This article argues that immoralists do not fully enjoy autonomous agency because they are not capable of engaging in the proper form of practical reflection, which requires relating to others as having equal standing. An adequate diagnosis of the immoralist’s failure of agential authority requires a relational account of reflexivity and autonomy. This account has the distinctive merit of identifying the cost of disregarding moral obligations and of showing how immoralists may become susceptible to practical reason. The compelling quality of (...) reason should not be represented as the capacity to force them to abide by morality on pain of incoherence. Rather, its authority (and objectivity) is shown when it presents them with the prospect of a transition that makes sense for them to undertake. (shrink)

It has been well documented that children perceive robots as social, mental, and moral others. Studies on child-robot interaction may encourage this perception of robots, first, by using a Wizard of Oz set-up and, second, by having robots engage in self-description. However, much remains unknown about the effects of transparent teleoperation and self-description on children’s perception of, and relationship formation with a robot. To address this research gap initially, we conducted an experimental study with a 2 × 2 between-subject design (...) in which 168 children aged 7–10 interacted with a Nao robot once. Transparency about the teleoperation procedure decreased children’s perceptions of the robot’s autonomy and anthropomorphism. Self-description reduced the degree to which children perceived the robot as being similar to themselves. Transparent teleoperation and self-description affected neither children’s perceptions of the robot’s animacy and social presence nor their closeness to and trust in the robot. (shrink)

In contemporary liberal ethics patient autonomy is often interpreted as the right to self-determination: when it comes to treatment decisions, the patient is given the right to give or withhold informed consent. This paper joins in the philosophical and ethical criticism of the liberal interpretation as it does not regard patient autonomy as a right, rule or principle, but rather as a practice. Patient autonomy, or so I will argue, is realised in the concrete activities of day-to-day health care, in (...) the material and technological context of care, in arrangements of health care institutions, in the physical training of people with disabilities, as well as in the concrete activities of care-giving. This move from conversations in the consultation room to other sites and situations in the practice of care takes seriously the empirical reality of medical care and intends to show that patient autonomy is practically realised in a much richer and more creative way than most ethical theory seems to assume. (shrink)

: The article first develops an account of autonomy, explaining individual autonomy by means of three normative components and then discussing two objections. The first objection claims that autonomy has to be thought of as essentially relational; this objection is refuted. The second objection, labeled the skeptical objection, claims that we simply do not live autonomously, nor could we ever. Reference is made to novels by Iris Murdoch to present a skeptical solution to this objection.

The article first develops an account of autonomy, explaining individual autonomy by means of three normative components and then discussing two objections. The first objection claims that autonomy has to be thought of as essentially relational; this objection is refuted. The second objection, labeled the skeptical objection, claims that we simply do not live autonomously, nor could we ever. Reference is made to novels by Iris Murdoch to present a skeptical solution to this objection.

A central focus of care ethics is on the compelling moral salience of attending to the needs of our particular others. However, there is no consensus within the care literature for how and when such partiality is morally justified. This article outlines and defends a novel justificatory argument that grounds partiality in the facts and values of the relation itself. Specifically, this article argues that partiality is justified when grounded in caring values exemplified in good caring relations. Hence, this justification (...) is termed the argument from good caring relations. This justification is promising for two reasons. First, the argument from good caring relations has the potential to spur engagement between care ethics and the broader partiality literature. In particular, the argument from good caring relations could enhance what Simon Keller has termed ‘the relationships view’. Second, the argument from good caring relations is more persuasive than the other major justificatory argument for partiality presently in the care literature: a distributive argument, which takes the form of a modified version of Robert Goodin’s assigned responsibility model of moral obligation. Indeed, where this distributive argument fails, the argument from good caring relation succeeds. This article thus concludes that the argument from good caring relations is preferable for justifying partiality in care ethics. (shrink)

