This book was first published in 1984, as the revised edition of a 1979 original. The text is composed of studies in a descending sequence from perfect rationality, through imperfect and problematical rationality, to irrationality. Specifically human rationality is characterized by its capacity to relate strategically to the future, in contrast to the myopic 'gradient climbing' of natural selection. There is trenchant analysis of some of the parallels proposed in this connection between the biological and the social sciences. In the (...) chapter on imperfect rationality the crucial notion is that of 'binding oneself', as Ulysses did before setting out to the Sirens, when weakness of will may prevent us from using our capacity for perfect rationality. The second half of the book deals with rational-actor theory, comparing its logical power and success to rival approaches, and with the varieties of irrationality expressed in contradictory beliefs and desires. (shrink)

: Ulysses contracts have faced paternalism objections since they first were proposed. Since the contracts are designed to override a present request from a legally competent patient in favor of a past request made by that patient, enforcement of these contracts was argued to be unjustifiable strong paternalism. Recent legal developments and new theories of practical reasoning suggest that the discussion of Ulysses contracts should be revived. This paper argues that with a proper understanding of the future-directed planning (...) embodied in Ulysses contracts, the charge of strong paternalism can be answered, and the enforcement of some Ulysses contracts may be justified under the rubric of weak paternalism. (shrink)

Common sense suggests that it is always preferable to have more options than fewer, and better to have more knowledge than less. This provocative book argues that, very often, common sense fails. Sometimes it is simply the case that less is more; people may benefit from being constrained in their options or from being ignorant. The three long essays that constitute this book revise and expand the ideas developed in Jon Elster's classic study Ulysses and the Sirens. It is (...) not simply a new edition of the earlier book, though; many of the issues merely touched on before are explored here in much more detail. Elster shows how seemingly disparate examples which limit freedom of action reveal similar patterns, so much so that he proposes a new field of study: constraint theory. The book is written in Elster's characteristically vivid style and will interest professionals and students in philosophy, political science, psychology, and economics. (shrink)

This article concerns the issue of how an ethic of care perspective may contribute to both normative theory and mental health care policy discussions on so called Ulysses arrangements, a special type of advance directives in psychiatry. The debate on Ulysses arrangements has predominantly been waged in terms of autonomy conceived of as the right to non-intervention. On the basis of our empirical investigations into the experiences of persons directly involved with Ulysses arrangements, we argue that a (...) care ethics perspective may broaden and deepen the debate on Ulysses arrangements, by introducing additional concepts, such as vulnerability, responsibility and mutuality, and by refining familiar concepts, such as autonomy. (shrink)

Ulysses contracts are a method by which one person binds himself by agreeing to be bound by others. In medicine such contracts have primarily been discussed as ways of treating people with episodic mental illnesses, where the features of the illness are such that they now judge that they will refuse treatment at the time it is needed. Enforcing Ulysses contracts in these circumstances would require medical professionals to override the express refusal of the patient at the time (...) treatment is required, something that is generally problematic both ethically and legally. In this paper I will argue that despite appearances Ulysses contracts can make it the case that treating a patient in such circumstances is an instance of treating him with his consent, although safeguards are needed to ensure that this is the case. Given the potential benefits to patients I further argue that modified Ulysses contracts should be made legally enforceable. (shrink)

A ‘Ulysses arrangement’ (UA) is an agreement where a patient may arrange for psychiatric treatment or non-treatment to occur at a later stage when she expects to change her mind. In this article, I focus on ‘competence-insensitive’ UAs, which raise the question of the permissibility of overriding the patient’s subsequent decisionally competent change of mind on the authority of the patient’s own prior agreement. In “The Ethical Justification for Ulysses Arrangements”, I consider sceptical and supportive arguments concerning competence-insensitive (...) UAs, and argue that there are compelling reasons to give such UAs serious consideration. In “Decisional Competence and Legal Capacity in UAs”, I examine the nature of decisional competence and legal capacity as they arise in UAs, an issue neglected by previous research. Using the distinctions which emerge, I then identify the legal structure of a competence-insensitive UA in terms of the types of legal capacity it embodies and go on to explain how types of legal capacity might be shared between the patient and a trusted other to offer support to the patient in the creation and implementation of a competence-insensitive UA. This is significant because it suggests possibilities for building patient support mechanisms into models of legal UAs, which has not addressed in the literature to date. Drawing on this, in “Using Insights from the Competence/Capacity Distinction to Enhance Patient Support in UAs”, I offer two possible models to operationalize competence-insensitive UAs in law that allow for varying degrees of patient support through the involvement of a trusted other. Finally, I outline some potential obstacles implementing these models would face and highlight areas for further research. (shrink)

