pulse Generators (IPGs) that play a central role in Deep Brain Stimulation (DBS) systems. Whilst brainjacking raises ethical concerns pertaining to privacy and physical or psychological harm, we claim (...) that the possibility of brainjacking DBS raises particularly profound concerns about individual autonomy, since the possibility of hacking such devices raises the prospect of third parties exerting influence over the neural circuits underpinning the subject’s cognitive, emotional and motivational states. However, although it seems natural to assume that brainjacking represents a profound threat to individual autonomy, we suggest that the implications of brainjacking for individual autonomy are complicated by the fact that technologies targeted by brainjacking often serve to enhance certain aspects of the user’s autonomy. The difficulty of ascertaining the implications of brainjacking DBS for individual autonomy is exacerbated by the varied understandings of autonomy in the neuroethical and philosophical literature. In this paper, we seek to bring some conceptual clarity to this area by mapping out some of the prominent views concerning the different dimension of autonomous agency, and the implications of brainjacking DBS for each dimension. Drawing on three hypothetical case studies, we show that there could plausibly be some circumstances in which brainjacking could potentially be carried out in ways that could serve to enhance certain dimensions of the target’s autonomy. Our analysis raises further questions about the power, scope, and necessity of obtaining prior consent in seeking to protect patient autonomy when directly interfering with their neural states, in particular in the context of self-regulating closed-loop stimulation devices. (shrink)

This paper offers an analysis of the relation between political populism and mass media, and how this relation becomes problematic for democratic societies. It focuses on the fact that mass media, due to their purpose and infrastructure, can unintentionally reinforce populist messages. Research findings from communication science and political psychology are used to illustrate how, for example, a combination of mass media agenda setting and motivated reasoning can influence citizens’ political decisions and impair their political autonomy. This poses a particular (...) normative challenge for modern democracies: how to counter these populism-supporting effects within the constraints of democratic legitimacy? After showing how severely limited legal measures to curb populist media effects would be, the paper argues in favour of media competence education as a way of providing future citizens with an epistemic toolkit to navigate the media environment and strengthen their political autonomy. (shrink)

In some cases, you may release someone from some obligation they have to you. For instance, you may release them from a promise they made to you, or an obligation to repay money they have borrowed from you. But most take it as clear that, if you have an obligation to someone else, you cannot in any way release yourself from that obligation. I shall argue the contrary. The issue is important because one standard problem for the idea of having (...) duties to oneself relies on the impossibility of self-release. The argument is that a duty to oneself would be a duty from which one could release oneself, but that this is an absurdity, and so there can be no duties to oneself. This argument is to be rejected because a duty from which one can release oneself is perfectly possible, and such release occurs quite properly from time to time. (shrink)

Critics have long dismissed paternalistic choice architecture as conceptually muddled at best and oxymoronic at worst. In this article, I argue that this criticism remains true despite recent replies to the contrary. Further, I suggest that a similar conceptual criticism also applies to non-paternalistic choice architecture. This is due to a three-way tension between the effectiveness, avoidability, and distinctiveness of each nudge. To illustrate this tension, I provide a novel explanation of the mechanics of nudging and a taxonomy of these (...) interventions. I then argue that choice architects who defend the distinctiveness of nudging according to how it guides our behaviour via our unreflective intuitive reasoning encounter a trilemma because the distinctiveness of nudging hinges on interventions being both avoidable and effective. Choice architects cannot achieve this aim without harnessing both our automatic and reflective systems of thought in tandem. However, this diminishes the distinctive character of nudging by bringing it closer to other traditional policy interventions. This establishes the choice architect’s trilemma: a nudge is likely to be either ineffective, effective via some morally unacceptable means, or effective in a manner that is conceptually indistinct from other evidence-based policy interventions. (shrink)

This article considers the sort of diversity in perspective appropriate for a presidential commission on bioethics, and by implication, high-level governmental commissions on ethics more generally. It takes as its point of comparison the respective reports on human cloning produced by the National Bioethics Advisory Commission, appointed by President Bill Clinton, and George W. Bush's President's Council on Bioethics, under the leadership of its original chair, Leon Kass. I argue that the Clinton Commission Report exemplifies forensic diversity (the type of (...) diversity between contesting parties in a legal case), while the Kass Council Report exemplifies academic diversity (the diversity found in a medieval disputatio). Drawing upon Thomas Aquinas, I argue that the type of diversity most appropriate for such advisory bodies is deliberative diversity, which facilitates the President's process of taking counsel. After considering their respective charges, I suggest that neither the Clinton Commission nor the Kass Council possessed an adequate degree of deliberative diversity for their respective tasks. (shrink)

