This chapter contains sections titled: Why a Philosophy of Fatherhood? Role Responsibilities Autonomy Autonomy and Fatherhood Conclusion Notes.

To be autonomous is to be a law to oneself; autonomous agents are self-governing agents. Most of us want to be autonomous because we want to be accountable for what we do, and because it seems that if we are not the ones calling the shots, then we cannot be accountable. More importantly, perhaps, the value of autonomy is tied to the value of self-integration. We don't want to be alien to, or at war with, ourselves; and it seems that (...) when our intentions are not under our own control, we suffer from self-alienation. What conditions must be satisfied in order to ensure that we govern ourselves when we act? Philosophers have offered a wide range of competing answers to this question. (shrink)

G.E.M. Anscombe famously remarked that an adequate philosophy of psychology was needed before we could do ethics. Fifty years have passed, and we should now ask what significance our best theories of the psychology of agency have for moral philosophy. My focus is on non-moral conceptions of autonomy and self-governance that emphasize the limits of deliberation -- the way in which one's cares render certain options unthinkable, one's intentions and policies filter out what is inconsistent with them, and one's (...) resolutions function to block further reflection. I argue that we can expect this deliberative "silencing" to lead to moral failures that occur because the morally correct option was filtered out of the agent's deliberation. I think it follows from these conceptions of self-governance that we should be considered culpable for unwitting acts and omissions, even if they express no ill will, moral indifference, or blameworthy evaluative judgments. The question is whether this consequence is acceptable. Either way, the potential tradeoff between self-governance and moral attentiveness is a source of doubt about recent attempts to ground the normativity of rationality in our concern for self-governance. (shrink)

This paper explores the value of respect for personal autonomy in relation to clearly immoral and irrational acts committed freely and intentionally by competent people. Following Berlin's distinction between two kinds of liberty and Darwall's two kinds of respect, it is argued that coercive suppression of nonautonomous, irrational, and self-harming acts of competent persons is offensive to their human dignity, but not disrespectful of personal autonomy. Irrational and immoral choices made by competent people may claim only the negative (...) liberty to be left alone. Lives disposed to autonomy are worthy of solidarity and active support in addition to the right of free choice and action. Autonomous premeditated desires (distinguished from mere consent) may embody transcendental choices, which transcend consideration of physical and psychological well-being. Choices made by incompetent persons (e.g., children and the mentally disabled) are not related to autonomy, but to self-directedness. The value of human dignity confers protection to self-directedness, but not at the expense of other vital interests. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Don Quijote and the Law of LiteratureCarl Good (bio)The part is one of these beings, the whole minus this part the other. But the whole minus a part is not the whole and as long as this relationship persists, there is no whole, only two unequal parts.—Rousseau, Social Contract, cited by Paul de Man in Allegories of ReadingBut it is not just that, because it is also a (...) performative.... There is first a performative, the act of positing..., which then moves to a system of tropes; a kind of anamorphosis of tropes takes place, in which all the tropological systems are engendered, as a result of this original act of positing.... It is circulation which is out of hand,... the sheer circulation or play of the signifier, and which is, as you know, the root of error, madness, stupidity and all other evil.—Paul de Man, “The Concept of Irony”Amid a confusion of narrative inversions, misleading appearances, and unresolvable disputes, at least two things are consistent in Don Quijote de la Mancha: first, the knight’s singular fidelity to what I will refer to as a law of literature, which persists like a phantasm of continuity throughout the larger narrative; and, second, the many interruptions of this narrative by the stories, or episodes, recounted by the characters who cross don Quijote’s path (including the knight himself), in the form of speeches, testimonies, plays, jokes, poems, and so on. In at least one strict sense, these other stories have nothing to do with that path other than their interruptions of it and by it. Such a claim has its own strategic value and does not entirely contradict the reasonings of a long history of critics of the Quijote who have tended to argue from a variety of different standpoints for some kind of ideological cohesion that would bind the smaller episodes to the larger story that they interpolate. But at a certain ground zero of interpretation—albeit a paradoxical ground that prohibits a scholarly shelter to be built on it—no argument would be sufficient to establish such a coherence among the work’s separate narrative parts, since such an argument would live in the brief, oneiric intensity of the critic’s testimony and that testimony’s potential effects rather than in the composition of the work itself somewhere beyond its apprehension by reading. Nonetheless, out of the dismembered ensemble of the Quijote what does perhaps effect its own strange kind of life is the very play of ironic interruptions and frictions between the dismembered parts, the profusion of which seems to impose itself as the work’s own aggressive insistence on itself as something which makes sense possible by constantly provoking and unsettling sense. That is where we could begin to speak of don Quijote himself, not only as the phantasmatic agent of this unsettling but also as the mad promise of justice that could be said to motivate it.The play of interruptions in don Quijote’s own story begins to outline the shifting contours and living contradictions of this novel as a “text” in the sense in which Derrida [End Page 44] and others have used the term: that which “names or relates in its way... [a] conflict without encounter between law and singularity” [“Before the Law” 187]. Although the story of this “encounter” has been often recounted, it bears another citation here, at least because it seems to be forgotten more often than it is told. Even when it is told, the story is often muted in homage to the name of Derrida by writers who tacitly assume that Derrida’s is the only possible version of this “conflict without encounter.” That version would be better described as merely one particular ethical shaping or forcing—a powerful one—of a story that has been told, and remains untold, in uncountable ways. Nonetheless, such a democratic assessment of Derrida does not quite justify a dismissal of his version as merely one among others, since, for one thing, it would be unable to account for the astonishing hold that different versions of Derridean “deconstruction” continue to have on the imagination of North American... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Intention and Wrongdoing: A Defense of the Principle of Double Effect by Joshua StuchlikMichael J. DegnanSTUCHLIK, Joshua. Intention and Wrongdoing: A Defense of the Principle of Double Effect. Cambridge: Cambridge University Press, 2021. xvi + 220 pp. Cloth, $99.99In this book Joshua Stuchlik vigorously defends the principle of double effect (PDE), which states, "There is a strict moral constraint against bringing about serious evil (harm) to an innocent (...) person intentionally, but it is permissible in a wider range of circumstances to act in a way that brings about serious evil incidentally, as a foreseen but non-intended side effect." After defining the terms of the principle and considering an intuitive case-based defense, he supports its truth based on a standard of solidarity. Since the PDE requires the distinction between intended consequences and nonintended side effects, he explains Elizabeth Anscombe's theory of intention, which supports the distinction's moral significance. He uses her theory to treat the closeness problem, the irrelevance of intention critique, and a challenge from Joshua Greene's empirical moral psychology that purports to undermine deontological constraints on causing harm.I present Stuchlik's grounding for the PDE followed by an uncontroversial example of its application. After this I consider two important objections to the PDE that Stuchlik critiques: the closeness problem and James Rachels's argument that intentions are irrelevant to judging the moral permissibility of actions. I conclude by examining Stuchlik's treatment of these challenges.Stuchlik interprets the PDE's very strict constraint against intentional killing or seriously harming the innocent as a near absolute prohibition, for he believes innocent persons are not suitable recipients of intentional harm. He grounds this constraint on the principle of solidarity. Being in solidarity with another is possessing concern for that other's sake. The ground for this concern is a shared human nature that enables members to think of themselves as making a "we." Human nature consists in the structured potentialities for knowing and freely choosing. Evidence of these rational potentialities is the human orientation toward the transcendent values of truth and goodness. Such embodied potentialities have inviolable worth.The scenarios of the precision bomber and the terror bomber illustrate the moral significance of the intended harm versus the nonintended but foreseen harm that Stuchlik adopts from Elizabeth Anscombe's action theory. Each bombers' goal is to help his country win a just war. The precision bomber pursues that goal by targeting a munitions factory. Though he foresees that many noncombatants will be killed or seriously [End Page 367] injured from the bomb, he does not necessarily intend these harms. By contrast, the terror bomber targets a civilian center necessarily intending harm for noncombatants. The PDE rules out his conduct.Anscombe's account of intention can lead to the problem of closeness in which the content of an intention is sufficiently fine-grained that an agent need not intend harm in almost any situation. Stuchlik illustrates the problem with Alexander Pruss's zookeeper scenario.An eccentric literalistic but always truthful magnate tells Sam he will donate to famine relief saving a hundred lives if and only if Sam follows his directions to the iota. Sam is to purchase a gun, sneak at night into a zoo owned by the magnate and kill the first mammal he sees. Sam sneaks into the zoo, sees a mammal in the distance, and forms the intention to shoot it. Then he notices that the mammal is human but shoots nonetheless on utilitarian grounds.In this case applying the PDE shows that Sam is simply intending that a mammal be killed. The fact that the mammal is a human is irrelevant, according to Anscombe's action theory.Stuchlik's response clarifies the scope of intention in the PDE. As stated above, the intention's content includes seriously harming an innocent human. However, if the intention ranges only over an intention to bring about an effect, E, and it turns out that E is a serious harm for an innocent human being, then applying the principle shows that Sam's action is wrong. The intended effect of killing the mammal is, as a matter of fact, an... (shrink)

In this article, we propose a philosophical exploration on the main problems involved in two neurorights that concern autonomous action, namely free will and cognitive liberty, and sketch a possible solution to these problems by resourcing to a holistic interpretation of human actions. First, we expose the main conceptual and practical issues arising from the neuroright to “free will,” which are far from minor: the term itself is denied by some trends participating in the neurorights debate, the related (...) concept of ultimate control is also disputed, the understanding of free will depends on cultural context, and the exercise of being free to act in several domains may be covered by other regulations. Second, we analyze the historical origin of cognitive liberty, its current status, and its relation with free will. Third, we criticize the concept of decision in mainstream action theory and propose to conceive action as a unified process constituted by three explanatory, non-sequential dimensions: intention, decision, and action realization. Fourth, we discuss two possible cases involving neurotechnologies and suggest ways to interpret them according to a unified framework in which free will and cognitive liberty fall under a single neuroright to personal autonomy. Finally, we outline a recommendation to introduce freedom of thought and personal autonomy as complementary neurorights to protect both the internal and external dimensions of thought and action. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Lack of Autonomy: A View From the InsideSteve Weiner (bio)Keywordsagency, autonomy, deficit, determinismThe most vivid and truly overwhelming response I have to all arguments stressing agency/autonomy, that is, what lay people call free will, is this: that I’ve never had the sensation of acting autonomously since the onset of my mental illness on August 28, 1965. I have never been comfortable with saying that “I made a (...) choice,” or with other people either lecturing me or attempting to reassure me, often at the same time, by saying that I acted with autonomy/primary agency, as it were. That is my overwhelming subjective experience. I usually refrain from attempting to make a general case for determinism about myself or the universe in general, although, again, I feel far more determined than free. (I would note that Mary Midgley [2006] points out that the word determined and the concept, by extension, of determinism have two different meanings in say, social theory and geometry.)One strong criticism of this article I would put forward is that the Davidson and Shahan seemed to mention only depression among many diagnoses to make their case, although their French mentors/ co-thinkers apparently focused on schizophrenia, however unusually defined by them. In obsessive-compulsive disorder, we all have the very strong impression of the obsessive thoughts having been forced into our mind by something or someone else. My impression is that we all engage in our warding-off rituals, especially in the later, most frequent, most ritualistic repetitions, “against our will.”My most frequent diagnoses over the decades have been paranoid schizophrenia and schizoaffective disorder, and I more or less agree most of the time with those labels. I find Louis Sass’ “discovery” that our delusions are better thought of as semi-delusions with our simultaneously believing and not believing them, and our usual failure to take action on them, pretty well describes my own long-term experience. I know he is insistent on ascribing some degree of agency/whole personality involvement to us as compared with the standard National Alliance on Mental Illness/biological model, but I feel that he is getting closer to most of the “truth” when he talks about a subtle interweaving of affliction/deficit and agency.The authors’ reliance on French thinkers almost inevitably sends me back to a once-prominent French intellectual, one of my favorite writers Albert Memmi, the Tunisian-Jewish born socialist and Zionist. In a book that mentions The Story of O, (Memmi 1984) a story of extreme sexual submission or masochism, he makes the striking remark that the mentally ill are “oppressed from within.” I have spoken of this often because it seems to touch perfectly on my experience and that of fellow mentally ill people I have met. From the perspective of the outsider, it seems that the whole [End Page 237] and integrated person is involved in every behavior. What looks like agency to others, especially when it comes to undesirable behaviors, when experienced from within, is actually a situation of affliction from a seemingly autonomous place. We experience this as coming, yes, from within us, but not ultimately of us.I cannot be sure, but a belief in some degree of metaphysical choice from the beginning of one’s life seems to me the only way the authors of this article can firmly, enthusiastically come down on the side of agency as opposed to deficit/malfunction in trying to explain human problems. In contrast, I suppose I could be called a physicalist. I have noticed that physical substances (alcohol, caffeine, psychiatric drugs) have such a vivid and consistent effect on my mind that it makes sense to me to conclude that yes, mind is probably ultimately reducible to brain/body/experience of the senses. That is my private opinion based on experience as mediated through knowledge/intellect.One final point: Despite the (almost certainly) radical left politics of the authors, as an officially disabled person almost completely dependent on the welfare state, I fear that in competitive individualist America, the authors’ hoped-for far greater emphasis on autonomy will feed into popular “blame the victim” ideology. I believe... (shrink)