A dominant area of inquiry within intergenerational ethics concerns how goods ought to be justly distributed between noncontemporaries. Contractualist theories of justice that have broached these discussions have often centered on the concepts of mutual advantage and reciprocal cooperation between rational, self‐interested beings. However, another prominent reason that many in the present feel that they have obligations toward future generations is not due to self‐interested reciprocity, but simply because they care about what happens to them. Care ethics promises to be (...) conceptually well‐suited for articulating this latter reason: given that future generations are in a perpetual condition of dependency on present‐day people's actions, this is precisely the kind of relational structure that care theorists should be interested in morally evaluating. Unfortunately, the care literature has been largely silent on intergenerational ethics. This article aims to advance this literature, offering the blueprints of what a care ethic concerning future generations—a “future care ethic”—should look like. The resultant ethic defends a sufficientarian theory of obligation: people in the present ought to ensure the conditions needed to encourage and sustain a world that enables good caring relations to flourish. (shrink)

Care ethics is often criticized for being incapable of outlining what responsibilities we have to persons beyond our personal relations, especially toward distant others. This criticism centres on care theorists’ claim that the concerns of morality emerge between people, generated through our relations of interdependent care: it is difficult to see how moral duties can be applied to those with whom we do not forge a relationship. In this article, I respond to this criticism by outlining a care ethical justification (...) for an interest theory of human rights. This theory will argue that the demands of global justice include various positive actions that aim toward ensuring the conditions for good caring relations to flourish, which in turn protect and promote the vital interests of all persons. In doing so, I aim to concurrently advance the sparse work on human rights within the care literature, systematizing the ideas of care theorists such as Daniel Engster, Virginia Held, and Fiona Robinson. (shrink)

Care theorists have yet to outline an account of how the concept of toleration should function in their normative framework. This lack of outline is a notable gap in the literature, particularly for demonstrating whether care ethics can appropriately address cases of moral disagreement within contemporary pluralistic societies; in other words, does care ethics have the conceptual resources to recognize the disapproval that is inherent in an act of toleration while simultaneously upholding the positive values of care without contradiction? By (...) engaging care ethics with John Locke’s influential corpus on toleration, I answer the above question by building the bases for a novel theory of toleration as care. Specifically, I argue that care theorists can home in on an oft-overlooked aspect of Locke’s later thought: that the possibility of a tolerant society is dependent on a societal ethos of trustworthiness and civility, to the point where Locke sets out positive ethical demands on both persons and the state to ensure this ethos can grow and be sustained. By leveraging and augmenting Locke’s thought within the care ethical framework, I clarify how care ethics can provide meaningful solutions to moral disagreement within contemporary pluralistic societies in ways preferable to the capability of a liberal state. (shrink)

This paper explores ethical concerns arising in healthcare integration. We argue that integration is necessary imperative for meeting contemporary and future healthcare challenges, a far stronger evidence base for the conditions of its effectiveness is required. In particular, given the increasing emphasis at the policy level for the entire healthcare infrastructure to become better integrated, our analysis of the ethical challenges that follow from the logic of integration itself is timely and important and has hitherto received insufficient attention. We evaluated (...) an educational intervention which aims to improve child health outcomes by making transitions between primary to secondary care more efficient, ensuring children and parents are better supported throughout. The programme provided skills for trainee paediatricians and general practitioners in co-designing integrated clinical services. The key ethical challenges of integrated care that arose from a clinical perspective are: professional identity and autonomy in an integrated working environment; the concomitant extent of professional responsibility in such an environment; and the urgent need for more evidence to be produced on which strategies for integrating at scale can be based. From our analysis we suggest a tentative way forward, viewed from a normative position broadly situated at the intersection of deontology and care ethics. We adopt this position because the primary clinical ethical issues in the context of integrated care concern: how to ensure that all duties of care to individual patients are met in a newly orientated working environment where clinical responsibility may be ambiguous; and the need to orientate care around the patient by foregrounding their autonomous preferences and ensuring good patient clinician relationships in clinical decision-making. (shrink)