In the long-running debate on the interest of the dead, Joan C. Callahan argues against such interests and although Søren Holm for practical reasons is prepared to consider posthumous interests, he does not see any moral basis to support such interests. He argues that the whole question is irresolvable, yet finds privacy interests where Tutankhamen is concerned. Callahan argues that there can be reasons to hold on to the fiction that there are posthumous interests, namely if it is comforting for (...) the living and instrumental for society. Thus, despite arguing against the position that the dead have any interests or for any moral basis for such interests, these “interests” are still taken into consideration in the end. This shows the unsatisfactory basis of their positions and indicates the tenacity of the moral intuition that the dead can have moral claims on the living. One example of a posthumous interest is the interest in one’s good name. Here we argue that it is an interest of moral significance. This implies that if individuals restrict use of their sample when they are still alive, those restrictions apply after their death. Further, it implies that one should be concerned with the reputation of historic persons. Research that defeats these interests calls for justification. We have suggested two lines of thinking along which such a discussion could go: investigating the truth-value of the good name and the relevance of bringing it into possible disrepute. (shrink)

There is broad agreement that humans can be wronged independently of their incurring any harm, that is, when their welfare is not affected. Examples include unnoticed infringements of privacy, ridiculing unaware individuals, or disregarding individuals’ autonomous decision-making in their best interest. However, it is less clear whether the same is true of animals—that is, whether moral agents can wrong animals in situations that do not involve any harm to the animals concerned. In order to answer this question, I concentrate on (...) the illustrative case of treating animals in a demeaning yet harmless way that would be disrespectful if humans were concerned. I discuss whether such actions are permissible or unjustifiably discriminatory from a moral point of view. I conclude that moral agents cannot directly wrong animals without harming them and thus do not owe it to a particular animal to refrain from such actions. However, if the actions increase the likelihood that animal abuse will occur, this presents a strong indirect reason against performing them. Thus, the reasons for refraining from such actions are merely indirect rather than direct. (shrink)

Human papillomavirus (HPV) infection is the world’s most common sexually transmitted infection. It is a prerequisite for cervical cancer, the second most common cause of death in cancer among women worldwide, and is also believed to cause other anogenital and head and neck cancers. Vaccines that protect against the most common cancer-causing HPV types have recently become available, and different countries have taken different approaches to implementing vaccination. This paper examines the ethics of alternative HPV vaccination strategies. It devotes particular (...) attention to the major arguments for and against one strategy: voluntary, publicly funded vaccination for all adolescent boys and girls. This approach seems attractive because it would protect more people against cervical cancer and other HPV-related cancers than less inclusive alternatives, without the sacrifice of autonomy that a comparably broad compulsory programme would require. Also, the herd immunity that it would likely generate would protect those who remain unvaccinated, a major advantage from a justice perspective. However, there is a possibility that a HPV vaccination programme targeting all adolescents of both sexes is not considered sufficiently cost-effective. Also, it might pose more difficulties for achieving informed consent than comparable vaccination programmes against other diseases. Ultimately, society’s choice of HPV vaccination strategy requires careful consideration not only of the values at stake but also of available and emerging scientific evidence. (shrink)

Inequalities of social goods between gender, racial, or other groups call out for explanation. Such inequalities might be explained by socialization and discrimination. But historically some have attributed these inequalities to biological differences between social groups. Such explanations are highly controversial: on the one hand, they have a very troubling racist and sexist history, but on the other hand, they are empirical claims, and so it seems inappropriate to rule them out a priori. I propose that the appropriate epistemic attitude (...) toward biological explanations of social inequalities is a general but defeasible skepticism. I then turn to the appropriate moral attitude, arguing that when such explanations are inadequately supported, they are offensive. (shrink)