TWENTIETH-CENTURY ETHICS. AFTER NIETZSCHE -/- Preface This book tells the story of twentieth-century ethics or, in more detail, it reconstructs the history of a discussion on the foundations of ethics which had a start with Nietzsche and Sidgwick, the leading proponents of late-nineteenth-century moral scepticism. During the first half of the century, the prevailing trends tended to exclude the possibility of normative ethics. On the Continent, the trend was to transform ethics into a philosophy of existence whose self-appointed task was (...) that of describing the human condition as consisting of choices, as unavoidable as arbitrary, without any attempt at providing criteria for making such choices. In the Anglo-Saxon countries, the heir of ethics was a philosophy of morality, that is, an analysis of the language of morality that intended to clarify valuations without trying to justify them. 1958 was the year of the normative turn that led to the Rehabilitation of practical philosophy, a turn followed by decades of controversies between distinct kinds of normative ethics: utilitarian, Kantian, virtue ethics. While the controversy was raging, a quiet revolution took place, that of applied ethics which surprisingly dissolved the controversy's very subject matter by providing methods for making convergence possible on intermediate principles even when no agreement was available about first principles. The normative turn and the revolution of applied ethics have led us, at the turn of the century, to a goal that was quite far from the starting point. Instead of scepticism and relativism that was the fashion at the beginning of the century, at the beginning of the third millennium impartial and universal moral arguments seem to hold the spot being supported, if not by a final rational foundation, at least by reasonableness, the most precious legacy of the Enlightenment. -/- ● TABLE OF CONTENTS -/- ● I Anglo-Saxon philosophy: naturalism 1. Dewey beyond evolutionism and utilitarianism 2. Dewey and anti-essentialist moral epistemology 3. Dewey and naturalist moral ontology 4. Dewey and normative ethics of conduct and function 5. Perry and semantic naturalism -/- ● II Anglo-Saxon philosophy: ideal utilitarianism and neo-intuitionism 1. Moore's critique of utilitarian empiricism 2. Moore on the naturalistic fallacy 3. Moore on the nature of intrinsic value 4. Moore on ideal utilitarianism 5. Prichard on the priority of the right over the good 6. Ross's coherentist moral epistemology 7. Ross's moral ontology: realism, pluralism, and non-naturalism 8. Ross's normative ethics of prima facie duties -/- The chapter reconstructs the background of ideas, concerns and intentions out of which Moore's early essays, the preliminary version, and then the final version of Principia Ethica originated. It stresses the role of religious concerns, as well as that of the Idealist legacy. It argues that PE is more a patchwork of somewhat diverging contributions than a unitary work, not to say the paradigm of a new school in Ethics. -/- ●III Anglo-Saxon philosophy: non-cognitivism 1. The Scandinavian School, the Vienna circle and proto-emotivism 2. Wittgenstein and the ineffability of ethics 3. Russell's and Ayer's radical emotivism 4. Stevenson and moderate emotivism 5. Stevenson and the pragmatics of moral language 6. Stevenson and the methods for solving ethical disagreement 7. Hare and prescriptivism The chapter reconstructs first the discussion after Moore. The naturalistic-fallacy argument was widely accepted but twisted to prove instead that the intuitive character of the definition of 'good', its non-cognitive meaning, in a first phase identified with 'emotive' meaning. Alfred Julius Ayer is indicated as a typical proponent of such non-cognitivist meta-ethics. More detailed discussion is dedicated to Bertrand Russell's ethics, a more nuanced and sophisticated doctrine, arguing that non-cognitivism does not condemn morality to arbitrariness and that the project of rational normative ethics is still possible, heading finally to the justification of a kind of non-hedonist utilitarianism. Stevenson's theory, another moderate version of emotivism is discussed at some length, showing how the author comes close to the discovery of the role of a pragmatic dimension of language as a basis for ethical argument. A section reconstructs the discussion from the Forties about Hume's law, mentioning Karl Popper's argument and Richard Hare's early non-cognitivist but non-emotivist doctrine named prescriptivism. -/- ●IV Anglo-Saxon philosophy: critics of non-cognitivism 1. Neo-naturalism and its objections to the naturalistic fallacy argument 2. Objections to Hume's law 3. Clarence Lewis and the pragmatic contradiction 4. Toulmin and the good reasons approach 5. Baier and moral reasons 5. Baier, social moralities and the absolute morality 6. Baier and the moral point of view 7. Baier and the contents of absolute ethics -/- ● V Continental philosophy: the philosophy of values 1. Max Weber and the polytheism of values 2. Phenomenology against psychologism and rationalism 3. Reinach and the theory of social acts 4. Scheler and the material ethics of values 5. Hartmann and the ontology of values 6. Plessner, Gehlen and the Philosophische Anthropologie -/- The chapter illustrates first the idea of phenomenology and the Husserl's project of a phenomenological ethic as illustrated in his 1908-1914 lectures. The key idea is dismissing psychology and trying to ground a new science of the apriori of action, within which a more restricted field of inquiry will be the science of right actions. Then the chapter illustrates the criticism of modern moral philosophy conducted in the 1920 lectures, where the main target is naturalism, understood in the Kantian meaning of primacy of common sense. The third point illustrate is Adolph Reinach's theory of social acts as a key the grounding of norms, a view that sketches the ideas 'discovered' later by Clarence I. Lewis, John Searle, Karl-Otto Apel and Jürgen Habermas. A final section discusses Nicolai Hartman, who always refused to define himself a phenomenologist and yet developed a more articulated and detailed theory of 'values' – with surprising affinities with George E. Moore - than philosophers such as Max Scheler, who claimed to be Husserl's legitimate heirs. -/- ● VI Continental philosophy: the critics of the philosophy of values 1. Freud, the Superego and Civilization 2. Heidegger on original ethos against ethics 3. Sartre and de Beauvoir on authenticity and ambiguity 4. Adorno and Horkheimer on emancipation and immoralism -/- ●VII Post-liberal theologians and religious thinkers 1. Barth on the autonomy of faith from ethics 2. Developments of Reformed moral theology after Barth 3. Bonhoeffer on the concrete divine command and ethics of penultimate realities 4. Developments of Reformed and Catholic moral theology after world war II 5. Baeck and the transformation of liberal Judaism 6. Rosenzweig against liberal Judaism 7. Buber and religion as the vital lymph of morality 8. Heschel and Judaism as a science of actions -/- The chapter examines the main protagonists of Christian theology and Jewish religious thinking in the twentieth century. It stresses how the main dilemmas of contemporary philosophical ethics lie at the root of the various path of inquiry taken by these thinkers. -/- ● VIII Normative ethics: neo-Utilitarianism 1. The discussion on act and rule utilitarianism 2. Hare on two-tiered preference utilitarianism 3. Harsanyi, Gauthier and rational choice ethics 4. Parfit, utilitarianism and the idea of a person 5. Brandt and indirect conscience utilitarianism -/- The chapter addresses the issue of the complex process of self-transformation Utilitarianism underwent after Sidgwick's and Moore's fatal criticism and the unexpected Phoenix-like process of rebirth of a doctrine refuted. Two examples give the reader a glimpse at this uproarious process. The first is Roy Harrod Wittgensteinian transformation of utilitarianism in pure normative ethics depurated from hedonism as well as from whatsoever theory of the good. This transformation results in preference utilitarianism combined with a 'Kantian' version of rule utilitarianism. The second is Richard Hare's two-level preference utilitarianism, where act utilitarianism plays the function of the eventual rational justification of moral judgments and rule-utilitarianism that of an action-guiding practical device. -/- ● IX Normative ethics: neo-Aristotelianism and virtue ethics 1. Hannah Arendt, action and judgement 2. Hans-Georg Gadamer and phronesis 3. Alasdair MacIntyre on practices, virtues, and traditions 5. Stuart Hampshire on deliberation 6. Bernard Williams and moral complexity 7. Feminist ethics -/- Sect 1 reconstructs the post-war rediscovery of ethics by many German thinkers and its culmination in the Sixties in the movement named 'Rehabilitation of practical philosophy' is described. Heidegger's most brilliant disciples were the promoters of this Rehabilitation. Hans-Georg Gadamer is a paradigmatic example. His reading of Aristotle's lesson I reconstructed, starting with Heidegger's lesson but then subtly subverting its outcome thanks to the recovery of the significant role of the notion of phronesis. Sect 3 discusses the three theses defended by Anscombe in 'Modern Moral Philosophy'. It argues that: a) her answer to the question "why should I be moral?" requires a solution of the problem of theodicy, and ignores any attempts to save the moral point of view without recourse to divine retribution; b) her notion of divine law is an odd one more neo-Augustinian than Biblical or Scholastic; c) her image of Kantian ethics and intuitionism is the impoverished image manufactured by consequentialist opponents for polemical purposes and that she seems strangely accept it; d) the difficulty of identifying the "relevant descriptions" of acts is not an argument in favour of an ethics of virtue and against consequentialism or Kantian ethics, and indeed the role of judgment in the latter is a response to the difficulties raised by the case of judgment concerning future action. The chapter gives a short look at further developments in the neo-naturalist current trough a reconstruction of Philippa Foot's and Peter Geach's critiques to the naturalist-fallacy argument and Alasdair MacIntyre's grand reconstruction of the origins and allegedly inevitable failure of the Enlightenment project of an autonomous ethic. -/- ● X Normative ethics: Kantian and rights-based ethics 1. Dialogical constructivism 2. Apel, Habermas and discourse ethics 3. Gewirth and rights-based ethics 4. Nagel on agent-relative reasons 5. Donagan and persons as ends in themselves Parallel to the neo-Aristotelian trend, there was in the Rehabilitation of practical philosophy a Kantian current. This current started with the discovery of the pragmatic dimension of language carried out by Charles Peirce and the Oxford linguistic philosophy. On this basis, Karl-Otto Apel singled out as the decisive proponent of the linguistic and Kantian turn in German-speaking ethics, worked out the performative-contradiction argument while claiming that this was able to provide a new rational and universal basis for normative ethics. The chapter offers an examination of his argument in some detail, followed by a more cursory reconstruction of Jürgen Habermas's elaboration on Apel's theory. -/- ● XI The applied ethics renaissance 1. Elisabeth Anscombe on the atom bomb 2. From medical ethics to bioethics 3. Rawls and public ethics 3. Nozick, Dworkin and further developments of public ethics 5. Sen and the revival of economic ethics -/- The chapter presents the revolution of applied ethics while stressing its methodological novelty, exemplified primarily by Beauchamp and Childress principles approach and then by Jonsen and Toulmin's new casuistry. The chapter argues that Rawls's distinction between a "political" and a "metaphysical" approach to the theory of justice, one central part of ethical theory, is a formulation of the same basic idea at the root of both the principles approach and the new casuistry, both discussed in the following chapter. The idea is that it is possible to reach an agreement concerning positive moral judgments even though the discussion is still open – and in Rawls' view never will be close – on the essential criteria for judgment. -/- ● XII Fin-de-siècle metaethics 1. Deontic logics 2. Anti-realism 3. External realism 4. Internal realism 5. Kantian constructivism -/- The chapter illustrates the fresh start of meta-ethical discussion in the Eighties and Nineties and the resulting new alignments: metaphysical naturalism, internal realism, anti-realism, and constructivism. (shrink)

BackgroundPsychiatric staff members have the power to decide the options that frame encounters with patients. Intentional as well as unintentional framing can have a crucial impact on patients’ opportunities to be heard and participate in the process. We identified three dominant ethical perspectives in the normative medical ethics literature concerning how doctors and other staff members should frame interactions in relation to patients; paternalism, autonomy and reciprocity. The aim of this study was to describe and analyse statements describing real work (...) situations and ethical reflections made by staff members in relation to three central perspectives in medical ethics; paternalism, autonomy and reciprocity.MethodsAll staff members involved with patients in seven adult psychiatric and six child and adolescent psychiatric clinics were given the opportunity to freely describe ethical considerations in their work by keeping an ethical diary over the course of one week and 173 persons handed in their diaries. Qualitative theory-guided content analysis was used to provide a description of staff encounters with patients and in what way these encounters were consistent with, or contrary to, the three perspectives.ResultsThe majority of the statements could be attributed to the perspective of paternalism and several to autonomy. Only a few statements could be attributed to reciprocity, most of which concerned staff members acting contrary to the perspective. The result is presented as three perspectives containing eight values.•Paternalism; 1) promoting and restoring the health of the patient, 2) providing good care and 3) assuming responsibility.•Autonomy; 1) respecting the patient’s right to self-determination and information, 2) respecting the patient’s integrity and 3) protecting human rights.•Reciprocity; 1) involving patients in the planning and implementation of their care and 2) building trust between staff and patients.ConclusionsPaternalism clearly appeared to be the dominant perspective among the participants, but there was also awareness of patients’ right to autonomy. Despite a normative trend towards reciprocity in psychiatry throughout the Western world, identifying it proved difficult in this study. This should be borne in mind by clinics when considering the need for ethical education, training and supervision. (shrink)

In this paper the question of autonomy in delusional disorders is investigated using a phenomenological approach. I refer to the distinction between freedom of intentional action, and freedom of the will, and develop phenomenological descriptions of lived autonomy, taking into account the distinction between a pre-reflective and a reflective type. Drawing on a case report, I deliver finely-grained phenomenological descriptions of lived autonomy and experienced self-determination when acting on delusions. This analysis seeks to demonstrate that a person with delusions (...) can be described as responsible for her behaviour on a ‘framed’ level (level of freedom of intentional action), even though she is not autonomous on a higher (‘framing’) level (level of freedom of the will), if, and only if, the goods of agency for herself and others are respected. In these cases the person with delusions is very nearly comparable to people in love, who are also not free to choose their convictions, and who could also be rightly held responsible for the behaviour flowing from their convictions. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Recovering One's Self from PsychosisA Philosophical AnalysisThe author reports no conflicts of interest.Rosanna Wannberg (2024) has given us a dense but helpful introduction to certain philosophical questions raised by the fact that many patients recovering from psychotic illnesses describe their recovery in terms of gaining or regaining a 'sense of self' and a 'sense of agency,' which often involves acceptance of the 'fact' of being mentally ill, (...) for example, of 'having schizophrenia.' She raises two important questions: How should we understand what is going on in these accounts? and What are the implications of these reports for our understanding of what it is to have a 'sense of self' or a 'sense of agency'—of 'subjectivity' generally—which might have, both, clinical and nonclinical implications?What does it mean to have a self or a sense of having one, agency or a sense of having it? One might think these are the possession or experience of something 'inner' such as feelings of confidence or assurance, perhaps having a kind of inner structure or a set of deeply held ideas which give us coherence, motivate us and justify our actions, and which we can know by 'looking inward,' in an introspective act which provides direct, privileged acquaintance.Yet Wittgenstein called this a dangerously misleading 'picture' which 'held us captive,' and needed always to be 'gotten rid of' (Wittgenstein, 1958). One way of seeing the problem is to consider that no inner 'object,' no thing inside us, can be, or give us a sense of having, a self or agency, because no mere thing (whether an experience of confidence, or having an inner structure) can have any meaning or provide any explanation. A thing (like a word on a page) is just a thing—inert, dead— and must be interpreted, that is used, before it can play a role in our 'forms of life' (Wittgenstein, 1958) including explaining our sense of self or agency.Semantic externalists (Burge, 1979; Putnam, 1975), have argued that even what is internal to our minds—like thoughts—have contents which are determined by experiences in the 'outside' world in which we have lived and learned: if our experiences in the world, they have shown, were different, then so, also, would be the contents of our thoughts. It has even been argued that internal mental experiences which appear to be purely phenomenological (such as an image or a thought-token, so-called narrow content) can only [End Page 67] be identified and thought about using concepts having references in the external world: there is, so it is claimed, no narrow content (Yli-Vakkuri and Hawthorne, 2018); or, if there is, it is of no explanatory use in psychology (Fodor, 1994).If this is the philosophical background from which Wannberg confronts first-person accounts of recovery from psychosis which include (re)gaining a sense of self or agency, and if this philosophy is right, what becomes of the accounts? How are they to be understood?To meet this challenge, Wannberg invokes an alternative account of self-possession and firstperson authority provided by Richard Moran (2001). Moran's position is that we find or possess ourselves when we find or hold beliefs about the world which we do not merely believe but endorse or avow, where to endorse or avow a belief about the world is to find and endorse reasons in the world, which support that belief. Thus, I can avow that it's raining if I can look outside and see that it is raining. This Moran calls the transparency condition. Endorsing or avowing both a belief and the external reasons for it gives the self what Moran refers to as authenticity and which also might be said to provide cohesion, consistency and intelligibility—plausibly, a 'sense of self.'The transparency condition also applies to beliefs that justify actions. We act intentionally when we can give good reasons for what we do (Anscombe, 1957; Moran, 2001) and we can give good reasons for what we do when we can identify facts in the world that support those reasons. Thus, the transparency condition can explain both a sense of self and a sense... (shrink)

We argue that animalism is the only materialist account of personal identity that can account for the autonomy that we typically think of ourselves as possessing. All the rival materialist theories suffer from a moral version of the problem of too many thinkers when they posit a human person that overlaps a numerically distinct human animal. The different persistence conditions of overlapping thinkers will lead them to have interests that conflict, which in many cases prevents them both (...) class='Hi'>from autonomously forming and acting on the same intentions. These problems are exacerbated by problems of self-reference plaguing the overlapping thinkers. We contend that the impossibility of simultaneous autonomous action by animals and persons provides a reason to favor animalism over Neo-Lockeanism, Four-Dimensionalism, Constitution theory, and brain-size views of the person. We anticipate and reject arguments that the autonomy of the person and the animal can be shown to be compatible by relying upon either the Parfitian thesis that identity isn’t what matters or claiming that animals acquire the interests of the person they constitute. (shrink)

If you injure me, it matters morally whether it was an accident or you did it intentionally, and whether you did it because you thought it would be fun. I take it that any ethical theory will have to include some explanation of why this is. There are two dominant views in the current debate about the moral significance of an agent’s intentions: The one is that the intention with which someone acts at least sometimes determines whether what she (...) does is right or wrong (permissible or impermissible). Proponents of the so-called doctrine of double-effect (DDE) hold that an action which has certain bad outcomes may be permissible if the bad consequences are only foreseen, even if the same action would be morally wrong if they were intended as a means. This is not the only way in which intentions could make a difference to an action’s permissibility, but it is the best-known defense that they do. According to the second view, intentions don’t matter in this way: they do not determine the permissibility of an action. They do matter, but in a different dimension of normative assessment: They determine whether the agent is a good or a bad person; or alternatively: they determine the “moral worth” of an action or its “meaning”, including its praiseworthiness or blameworthiness , or the severity of a wrong-doing. The main thesis is what Thomson called “The Irrelevance-of-Intentions-to-Permissibility Thesis” (for short: IIP) -/- [IIP] “It is irrelevant to the question whether X may do alpha what intention X would do alpha with if he or she did it.” -/- IIP is driven in part by skepticism about DDE: since – according to proponents of IIP - DDE is false, we must explain the relevance of intentions and reasons in a different way. Proponents of IIP tend not to consider the possibility that intentions might matter to permissibility in ways that are different from DDE. In this paper I do not focus on the arguments for or against DDE, but investigate IIP itself more closely, and look at some of the arguments for and against it. (shrink)

In this article, responding to assertions that the principle of double effect has no place in legal analysis, I explore the overlap between double effect and negligence analysis. In both, questions of culpability arise in situations where a person acts with no intent to cause harm but where reasonable foreseeability of unintended harm exists. Under both analyses, the determination of whether such conduct is permissible involves a reasonability test that balances that foreseeable harm against the good intended by the (...) actor's conduct. In both, absent a finding that the foreseeable harm is unreasonable in light of that intended good, no liability will be imposed upon the actor. Even conceding, however, such general similarity between double effect and negligence analysis - disagreement over the proper interpretation of the reasonability criterion at play in negligence poses an additional challenge for the attempt to correlate negligence with double effect. Economic efficiency interpretations of negligence, for example, purportedly based on the Learned Hand Formula and the RESTATEMENT (SECOND) OF THE LAW OF TORTS, propose that culpability depends upon a utilitarian balancing of good effects of conduct (utility) versus its harmful foreseeable consequences (magnitude of risk of injury). Based on such an interpretation of negligence, however, contrasts between actors' states of mind, and normative differences between kinds of goods and harms, ultimately fade into the background and become irrelevant as essential conditions for properly assessing liability. This article elaborates and defends the view that double effect analysis lies at the heart of negligence theory. Part I elucidates in more detail the principle of double effect and describes its prima facie operation in negligence analysis. Part II considers and rejects the economic efficiency interpretation that has been offered as a theory of negligence, overcoming the challenge that such an interpretation presents for the effort to locate double effect analysis in the law. Part III illustrates and confirms the overlap between double effect and negligence by consideration of a series of case applications. The Article proposes that the weighing of conflicting values in double effect analysis and negligence is not achieved - as proposed by law and economics theory with respect to negligence - by imposing a consequentialist-utilitarian reduction of all value to a single concept of good and eliminating the relevance of traditional state of mind distinctions between intention and foreseeability. Instead, each mode of analysis recognizes that distinct culpability determinations flow naturally and plausibly from an appreciation of the traditional legal distinctions made between various types of goods and harms, and upon whether such goods and harms come about as result of an actor's intention or mere foreseeability. Keywords: Double effect, negligence, intention, foreseeability, choice, law and economics, utilitarianism, consequentialism, weighing of values. (shrink)