In this article I wish to show how care ethics puts forward a fundamental critique on the ideal of independency in human life without thereby discounting autonomy as a moral value altogether. In care ethics, a relational account of autonomy is developed instead. Because care ethics is sometimes criticized in the literature as hopelessly vague and ambiguous, I shall begin by elaborating on how care ethics and its place in ethical theory can be understood. I shall stipulate a definition of (...) care ethics as a moral perspective or orientation from which ethical theorizing can take place. This will mean that care ethics is more a stance from which we can theorize ethically, than ready-made theory in itself. In conceiving care ethics in this way, it becomes possible to make clear that, for instance, a moral concept of autonomy is not abandoned, but instead is given a particular place and interpretation. In the final part of this article I will show how ‘relational autonomy’ can be applied fruitfully in the practice of psychiatric care. (shrink)

Decisions based on ethics confront nurses daily. In this account, a cardiac nurse struggles with the challenge of securing health care benefits for Justin, a patient within the American system of health care. An exercise therapy that is important for his well-being is denied. The patient’s nurse and an interested insurance agent develop a working relationship, resulting in a relational narrative based on Justin’s care. Gadow’s concept of a relational narrative and Keller’s concept of a relational autonomy guide this particular (...) case. As an ethics framework influenced by feminist ethical theory, Gadow’s, Keller’s and Tisdale’s ideas demonstrate the fluidity with which the nurse and others can work while maintaining both autonomy and engagement without being self-sacrificing. (shrink)

Decisions based on ethics confront nurses daily. In this account, a cardiac nurse struggles with the challenge of securing health care benefits for Justin, a patient within the American system of health care. An exercise therapy that is important for his well-being is denied. The patient’s nurse and an interested insurance agent develop a working relationship, resulting in a relational narrative based on Justin’s care. Gadow’s concept of a relational narrative and Keller’s concept of a relational autonomy guide this particular (...) case. As an ethics framework influenced by feminist ethical theory, Gadow’s, Keller’s and Tisdale’s ideas demonstrate the fluidity with which the nurse and others can work while maintaining both autonomy and engagement without being self-sacrificing. (shrink)

Graduate nursing students should have a strong ethical theoretical foundation to identify and explore scientific and technological ethical issues impacting nursing care, to assume leadership positions in practice and education, and to conduct research contributing to nursing’s knowledge base. This paper reports the implementation and evaluation of a new ethics course at Turkish doctoral nursing programs. The first section describes course design and implementation. The second section evaluates the course and discusses results. Students’ evaluations indicated that the concept of caring (...) in key ethical theories, particularly care ethics, was vital to course content. The most preferred teaching method was case analysis. Students suggested increase in course length and credits, content inclusion of feminist ethics, and real-world knowledge application by other teaching strategies such as clinical practice visits and hospital ethics committee member participation. (shrink)

I, along with others, have been critical of the social construction of brain death and the various social factors that led to redefining death from cardiopulmonary failure to irreversible loss of brain functioning, or brain death. Yet this does not mean that brain death is not the best threshold to permit organ harvesting—or, as people today prefer to call it, organ procurement. Here I defend whole-brain death as a morally legitimate line that, once crossed, is grounds for families to give (...) permission for organ donation. I do so in five moves. First, I make the case that whole-brain death is a social construction that transformed one thing, coma dépassé, into another thing, brain death, as a result of social pressures. Second, I explore the way that the 1981 President’s Commission tried to establish the epistemological certainty of brain death, hoping to avoid making arcane metaphysical claims and yet still utilizing metaphysical claims about human beings. Third, I explore the moral meaning of the social construction of a definition that cannot offer metaphysical certainty about the point at which somebody becomes just some body. Fourth, I describe how two moral communities—Jewish and Catholic—actually ground their metaphysical positions with regard to brain death in the normativity of prior social relations. Finally, I conclude with a reflection on the aesthetic-moral enterprise of the metaphysical-epistemological apparatus of brain death, concluding that only such an aesthetic-moral approach is sufficiently strong to stave off the utility-maximizing tendencies of late-modern Western cultures. (shrink)