This paper discusses what kinds of conflicts arise when a crime has been committed, and with whom—and in which of their possible roles—the offender should be seen as having such conflicts. The possible roles of the victim are in focus, as is the constitutive role of the act of criminalizing a certain kind of behavior. It is argued that while in the tort conflict the victim should be seen as a party qua him- or herself in a ‘fuller’ sense (and (...) with full freedom on how to handle the conflict, including dropping it), in the criminal law conflict it is community, the ‘we’, that should be looked upon as the party to the conflict with the offender. The victim should not be seen as excluded from the criminal law conflict, though: to the contrary, he or she is a member of community and has an important role to play. This role, however, needs to be strictly defined in a way that gives the victim the function of a certain kind of representative for ‘us’, the community. This role should not allow the victim much room to influence how the criminal law conflict is handled. The model I am suggesting presupposes—I think, at least—that criminal law conflict and tort conflict should be handled together at the same trial. (shrink)

Genomic research can reveal ‘unsolicited’ or ‘incidental’ findings that are of potential health or reproductive significance to participants. It is widely thought that researchers have a moral obligation, grounded in the duty of easy rescue, to return certain kinds of unsolicited findings to research participants. It is less widely thought that researchers have a moral obligation to actively look for health-related findings. This paper examines whether there is a moral obligation, grounded in the duty of easy rescue, to actively hunt (...) for genomic secondary findings. We begin by showing how the duty to disclose individual research findings can be grounded in the duty of easy rescue. Next, we describe a parallel moral duty, also grounded in the duty of easy rescue, to actively hunt for such information. We then consider six possible objections to our argument, each of which we find unsuccessful. Some of these objections provide reason to limit the scope of the duty to look for secondary findings, but none provide reason to reject this duty outright. We argue that under a certain range of circumstances, researchers are morally required to hunt for these kinds of secondary findings. Although these circumstances may not currently obtain, genomic researchers will likely acquire an obligation to hunt for secondary findings as the field of genomics continues to evolve. (shrink)

This article considers the sort of diversity in perspective appropriate for a presidential commission on bioethics, and by implication, high-level governmental commissions on ethics more generally. It takes as its point of comparison the respective reports on human cloning produced by the National Bioethics Advisory Commission, appointed by President Bill Clinton, and George W. Bush's President's Council on Bioethics, under the leadership of its original chair, Leon Kass. I argue that the Clinton Commission Report exemplifies forensic diversity (the type of (...) diversity between contesting parties in a legal case), while the Kass Council Report exemplifies academic diversity (the diversity found in a medieval disputatio). Drawing upon Thomas Aquinas, I argue that the type of diversity most appropriate for such advisory bodies is deliberative diversity, which facilitates the President's process of taking counsel. After considering their respective charges, I suggest that neither the Clinton Commission nor the Kass Council possessed an adequate degree of deliberative diversity for their respective tasks. (shrink)

In this paper I make the following claims. In order to see anthropogenic climate change as clearly involving moral wrongs and global injustices, we will have to revise some central concepts in these domains. Moreover, climate change threatens another value that cannot easily be taken up by concerns of global justice or moral responsibility.

What is the moral value of formal democratic decision-making? Egalitarian accounts of democracy provide a powerful answer to this question. They present formal democratic procedures as a way for a society of equals to arrive at collective decisions in a transparent and mutually acceptable manner. More specifically, such procedures ensure and publicly affirm that all members of a political community, in their capacity as autonomous actors, are treated as equals who are able and have a right to participate in collective (...) decision-making. Recently, a number of authors have raised what I describe as the ‘no impact’ objection. This objection focuses on the egalitarian emphasis on autonomy to cast doubt on the moral value of formal democratic procedures. It holds that individual participation in formal democratic decision-making has no impact on the eventual result, and therefore cannot be understood as an exercise in autonomy. Consequently, the ‘no impact’ objection claims that the moral value of formal democracy cannot be explained with reference to an egalitarian ideal of ‘rule by the people’. In this article, I refute this objection by complementing an egalitarian account of democracy with an account of basic autonomy. (shrink)