In Morals from Motives, Michael Slote proposed an agent-based approach to virtue ethics in which the morality of an action derives solely from the agent’s motives. Among the many objections that have been raised against Slote’s account, this article addresses two problems associated with the Kantian principle that ought implies can. These are the problems of “deficient” and “inferior” motivation. These problems arise because people cannot freely choose their motives. We cannot always choose to act from (...) class='Hi'>good motives; nor can we always avoid acting from bad ones. Given this, Slote’s account implies that we sometimes cannot do what we ought to do, contrary to Kant’s principle. In this article, I propose an alternative agent-based account which, I argue, circumvents these problems. While people cannot choose their motives, they can choose their intentions. By characterizing virtuous action, as I do, in terms of good intentions rather than in terms of good motives, the conflict between what people can do and what they ought to do is resolved. (shrink)

In this article I consider whether there a right to incestuous marriage. I begin by suggesting that the liberal state get out of the "marriage" business by leveling down to a universal civil union or "registered domestic partnership" status. Removing the symbolism of the term "marriage" from political conflict, privatizing it in the same way as religion, would have the advantage of both consistency and political reconciliation. The question is then whether incestuous unions should be both legal and eligible (...) for this status. I argue that the arguments compatible with public reason for prohibiting them outright, or even for excluding them from the permissible types of legally registered partnerships, are quite weak. The objections to allowing such relations are those from (1) child abuse; (2) unfair burdening of society; and (3) the creation of bad lives. I argue that while rape and other forms of child abuse would be no more legal or tolerated than they are now, the concern about any form of weakening a society's legal and political resources to combat such abuses does indeed register on the justificatory scale, but does not prove that such first-degree incestuous sexual relations are inherently bad enough to warrant intervention in their own right. I then argue that the concern about unfairly burdening society with unhealthy persons is not as dangerously totalitarian as we might initially fear, but nor is it strong enough to justify an outright prohibition. Finally, I argue that a concern to dissuade persons from creating certain kinds of lives (children with extreme birth defects) is also not as dangerously totalitarian as we might initially fear, and in fact goes further towards explaining why we might have a legitimate interest in intervening. Nonetheless, I argue that the criminalization of such acts only make sense when they are indicators of other offenses, namely negligence or abuse, and it thus seems that the act of consanguineous reproduction is itself insufficient. One potentially surprising conclusion of this inquiry is that far from creating strong reasons for tolerating these practices, religious or cultural reasons for valuing incest (as well as polygamy) actually seem to count against tolerating them. The reason is that from a liberal perspective, tolerating polygamy and incest involves the assumption that it is possible to disassociate polygamy and incest simpliciter from abusive practices associated with them, including environments where children are raised to devalue their own sexual (and other) autonomy. However, the presence of comprehensive doctrines which include polygyny or incest as part of a good life actually makes it harder to justify disassociating polygamy and incest themselves from the likely abuse and coercion practiced by those who would value polygyny or incest. (shrink)

This thesis argues for a radical understanding of personal autonomy as constitutively social-relational. Standard conceptualisations in liberalism construe autonomy broadly in line with Frankfurt and Dworkin’s accounts, which rely on the idea of an inner self as the authenticator of personal commitments. These conceptualisations suffer from serious theoretical limitations including problems of regress, manipulation and authority. I argue that attempts to address these problems from within the standard paradigm, for example by building in conditions of procedural (...) independence to prevent commitments from being manipulated, help to an extent. However, they remain reliant on an insufficiently explained idea of an inner self as the source of an autonomous agent’s motives, so they do not go far enough to capture what we want from autonomy: that it explains how a person can have the power to shape her life. I explore two sets of criticisms of the standard paradigm, from communitarianism and feminism; both argue that standard autonomy is excessively individualistic and fails to pay enough attention to the role of social factors. I enter the debate about how far, if at all, autonomy might be either causally (weakly) or constitutively (strongly) social-relational. I show that the liberal can accommodate the idea that autonomy is enabled by social relations, but is severely challenged by more strongly relational, constitutive claims. I make the original point that standard views cannot explain how individuals can be sure which of their motives are authentic and which should be endorsed. This is a significant gap in autonomy theory. I propose a methodological shift from analysing autonomous actions to analysing autonomous agency. Drawing on dialogical accounts of critical reflection, Axel Honneth’s inter-subjectivity, and Bernard Williams’ notion of ‘trustful conversation’ I contribute a constitutively social-relational condition for autonomous agency. From this I argue for a constitutive condition for autonomous actions. (PhD, 2014. Supervisors: Miranda Fricker and Susan James.). (shrink)

Global mental health in a changing world -- Contemporary humanitarianism -- Humanitarian ethics -- Professional and personal challenges in humanitarian work -- Managing ethical challenges in global mental health -- Aspirational guidance : principles of humanitarian assistance -- Operational guidance : IASC guidelines -- Ethical dilemmas : damned if you do and damned if you don't -- Ethically questionable practices -- Safety imperative and self-care -- Values-based ethical framework and core competencies in global mental health -- Ethical considerations for (...) refugee mental health providers in the United States -- Conclusion and future directions. (shrink)

It is suggested that the current hierarchical (Frankfurt-Dworkin) model of personal autonomy in philosophical anthropology gives expression to the fundamental presupposition of self-determination in much educational practice and pedagogical theory. Radical criticisms are made of the notions of self-identification and self-evaluation which are of the utmost importance to this model. Instead of relying on such ‘acts of the will’ as decision and choice for the explanation of self-identification and self- evaluation, the non-intentional as well as the non-individualistic character of (...) these processes is stressed and analysed in terms of volitional necessity and social dependence. The consequence of this criticism is the substitution of the concept of extreme personal autonomy by that of caring about oneself as the first principle of education. (shrink)

It is suggested that the current hierarchical (Frankfurt-Dworkin) model of personal autonomy in philosophical anthropology gives expression to the fundamental presupposition of self-determination in much educational practice and pedagogical theory. Radical criticisms are made of the notions of self-identification and self-evaluation which are of the utmost importance to this model. Instead of relying on such ‘acts of the will’ as decision and choice for the explanation of self-identification and self- evaluation, the non-intentional as well as the non-individualistic character of (...) these processes is stressed and analysed in terms of volitional necessity and social dependence. The consequence of this criticism is the substitution of the concept of extreme personal autonomy by that of caring about oneself as the first principle of education. (shrink)

The law of England and Wales provides that an adult with capacity has the right to refuse medical treatment both contemporaneously and in an advance refusal. Legislation separates general advance refusals of treatment from advance refusals of life-sustaining treatment. The law, outlined in ss.24 to 26 of the Mental Capacity Act 2005, is stricter for creation of the latter. These sections brought with them a new age of interests by purporting to elevate individual autonomy as the primary concern. Beginning (...) with the classical tale of Odysseus and a general discussion of the value to be found in a law seeking to preserve individual autonomy, this thesis seeks to act as a critique of the current enactment in practice. The provisions are already under-used and under-applied; without change, they may never reach the stage where they are ethically and practically viable. It is argued that the advance refusals provisions are not taking full effect due to a combination of lacking moral grounding and general dismissal of key ethical dilemmas at the forefront of application. Building on this, the moral basis for this thesis is found in Alan Gewirth’s Principle of Generic Consistency (PGC) which links directly with the general application of human rights. The PGC becomes a compass for determining how best to treat persons when addressing the three most prominent challenges faced by the 2005 Act which are: the debate between the conferred right of autonomy versus the right to life; the issue of personhood; and, the personal identity problem. Ultimately, unless framework provisions are strengthened, and the Mental Capacity Act 2005 is rethought in light of prominent ethical, legal and social considerations, the constraints of the Act on paper will continue to suppress the important underlying values promulgating individual autonomy. (shrink)

This paper is concerned with a recent, clever, and novel argument for the need for genuine collectives in our ontology of agents to accommodate the kinds of normative judgments we make about them. The argument appears in a new paper by David Copp, "On the Agency of Certain Collective Entities: An Argument from 'Normative Autonomy'" (Midwest Studies in Philosophy: Shared Intentions and Collective Responsibility, XXX, 2006, pp. 194-221; henceforth ‘ACE’), and is developed in Copp’s paper for this special (...) journal issue, “The Collective Moral Autonomy Thesis” (henceforth ‘CAT’). The argument goes as follows. -/- (1) We correctly assign blame (or obligations) to collectives in circumstances in which it would be a mistake to assign any (relevantly related) blame (or obligations) to their members. (2) If (1), then collectives are genuine agents over and above their members. (3) Therefore, collectives are genuine agents over and above their members. -/- Following Copp, I call (1) the Collective Moral Autonomy Thesis (CMA). Copp argues for CMA primarily by appeal to cases, but also offers two general arguments for it. In the cases that Copp describes, we are to judge that a collective act is blameworthy, though each member of the group that acts is blameless because he is merely following procedures appropriate for his participation, or because there are excusing factors, or because of overriding personal duties. -/- I argue that the case for CMA has not been made. In particular, I argue that, in each case in which we feel inclined to hold a group responsible for something but not its members, it is because -/- 1. we have accepted a false dilemma, that when no one agent is fully responsible for the action of a group of which he is a member, the only entity that could be responsible is the group as such, or 2. we have directed our attention to the wrong individual or individuals, or 3. we have become confused about the commitments of the individuals, or 4. we have mistaken ameliorating for excusing factors, or 5. we have mistaken moral blameworthiness and all-in rational blameworthiness, or 6. a combination of these things. (shrink)

Many digital technologies, designed and controlled by intensive data-driven corporate platforms, have become ubiquitous for many of our daily activities. This has raised political and ethical concerns over how they might be threatening our personal autonomy. However, not much philosophical attention has been paid to the specific role that their hyper-designed (sensorimotor) interfaces play in this regard. In this paper, we aim to offer a novel framework that can ground personal autonomy on sensorimotor interaction and, from there, (...) directly address how technological design affects personal autonomy. To do this, we will draw from enactive sensorimotor approaches to cognition, focusing on the central notion of habits, understood as sensorimotor schemes that, in networked relations, give rise to sensorimotor agency. Starting from sensorimotor agency as a basis for more complex forms of personal autonomy, our approach gives us grounds to analyse our relationship with technology (in general) and to distinguish between autonomy-enhancing and autonomy-diminishing technologies. We argue that, by favouring/obstructing the enactment of certain (networks of) habits over others, technologies can directly act upon our personal autonomy, locally and globally. With this in mind, we then discuss how current digital technologies are often being designed to be autonomy-diminishing (as is the case of “dark patterns” in design), and sketch some ideas on how to build more autonomy-enhancing digital technologies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Thomas Aquinas on the Metaphysics of the Human Act by Can Laurens LöweThomas M. Osborne Jr.Can Laurens Löwe. Thomas Aquinas on the Metaphysics of the Human Act. Cambridge: Cambridge University Press, 2021. Pp. 225. Hardback, $99.99.This book is about the way in which Thomas Aquinas understands the human act to be composed of form and matter. It provides a fresh reading of many central texts from Thomas (...) and addresses philosophical concerns that are relevant to the contemporary literature. Although Löwe is not clear about this point, Thomas does not use in this context the terms 'formal' and 'material' in the strictest sense, as when he describes the soul as the form of the body, but in different extended senses, as when he says that charity is the form of the other virtues because it gives them a new character (Summa Theologiae, II–II, q. 23, art. 8).Löwe focuses on choice, which he considers to be antecedent to the human act, and the commanded or exterior act, which he considers to be the entire human act. This focus simplifies his account, since in one and only one text—the Prima Secundae of the Summa Theologiae—does Thomas appear to give as many as twelve acts that are stages or phases of a complete human act. Thomas devotes special attention to three acts of the will concerning the end, namely simple willing, intention, and enjoyment; and three acts of the will concerning the means, namely consent, choice, and use; and two intellectual acts, namely deliberation and command. Four other possible phases or stages are mentioned in passing, such as the judgment of choice. According to the standard interpretation, a human [End Page 152] act such as almsgiving might consist of intending to help an indigent person, deliberating about whether to give food or money, making a judgment of choice about the best means of helping (such as giving money), choosing to give the money, and then commanding the will's use of certain other powers, such as the movement of the hands and feet. In his other writings, Thomas mentions only some of these stages, and he often mentions only simple willing, deliberation, and choice. Scholars disagree over the number and importance of the acts or parts of acts discussed in the Prima Secundae and how to integrate them with what Thomas says in other texts. Löwe argues that the human act is what Thomas describes as the act's execution; he claims that this act has the intellect's command for its extrinsic form, the will's use for its intrinsic form, and the commanded act for its matter.This book has three parts. Part 1 provides a general account of the author's view that choice explains the act's freedom even if it is not part of the resulting act. In part 2, Löwe gives a novel account of Thomas's claim that the judgment of the intellect gives form to the act of choice. He draws on the distinction that Thomists make (although Thomas is less clear) between the composition of terms, or the enunciative proposition, and the judgement, or judicative proposition. For instance, the statement 'carrots are orange' as an enunciative proposition might be entertained as doubtful or likely, or placed in a conditional statement. However, someone might assent to this same composition by judging that it is true. Löwe's account is confusing on this point, as he describes as "judgment" what his Thomists describe as the enunciative proposition, which is the composition of terms (38–41). Terminological difficulties aside, Löwe draws on what he sees as the related distinction between the content of a judgment and the attitude toward the judgment, using this distinction to describe the freedom of the judgment that precedes choice. The intellect composes different precepts and then assents to one of them. According to Löwe, Thomas thinks that the agent's ability to choose between different goods is reduced to the intellect's ability to assent to the content of one precept and not the content of another according to a kind of second-order... (shrink)

This is a detailed, sophisticated and comprehensive treatment of autonomy. Moreover it argues for a quite different conception of autonomy from that found in the philosophical literature. Professor Berofsky claims that the idea of autonomy originating in the self is a seductive but ultimately illusory one. The only serious way of approaching the subject is to pay due attention to psychology, and to view autonomy as the liberation from the disabling effects of physiological and psychological afflictions. A sustained (...) critique of concepts such as moral autonomy, self-realisation, ideal autonomy, and identification is offered. The author replaces these with an alternative model that reveals how spontaneity, vitality and competence enable human beings to act in the real world. (shrink)

Critics have charged that John Stuart Mill''s discussion as of paternalism in On Liberty is internally inconsistent, noting, for example, the numerous instances in which Mill explicitly endorses examples of paternalistic coercion. Similarly, commentators have noted an apparent contradiction between Mill''s political liberalism – according to which the state should be neutral among competing conceptions of the good – and Mill''s condemnation of non-autonomous ways of life, such as that of a servile wife. More generally, critics have argued that (...) while Mill professes an allegiance to utilitarianism, he actually abandons it in favor of a view that values personal autonomy as the greatest intrinsic good. This paper presents an interpretation of Mill that provides a viable and consistent treatment of paternalism, thereby refuting each of the aforementioned critiques. Mill''s views, it argues, are consistently utilitarian. Moreover, the interpretation accounts for all of Mill''s departures from his otherwise blanket prohibition of paternalistic legislation. In particular, it explains his most notorious example, the condemnation of voluntary contracts for slavery. The interpretation emphasizes Mill''s conceptual linkage between autonomy and utility, noting his implicit use of at least three different senses of the notion of autonomy. (shrink)