Some philosophers object that Kant's respect cannot express mutual recognition because it is an attitude owed to persons in virtue of an abstract notion of autonomy and invite us to integrate the vocabulary of respect with other persons-concepts or to replace it with a social conception of recognition. This paper argues for a dialogical interpretation of respect as the key-mode of recognition of membership in the moral community. This interpretation highlights the relational and practical nature of respect, and accounts for (...) its governing role over other persons-regarding concepts. (shrink)

In this essay, I depart from the historical exclusion of trans women’s ethical insights from care ethics by focusing on trans literature as a source of knowledge expressed by trans women about care. I open up with the systematic denial of trans women as ethical knowers by analyzing Marilyn Frye's characterization of trans women as mindless servile robots under patriarchy. I then turn to trans literature to counter this portrayal. Specifically, I discuss short stories by Casey Plett and Ryka Aoki (...) as sources of knowledge about assumptive and futurebound practices of care. I begin by arguing that the work of Maria Lugones considers the spatial dimensions of love, and that this suggests that care involves giving space to another on their own terms. I then turn to Plett’s story “Other Women” to unpack assumptive care as a short-circuited form of caring in which a relationship to the other on their own terms is closed off by transphobic assumptions. I contrast this with Plett’s story “Winning,” which describes a futurebound care in which another’s space is kept open, permitting action that allows them to flourish on their own terms. After this, I discuss Aoki’s “To the New World” as an engagement with both racist assumptive care and futurebound care aimed at self-care. I conclude that these stories provide a rich space for considering trans ethical knowledge about care. (shrink)

The main question explored by the book is: How can cross-border access to human genetic resources, such as blood or DNA samples, be governed in such a way as to achieve equity for vulnerable populations in developing countries? The book situates the field of genomic and genetic research within global health and research frameworks, describing the concerns that have been raised about the potential unfairness in exchanges during recent decades. Access to and sharing in the benefits of human biological resources (...) are aspects not regulated by any international legal framework such as the Convention on Biological Diversity, which applies only to the exchange of plants, animals and microorganisms, as well as to associated traditional knowledge. Examples of genetic research perceived as exploitative are provided in order to illustrate the legal vacuum concerning the global governance of human genetic resources. The main conclusions drawn from the legal and ethical analysis are: - Benefit sharing is crucial in order to avoid the exploitation of developing countries in human genetic research. - With functioning research ethics committees, undue inducement is less of a concern in genetic research than in other areas of medical research (e.g. clinical trials). - Concerns remain over research involving indigenous populations; accordingly, recommendations are provided. In drawing these conclusions, the book addresses in detail a highly pressing topic in global bioethics and international law. In this regard, it combines bioethical arguments with jurisprudence, in particular with reference to the law of equity and the legal concepts of duress (coercion), unconscionable dealing, and undue inducement. (shrink)

In her Nobel speech in 2019, Olga Tokarczuk presented the category of tenderness as a new way of narrating the contemporary world. This article is a proposal for the analysis and interpretation of tenderness in ethical and aesthetic terms. (1) From an ethical perspective, tenderness is interpreted as an extension and complement of feminist relational ethics, i.e., the ethics of care. In the proposed approach, tenderness is a broader and more universal quality than care in the feminist understanding. This article (...) opens with a brief discussion of feminist interventions in ethics, with particular emphasis on the ethics of care. Next, the differences between care and tenderness are enumerated and described, in order to show how tenderness can serve as an extension and complement of the feminist ethic of care. These considerations are guided by the question of why tenderness is a better—more appropriate and more responsive to contemporary challenges—moral guidepost than care. (2) From the aesthetic perspective, tenderness is the negation of a contemplative, distanced, impersonal, and rational view of reality. As an aesthetic imperative, tenderness implies engaged experience of the beauty of reality in all of its manifestations. Therefore, in the last part of the article, existential tender attunement is described in aesthetic terms, as a position serving to sensitize others to the beauty and complexity of the post-anthropocentric world. (shrink)