ZusammenfassungOnora O’Neill hat 1984 den Zusammenhang zwischen grundsätzlichen Bedenken gegenüber dem ethischen Autonomiebegriff und der Kritik an der paternalistisch geprägten medizinethischen Praxis hergestellt, nicht die tatsächliche Einwilligung des konkreten Patienten zu berücksichtigen, sondern die angenommene, hypothetische Einwilligung, die ein idealisierter, völlig rationaler Patient geben würde. Im Anschluss an experimentalpsychologische Studien zur subliminalen Wahrnehmung, zu Volition und Handlungskontrolle erfahren kompatibilistische Theorien menschlicher Freiheit innerhalb der theoretischen Philosophie neue Popularität. Eine Handlung ist demnach frei, wenn sie das Resultat bestimmter Fähigkeiten einer Person (...) ist („Kompetenztheorie“). Der Artikel setzt sich mit zwei dieser Theorien, Henrik Walters Konzept „natürlicher Freiheit“ und Michael Pauens „Minimalkonzeption personaler Freiheit“ näher auseinander—und zwar vorderhand im Hinblick auf den Entwurf eines nichtidealisierten ethischen Autonomiekonzeptes. Als solches ist es an der aktualen bzw. faktischen Fähigkeit einer Person ausgerichtet, rekurrierend auf die spezifische Determiniertheit autonomer Entscheidungen und Handlungen sowie auf ein relativiertes Konzept menschlicher Vernunft. (shrink)

ZusammenfassungOnora O’Neill hat 1984 den Zusammenhang zwischen grundsätzlichen Bedenken gegenüber dem ethischen Autonomiebegriff und der Kritik an der paternalistisch geprägten medizinethischen Praxis hergestellt, nicht die tatsächliche Einwilligung des konkreten Patienten zu berücksichtigen, sondern die angenommene, hypothetische Einwilligung, die ein idealisierter, völlig rationaler Patient geben würde. Im Anschluss an experimentalpsychologische Studien zur subliminalen Wahrnehmung, zu Volition und Handlungskontrolle erfahren kompatibilistische Theorien menschlicher Freiheit innerhalb der theoretischen Philosophie neue Popularität. Eine Handlung ist demnach frei, wenn sie das Resultat bestimmter Fähigkeiten einer Person (...) ist. Der Artikel setzt sich mit zwei dieser Theorien, Henrik Walters Konzept „natürlicher Freiheit“ und Michael Pauens „Minimalkonzeption personaler Freiheit“ näher auseinander—und zwar vorderhand im Hinblick auf den Entwurf eines nichtidealisierten ethischen Autonomiekonzeptes. Als solches ist es an der aktualen bzw. faktischen Fähigkeit einer Person ausgerichtet, rekurrierend auf die spezifische Determiniertheit autonomer Entscheidungen und Handlungen sowie auf ein relativiertes Konzept menschlicher Vernunft. (shrink)

The traditional liberal view on conflicts between care for wellbeing and respect for choice and desire is that we should look to degrees of competence and voluntariness to determine which moral imperative should take priority. This view has likely influenced the common view that children’s choices should be considered only to the extent that this promotes their future autonomy and helps us determine their best interests. I reject both the general traditional liberal view and its application to children. Competence and (...) voluntariness, as well as maturity, are at best proxies for what really matters, which is wellbeing, choice and desire. We typically have reason to respect children’s choices, irrespective of any further positive consequences. If we should more often make children do what they do not want to do, this is mainly because, though we should care about respecting their choices, we should care even more about their wellbeing and future autonomy. (shrink)

Many parents are hesitant about, or face motivational barriers to, vaccinating their children. In this paper, we propose a type of vaccination policy that could be implemented either in addition to coercive vaccination or as an alternative to it in order to increase paediatric vaccination uptake in a non-coercive way. We propose the use of vaccination nudges that exploit the very same decision biases that often undermine vaccination uptake. In particular, we propose a policy under which children would be vaccinated (...) at school or day-care by default, without requiring parental authorization, but with parents retaining the right to opt their children out of vaccination. We show that such a policy is likely to be effective, at least in cases in which non-vaccination is due to practical obstacles, rather than to strong beliefs about vaccines, ethically acceptable and less controversial than some alternatives because it is not coercive and affects individual autonomy only in a morally unproblematic way, and likely to receive support from the UK public, on the basis of original empirical research we have conducted on the lay public. (shrink)

This paper investigates legal and moral justificationsof coerced treatment for psychiatric patients who aredetained on the grounds that they may harm others.While the general issues concerning compulsorytreatment and detention have been widely canvassed, ithas seldom, if ever, been noticed that the moralreasons that we may have to detain a person whoappears to be dangerous to others are different fromthe moral reasons we may have to treat him or her. For example, it has not been noticed that compulsorydetention and compulsory treatment (...) are supported bytwo different moral principles, namely the Principleof Harm and the Principle of Beneficence, and,therefore, that the arguments which support compulsorydetention do not also support compulsorytreatment. The conceptual confusion between legitimacyof compulsory detention and legitimacy of compulsorytreatment is exacerbated by the ambiguous wordingutilised in S 3 of the UK Mental Health Act, whichimplies that treatment may be necessary for theprotection of others. Failure to pay attention to these distinctions has led to tragic consequences, in terms of violations of individual autonomy and in terms of public safety. (shrink)