continent. 1.2 (2011): 78-91. This article consists of three parts. First, I will review the major themes of Quentin Meillassoux’s After Finitude . Since some of my readers will have read this book and others not, I will try to strike a balance between clear summary and fresh critique. Second, I discuss an unpublished book by Meillassoux unfamiliar to all readers of this article, except those scant few that may have gone digging in the microfilm archives of the École normale (...) supérieure. The book in question is Meillassoux’s revised doctoral dissertation L’Inexistence divine (or The Divine Inexistence ), with its seemingly bizarre vision of a God who does not yet exist but might exist in the future. Without literally accepting this view, I will claim that it is philosophically interesting in ways that even a hardened sceptic might be able to appreciate. Third and finally, I will speculate on the possible future of Meillassoux’s speculative materialism itself. And here I mean its future development not by Meillassoux, but by those readers who might be inspired by his book. Plato could never have predicted the emergence of Aristotle’s philosophy, despite the obvious debt of the latter to the former. Nor could Descartes have predicted Spinoza and Leibniz, nor Kant the German Idealists, and neither could Husserl in 1901 have foreseen the later emergence of Heidegger. How are the works of interesting philosophers transformed by later thinkers of comparable importance? While it may seem that there are countless ways to do this, I think there are only two basic ways in which this happens: you can radicalize your predecessors, or you can reverse them. I will close this article with a few words about these two methods, and try to imagine how Meillassoux might be radicalized or reversed by some future admirer. My view is that the more important thinkers are, the easier they are to radicalize or reverse. This helps explain why the great philosophers of the West have so often appeared in clusters, succeeding one another at relatively brief intervals during periods of especial ferment. 1. After Finitude After Finitude is unusually short for such an influential book of philosophy: running to just 178 pages in the original French, and an even more compact 128 pages in the English version, despite the introduction of roughly eight pages of new material for the English edition. Rather than summarizing Meillassoux’s book in the order he intended, I will focus on six points that strike me as the pillars of his debut book. Along the way, I will offer a few criticisms as well. The first pillar of the book is Meillassoux’s own term “correlationism.”1 Although he introduces this term as the name for an enemy, it is striking that Meillassoux remains impressed by correlationism much more than his fellow speculative realists are. This continued appreciation for his great enemy influences the shape of his own ontology. Is there a world outside our thinking of it, or does the world consist entirely in being thought? Traditionally, this dispute between realism and idealism has been dismissed in continental philosophy as a “pseudo-problem,” in a strategy pioneered by Husserl and extended by Heidegger. We cannot be realists, since following Kant we have no direct access to things-in-themselves. But neither are we idealists, since the human being is always already outside itself, aiming at objects in intentional experience, deeply engaged with practical implements, or stationed in some particular world-disclosing mood. The centuries-old dispute between realism and idealism is dissolved by saying that we cannot think either real or ideal in isolation from the other. There is neither human without world nor world without human, but only a primordial correlation or rapport between the two. This is what “correlationism” means: philosophy trapped in a permanent meditation on the human-world correlate, trying to find the best model of the correlate: is it language, intentionality, embodiment, or some other form of correlation between human and world? Among other problems, this generates some friction between philosophy and the literal meaning of science. When cosmologists say that the universe originated 13.5 billion years ago, they do not mean “13.5 billion years ago for us ,” but literally 13.5 billion years ago, well before conscious life existed, and thus at a time when there was no such thing as a correlate. Meillassoux also coins the term “ancestrality” (10) for the reality that predated the correlate, and later expands this term to “dia-chronicity,” (112) to refer to events occurring after the extinction of human beings no less than to those occurring before we existed. Up to this point, Meillassoux’s focus on ancestral entities existing prior to consciousness might seem like a straightforward realist who wants to unmask correlationism as just another form of idealism. Yet Meillassoux also admires the correlationist maneuver, which can obviously be traced back to Kant. Unlike a thinker such as Whitehead, Meillassoux feels no nostalgia for the pre-critical realism that came before Kant: “we cannot but be heirs of Kantianism,” he says (29). What impresses Meillassoux about correlationism is something both simple and familiar. If we attempt to think a tree outside thought, this is itself a thought . Any form of realism which thinks it can simply and directly address the world the way it is fails to escape the correlational circle, since the attempt to think something outside of thought is itself nothing other than a thought, and thereby collapses back into the very human-world correlate that it pretends to escape. For Meillassoux this step, suggested by Kant but first refined by the ensuing figures of German Idealism, marks decisive forward progress in the history of philosophy that must not be abolished. Any attempt to break free from the correlate must first acknowledge its mighty intellectual power. Realist though he may seem, Meillassoux’s works are filled with praise of such figures as Fichte and Hegel, not of so-called “naïve realists.” It is also the case that for Meillassoux, not all correlationisms are the same. The second pillar of his book is a distinction between various positions that I have termed “Meillassoux’s Spectrum,” though of course he is never so immodest as to name it after himself. He distinguishes between at least six different possible positions, and perhaps we could add even subtler variations if we wished. But in its simplest form, Meillassoux’s Spectrum allows for just four basic outlooks on the question of realism vs. anti-realism. Three of these are easy to understand, since we have already been discussing them. At one extreme is so-called “naïve realism,” which holds that a world exists outside the mind, and that we can know this world. Meillassoux rejects this naïve realism as having been overthrown by Kant’s critical philosophy. At the other extreme is subjective idealism, in which nothing exists outside the mind. For to think a dog outside thought immediately turns it into a thought, and therefore there cannot be anything outside; the very notion is meaningless. In between these two is what we have called correlationism. And here comes a crucial moment for Meillassoux, since he distinguishes between the two forms of “weak” and “strong” correlationism, and chooses the strong form as the launching pad for his own philosophy. Weak correlationism is easy to explain, since we all know it from the philosophy of Kant. The things-in-themselves can be thought but not known. They certainly must exist, since there cannot be appearances without something that appears. And we can think about them, which idealism holds to be impossible. They are simply unknowable due to the finitude of human thought. Strong correlationism is the new position introduced by Meillassoux (though he sees it at work in numerous twentieth century thinkers), midway between weak correlationism and subjective idealism. The major difference between the three positions is as follows. Weak correlationism says: “The things-in-themselves exist, but we cannot know them.” The subjective idealist says: “This is a contradiction in terms, since when we think the things-in-themselves, we already turn them into thoughts.” But the strong correlationist says: “Just because ‘things-in-themselves’ is a meaningless notion does not mean that they cannot exist. No one has ever traveled to the world-in-itself and come back to make a report on it. Thus, the fact that we cannot think things-in-themselves without contradiction does not prove that they do not exist anyway. There may be things-in-themselves, we simply are not capable of thinking them without contradiction form within the correlational circle.” This step is crucial for Meillassoux, since strong correlationism is the position he attempts to radicalize into his own new standpoint: speculative materialism. As I see it, this step of the argument fails. Strong correlationism cannot avoid collapsing into subjective idealism, since the statements of the strong correlationist are rendered meaningless from within. All three of the other positions in the Spectrum make perfectly good sense even for those who disagree with them. The naïve realist says that things-in-themselves exist and we can know them; the meaning of this statement is clear. The weak correlationist can say that things-in-themselves exist but lie forever beyond our grasp; this too makes perfect sense, even though the German Idealists try to show a contradiction at work here. We can also understand the claim of the subjective idealist that to think anything outside thought turns it into a thought, and that for this reason we cannot think the unthought. The strong correlationist, alone among the four, speaks nonsense . This person says “I cannot think the unthought without turning it into a thought, and yet the unthought might exist anyway.” But notice that the final phrase “the unthought might exist anyway” is fruitless for this purpose. For we have already heard that to think any unthought turns it into a thought. But now the strong correlationist wants to do two incompatible things simultaneously with this unthought. On the one hand, he neutralizes the unthought by showing that it instantly changes into just another thought. But on the other hand, he wants to appeal to the unthought as a haunting residue that might exist outside thought, thereby undercutting the absolute status of the human-world correlate found in idealism. But this is impossible. If you accept the argument that thinking the unthought turns it into a thought, you cannot also add “but maybe there is something outside that prevents this conversion from being absolutely true,” because this “something outside” is immediately converted into nothing but a thought for us. In short, Meillassoux here seems to be offering a kind of Zen koan: his “strong correlationism” is reminiscent of the gateless gate, or the sound of one hand clapping, or the command to punch Hegel in the jaw when meeting him on the road. We cannot at the same time both destroy the realist challenge of the things-in-themselves in order to undercut realism and reintroduce that very realist sense in order to undercut idealism. In a world where everything is instantly converted into thought, we cannot claim that there might be something extra-mental anyway, because this “might be something” is itself converted into a thought by the same rules that condemned dogs, trees, and houses to the idealist prison. This brings us to the third pillar of Meillassoux’s argument, which is the key to all the rest: the necessity of contingency. His strategy is to transform our supposed ignorance of things-in-themselves into an absolute knowledge that they exist without reason, and that the laws of nature can change at any time for no reason at all. In this way the cautious agnosticism of Kantian philosophies is avoided, but so is the collapse of reality into thought as found in German Idealism. Meillassoux does try to prove the existence of things-in-themselves existing outside thought; he simply holds that they must be proven after passing through the rigors of the correlationist challenge, not just arbitrarily decreed to exist in the manner of naïve realism. As he puts it, “Everything could actually collapse: from trees to stars, from stars to laws, from physical laws to logical laws; and this not by virtue of some superior law whereby everything is destined to perish, but by virtue of the absence of any superior law capable of preserving anything, no matter what, from perishing” (53). If idealism thinks that the human-world correlate is absolute, for Meillassoux it is the facticity of the correlate that is absolute. He tries to show this with a nice brief dialogue between five separate characters (55-59) which is covered in detail in my forthcoming book,2 but which I will simplify here for reasons of time. In this simplified version, we first imagine a dogmatic realist arguing with a dogmatic idealist. The realist says that we can know the truth about the things-in-themselves; the idealist counters that we can only the truth about thought, since all statements about reality must be turned into statements concerning our thoughts about reality. Here the correlationist enters and proclaims that both of these positions are equally dogmatic. For although we have access to nothing but thoughts, we cannot be sure that these thoughts are all that exist; there could be a reality outside thought, there is simply no way to know for sure. And this latter position is the one that Meillassoux attempts to transform from an agnostic, skeptical point into an ontological claim about the contingency of everything. Consider it this way. How does the correlationist defeat the idealist? The idealist holds that the existence of anything outside thought is impossible. The correlationist, by contrast, holds that something might exist outside the human-world correlate. But this “something might” has to be an absolute possibility. It cannot mean that “something outside thought might exist for thought ,” because that is what the idealist already says. No, the correlationist must mean that something might exist outside thought quite independently of thought. In other words, the correlationist says that idealism might be wrong, and this means it is absolutely true that idealism might be wrong. Thus, correlationism is no longer just a skeptical position. It holds that all the possibilities of the world are absolute possibilities. We have absolute knowledge that any of the possibilities about the existence or non-existence of things-in-themselves might be true, and this means that correlationism flips into Meillassoux’s own position: speculative materialism. As Meillassoux sees it, there are only two options here. Option A is to absolutize the human-world correlate, which is what the idealist does: there absolutely cannot be anything outside thought. Option B, by contrast, is to absolutize the facticity of the correlate: its character of simply being given to us, without any inherent necessity. The correlationist cannot have it both ways by saying: “there absolutely might be something outside thought, yet maybe this is absolutely impossible.” In other words, once we escape dogmatism we can only be idealists or speculative materialists, not correlationists. The human-world correlate is merely a fact, not an absolute necessity. But this facticity itself cannot be merely factical: it must be absolute. Here Meillassoux coins the French neologism factualité , which has been suitably translated into the English neologism “factiality.” (7, 122-3) Factialty means that for everything that exists, it is absolutely possible that it might be otherwise, not just that we cannot know whether or not it might be otherwise. Just as Kant transformed philosophy into a meditation on the categories governing human finitude, Meillassoux wishes to turn philosophy into a meditation on the necessary conditions of factiality, which he calls “figures”—a new technical term for him. (80) One such figure is that the law of non-contradiction must be true, and for an unusual reason. Since everything is proven to be contingent, nothing that exists can be contradictory, for whatever is contradictory has no opposite into which it might be transformed, and thus contingency would be impossible.3 Another such figure is that there must be something rather than nothing: for since contingency exists, something must exist in order to be contingent. It is a daring high-wire act, one that sacrifices realism to the correlational circle in order to rebuild it from out of its own ashes. Some might conclude that the lack of reason in things is a byproduct of the ignorance of finite humans, Meillassoux is making precisely the opposite point. For in fact, the doctrine of finitude usually leads directly to belief in a hidden reason. The fact that it lies beyond human comprehension merely increases our belief in this arbitrarily chosen concealed ground. By defending anew the concept of absolute knowledge Meillassoux evacuates the world of everything hidden. The reason for things having no reason is not that the reason is hidden, but that no reason exists. Thus, even while insisting on the necessity of non-contradiction, he rejects the other Leibnizian principle: sufficient reason. Everything simply is what it is, in purely immanent form, without deeply hidden causes. Or as Meillassoux puts it: “There is nothing beneath or beyond the manifest gratuitousness of the given—nothing but the limitless and lawless power of its destruction, emergence, or persistence” (63).The world is a “hyper-chaos”(64). But this is not the same thing as flux. For the chaos of the world is such that stability might occur just as easily as constant, turbulent change. Let’s now digress a bit, and return to the question of ancestrality, which Meillassoux transforms later in the book into “dia-chronicity.” Correlationism holds that all talk of a world outside the correlate is immediately recuperated by the correlate. The phrase “13.5 billion years ago” becomes “13.5 billion years ago for us ,” and the phrase “the universe following the extinction of humans” becomes “the universe following the extinction of humans for humans .” But notice that whether we talk about the world before or after humans, in both cases it is time that is used to challenge the correlate. Meillassoux has no interest in challenges that might be posed by space. For example, what about a vase in a lonely country house that topples to the floor and smashes when no one is there to watch it? Isn’t this also a challenge to correlationism, no less than the Big Bang or the heat death of the universe long after humans have vanished? In an eight-page supplement to the English translation of After Finitude ,4 possibly in response to my own 2007 review of the French original,5 Meillassoux bluntly denies that space is of any relevance to the question. Spatial distance is a merely harmless challenge to the human-world correlate. After all, even though no one is there in the lonely country house to witness the shattering of the vase, we can say that had there been an observer , that observer would have witnessed the toppling and destruction of the vase. For this event still occurs in a world in which the human-world correlate already exists, whereas the diachronicity of events both before and after the existence of humans makes it impossible to say that had there been an observer they would have witnessed the Big Bang occurring in such and such a fashion. However, it seems to me that Meillassoux merely asserts that the temporal simultaneity of our existence with that of the vase in the lonely country house is enough to render it harmless. It is true that the house does not exist prior to the correlate, but nonetheless it exists outside the correlate, and that is enough to make the same challenge. It is difficult to see why the “had there been an observer” maneuver succeeds in the case of a vase in the countryside in April 2011 but fails in the case of the Big Bang. This is not just a matter of nitpicking Meillassoux’s argumentative style: the fact that he bases his argument on time has at least two important consequences for his position. For in the first place, even though Meillassoux insists that the laws of nature are absolutely contingent, this turns out to be true only in a temporal sense. That is to say, it is a paradoxical feature of Meillassoux’s philosophy that he does allow for the existence of laws of nature, and simply believes that they can change at any moment without reason. Within any given moment, laws of nature do exist. He never suggests that different parts of the universe can have different laws at the same time, nor does he have any interest in the laws of part/whole composition that take place within any given instant. Could it be the case that rather than being made of gold atoms, a small chunk of gold could be made of silver atoms, cotton, horses, or that this same small piece of gold could be made of gigantic vaults filled with even more gold? These are not topics that draw Meillassoux’s attention, since he is focused solely on how the laws of nature might change or endure from one moment to the next . Another implication for Meillassoux’s system is that his concept of things-in-themselves turns out to be to be inadequate. For when he proves that things-in-themselves can exist without humans, this turns out to be true only in a temporal sense as well. Namely, things-in-themselves existed ten billion years ago, and they will continue to exist after all humans have succeeded in exterminating themselves. However, being able to exist before our births and after our deaths is just one small part of what it means to be a thing-in-itself. The more important part is that even if a thing is sitting on a table right now, in front of me, even if I stroke it lovingly or press my face up against it directly, I am still dealing only with a phenomenal version of the thing; the thing-in-itself continues to withdraw from all access. Yet no such thing is acknowledged by Meillassoux. For him finitude is a disaster, and absolute knowledge is in fact possible. Meillassoux’s thing-in-itself exists in independence only of the human lifespan , not of human knowledge. The fifth pillar of Meillassoux’s argument is his use of Cantor’s transfinite mathematics to show that even if the laws of nature are contingent, they need not be unstable, and thus we cannot use the apparent stability of nature to disprove his metaphysics of absolute contingency. What Cantor showed is that there are different sizes of infinity, and that all these infinities cannot be totalized in a single infinite number of infinities. Meillassoux sees this as crucial, since it allows him to discredit any “probabilistic” argument against his theory. The probabilistic argument (as defended quite clearly by Jean-René Vernes)6 would say this: given that the laws of nature seem so stable, it it is extremely improbable that there is no hidden reason for their remaining so stable. As Meillassoux sees it, probability is of value only when we can index an accessible total of cases. These can even be infinite: for example, there are an infinite number of points where a rope can break when stretched tight, but this does not stop us from calculating probabilities for various sections of the rope to break. By contrast, there is no way to sum up the number of possible laws of nature. For here there is no way to totalize; we cannot stand outside of nature and calculate the possible number of laws so as to determine the probabilities that any one of them might change. Therefore, although we can speak of probability when dealing with intraworldly events such as elections, horse races, and coin-flips, we cannot use the words “probable” or “improbable” when describing alterations at the level of nature as a whole. Rather than commenting on the validity of this argument and its use of Cantor, let me simply note that it once again creates a dualistic ontology. We already saw that Meillassoux treats time differently from space. In analogous fashion, he now treats the level of world differently from that of intraworldly events. The emergence of worlds is purely contingent and virtual and governed by no probability at all, while events within the world necessarily follow laws (even if these laws can change at any moment without reason), and thus their probabilities can be calculated. It is a strategy deeply reminiscent of Badiou’s (2005) own dualism between the normal “state of the situation” and the rare and intermittent “event.” The sixth and final pillar of Meillassoux’s book can be dealt with briefly, since we have already touched on it elsewhere. It comes at the very beginning of the book, when Meillassoux says that we must revive the distinction between primary and secondary qualities, and that the primary qualities are the ones that can be mathematized. He admits that he has not yet published a proof of this idea, though in fact it is already known as one of his primary doctrines. And here we encounter the familiar problem with Meillassoux’s inadequate conception of things-in-themselves. “Primary qualities” refers to those qualities that a thing has independently of its relations with us or anything else. But if the primary qualities can be mathematized, this means that they are not entirely independent of us, since our knowledge can get right to the bottom of them. The mathematized qualities of things are independent of us only in Meillassoux’s sense that they will still have those qualities even when all humans are dead. But to repeat, autonomy from the human lifespan is not the same as autonomy from human access. Here once more Meillassoux is concerned only with independence from the human-world correlate across time, not in any given instant. 2. L’Inexistence divine In 1997, the same year in which he turned thirty years old, Meillassoux earned his doctorate at the École normale supériuere with a brazen dissertation entitled L’Inexistence divine ( The Divine Inexistence ). The work was substantially revised in 2003. But even then, with typical fastidiousness, Meillassoux decided that the work was not yet ready for press. It has now been scrapped in favor of some future, multi-volume work bearing the same title. While writing my book on Meillassoux for Edinburgh University Press, I was permitted to translate excerpts from this unpublished work for use as an appendix in my own book; in total, the appendix contains approximately twenty percent of Meillassoux’s 2003 manuscript, the first time any of it will be published in any language. Nonetheless, a portion of the argument was already tested in the article “Spectral Dilemma,” published in English in the journal Collapse (2008: 261-75). There the philosophical motives for the virtual God are already made clear. What troubles us most are early deaths, brutal deaths, deaths of especial injustice– the sorts of deaths in which the brutal twentieth century was so abundant. And here, neither the atheist nor the believer can help us. The atheist can offer nothing but a sad and cynical resignation when reflecting on the victims of these terrible crimes. The believer does little better, being unable to explain how God could have allowed such things to happen, due to the famous intractability of the problem of evil. The solution offered to this dilemma by Meillassoux is bold, and all the more so given that he emerges from such a deeply Leftist, materialist, and unreligious background. His solution is that God does not yet exist, and therefore is not blameworthy for these catastrophes. Given that everything is contingent in Meillassoux’s philosophy, this God and divine justice might never exist, but they can at least exist as an object of hope. Let’s begin by jumping to the end of L’Inexistence divine , where the alternatives are laid out so nicely. There are four basic attitudes that humans can have towards God, Meillassoux says. First, we can believe in God because he exists. This is the classical theist attitude, rejected for the simple reason that it would be amoral and blasphemous to believe in a God who allows children to be eaten by dogs, to use Dostoevsky’s example. Second, we can disbelieve in God because he does not exist: the classical atheist attitude. But this leads to sadness, cynicism, and a sneering contempt for the greatness of human capacity. The third option, rather more complex, is to disbelieve in God because he does exist: in other words, to exist in rebellion against God as the one who must be blamed for the evils of the earth. The examples here might range from Lucifer himself, to the more human figure of Captain Ahab in Melville’s Moby-Dick , to Werner Herzog’s even more recent catchphrase, “Every man for himself, and God against all.” That leaves only the fourth option: believing in God because he does not exist. Meillassoux closes his book by saying that the fourth option has now been tried (namely, in the course of his own book), and that now that all four have been specified, we must choose. The first reaction to this theory of the inexistent God will be laughter. Few readers will ever be literally convinced by it, and probably none will immediately be convinced by it. But if we ask ourselves why we laugh, the answer is because it sounds so improbable that an inexistent God might suddenly emerge and resurrect the dead. It obviously sounds more like a gullible theology than a rigorous piece of philosophical work. Yet two things need to be kept in mind. First, Meillassoux’s theories are hardly more unlikely than those of great philosophers of the past such as Plato, Plotinus, Avicenna, Malebranche, Spinoza, Leibniz, Nietzsche, or Whitehead. We read the great philosophers not because their systems are plausible in commonsense terms that can be measured by the laws of probability. Instead, we read them precisely because they shatter the existing framework of common sense and open up new window on the universe. Second, and even more importantly, Meillassoux has already rejected probability as a valid measuring stick in philosophy. Or rather, he accepts probability in the intra-worldly realm (where it is linked with potentiality), and rejects it at the level of the world itself (where potentiality is replaced with what he calls virtuality). The virtual God can appear at any moment for no reason at all, just as any other new configuration of laws of nature can appear: in a manner that the laws of probability cannot calculate. Responding to those who might ridicule the idea of a sudden emergence of God and a resurrection of the dead, Meillassoux cites Pascal, who asserts that the resurrection of the dead would be far less incredible than the fact that we were born in the first place. This shifts philosophy onto new ground. Rather than concerning ourselves with what is likely to happen in the world as we know it, we focus instead on the most important things that could happen. For this reason, the expected objection that a virtual God is no more likely to appear than a virtual unicorn or a virtual flying spaghetti monster misses the point. Unicorns and spaghetti monsters could also appear, just like any other non-contradictory thing. But these would just be novel bizarre entities among others, not the heralds of completely new worlds. For Meillassoux, the emergence of matter, life, and thought have been the three truly amazing advents of the world so far, each of them dependent on the advent(s) preceding them. As he sees it, there can be no greater intraworldly entity than the human beings who already exist, since nothing in the world is better than the absolute knowledge of which humans alone are capable. This means that the next great advent must be something that perfects human beings rather than superseding them. And this can only be the world of justice, in which the dead are resurrected and their horrible deaths partially cancelled (Meillassoux never considers the possibility of a God who would literally erase the pre-divine past so that it never happened at all). The only immortality worth having is an immortality of this life, not an existence in some ill-defined afterworld. Human existence, he holds, must always be governed by a “symbol” that gives us the “immanent and comprehensible inscription of values in a world.” And just as cosmic history made the three great contingent leaps of matter, life, and thought, with a leap to justice as the only one still to come, a similar structure occurs within human culture and its symbols, which consist so far of the cosmological, naturalistic, and historical symbols, with a “factial” symbol still to come. We can review each of these symbols briefly. The cosmological symbol refers to the ancient dualism between the terrestrial and celestial spheres. Here below everything is conflict, corruption, and decay; but in the heavens nothing is perishable, all movement is circular, and everything is arranged in mutual harmony. This symbol is ended by modern physics when Galileo discovers such blemishes as sunspots and craters on the moon, and when Newton integrates both celestial and terrestrial movement into a single gravitational law. Next comes the naturalistic or romantic symbol, in which perfection comes not from the sky but from nature itself. The world is filled with pretty flowers (Meillassoux claims that the ancients never discussed the beauty of flowers until Plotinus in the third century) and with living creatures naturally moved by pity, at least until society corrupts them. This symbol collapses in the face of reality as we know it, since pity is no more common than war, corruption, and violence. This brings us to the historical symbol, which only now is passing away. Bad things may happen, but history has an inner logic of its own, such that everything works out in the end. The ultimate form of the historical symbol is the economic symbol, whether in a Marxist or neo-liberal form. Just as the Marxist holds that the inner economic logic of the capitalists will inexorably lead them to self-destruction, the neo-liberal assumes that the sum total of individual selfish actions will lead, in the long run, to the greatest possible good. We worship the economy and let it guide history for us, just as the ancients worshipped celestial bodies and held them to be free from blemish. The final remaining symbol is the factial symbol, which Meillassoux hopes will now emerge. Factiality, we recall, is his term for the absolute contingency of everything that exists. Once we have grasped this absolute contingency, we are free to expect the dramatic advent of the coming fourth World: the world of justice, inaugurated by a virtual God and even mediated by a messianic human figure. There is the added feature, however, that this messiah must abandon all claims to special status once the messianic realm of justice is achieved. The messianic figure will then be no more special than any person on the street, since a reign of human equality will have arisen. Although this focus on human being might seem like a return to standard humanism, Meillassoux holds that human pre-eminence has never truly been maintained. Previously, humans have been treated as special only because they contemplate the Good, because they resemble their omnipotent creator, or because they happen to be the temporary victors in a cruel Darwinian death-match between millions of living species. For Meillassoux, by contrast, humans have value because they know the eternal. But it is not the eternal that is important, since this merely represents the blind, anonymous contingency of each thing. What is important is not knowledge of the eternal , but knowledge of the eternal. We should not admire Prometheus for stealing fire from the gods; Prometheus is simply as bad as all the gods, no matter how much he increased our power. Feuerbach and Marx were wrong to say that God is a projection of the human essence, since for Meillassoux the usual concept of God represents the degradation of the human essence. If the traditional God was allowed to inflict plagues and tsunamis on the human race, the Promethean human of the twentieth century simply assumes the right to inflict death camps and atomic fireballs instead. In this respect, we have simply begun to imitate the degradation of humanity that was formerly invested in an omnipotent and arbitrary God. In response to charges that absolute contingency might lead to political quietism, Meillassoux counters that the World of justice would mean nothing unless we had already hoped for it beforehand. A World of justice that came along at random would merely be an improved third World of thought: indeed, a perfect one. But it would have satisfied no craving, and would therefore have no redemptive power. For this reason, we must actively hope for the fourth World of justice for such a fourth World ever to arise. Not only justice, but beauty is dependent on such hope: for Meillassoux, who is here somewhat dependent on Kant, beauty means an accord between our human symbolization and the actual world, which could never be present in a World of the blessed any more than justice could. And just as a messianic figure is needed to incarnate our hope and then abandon power once the World of justice is realized, it is the figure of the child whose fragile contingency shows us a dignity and a demand for justice beyond all power. 3. Meillassoux Radicalized or Reversed Given the promising reception of Meillassoux’s first book, it would not be groundless to engage in early speculation about what it might take to earn him a place in the history of philosophy. Maybe this will never happen—who knows?—but quite possibly it will: his lucid argumentative methods and sheer philosophical imagination at least make him a good candidate to be read well into the future, especially following further elaboration in print of his mature system. Philosophy is often practiced as thought it were nothing more than the amassing of “knockdown arguments.” But this is no more insightful than saying that good architecture is the amassing of steal beams. It is true that poorly constructed building cannot stand for long, but sound construction is merely the first, indispensable step in building. In fact, I am inclined to say that what really makes a philosopher important is not being right, but being wrong . I mean this in a very specific sense. I once heard the interesting remark about twentieth century culture that “you have to remember that the sixties really happened in the seventies.” That is to say, it was in the 1970’s rather than the more honored 1960’s that civil rights, free love, long hair, and the rock and roll drug culture really took root. With respect to the history of philosophy, we might just as easily say: “you have to remember that Plato really happened in Aristotle,” that “Kant really happened in Hegel” or “Hume really happened in Kant,” or that “Husserl’s phenomenology first achieved its truth in Heidegger.” One becomes an important philosopher not by being right, but by attracting rebellious admirers who tell you that you are wrong , even as their own careers silently orbit around your own. To recruit faithful disciples may be comforting and flattering, but the greatest thinkers have generally had to experience refutation at the hands of their most talented heirs. For this reason, I would propose that we size up the magnitude of living thinkers not by deciding how many times they are right and wrong, but by asking instead: who would take the trouble to refute this author? For this reason I do not ask: “Is Meillassoux right?”, since I do not believe in the virtual God myself, nor am I convinced by any important aspect of Meillassoux’s philosophy. Instead, I ask if there are interesting ways to overturn him. Only by being overturned, by no longer remaining a contemporary, does one become a classic. Let’s begin with a simple model of refutation, which can be refined further at a later date once the basic point is established. One kind of refutation simply consists in saying: “This author is a complete idiot.” The refuter now walks away in celebration, and no link between the present and the future is built; all is reduced to rubble. But this sort of mediocre triumphalism is generally practiced by those who achieve little of their own, and is not especially interesting. Much more interesting is the sort of refutation that does not take its target to be a complete idiot. I would like to suggest that there are just two basic ways in which this can be done: radicalization and reversal . It has not escaped my notice that this is a fairly good match for the Deleuzian distinction between irony and humor. Whereas irony critiques and adopts the opposite principle of what it attacks, humor accepts what it confronts but pushes it into highly exaggerated form. The ironist is like the worker who sows chaos by rebeling and contradicting the boss, while the humorist is like the worker who follows orders to an absurdly literal degree, with equally chaotic results. Let’s start with a few examples. In Aristotle’s treatment of Plato, and Heidegger’s of Husserl, we find reversal. Plato’s eidei are transformed by Aristotle into mere secondary substances, and the individual worldly things despised by Plato become what is primary. For Husserl what is primary is whatever is present to consciousness, while for Heidegger this is precisely what is secondary, since the primary stuff of the world withdraws from any form of presence at all. As for radicalization, it is most easily found in the transformation of Kant by German Idealism: “Kant was right to wall off the things-in-themselves from human access, and simply should have realized that the thought of the Ding an sich is also a thought, and thereby the noumena are just special cases of the phenomena,” with much following from this discovery. It would also be easy to read Spinoza as a radicalizer of Descartes, and Berkeley and Hume as radicalized versions of Locke. Perhaps the distinction is now sufficiently clear. Admiring refutations are not those that say “Professor X is an idiot,” which is merely the flip side of the eager disciple’s fruitless “Professor X got everything right.” Instead, it will be some variant of one of the following two options: “Professor X is important, but got it backwards,” or “Professor X is important, but didn’t push things far enough.” In the history of philosophy these two latter cases have often been painful in purely human terms: Aristotle expresses sadness at refuting Plato, Kant is openly annoyed at Fichte, and Husserl feels betrayed and used by Heidegger. Rude handling from later figures almost seems to be the sine qua non of being a great philosopher. Now, it has already been claimed that Meillassoux is an emerging philosopher of the first importance, and by no less a figure than Alain Badiou: “It would be no exaggeration to say that Quentin Meillassoux has opened up a new path in the history of philosophy…” (Preface, vii). But rather than taking Badiou’s word for it, or rejecting his word, we might experiment by asking how Meillassoux could be radicalized or reversed. Are there interesting ways of doing this that might launch whole new schools of philosophy, unexpected or even condemned by Meillassoux himself? While no one can see the future, the present is poor when it is not riddled with virtual futures. The relation between philosophers and their predecessors and successors is always somewhat complicated, of course. But generally there is one central divergence at stake, which might be taken as the key to all the others. On this basis we could say that new thinkers primarily radicalize or primarily reverse the main ideas of their chief philosophical forerunner. There may be specific historical conditions and perhaps even personality traits connected with these two types, but this question can be left aside for now. More important for us is that radicalizers will generally be followed by reversers, and vice versa. Consider the textbook example of a reversal in the history of philosophy: Kant’s Copernican Revolution, which inverts the so-called dogmatic tradition that addresses the world itself, and makes the world revolve instead around the conditions by which it is known. While it is not completely impossible that Kant’s successors might have re-reversed this principle back into a new and stronger dogmatic realism, conditions were premature for such a move. Anyone doing this too early would likely have been an angry anti-Kantian reactionary rather than an original thinker in command of a genuinely new realist principle. The far more likely outcome is the one that actually happened: Kant’s reversal of his predecessors was viewed as incomplete, or as retaining lamentable bits of the traditional view, which despite his admirable breakthrough he was unable to shake off. This was the view of German Idealism, anyway. In similar fashion, Spinoza could also be viewed as a radicalizer of Descartes, who is equally accused of preserving various Scholastic dogmas in an otherwise radical project of philosophical reversal. The point is this: reversals in the history of thought tend to be followed soon thereafter by radicalizations of those reversals. The same may hold true in reverse: radicalizations might generally be followed by reversals, given that it is not always possible to be more radical than the radicals have already been. Consider the case of Husserl, who radicalizes Brentano’s early vagueness about what lies beyond immanent objectivity, and Twardowski’s assertion that there must be an external object lying outside the intentional content, by collapsing everything into the intentional sphere: there is no difference between the Berlin in my consciousness and the actual Berlin that is home to millions of people. It is difficult to see how one could be even more radical than Husserl’s idealist turn here. And thus the road is paved to Heidegger’s reversal of classical phenomenology, in which the key point is what lies deeper than any presence to consciousness: the Sein whose power and obscurity cannot be made exhaustively present, but only sends itself in historical epochs. In similar fashion we might also read Leibniz as a reverser of Spinoza’s radicalization, retrieving a strong sense of individual substance and a certain validity of what the Scholastics had said. Returning to Meillassoux, we might ask which kind of philosopher he is: a radicalizer or a reverser? At present, Meillassoux looks to me like a radicalizer (though for now his future remains shrouded in mist). He takes the correlationist tradition, which allows us to speak only of the relation between human and world, and tries to raise it into an even more extreme claim about the absolute contingency of everything. But whereas German Idealism did this by trying to collapse the distinction between thought and world entirely into the “thought” side, Meillassoux does it by trying to shift the non-absolute contingency of the thought-world correlate from epistemology to ontology. It is no longer a question of the inability of human knowledge to know what lies outside the correlate, but the inability of reality itself to be rooted in any definite laws. Furthermore, if we look at the various features of Meillassoux’s philosophy identified earlier tonight, all but one are already so radical that there is no obvious way to push them further. The one exception would be his claim that the world as a whole can change for no reason at any moment, coupled with the inconsistent claim that within a given world there are laws of nature that everything must follow. If gravitational attraction between all masses is a current law in our world, then for Meillassoux there can be no exceptions to this law for as long as it remains in force. A toppled vase will fall to the floor every time for sure,unless there is a cosmic change by which the laws of nature as a whole have altered. (This is reminiscent of the late medieval distinction between the absolute and ordained power of God, according to which God has the power to set or change the laws of nature, but not to contravene those laws locally once they are set.) On this point, to radicalize Meillassoux would simply be to say: there are no laws of nature even in the local sense. Everything that happens, even in the world here and now, is purely contingent and not governed by even a trace of law. And while this would be a more consistent development of Meillassoux’s thoughts on contingency, it is difficult to see how it could lead to a new philosophy. Instead, the admiring successors of Meillassoux are more likely to reverse one of his already sufficiently radical points. At least four candidates come to mind: *First, we have seen that Meillassoux thinks correlationism is challenged by a time before or after consciousness, but not by a space lying outside it. Perhaps this could be reversed into saying that spatial exteriority is the really crucial point. The arguments on this point are perhaps the least convincing in After Finitude (and do not even occur in the original French edition), and therefore it might be a candidate for the “blind spot” of which no philosopher is ever free. *Second, Meillassoux uses Cantor to claim that the contingency of laws of nature would not entail that they are unstable. A successor of Meillassoux might claim that it does make them unstable, and celebrate this fact. This person would then have to explain why common sense seems to encounter a relatively stable world despite its truly rampant instability. Whereas Meillassoux’s problem is to show how stability might exist despite contingency, this successor’s problem would be slightly different: to show why actual, full-blown instability might have the appearance of stability. *Third, Meillassoux claims that the primary qualities of things are those that can be mathematized. He might be reversed by a successor who says the opposite: the mathematizable qualities are the secondary ones, and the primary ones are those that elude symbolic formulation. While this is a perfectly valid possible objection to Meillassoux, it is one that is made in advance by some of his predecessors and is still made by some of his peers, making it less interesting for futurology than some of his other points. *Fourth and finally, whereas Meillassoux claims that God does not exist but might exist in the future, a successor might argue even more bizarrely that God has always existed but might vanish in the future. Let’s arbitrarily select the first of these possibilities, and imagine briefly where it might lead, if pursued in the future by admiring detractors. Meillassoux comes from the circle of Badiou, and some of Badiou’s most ardent admirers are found in Latin America. So, let’s imagine that towards mid-century some ingenious reversers of Meillassoux emerge in that portion of the Spanish-speaking world. Just for fun, let’s call them Castro and Chávez. And in order to avoid any confusion with the present-day politicians of those names, we will stipulate that Meillassoux’s great successors are both women. The philosopher Castro (we will suppose she comes from Peru) reverses Meillassoux’s argument that the ancestral or diachronic are what most threaten the human-world correlate. Instead, she claims that the diachronic does not threaten the correlate at all, and that we must instead look at space as what ruins the correlate and demands a strange new realism. What would such a philosophy look like? In order to determine this, we might ask what price Meillassoux pays for doing it the opposite way. As I see it, he pays in two separate ways. One is that laws of nature for him are contingent over time . The laws of nature apply to the universe as a whole at any given moment, and would be changed globally if they are ever changed at all. The second price he pays is that Meillassoux has no mereology , or theory of parts and wholes. Everything for him is on the level of the given, or immanent in experience, with the sole proviso that the laws governing this immanence might change without notice at any given moment. In reversing Meillassoux, Castro makes the following claims in the preface to her stunning debut book of 2045, The Cosmos and its Neighborhoods , rapidly translated from Spanish into all the languages of the world: Despite his brilliant analysis of the contingency of laws of nature over time, Meillassoux gets two important assumptions wrong. First, he allows for only one set of contingent laws to govern nature as a whole. Second, he allows laws to govern only the world that is immanent in experience, and thereby fails to explore the contingency among part-whole relations. In this book I will argue, first, that the laws of nature vary in any given instant between one region of the universe and the next; and second, that the world is made up of layers of parts and wholes that are also contingent with respect to one another. Those are the words of Castro. This may sound like a hopeless free-for-all of chaos, yet the book somehow succeeds in drawing some compelling deductions about how laws must vary from one place or level in the world to the next. Trapped in the limited horizon of 2011, and not yet inspired by the heavily balkanized political and technological situation of 2050 that somehow lends additional credence to Castro’s vision, we can only vaguely grasp what such a philosophy might look like. After this reversal of Meillassoux by Castro, the usual pattern leads us to expect a radicalization by Chávez, a young Argentine student of Castro. How could the already strange theories of Castro be radicalized? Perhaps as follows, in a disturbing new book entitled The Implosion of the Neighborhoods , which argues as follows: Castro was right to shift the Meillassouxian framework of contingency from time to space. However, in this respect she retained a surprisingly traditional opposition between the two. In this book I will show that time and space collapse into one another. This may sound too much like the discredited four-dimensional block universe of twentieth century physics and philosophy. However, the four-dimensional universe is a model biased in favor of space, merely adding an extra dimension to the commonsense spatial continuum while stipulating that the serial passage of time is an illusion. In this book I will argue instead for a one-dimensional space-time modeled after our experience of time, in which there is no simultaneous co-existence at all between different parts of the universe, or ‘neighborhoods’ as my esteemed teacher Castro has called them. Instead, the various portions of the universe link to one another by succession rather than by coexistence. Buenos Aires, New York, and Amsterdam do not exist simultaneously in the same landscape, but one after the other in the mind of some observer, and this observer can only be an observer much larger than any human. Against Meillassoux’s notion of a virtual God that does not exist now but might exist in the future, I will argue for an actual God that surveys the universe in sequence, thereby generating the illusion of spatial diversity and even the illusion of individual minds located within that diversity. Once this divine observer dies, the universe as a whole must perish. Again, these ideas are so bizarre that we of 2011 can barely comprehend them, just as Aristotle would have had a difficult time grasping the theories of Descartes. We could then perhaps imagine a further reversal of this theory, emanating from the intellectually resurgent Philippines of the twenty-second century. The Filipino School might argue that the universe is already dead, given the collapse of its spatial richness into the serial observations of a flimsy and mortal God. The virtual universe does not yet exist, but might exist in fully spatial form in the future, and this would require the death of God and the resulting liberation of God’s succession of images as independent, spatially situated realities. With a bit of sharpening, we might be able to make all of these imaginary thinkers more intuitively clear. Along with the history of philosophy, there might arise a new discipline generating imaginary futures for philosophy. The richness of Meillassoux’s system comes not from the fact that he is plausibly right about so many things, but because his philosophy offers such a treasury of bold statements ripe for being radicalized or reversed. He is a rich target for many still-unborn intellectual heirs, and this is what gives him the chance to be an important figure. NOTES 1. Quentin Meillassoux, After Finitude . Trans. R Brassier. (London: Continuum, 2008.) Page 5. The word “correlationism” does not appear in his doctoral thesis. As Meillassoux informed me in an email of February 8, 2011, he first coined this term in 2003 or 2004, while editing for publication a lecture he had given at the École normale supérieure on a day devoted to the theme of “Philosophy and Mathematics,” an event including Alain Badiou as one of the participants. 2. Graham Harman, Quentin Meillassoux: Philosophy in the Making . (Edinburgh: Edinburgh University Press, forthcoming 2011). 3. In an email of December 6, 2010, Meillassoux clarifies that in After Finitude he only deduces the impossibility of a “universal contradiction,” not of a determinate contradiction. In the same email he suggests that he can also prove the latter, though the proof is somewhat lengthier than the one found in After Finitude . 4. After Finitude (18-26), in the passage falling between the two sets of triple asterisks. These pages were sent by Meillassoux to translator Ray Brassier (in French) during the translation process, and do not appear in the original French version of the book. 5. Graham Harman, “Quentin Meillassoux: A New French Philosopher.” Philosophy Today 51.1 (2007): Pages 104-117. The passage where I raise the question of space can be found in the first column of page 107. 6. Vernes is first cited on p. 95 of After Finitude . See Jean-René Vernes, Critique de la raison aléatoire, ou Descartes contra Kant . (Paris: Aubier, 1982).  . (shrink)