This paper presents four arguments in favour of respecting Ulysses Contracts in the case of individuals who suffer with severe chronic episodic mental illnesses, and who have experienced spiralling and relapse before. First, competence comes in degrees. As such, even if a person meets the usual standard for competence at the point when they wish to refuse treatment, they may still be less competent than they were when they signed the Ulysses Contract. As such, even if competent at (...) time 1 and time 2, there can still be a disparity between the levels of competence at each time. Second, Ulysses Contracts are important to protect people’s most meaningful concerns. Third, on the approach defended, the restrictions to people’s liberty would be temporary, and would be consistent with soft paternalism, rather than hard paternalism: the contracts would be designed in such a way that individuals would be free to change their minds, and to change or cancel their Ulysses Contracts later. Finally, even if one rejects the equivalence thesis, this is still consistent with the claim that, in particular cases, it can be as wrong to allow a harm as to do a harm. Nevertheless, controversies remain. This paper also highlights several safeguards to minimise risks. Ultimately, we argue that people who are vulnerable to spiralling deserve a way to protect their autonomy as far as possible, using Ulysses Contracts when necessary. (shrink)

Introduction Compulsory care is controversial, since respect for the patient’s autonomy is a standard requirement in health care. Many psychiatrists have experienced that patients with borderline personality syndrome sometimes demand compulsory care for themselves in order not to exert self-harm—like Ulysses contracts. The aim of this study was to examine the possible existence and extent of borderline personality syndrome-patient demands for Ulysses contracts regarding compulsory care in acute psychiatry, and how external influences and demands could affect the caregivers’ (...) decisions about compulsory care. Method An anonymous questionnaire, with three questions with fixed answers, was distributed to 42 licensed medical doctors on call at the psychiatric emergency unit in the city of Stockholm. Thirty-three questionnaires were answered, giving a response rate of 79%. Results Ninety-four percent of the respondents recognized the phenomenon of borderline personality syndrome patients requesting compulsory care, 21% stated that this request had affected their clinical decision, and 55% had used compulsory care for other reasons than the patient’s best interest. Discussion The results indicate that compulsory care is sometimes given in the form of Ulysses contracts for borderline personality syndrome patients. Also, compulsory care is sometimes used for other reasons than the borderline personality syndrome patient’s best interest. Psychological mechanisms affect the decisions of both patients and caregivers. More research should be done concerning to whom, why, and with what consequences compulsory care is prescribed. (shrink)

Women recognise that labour represents a mind-altering event that may affect their ability to make and communicate decisions and choices. For this reason, birth plans and other pre-labour directives can represent a form of Ulysses contract: an attempt to make binding choices before the sometimes overwhelming circumstances of labour. These choices need to be respected during labour, but despite the reduced decisional and communicative capacity of a labouring woman, her choices, when clear, should supersede decisions made before labour.

The American Journal of Bioethics, Volume 12, Issue 3, Page 37-39, March 2012.

In this chapter, I articulate the structure of a general concept of autonomy and then reply to possible objections with reference to Ulysses arrangements in psychiatry. The line of argument is as follows. Firstly, I examine three alternative conceptions of autonomy: value-neutral, value-laden, and relational. Secondly, I identify two paradigm cases of autonomy and offer a sketch of its concept as opposed to the closely related freedom of action and intentional agency. Finally, I explain away the autonomy paradox, to (...) which the previously identified pair of paradigm cases seems to give rise in the context of mental disorder. By addressing this paradox, we learn two valuable lessons. The first is about the relationships between the three conceptions of autonomy above. The second is about the relationship between autonomy and mental disorder. (shrink)

Patients with borderline personality disorder sometimes request to be admitted to hospital under compulsory care, often under the argument that they cannot trust their suicidal impulses if treated voluntarily. Thus, compulsory care is practised as a form of Ulysses contract in such situations. In this normative study we scrutinize the arguments commonly used in favour of such Ulysses contracts: the patient lacking free will, Ulysses contracts as self-paternalism, the patient lacking decision competence, Ulysses contracts as a (...) defence of the authentic self, and Ulysses contracts as a practical solution in emergency situations. In our study, we have accepted consequentialist considerations as well as considerations of autonomy. We conclude that compulsory care is not justified when there is a significant uncertainty of beneficial effects or uncertainty regarding the patient’s decision-making capacity. We have argued that such uncertainty is present regarding BPD patients. Hence, Ulysses contracts including compulsory care should not be used for this group of patients. (shrink)