Three views of sustainability are juxtaposed with four views about who the members of the moral community are. These provide points of contact for understanding the moral issues in sustainability. Attention is drawn to the preferred epistemic methods of the differing factions arguing for sustainability. Criteria for defining membership in the moral community are explored; rationality and capacity for pain are rejected as consistent criteria. The criterion of having interests is shown to be most coherent for explaining why all living (...) humans belong to the moral community. This criterion allows inclusion of future generations as well, and extends to animals and plants membership in the moral community. Inferences are drawn that food sufficiency advocates hold only presently living persons to be full-fledged members of the moral community, but that this view is internally inconsistent. Stewards should agree that all living things are members of the moral community. A distinction between welfare interests and ulterior interests allows the steward to include the aims of those who argue for sustainability as community without committing some of their errors. Community advocates argue that essential values and virtues will be lost is the culture of agriculture is transformed. I argue that community advocates may fail to pass on our most important virtue — justice — without such a transformation. (shrink)

In this paper I propose and develop a social account of global autonomy. On this view, a person is autonomous simply to the extent to which it is difficult for others to subject her to their wills. I argue that many properties commonly thought necessary for autonomy are in fact properties that tend to increase an agent’s immunity to such interpersonal subjection, and that the proposed account is therefore capable of providing theoretical unity to many of the otherwise heterogeneous requirements (...) of autonomy familiar from recent discussions. Specifically, I discuss three such requirements: (i) possession of legally protected status, (ii) a sense of one’s own self-worth, and (iii) a capacity for critical reflection. I argue that the proposed account is not only theoretically satisfying but also yields a rich and attractive conception of autonomy. (shrink)

Toleration is one of the fundamental principles that inform the design of a democratic and liberal society. Unfortunately, its adoption seems inconsistent with the adoption of paternalistically benevolent policies, which represent a valuable mechanism to improve individuals’ well-being. In this paper, I refer to this tension as the dilemma of toleration. The dilemma is not new. It arises when an agent A would like to be tolerant and respectful towards another agent B’s choices but, at the same time, A is (...) altruistically concerned that a particular course of action would harm, or at least not improve, B’s well-being, so A would also like to be helpful and seeks to ensure that B does not pursue such course of action, for B’s sake and even against B’s consent. In the article, I clarify the specific nature of the dilemma and show that several forms of paternalism, including those based on ethics by design and structural nudging, may not be suitable to resolve it. I then argue that one form of paternalism, based on pro-ethical design, can be compatible with toleration and hence with the respect for B’s choices, by operating only at the informational and not at the structural level of a choice architecture. This provides a successful resolution of the dilemma, showing that tolerant paternalism is not an oxymoron but a viable approach to the design of a democratic and liberal society. (shrink)

This paper seeks to identify a mid-level unifying ethical principle that may help clarify and articulate the ethical responsibilities of business firms in the field of marketing ethics. The paper examines critically the main principles which have been proposed to date in the literature, namely consumer sovereignty, preserving the conditions of an acceptable exchange, paternalism, and the perfect competition ideal, and concludes that all of them are vulnerable to damaging criticisms. The paper articulates and defends the mutuality principle as the (...) most plausible candidate for the role of master principle in the relations between a firm and its customers. This principle requires that sellers look for reciprocity in their relations with their customers, seeking to provide to their customers something that helps them improve in some way their well-being and is commensurate with what they receive from them. (shrink)

It is often alleged that an agent is morally responsible in a liability sense for a transgression just in case s/he deserves a negative interpersonal response for that transgression, blaming responses such as resentment and indignation being paradigms. Aside from a few exceptions, guilt is cited in recent discussions of moral responsibility, if at all, as merely an effect of being blamed, or as a reliable indicator of moral responsibility, but not itself an explanation of moral responsibility. In this paper, (...) I argue that an agent is morally responsible in a liability sense for a transgression just in case s/he deserves to feel moral guilt for that transgression. I argue that this alternative view offers all that the predominant blame-focused view offers, while also solving some puzzling features of moral responsibility. Specifically, it offers a compelling way to reconcile conflicting intuitions about the suberogatory, and allows those who do not understand what Darwall calls ‘second-personal’ reasons to be morally responsible for their immoral acts. (shrink)