This contribution deals with the issue of the professional autonomy ofthe medical doctor. Worldwide, the physician's autonomy is guaranteedand limited, first of all, by Codes of Medical Ethics. InItaly, the latest version of the national Code of MedicalEthics (Code 1998) was published in 1998 by the Federation ofprovincial Medical Associations (FnomCeO). The Code 1998acknowledges the physician's autonomy regarding the scheduling, thechoice and application of diagnostic and therapeutic means, within theprinciples of professional responsibility. This responsibility has tomake reference to the following (...) fundamental ethical principles:(1) the protection of human life; (2) the protection of thephysical and psychological health of the human being; (3) therelief from pain; (4) the respect for the freedom and the dignityof the human person, without discrimination; (5) an up-to-datescientific qualification (Art. 5). The authors underline that autonomyis an anthropological – and consequently ethical –characteristic of the human person. Different positions on autonomy inbioethics (individualistic, evolutionistic, utilitarian andpersonalistic models) are explained. The relation between theprofessional autonomy of the physician and the autonomy of the patientand of colleagues is discussed. In fact, the medical doctor isobliged: (1) to respect the fundamental rights of the person,first of all his/her life; (2) to ensure the continuity of thecare, even if he can only relieve the patient's suffering; (3) tomaintain, except under certain circumstances, professional secrecy andconfidentiality regarding patients and their medical records. Moreover,the physician cannot deny the patient correct and appropriateinformation. He/she should not perform any diagnostic or therapeuticactivity without the informed consent of the patient and the medicaldoctor must give up medical treatment in case of documented refusal ofthe individual. Furthermore, the medical doctor has the right to raiseconscientious objections if he/she is requested to perform medicalactions that are contrary to his/her conscience or medical opinion,unless this attitude would seriously and immediately harm the patient.Regarding the relationships with colleagues, the physician is obliged tosolidarity, mutual respect, and care of sick colleagues. Finally, theauthors discuss the Italian legislation affecting the physician'sprofessional autonomy: (1) the SSN health care Acts; (2) theso-called Charter for Public Health Care Services; (3) the Acts onprivacy; (4) Good Clinical Practice. (shrink)