Although Joyce was losing his sight when he wrote Ulysses, Stephen's and Bloom's visual experiences are extraordinarily rich and complex. Absorbing the influences of popular visual attractions such as dioramas, stereoscopes and mutoscopes, their perceptions of Dublin are shaped by what Walter Benjamin calls 'unconscious optics'. Analyzing closely the texture of their impressions and of Joyce's prismatic narrative styles, Philip Sicker explores the phenomenon of sight from a wide-ranging set of perspectives: eighteenth-century epistemology, theories of the flaneur, Italian Futurist (...) art, photography, and the silent films Joyce watched in Dublin and Trieste. The concept of 'spectacle' as a mechanically-constructed visual experience informs Sicker's examination of mediated perception and emerges as a hallmark of modernist culture itself. This study is an important contribution to the growing interest in how deeply the philosophy and science of visual perception influenced modernism. (shrink)

Drawing on notions of alienation, reification and rationalization in their book Dialectic of Enlightenment, Adorno and Horkheimer explored the phenomenon of reason as such concerning the subject and the species, and diagnosed the pathologies of occidental societies. Reason provides the means for a vulnerable being to subordinate nature and serve its desire for self-preservation. However, this reason is instrumental since it objectifies the world and reifies other beings in order to render them manipulable. It is a subjective reason because it (...) promotes the subject's own ends and aims at the subject's survival at the expense of the individual's inner world of unconscious desires and instincts and the reconciliation of human beings with the external world. The myth of Ulysses is magnificantly interpreted by Horkheimer and Adorno along such anthropological lines. As I see it, this anthropology inexorably connects the advent of civilization with the reifying power of reason from the start. Against the early Frankfurt School anthropological explanation of reason, I defend the distinction between communicative and strategic rationality that presupposes a different anthropology from the Freudian one that informed the Dialectic of Enlightenment. (shrink)

Drawing on notions of alienation, reification and rationalization in their book Dialectic of Enlightenment, Adorno and Horkheimer explored the phenomenon of reason as such concerning the subject and the species, and diagnosed the pathologies of occidental societies. Reason provides the means for a vulnerable being to subordinate nature and serve its desire for self-preservation. However, this reason is instrumental since it objectifies the world and reifies other beings in order to render them manipulable. It is a subjective reason because it (...) promotes the subject's own ends and aims at the subject's survival at the expense of the individual's inner world of unconscious desires and instincts and the reconciliation of human beings with the external world. The myth of Ulysses is magnificantly interpreted by Horkheimer and Adorno along such anthropological lines. As I see it, this anthropology inexorably connects the advent of civilization with the reifying power of reason from the start. Against the early Frankfurt School anthropological explanation of reason, I defend the distinction between communicative and strategic rationality that presupposes a different anthropology from the Freudian one that informed the Dialectic of Enlightenment. Key Words: Adorno • alienation • critique • culture • Enlightenment • Freud • Habermas • Horkheimer • Lukács • Marcuse • paradox of reason • reason • self-preservation • subjectivity. (shrink)

‘Ulysses contracts’ are an instrument through which a psychiatric patient may prearrange involuntary commitments to be put into effect if the patient satisfies certain diagnostic criteria in the future. Proposals for Ulysses contracts typically impose numerous safeguards. This paper argues against the intuitively plausible safeguard which permits only presently remitted patients to contract. Instead of requiring a patient's remission, it is argued that the appropriate safeguard is the patient's ability, whether remitted or not, to offer good reasons for (...) wishing to contract. In short, what matters is not an executive's character, but an executive's reasons, and a bad executive may have good reasons. Attempts to deny the accessibility of good reasons in unremitted patients are rejected on the ground that psychiatric diagnosis requires psychiatrists to be able to distinguish between good and bad reasons in both remitted and unremitted patients. If psychiatrists cannot do that, psychiatric diagnosis is impossible. (shrink)