Für die Argumentation von Moralphilosophen, die die Legalisierung der aktiven Sterbehilfe befürworten, spielt das Autonomieprinzip eine wichtige Rolle. Ihrer Auffassung nach verlangt der Respekt vor der Autonomie, die Entscheidung eines schwer kranken Menschen gegen die Fortsetzung des Lebens vorbehaltlos anzuerkennen. Dagegen haben verschiedene Theoretiker auf Gefahren hingewiesen, die die rechtliche Zulassung der Tötung auf Verlangen für die individuelle Autonomie mit sich bringt. Sobald der Kranke über die Möglichkeit der aktiven Sterbehilfe verfüge, falle ihm die Verantwortung für die Inanspruchnahme von Pflegeleistungen (...) zu. In der Folge könne u. a. von Seiten der Familie die Forderung an ihn gestellt werden, den vom Gesetzgeber eröffneten Ausweg zu nutzen und sie von der Last seiner Pflege zu befreien. Die Bedenken erscheinen insofern berechtigt, als Formen sozialen Zwangs vorstellbar sind, die eine freie Entscheidung des Patienten verhindern. Allerdings vermag weder das Verbot noch die Zulassung der aktiven Sterbehilfe eine autonome Entscheidung aller Individuen zu gewährleisten. Die Abwägung der Risiken, mit denen beide Optionen behaftet sind, spricht im Ergebnis für die Legalisierung der Tötung auf Verlangen. (shrink)

The interest in "social sustainability" has recently increased in the field of urban development. We want societies, cities, and neighborhoods to be economically and environmentally sustainable, but we also want urban areas that are safe, diverse, walkable, and relaxing, just to mention a few examples. Strikingly, however, there is no consensus regarding what definition of "social sustainability" should be employed. Additionally, some people are skeptical about the prospect of finding a useful definition at all and claim it is impossible to (...) satisfactorily define the concept for various reasons, such as its complexity. A potential first step towards navigating this conceptual maze is to provide desiderata for a definition of social sustainability. We defend a list of nine desiderata and thereby create a theoretical framework for analyzing and constructing a definition of "social sustainability". We also examine the skeptical arguments and find that it is premature to conclude that the goal of finding a useful definition is hopeless. With the criteria in place, the future debate can proceed by assessing definitions of "social sustainability" in a more structured and transparent manner. This activity is of upmost importance if we want to create just cities. Keywords: Social Sustainability, Definition, Purposes and Aims, Conditions of Adequacy. (shrink)

Discussions of ‘cultural appropriation’ in popular culture suffer from an inherited politics of authenticity and ownership originating in a liberal legal–ethical framework. Here, I use Raymond Williams’s and Stuart Hall’s cultural theory to pinpoint the place at which cultural-appropriation discourse goes wrong – an essentialist and anti- historical notion of colonial encounters. We can overcome these limits through Marxist cultural and historical analysis. Outrage about colonial violence which most often roots appropriation discourse is better understood within the context of an (...) account of the transition to capitalism beginning with the Low Countries and their eastern colonies. Furthermore, the Marxist idea of the cosmopolitan cultures of both capital and labour offers a productive path for the history of culture rooted in the same colonial encounter. (shrink)

This paper seeks to provide some of the roles of philosophy in the field of academic ethics.

Beneficence and respect for autonomy are two of the most fundamental moral duties in general and in bioethics in particular. Beyond the usual questions of how to resolve conflicts between these duties in particular cases, there are more general questions about the possible forms of the interactions between them. Only recognition of the full spectrum of possible interactions will ensure optimal moral deliberation when duties potentially conflict. This paper has two simultaneous objectives. The first is to suggest a typological scheme (...) of all possible modes of interaction; these will be classified under the “discrete,” “semi-discrete,” and “non-discrete” categories, according to whether the meaning and/or forms of expression of each duty are treated as independent from or rather as constrained by the other. The second objective is to show that all logical possibilities of interaction indeed have real expressions in medical ethics, to provide clear illustrations of each, and in particular to stress those that have usually escaped recognition. (shrink)