In this study, Consistency and Balance Model (CBM) is proposed and introduced. In the context of the model, the importance of consistency is emphasized in morality just like in Philosophy. Therefore, CBM gives the reason prominence in morality to ensure the consistency and according to CBM the emotion, the intuition and the conscience in addition to the reason, are also important. In order to see the principles determined by the reason in human behaviors, two kinds of classification are developed for (...) the virtues that is defined as the middle of excess and defect. The first of them is the triple classification of virtues that draws attention to the false existence of virtues and determines the opposite of virtues as forming dichotomy. The latter is the tetrad classification, which is based on the duality of two means that propose to consider the virtues together. The Contrast is considered as the central concept in the first classification and the integration is considered as the central concept in the second classification. Then it is offered that the virtues may be evaluated consistently in the social, global and theological contexts. However, the ideal morality with objective qualities and the real morality with subjective qualities are produced in order to reach the universal morality that is determined by the reason, then the consistency and the integration are proposed for them. Similarly, consistency and integration are proposed in the dualities of principle-virtue, abstract-concrete, intention-outcome, universality-locality, objectivity-subjectivity throughout the study. Finally, it is pointed out that the reasonableness of applying consistency in morality has exceptions.Summary: Philosophy is the logical, systematic and consistent thinking that focuses on specific questions and topics to reach the reality. When this basic tendency of philosophy is applied to morality, logical, systematic and consistent actions are expected to emerge. Accordingly, a new model called as Consistency and Balance Model (CBM) is proposed and introduced in this article. By this model, the importance of consistency is emphasized in morality just like in philosophy. Therefore, CBM gives the reason prominence in morality to ensure thought, expression and behavior consistency. According to CBM the human emotion, the divine intuition and the solid conscience in addition to reason are required to determine the virtues. CBM, which is a synthesis of the good intention and the reason, aims to constitute the sensible and good actions. According to CBM, which has a holistic structure, if a person can adopt the virtue as a principle and reflect the virtue in all of his behaviors during his whole life, he can be defined as consistently virtuous.CBM defines the good with the concepts of consistency and balance. According to CBM, the good is the mean of excess and defect. In this respect, CBM is based on Aristotle’s mean idea. However, CBM aims to develop it with new content. Two important questions arise during the identification of the evil: 1. Is it bad that nothing happens? 2. Is it bad that something is wrong? The point of defect represents the absence and the point of excess represents the fallacy in the entity. Both of them are bad in morality. The middle of them is the virtue. In order to see the principles determined by the reason in human behaviors, two kinds of classification are developed for the virtues which are defined as the middle of excess and defect. The first is the triple classification of virtues that draws attention to the false existence of virtues and determines the opposite of virtues as forming dichotomy. The triple classification, which forms a dichotomy as an empty pattern that can be applied to all virtues, is determined as over virtue-virtous-virtueless. According to CBM the opposite of the mean is always clearly the point of defect and implicitly the point of excess. Therefore, it is important to determine extremes of virtues. The point of defect can be briefly denoted as virtueless. The point of excess can be denoted as in fact virtueless, pretending as virtuous, masked virtue and over virtue. The latter is the tetrad classification, which is based on the duality of two means. In this classification, it is possible to produce new and better virtues by considering two virtues together. The Contrast is considered as the central concept in the first classification and the integration is considered as the central concept in the second classification.The principle is seen as a guarantee for the consistency in philosophy. CBM points out that a similar situation should be in ethics. According to Kant, the invisible internal principles of the actions are more important than the actions themselves to determine the moral value. The principle does not vary according to the individual and the condition, on the contrary, the individual is shaped by the principle and all individuals benefit equally from the outcome of the principle. Thus, the abuse of the rights of individuals with arbitrary treatments and double standards are prevented. In this democratic environment formed by the principle not only the owner of the power, but all right holders can get their rights. In this respect, the adherence to the principle is the guarantee of the rights and the freedom by establishing a balance between the rule and the freedom.Aristotle’s virtue and Kant’s principle are discussed in a holistic manner in this study. Thus, it is aimed that the principles in the human mind and the virtues in human actions are consistent in themselves and ultimately the union of the principles and the virtues can be ensured. Besides, the concepts of the ideal morality and the real morality are introduced in this article. The ideal morality takes place on the objective basis of the good and the truth, which is absolute, universally and unarguably accepted by everyone. The ideal morality with its objective qualities can be seen as the target that people know and want to achieve. The real morality is the morality that is shaped in the people or society in all its positive and negative aspects, which also includes the subjectivity of them as their own realities. The real morality with subjective qualities is the morality that occurs in life. CBM aims at the integrity and the consistency between the ideal morality and the real morality to reach the universal morality. In this article, the virtues are divided into two parts as material and spiritual. Then it is offered that the virtues may be evaluated consistently in the principal, individual, social, global and theological contexts. In this context, on the one hand it is aimed that the principal, individual, social, global and theological virtues are consistent within themselves and on the other hand they all are consistent within each other. In this classification the principal and theological morality have objective qualities and the individual and social morality have subjective qualities. CBM aims at an objectivity that incorporates subjectivity within the consistency and integrity of the principal, individual, social, global and theological morality. CBM aims to achieve the ultimate morality by integrating the starting point as the principal morality and the end point as the theological morality and to make them clear in the individual and social morality. As a result, CBM confirms the mean found by reason, by the revelation given by God. In other words, the morality that God has already there and always presents and the morality that the human mind finds here and now coincide. The consistency and integration are also proposed in the dualities of principle-virtue, abstract-concrete, intention-outcome, universality-locality, objectivity-subjectivity in the article. However, consistency, which is the central concept of the article, can form the basis for possible criticisms. But, it can be foreseen that the possible criticisms oriented to CBM would come from an extreme consistency perception that detaches the concept of consistency from reality without careful consideration. For this reason it should be kept in mind that it is wrong to expect excessive consistency in human behavior and to accept the ideal morality as absolute by neglecting the real morality. Finally, it is pointed out that the reasonableness of applying the consistency in morality has exceptions. (shrink)

Respect for autonomy is a central moral principle in bioethics. The concept of autonomy can be construed in various ways. Under the non-ideal conceptualization proposed by Beauchamp and Childress, everyday choices of generally competent persons are autonomous to the extent that they are intentional and are made with understanding and without controlling influences. It is sometimes suggested that authenticity is important to personal autonomy, so that inauthenticity prevents otherwise autonomous persons from making autonomous decisions. Building from Beauchamp (...) and Childress’s theory, this article develops a non-ideal authenticity-based conceptualization of personal autonomy. Factors that indicate inauthentic decision-making are explicated, and the full concept is defended from three expected objections. The theory is then tested on a paradigm case which has concerned theorists and practitioners for some time, namely the possible inauthenticity of anorexia nervosa patients’ decision-making. It is concluded that the theory seems to be fruitful in analyses of the degree of autonomy of patients’ decision-making, and that it succeeds in providing reliable action-guidance in practical contexts. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:GOOD MEN'S WOMEN: HUME ON CHASTITY AND TRUST At the very heart of Hume's philosophy in the Treatise, namely between his discussion of the artificial and the natural virtues, he places a short chapter entitled "Of Chastity and Modesty." Its central position is appropriate, since these supposed virtues present something of a test case for Hume's account of the relation between nature and artifice, and, more generally, beyond (...) his moral philosophy, for his views on regularity and constancy in and out of individual lives. For these theoretical reasons, as well as for the calm realism of his treatment of sexual inequality, the chapter warrants more attention than it has received. Perhaps Hume's most important contribution to moral philosophy is his account of the difference between natural virtues, displayed in actions which do good one by one, each act having value independently of whether similar acts are performed by oneself and others on other occasions, and artificial virtues displayed in acts in essential conformity to established socially useful conventions, which do good only in so far as they are supported by general conformity. Hume does not, like Kant, insist that we always see morally good action as obedience to law, nor does he neglect the importance of those areas where good can be done only if acts are correctly seen as conforming to general laws, general conformity to which is not only willed by the agent but assumed by him to be in effect. Hume gives a subtle and elaborate account of when we do and when we do not need moral and social conformity, of which virtues are and which virtues are not mediated by changeable public will or convention. Conventions must operate before any act can count as property-respecting, but there is no need to ask 'can I will this as universal law?' before comforting a frightened child. Whatever the conventions, whatever others do, such an act does some good, and is the sort of 2. act which displays the natural virtue of kindness. Hume requires of a virtuous act not merely that it be helpful or agreeable to someone (or some public) but that it display a durable character trait in the agent. An uncharacteristic act of kindness to a child may do good without displaying a virtue or a good character. Approval is given, according to Hume, to persons on account of theii durable character traits, as displayed in their actions and reactions. The natural response to virtue is to welcome its possessor: His company is a satisfaction to me (T588), and virtue in rags will be the exception in a smoothly functioning society. The fact that Hume's ethics is an agent ethics, and that the concept of welcome virtue is more fundamental to it than that of a useful action, commits Hume, throughout his moral philosophy and especial!, in his treatment of the natural virtues, to an emphasis on consistency or integrity of character, to a search for durable character traits and so for characteristic actions. Now a person might be characteristically kind, yet on occasion, under stress, give expression to unaccustomed malice. The uncharacteristic malicious act may weaken but not destroy the virtue of kindness which kind acts have both expressed and infixed (T411). When the malicious act is known, the person's reputation for benevolence may be slightly sullied, but certainly not ruined. Both within one person's life, and within one population, there will be reason to encourage consistently virtuous action, but no reason to feel that all is lost or spoiled if lapses from the natural virtues occur. Even when cruelty is the norm, the rare kind act may be appreciated, if not rewarded, the rare kind person may be welcome, if also exploited and victimized. With the artificial virtues there is a stronger demand and need for uniformity in a population, since the value of any one just act, or one person's character trait, depends upon the support received from the similar acts and 3. traits of others. Every single act is performed in the expectation that others are to perform the like (T498). To display artificial virtues, actions must be seen as rule... (shrink)

Leading accounts of personal autonomy arecontent-neutral:they insist that there are noa prioriconstraints on the content of the desires or values that might motivate an autonomous action. In Gerald Dworkin's provocative words, ‘the autonomous person can be a tyrant or a slave, a saint or sinner, a rugged individualist or champion of fraternity, a leader or follower.’ ‘There is nothing in the idea of autonomy that precludes a person from saying, “I want to be the kind of person who (...) acts at the command of others. I define myself as a slave and endorse those attitudes and preferences. My autonomy consists in being a slave.” ’ John Christman similarly claims that ‘any desire, no matter how evil, self-sacrificing, or slavish it might be’ could be autonomously formed. The same seems to apply to Harry Frankfurt's view, that actions are autonomous if they stem from second-order volitions that reflect what the agent cares about; it puts no constraints on the content of what a person might care about. All of these accounts hold that the mere content of a desire or value is never sufficient to rule out that it might be autonomously acted on by someone. (shrink)

Philosophical orthodoxy identifies weakness of will with akrasia: the weak willed person is someone who intentionally acts against their better judgement. It is argued that this is a mistake. Weakness of will consists in a quite different failing, namely an over-ready revision of one's intentions. Building on the work of Bratman, an account of such over-ready revision is given. A number of examples are then adduced showing how weakness of will, so understood, differs from akrasia.