This is surely a bit of Socrates' famous irony. He draws the analogy to explain how his friends should regard poetry as they regretfully banish it from the ideal state. But lovers were no more sensible then than they are now. The advice to banish poetry, undermined already by Plato's own delight and skill in drama, is perhaps undermined still further by this evocation of a 'sensible' lover who counts love so well lost. Yet Socrates' image is one of avowed (...) rationality and prudence. The sensible lover imitates the older literary example of Ulysses' tying himself to the mast. (The example belongs therefore to the class of problems treated in Elster (1979)). Both this lover and Ulysses foresee that under certain possible future conditions, their opinions, values and preferences will or would differ from what they are now, in a very definite fashion. To what extent is such foresight possible? Correspondingly (when we do not claim foreknowledge) to what extent is such opinion reasonable, rational, coherent, or consistent in some suitably broad sense? It is not easy to understand exactly what is possible or even logically permissible in this respect. In an earlier paper, "Belief and the Will", I argued for a principle ("Reflection") to govern such deliberation. Here I will both generalize the treatment of opinion in "Belief and the Will" and respond to criticism. Critical examples mainly resembled the story of Ulysses who foresaw a period of dysfunction (at the sound 2 of the sirens) in his epistemic and/or doxastic future. Other criticism focused on the model of opinion used (precise numerical subjective probability) and on the merits of Dutch Book arguments. The present argument will not rely on Dutch Book arguments and strategies, and the Reflection principle will be formulated so as to apply also to vague opinion. (shrink)

Irrational people create problems not only for themselves and those around them, but also for those who study them. They cause trouble for social scientists because their actions are inexplicable, at least according to generally accepted models of explanation. Explanations in the social sciences normally assume the form of rationalizations: actions are explained by showing that, relative to what the subjects believe and desire, the actions were done for good reasons. Conversely, when good reasons cannot be found for why someone (...) acted as they did, their behavior remains inscrutable. Irrational people, therefore, stymie social scientists because their actions do not reveal the rationality needed to produce adequate explanations. (shrink)

Efforts have been dedicated to the understanding of social-ecological systems, an important focus in ethnobiological studies. In particular, ethnobiological investigations have found evidence and tested hypotheses over the last 30 years on the interactions between human groups and their environments, generating the need to formulate a theory for such systems. In this article, we propose the social-ecological theory of maximization to explain the construction and functioning of these systems over time, encompassing hypotheses and evidence from previous ethnobiological studies. In proposing (...) the theory, we present definitions and two conceptual models, an environmental maximization model and a redundancy generation model. The first model seeks to address biota selection and its use by human populations. The second emphasizes how the system organizes itself from the elements that were incorporated into it. Furthermore, we provide the theoretical scenario of plant selection and use from an evolutionary perspective, which explicitly integrates the phylogenetic relationships of plants and human beings. (shrink)

The scientific community has debated the importance of “return” activities after ethnobiological studies. This issue has provoked debate because it touches on the ethics of research and the relationships with the people involved in these studies. This case study aimed to investigate community perception of an ethnobotany research project that was carried out in the semi-arid region of northeastern Brazil. Furthermore, we reported how the residents of this rural community felt about participating in the activities of “return” that arose from (...) the projects. Our findings demonstrate that “return” activities should be planned from the design phase of the research until its closure as a lifelong process that allows the communities involved to gradually take ownership of the information and actions that are being generated. Similarly, we argue that such activities must be negotiated with the people of the community so that they have decision-making power and autonomy to decide what is most relevant to their lives. (shrink)

According to contemporary moral realism a moral property, like goodness or badness, is either a natural property or a non-natural property of actions or situations. Contemporary moral naturalists like Richard Boyd, Nicholas Sturgeon, and David Brink are a group of philosophers who are often referred to as Cornell realists because of their connection with Cornell University. Frank Jackson is another contemporary moral naturalist who is one of the leaders of The Canberra Planners at the Australian National University with which he (...) is connected. Jackson defends “the most extreme form of naturalism.” Jackson’s view is considered extremeby those who disagree with him because he believes that moral properties are reducible or identical to natural properties. This view of Jackson is opposed by contemporary non-naturalists like Jonathan Dancy, Derek Parfit, and Russ Shafer-Landau for reasons which in my view are not successful. Despite Jackson’s reductionism about the ethical, the Cornell realists, nevertheless, agree with him that moral properties are natural properties. (shrink)

Part of the task of doing moral philosophy is to strengthen our confidence in morality or to bring back the gravitas of morality. I argue that this cannot be done by a representational view of moral reality and by downplaying the importance of human sentiments that make our moral assertions more natural and authentic.