Leading accounts of personal autonomy are content-neutral: they insist that there are no a priori constraints on the content of the desires or values that might motivate an autonomous action. In Gerald Dworkin's provocative words, ‘the autonomous person can be a tyrant or a slave, a saint or sinner, a rugged individualist or champion of fraternity, a leader or follower.’ ‘There is nothing in the idea of autonomy that precludes a person from saying, “I want to be the (...) kind of person who acts at the command of others. I define myself as a slave and endorse those attitudes and preferences. My autonomy consists in being a slave.” ’ John Christman similarly claims that ‘any desire, no matter how evil, self-sacrificing, or slavish it might be’ could be autonomously formed. The same seems to apply to Harry Frankfurt's view, that actions are autonomous if they stem from second-order volitions that reflect what the agent cares about; it puts no constraints on the content of what a person might care about. All of these accounts hold that the mere content of a desire or value is never sufficient to rule out that it might be autonomously acted on by someone. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:"Divine Person" as Analogous NameDylan SchraderThe position of St. Thomas Aquinas and the Thomistic school that human beings cannot name God and creatures univocally is well-known.1 This includes the term "person," which is predicated of the Trinity, of angels, and of human beings truly but analogically. In contrast, it might seem that, when speaking of the Father, Son, and Holy Spirit in respect of one another, "divine person" must (...) be univocal.2 [End Page 217]The seventeenth-century Discalced Carmelites of Salamanca (the Salmanticenses) thought otherwise. They argued that the ratio3 of "divine person" is common to the Father, Son, and Holy Spirit not univocally, but analogically, and that this follows from established Thomistic principles.4 Their position makes for an interesting case study in religious language, as the Salmanticenses apply a highly developed material logic to the central mystery of Christian faith.Words, Concepts, and ThingsIn On Interpretation (Peri hermeneias), Aristotle explains that words immediately signify concepts and, by means of concepts, things.5 This so-called "semantic triangle" makes it easy to misunderstand univocity and analogy if we do not first determine how a particular thinker conceives of the relationship among words, concepts, and things. To discern how the Salmanticenses understood this relationship, it is most helpful to look to their counterparts, the Discalced Carmelites at neighboring Alcalá de Henares outside Madrid, commonly called the Complutenses.6 The Complutenses' Artium cursus [End Page 218] serves as philosophical handmaid to the Salmanticenses' Cursus theologicus, and is therefore essential for correctly interpreting the latter's claims about grammar, logic, and metaphysics.7To begin with the verbal element, this is how the Complutenses, following a fairly typical account, explain the difference between a vocal sound, a name, and a term: A vocal sound (vox) is speech considered simply as an audible phenomenon, the pure sound wave. A name (nomen) is a vocal sound that signifies something. A term (terminus) is a name insofar as it serves as one end of a proposition.8 Terms may be purely mental (as when a proposition is conceived of in the mind alone), or they may be spoken or written.Names and terms are useful precisely because they signify. The Complutenses define "signifying" (significare) as "representing to the knowing power something other than [the signifier] itself."9 A name or term points beyond itself so that something else can become known to the mind through that name or term.When it comes to spoken (or written) terms, a term is "common" (communis) if it signifies more than one thing. Common terms may be "non-transcendent" (non transcendens) or "transcendent" (transcendens). Common terms are non-transcendent if they are predicated of certain things (such as "man" or "animal"). They are transcendent if they are predicated of all things. Six terms are usually acknowledged to be transcendent: "being" (ens); "thing" (res); "true" (verum); "good" (bonum); "something" (aliquid); and "one" (unum).10 [End Page 219]Here it is necessary to distinguish first and second "intention" (intentio).11 The Carmelites take "first intention" properly to be the act whereby the intellect knows things in accord with what is in them as realities.12 This act of the intellect is the "formal first intention," while the thing known is the "objective first intention." A name signifying a thing in this way is a "name of first intention."But the intellect can also attend to those things not in accord with what is in them from their own perspective as realities, but instead with reference to their character as acted upon by the intellect itself. This act is called "second intention."13 An example of first intention is the intellect's knowing that "man is an animal," whereas an example of second intention is its knowing that "'animal' is a genus."The Complutenses stress that first and second intention are, properly speaking, acts of the intellect—distinct ways of attending to what it knows—even though logicians often use "first intention" and "second intention" as shorthand to refer to the objects of these acts.14 In fact, because objective second intentions (the objects of the intellect's second-intentional acts) are beings of reason... (shrink)

PHOTO ID 121339257© Designer491| Dreamstime.com ABSTRACT When physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be apparent conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters future physicians’ commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. We use an ethical dilemma that was presented to a group of third-year medical students to examine how ethics education might be causing (...) them to give undue deference to autonomy, thereby undermining their commitment to beneficence. INTRODUCTION The right of patients to choose which treatments they prefer is rooted in today’s social mores and taught as a principle of medical ethics as respect for autonomy. Yet, when physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be a conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters a commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. I. An Ethical Dilemma The impetus for this paper arose when students who were completing their third clinical year discussed a real-life ethical dilemma. A middle-aged man developed a pulmonary hemorrhage while on blood thinners for a recently placed coronary stent. The bleeding was felt to be reversible, but the patient needed immediate intubation or he would die. The cardiologist was told that the patient previously expressed to other physicians that he never wanted to be intubated. However, the cardiologist made the decision to intubate the patient anyway, and the patient eventually recovered.[1] Students were asked if they believed that the cardiologist had acted ethically. Their overwhelming response was, “No, the patient should have been allowed to die.” We looked into how students applied ethical reasoning to conclude that this outcome was ethically preferred. To explore how the third-year clinical experience might have formed the students’ judgment, we presented the same case to students who were just beginning their third year. Their responses were essentially uniform in recommending intubation. While there is likely more than one reasonable view in this case, we agree with the physician and the younger medical students that intubation was the ethically appropriate decision and will present an argument for it. But first, we explain the reasoning behind the more advanced medical students’ decision to choose patient autonomy at the expense of beneficence. II. Medical Ethics Education and the Priority of Autonomy Beauchamp and Childress’s Principles of Biomedical Ethics, first published in 1979 and now in its 8th edition, is a significant part of the formal ethics education in medical school.[2] Students learn an ethical decision-making approach based on respect for four ethical principles: autonomy, beneficence, nonmaleficence, and justice. While Beauchamp and Childress officially afford no prima facie superiority to any principle, the importance of respect for patient autonomy has increased through the editions of their book. For example, early editions of their book opposed the legalization of physician-assisted death compared to recent editions that defended it.[3] As another example, Beauchamp and Childress make paternalism harder to justify by adding an autonomy-protecting condition to the list of conditions for acceptable paternalism.[4] Authority, they contend, need not conflict with autonomy—provided the authority is autonomously chosen.[5] “The main requirement,” they write, “is to respect a particular patient’s or subject’s autonomous choices, whatever they may be.[6] In the principlism of Beauchamp and Childress, autonomy now seems to have a kind of default priority.[7] However, the bioethics discourse has strong counternarratives, noting some movement to elevate the role of beneficence and to respect the input of stakeholders, including the family and the healthcare team. Ethics education achieves particular relevance in the third clinical year when students become embedded in the care of patients and learn from what has been called the informal curriculum. They observe how attending physicians approach day-to-day ethical problems at the patient’s bedside. In this context, students observe the importance of informed consent for serious treatments or invasive procedures, a practice that highlights the principle of patient autonomy. In both the formal and informal curriculum, medical students observe how, in the words of Paul Wolpe, “patient autonomy has become the central and most powerful principle in ethical decision-making in American medicine.”[8] In short, students appear to learn a deference for patient autonomy. This curricular shift in favor of autonomy coincides with legal developments that protect patients’ rights and decision-making with respect to their healthcare choices. The priority of autonomy in medicine benefits patients by reflecting their choices and, in some cases, their fundamental liberty. III. The Practice of Medicine and the Commitment to Beneficence There are many critiques of the dominant place that autonomy has in biomedical ethics,[9] especially considering that autonomy seems to be biased toward individualistic, Western, and somewhat American culture-driven values.[10] In addition, many bioethical dilemmas are cast as a conflict between autonomy and beneficence. Our point is that medical students bring to their study of medicine a commitment to beneficence that seems to be suppressed by practical ethics education. We think this commitment is rationally defensible and should be nurtured. It is striking that young medical students have a pre-reflective commitment to beneficence at all. For, as we mentioned, it is not just medicine but Western culture generally that prioritizes autonomy in settling ethical dilemmas. In wanting to act for the good of others (rather than simply agreeing to what others want), physicians are already swimming somewhat against the cultural tide.[11] However, doing so makes sense, given the nature of medicine and the profession of healing. When prospective medical students are asked why they wish to become physicians, the usual answer is some variation on caring for the sick and preventing disease. It is unlikely that a reason to become a physician is to respect a patient’s autonomy. It would be easy to dismiss medical students’ commitment to beneficence as a mere intuition and contrary to a more reasoned and deliberative approach. Beauchamp and Childress seem to minimize the value of physician intuition, stating that justifications for certain procedures are “…supported by good reasons. They need not rest merely in intuition or feeling.”[12] Henry Richardson writes that “situational or perceptive intuition…leaves the reasons for decision unarticulated.”[13] We think this is a crude and rather thin way of understanding intuition. Some bioethicists have defended intuition as essential to the practice of medicine and not something opposed to reason.[14] In the case we describe, we believe the ethical justifications s for the patient’s intubation are fundamentally sound: the patient did not have a “do not intubate” order written in the chart, the emergency intubation had not been foreseen, so the patient did not have the opportunity to consent to or reject intubation; the patient had consented to the treatment for his cardiac disease so his consent for intubation could have been assumed;[15] and the consequences of respecting his autonomy did not justify allowing him to die.[16] While it is possible to have more than one reasonable view on this case, we think the case for beneficence is strong and certainly should not be dismissed out of hand. We do not deny that if a patient makes a clearly documented, well-informed decision to forgo intubation that this decision ought to be respected by the physician (even if the physician disagrees with the patient’s decision). But, in this situation, as in many others in the practice of medicine, the patient’s real wishes and preferences are not well-articulated in advance. There are many cases where a physician acts based on what she believes the patient, or the surrogate, would want, sometimes in situations that do not allow much time for reflection. An example might be resuscitation of a newborn at the borderline of viability. In their ethics education, beneficence would mean acting first to save a life. If the patient or surrogate makes an informed decision to the contrary, a beneficent physician respects that autonomous decision. In the case presented, the patient expressed gratitude to the cardiologist when extubated. But what if he had expressed anger at the physician for violating his autonomy? There are those who could argue that not only was intubation ethically wrong but that the cardiologist put himself in legal jeopardy by his actions (especially if there had been a written refusal applicable to the specific situation). In the example we use, we point out that the cardiologist may not have escaped a lawsuit if the patient had died without intubation. His family, when hearing the circumstances, may have sued for failure to act and dereliction of the cardiologist’s duty to save him. Beyond a potential legal challenge for either action or inaction, there is an overriding ethical question the cardiologist had to address: what course would be most satisfying to his conscience? Would he rather allow a patient to die for fear of recrimination, or act to save his life, regardless of the personal consequences? In the absence of real knowledge about the patient’s considered wishes, it is most reasonable to err on the side of promoting patient well-being. A physician’s commitment to beneficence is not necessarily a way of undermining a patient’s autonomy. In acting for the patient's good, physicians are also acting on what it is reasonable to believe a patient (or most patients, perhaps) would want, which is obviously connected to what a patient does want. Pellegrino and Thomasma argue that beneficence includes respect for a patient’s autonomy since “the best interests of the patient are intimately linked with their preferences.”[17] Instead of conceptualizing ethical dilemmas in medicine as conflicts between autonomy and beneficence, it is possible that medical schools could teach students that truly practicing beneficence is a way of valuing patient autonomy, especially when the patient’s wishes are not specific to the situation and are not clearly expressed. CONCLUSION It is important for students and practicing physicians to understand the principle of respect for patient autonomy in a pluralistic society that demands personal self-determination. However, the role of the physician as a beneficent healer should not be diminished by this respect for autonomy. Respecting a patient’s autonomy is grounded in and manifested by physician beneficence.[18] That is, seeking what is good for the patient can only be good if it respects their personhood and dignity. We propose that a commitment to beneficence, incipient in young medical students, should be developed over time with their other clinical reasoning skills. Such a commitment need not be sacrificed on the altar of patient autonomy. Beneficence needs greater relative moral weight with students as they proceed in their ethics education. - [1] S. Jauhar, “When Doctors Need to Lie,” New York Times, February 22, 2014, https://www.nytimes.com/2014/02/23/opinion/sunday/when-doctors-need-to-lie.html. [2] T. L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019). [3] Louise A. Mitchell, “Major Changes in Principles of Biomedical Ethics,” The National Catholic Bioethics Quarterly 14, no. 3 (2014): 459–75, https://doi.org/10.5840/ncbq20141438. [4] Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019), 238. [5] Beauchamp and Childress, 103. [6] Beauchamp and Childress, p. 108. [7] For other accounts that prioritize autonomy, see e.g. Allen E. Buchanan and Dan W. Brock, Deciding for Others: The Ethics of Surrogate Decision Making (Cambridge University Press, 1989), 38–39; R Gillon, “Ethics Needs Principles—Four Can Encompass the Rest—and Respect for Autonomy Should Be ‘First among Equals,’” Journal of Medical Ethics 29, no. 5 (October 2003): 307–12, https://doi.org/10.1136/jme.29.5.307. For examples of critiques of these accounts, see footnote 9. [8] P. R. Wolpe, “The Triumph of Autonomy in American Bioethics: A Sociological View,” in Bioethics and Society: Constructing the Ethical Enterprise, p. 43. [9] V. A. Entwistle et al., “Supporting Patient Autonomy: The Importance of Clinician-Patient Relationships,” Journal of General Internal Medicine 25, no. 7 (July 2010): 741–45; C. Foster, Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law, 1st ed. (Oxford ; Hart Publishing, 2009); O. O’Neill, Autonomy and Trust in Bioethics, The Gifford Lectures, University of Edinburgh 2001 (Cambridge, UK: Cambridge University Press, 2002). [10] P. Marshall and B. Koenig, “Accounting for Culture in a Globalized Bioethics,” The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics 32, no. 2 (2004): 252–66; R. Fan, “Self-Determination vs. Family-Determination: Two Incommensurable Principles of Autonomy,” Bioethics 11, no. 3–4 (1997): 309–22. [11] Arguments stressing the importance of beneficence, as ours does here, certainly approach paternalistic arguments. We set aside the complex issue of paternalism for purposes of this paper and simply note that the principle of beneficence as such does not say anything specifically about acting against the patient’s will. In the case study that focuses this paper, we do not believe the patient’s will or wishes were clearly indicated. [12] Beauchamp and Childress, Principles of Biomedical Ethics, p. 20, see note 2 above. [13] H. S. Richardson, “Specifying, Balancing, and Interpreting Bioethical Principles,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 25, no. 3 (January 1, 2000): 285–307, p. 287. [14] H. D. Braude, Intuition in Medicine a Philosophical Defense of Clinical Reasoning (Chicago ; University of Chicago Press, 2012). [15] R. Kukla, “Conscientious Autonomy: Displacing Decisions in Health Care,” The Hastings Center Report 35, no. 2 (2005): 34–44. [16] M. Schermer, The Different Faces of Autonomy: Patient Autonomy in Ethical Theory and Hospital Practice, vol. 13, Library of Ethics and Applied Philosophy (Dordrecht: Springer Netherlands, 2002). [17] E. D. Pellegrino and D. C. Thomasma, For the Patient’s Good - the Restoration of Beneficence in Health Care (New York, NY: Oxford University Press, 1988), p. 29. [18] Pellegrino and Thomasma, For the Patient’s Good. 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Summary Liberals, from Mill to Rawls see personal autonomy as paramount in civil society. They see human dignity to consist essentially in personal autonomy, that is, ?in the ability of each person to determine for himself or herself a view of the good life? (Taylor, C. (1992) p. 27). Multiculturalism and ?The Politics of Recognition? p. 57 (Princeton, Princeton University Press). This emphasis on personal autonomy underlies much of liberal emphasis on freedom of conscience, justice, (...) rights and fairness. Its core thesis is that a just society seeks not to promote any particular view of the good life, but enables its citizens to pursue their own ends consistent with a similar liberty for all others. Yet, when some citizens in America attempted to pursue their own view of the good life, they came up against head?on conflict with the liberal state. These groups saw civic education with its emphasis on individual choice, on reflecting and weighing of alternative viewpoints and on personal autonomy, as threatening to their way of life and to their fundamental religious beliefs, and consequently they challenged the state in the courts. What ensued raised profound educational problems for educating children, parental rights, and the right of the State in a liberal democratic society, which are discussed in this paper. (shrink)

Haworth has set out in his book to expound and provide a preliminary defence of the idea that the pursuit of human autonomy represents our highest good. He begins by telling us that autonomism is characteristic of "one who has individuated himself vividly" and who possesses independence and self-control, who acts intentionally and with competence. These things are not only qualities of individual acts, but of a person's life as a whole.

The problem of the ‘mountain man’, the caricature of self-sufficiency and individualism, is not a new one for autonomy theorists. It seems plausible that there is genuine value in self-direction according to one’s deeply-held principles. If autonomy involves something like this, then anyone concerned with autonomy as a social rather than individualistic phenomenon must explain what the mountain man gets wrong when he denies that his autonomy admits of being placed under obligations to others. In particular, the mountain man challenges (...) autonomy-minded social anarchists: if his denial of legitimate non-voluntary obligations is correct, then it is not just the state we should reject, but any organising body with coercive powers. This may be consistent with individualist anarchism or right-libertarianism, but it sits ill with the social anarchist intuition that we can have genuine political obligations. My thesis addresses this problem in three stages. First, I argue for a functional analysis of authority and autonomy: the concepts are not pre-existing “immovable objects”, but rather are defined by the role that they are intended to play in our discourse. I suggest that we need a concept of political or institutional authority in order to resolve co-ordination problems and pursue collaborative social goods, and a concept of autonomy to explain when and why self-direction is valuable. Second, I defend a social-relational conception of autonomy. The autonomous agent is powerful and authoritative, where this power and authority is in large part constituted, rather than merely affected, by the social structures and relations that we stand in. We are powerful and authoritative, I argue, when we stand in relations of non-domination: we are not vulnerable to arbitrary interference in our lives, and this non-vulnerability is defended in virtue of recognition respect for us as agents. There are two important implications of this account: that autonomy comes with a built-in equality condition whereby everybody’s autonomy is threatened if anybody’s is, and that there is no principled distinction to be drawn between ‘personal’ and ‘political’ autonomy. In the last three chapters, I suggest an autonomy-justified conception of authority. I argue for autonomy as the crucial collaborative good which authoritative institutions help us to pursue, and suggest that such institutions may legitimately claim authority if they act or effect actions in ways which are likely to promote or defend autonomy-constituting relations, and act or effect actions in ways consistent with maximal equal autonomy. Finally, I return to the anarchist argument, showing that while my accounts of autonomy and authority give us a plausible picture of how autonomy is compatible with genuinely authoritative institutions, this picture still has no room for the state. (shrink)

It seems to be a humdrum fact of human agency that we act on intentions or decisions that we have made at an earlier time. At breakfast, you look at the Taco Hut menu online and decide that later today you’ll have one of their avocado burritos for lunch. You’re at your desk and you hear the church bells ring the noon hour. You get up, walk to Taco Hut, and order the burrito as planned. As mundane as this (...) sort of scenario might seem to be, philosophers have raised a problem in understanding it. If you are simply abiding by this morning’s decision, how are you acting autonomously? Your earlier self seems to be calling the shots; if you are just acting accordingly, without thinking through it or in some other way trying to ensure that the past decision conforms to your present standpoint, it is not clear how this amounts to an exercise of your present autonomous agency. It seems, rather, that your earlier self has succeeded in slaving you to her own purposes. She was the one who wanted (intended, judged it to be good, etc.) to have an avocado burrito. In simply following through, your current self seems to be just an automaton performing the commands left behind by your former self. Of course, you might not allow yourself to be shackled by your earlier self. You might refuse to follow anything but your own present judgments: you will only go to Taco Hut if this is what you judge you should do right now, and once at Taco Hut you will only eat the avocado burrito if that is what you want to eat once there. But if this is the way you generally operate, this seems to block your ability to make effective future-directed decisions. The puzzle, then, is one of explaining how the future self can do the bidding of her past self without losing her autonomy. We call this “the Problem of Diachronic Autonomy.” Philosophers raising this problem take it to show that there must be reasons or rational requirements to follow-through with our past decisions. According to these philosophers, we can only make sense of our diachronic autonomy if our past decisions put rational pressure on us to follow through. We argue that there is no Problem of Diachronic Autonomy. There is, in other words, no puzzling situation that needs explaining. Consequently, there is no need coming from this purported puzzle to think that our future-directed decisions generate reasons or rational requirements to follow through. The correct view of our diachronic autonomy is the “naïve” one: the “future self” can do the bidding of the “past self” without giving up its autonomy because, very simply, the past self is the same agent as the future self. I am acting autonomously when I get the avocado burrito, because I was the one who decided to get the burrito. I am acting on my own freely-formed decision. (shrink)

A child is a developing person with evolving capacities that include autonomy, mental capacity and capacity to assume responsibility. Hence, children are entitled to participatory rights in South Africa as observed in the Children’s Act 38 of 2005. According to section 129 of the Act a child may consent to his or her own medical treatment provided that he or she is over the age of 12 years and is of sufficient maturity and decisional capacity to understand the various implications (...) of the treatment including the risks and benefits thereof. However, the Act does not provide a definition for what qualifies as ‘sufficient maturity’ nor does it stipulate how health professionals ought to assess the decisional capacity of a child. In addition, South Africa is a culturally diverse country. The Western liberal notion of autonomy may not necessarily find equal prominence in the mores of people with a different worldview. Hence we demonstrate a few salient comparisons between legal liberal moral theory and African communitarianism as pertinent to the autonomy of the child. Children are rights-holders by virtue of their humanity. Their dignity as individual human persons affords them the entitlement to human rights as contemplated under the Constitution of the Republic of South Africa. However, contrary to the traditional Western notion of individual autonomous persons African societies hold a communalistic notion of person hence there is less regard for individual autonomy and rights with more emphasis on the communal good and maintaining the continuity of relationships and interdependencies shared within a community. A child considered in this view is not regarded as a full person. This implies that decisions concerning the child, including consent to medical treatment are discussed and determined by the community to which the child belongs. Lastly, in this article, we draw on the notion of capacity for responsibility to produce a pragmatic definition of sufficient maturity. It seems reasonable to suggest a move away from a general legal age of consent for medical treatment toward more individualised, context-specific approaches in determining the maturity of a child patient to consent to medical treatment. Perhaps, decision-making with respect to consent to the medical treatment of a child belonging to a traditional African community where the notion of a person is embedded in communitarianism ought to involve the child’s parents/guardians/caregivers where possible provided that the best interests of the child are awarded priority. (shrink)

Smajdor invites welcome interrogation of the distance between our philosophical justifications of how we engage people in decisions about healthcare or research, and the ways we do so.1 She notes the implicit elision made between autonomy and informed consent, and argues the latter alone cannot secure the former, proposing a more flexible approach. As researchers working with people with dementia (PwD), we share Smajdor’s reservations. We argue that an autonomy worthy of respect requires not just decision-making capacity, but also authenticity; (...) the ability to determine for oneself what is good for oneself.2 Furthermore, our relationships support or undermine both capacity and authenticity, and autonomous expression manifests throughout evolving relationships. This invites us to view respect differently—as an ongoing conversation with another person, capable of holding values that may move us. In Smajdor’s terminology, it requires that we recognise them. We describe how we operationalise this in our research. Three broad arguments usually support respect for autonomy.2 One—owed to JS Mill—holds that permitting individuals free choice promotes utility of all, by helping them fulfil ideas of the good, demonstrating ‘experiments in living’. Another draws from Kant’s categorical imperative; its Formula of Humanity holds that the capacity to determine our own values gives us reason to act, and we ought, therefore, to treat others’ values with the respect we show our own. Lastly, many simply assume ‘liberal neutrality’—an intrinsic value in people being permitted to pursue the …. (shrink)

The tripartite model of militant extremist mind-set proposed by Stankov et al. (2010b) includes three components: War (justification of violent acts); God (extremist acts are moral because they are done in the name of God/Allah); and West (violence against Western countries is justified because they are perceived as evil). There is a lack of conceptual framework regarding psychological mechanism that underlie radicalization and extremism, and there is little evidence regarding risk factors for radicalization in the scientific literature. In the present (...) study, it is hypothesized that irrational beliefs and a constellation of personality factors are two possible psychological mechanisms that put adolescents in a vulnerable position and could influence them to develop an extremist mind-set. The sample consists in 295 Romanian adolescents, ages 15-18 years, and the mean age being 16.41. The present study was conducted in several schools from Bihor County located in the north-western part of Romania. Adolescents took part on a voluntary basis in the study after the written, informed consent was obtained from their parents. A confirmatory factor analysis (CFA) on the structure of Militant Extremist Mind-Set Scale confirmed the three-factor model of the extremist mind-set. Two confirmatory factor analyses were also conducted for the other two administered scales: CASI and Mini-IPIP. The results support the previous models for both subscales, including items loading on factors. SEM analysis was performed with AMOS 23 statistical package on a final sample size of 242 participants and there were no missing data. Fifth structural models were specified. The fifth model had adequate fit based on all three indices including the RMSEA (0.054), CFI (0.958), and SRMS (0.047). Global evaluation of self seems to be the only irrational belief that was somewhat related with the extremis mind-set, being part of it. Neuroticism was not identified as being a variable that could have a direct influence on mind-set extremism, or an indirect influence through personality. Religious adherence is a good predictor of extremist ideology. A global personality factor consisting in low Intellect/Imagination, low Extraversion and high Agreeableness seems to be a vulnerability factor that influences people to believe in extremist ideology. (shrink)

The main theory at the core of this monograph is that the person is an entity ontologically new, since she is able to perform an act of self-transcendence, which is meant as her critical distancing from her own “self”, understood as subject of social recognition (Anerkennung), in order to open to the encounter with the world (Weltoffenheit). This allows us to consider a person in a new way, different both from confessional interpretations that see her only as a (...) center of the spirit and from reductivistic views. Schelling examines the act of self-transcendence through the concept of ecstasy, whereas Scheler associates it with the phenomenological reduction. The act of self-transcendence, that Schelling sees as originated by the “hunger of being”, is at the roots of the formation process of a person (Bildung): the person takes her shape by exiting from her own self-referential dimension and encountering otherness. If considered from this viewpoint, Plato’s “epimeleia heautou” exceeds an intimistic perspective: the “care” is no more a solipsistic self-care, but rather becomes the care through which the person transcends her own self to open to the relationships with otherness. It turns, therefore, into a care for world-openness (care for Weltoffenheit). The transformation of the individual and of society so becomes the double-faced aspect of the same process. The development of this set of problems occurs through a dialogue with Schelling’s and Scheler’s positions, but it is also supported by a historical-philosophical investigation, that for instance provides evidence of the influences of Schelling’s Berlin period on Scheler’s last theories and on the philosophical anthropology of the 20th century. Schelling was the first to conceive the concept of “eccentricity” in an anthropological sense, since until then the term had been confined to Kepler’s astronomy. Consequently, the planets’ elliptic (eccentric) movement heightens to an emblematic metaphor of human nature and freedom. The monograph also examines a possible convergence between Plato’s epimeleia heautou and Scheler’s phenomenological reduction. The book ends with a chapter on the topic of Vorbild. The exemplary testimony, that is Vorbild, becomes witnessing evidence immune from any pedagogical-moralistic intent: in fact, if it should relapse into the rhetoric of the “wish to give a good example”, it would immediately conform to the opposite logic of the model. A model is universal in so far as it makes everyone more like the others, nullifying the diversity, whereas exemplariness is universal in so far as it makes everyone more unique and motivates each one to follow her own characteristic path of existential trans-formation. Exemplarity doesn’t convey any contents, but rather encourages a kind of solidaristic involvement. Yet there are also negative exemplarities (Gegenbild) that place obstacles in the formation and block the existence of the personal center. (shrink)

The paper is about Kant’s moral psychology, a complex analysis and philosophical reflection on the tension of human will as arbitrium sensitivum in acting consistently as ratio essendi. It explores the tension of fallibility of the human will. In Kant’s notion of practical freedom he points to the dynamics of the will—Wille and Willkur—and how it creates tension between choice and culpability. This occurs specifically in the Willkur’s function as the arbiter. I explore the impact of Willkur’s arbitration (...) in self-determination, especially the important call of obedience to the Wille. I conclude with an emphasis on the challenge for Kantian will to operate towards unity which enables the agent to be authentically autonomous. (shrink)

This book begins and ends with a defense of an interesting and provocative thesis. Right actions, choices, intentions, and the virtues which dispose one to right actions are neither necessary nor sufficient conditions for being a good person. As Keenan defines it "goodness is the measure of persons, their habits of conduct, and their acts as proceeding from one who strives openly out of love to realize right living" ; and "rightness is the measure of acts and (...) the proximate sources of acts, that is, choices, intentions, and virtues, according to their fittingness to reason". Since an agent's failure to conform to rational standards of conduct does not mean that the agent is not striving to do so, rightness is not a necessary condition for goodness. Since an agent's actually conforming to rational standards does not mean that the agent is striving out of love to become more rightly ordered, rightness is not a sufficient condition for goodness. (shrink)

Certain philosophers have argued in favour of recognising a right to freedom of conscience that includes a defeasible right of individuals to live in accordance with their perceived moral duties. This right requires the government to exempt people from general laws or regulations that prevent them from acting consistently with their perceived moral duties. The importance of protecting individuals’ integrity is sometimes invoked in favour of accommodating conscience. I argue that personal integrity is valuable since (...) autonomy, identity and self-respect are all dependent on the preservation of personal integrity. I respond to two objections, one pressed by Andrew Koppelman and the other by Richard Arneson, to the claim that personal integrity is valuable, and to a further argument by Arneson to the effect that it is unfair to others claiming accommodations to exempt those with conscience-based claims. (shrink)

It is practically inevitable that even the best-intentioned public officials occasionally inflict unjust harm on people who should not have to suffer it. They mistakenly arrest innocent suspects, and convict innocent defendants. They erroneously adopt and enforce criminal laws that unduly restrict our freedom. They vote for, implement, and enforce tax laws that unfairly burden some citizens. And yet it is widely assumed that, as long as such officials act in good faith, and follow certain institutional rules, we aren’t (...) permitted to protect the innocent victims of their mistakes by inflicting defensive harm on the officials. As a result, those victims may have to suffer injustices that we could, in principle, prevent. This is so even though, if a private person imposed similarly unjust harm, and did so on the basis of mistaken judgments that were equally in good faith, and just as reliable as the institutional judgments guiding the official, we could permissibly harm that person to defend the victim. This essay considers whether, and how, this asymmetric treatment can be justified. After some ground-clearing that sharpens the question, it briefly considers the dominant explanation offered by political philosophers, which focuses on how resisting official mistakes would impact innocent third parties (most obviously, one’s fellow citizens). Finding these explanations wanting, the essay turns to a less frequently considered alternative: under certain conditions, defending the innocent victim against the official’s mistake is unfair to the official who would be harmed in the process. In particular, if officials act for their subjects (in a quite specific sense), then we may, as a matter of fairness, be barred from harming the officials to protect those subjects from (some of) the unjust harms that officials erroneously inflict. This account chimes with familiar views in the history of political thought that take legitimate political power to be held in trust for the people, and legitimate governments to stand in fiduciary relations to their subjects. It explains why officials may in principle have special moral protection that private persons usually lack, and why we may have to put up with officials’ mistakes even if they inflict injustice on innocent persons. But it also reveals how demanding the conditions are under which officials have such protection, and why many existing legal and political institutions lack the legitimacy, and their officials the special moral protection against defensive harm, that they purport to have. (shrink)

I am grateful to the Journal of Medical Ethics for asking these critics to discuss my book, and am grateful to each of the critics themselves for raising interesting and often difficult issues for me to think about.Alan Wertheimer makes a number of good points. One of the most significant, to me, is how paternalism might function at what I will call an institutional level. In my book, I endorse paternalistic actions by the state, when the cost benefit analysis (...) justifies that. I have not supported paternalistic interventions by private individuals, though. For one thing, private individuals will make decisions without public input, and without their justification being examined by experts in the field, and for these reasons they are too likely to make mistakes as to when intervention is appropriate. For another, the interventions by random individuals haranguing us about our failure to eat our broccoli is likely to drive us crazy—unexpected interference from people with no particular authority will give us just that sense of harassment I say paternalists need to avoid.However, between the public, authorised actions of a democratic state and the private actions of individuals with no authority lies the significant area of non-state institutions. Such institutions develop regulations and standards their members are expected to act in accordance with, and these in turn can have a significant impact on private persons. Of course, there have also been legal actions, notably court decisions, that have played a role here, but much of the specific interpretation of things like consent has been determined by the medical community developing what it believes to be an appropriate ethic for itself. And we know, here, that in recent years there has been a movement away from the paternalism that was once common, and a reorientation towards respect for …. (shrink)