Restraint as an intervention in the management of acute mental distress has a long history that predates the existence of psychiatry. However, it remains a source of controversy with an ongoing debate as to its role. This article critically explores what to date has seemingly been only implicit in the debate surrounding the role of restraint: how should the concept of validity be interpreted when applied to restraint as an intervention? The practice of restraint in mental (...) health is critically examined using two post-positivist constructions of validity, the pragmatic and the psychopolitical, by means of a critical examination of the literature. The current literature provides only weak support for the pragmatic validity of restraint as an intervention and no support to date for its psychopolitical validity. Judgements regarding the validity of any intervention that is coercive must include reference to the psychopolitical dimensions of both practice and policy. (shrink)

In recent years there has been wide-ranging discussion of epistemic virtues. Given the value and importance of acquiring knowledge this discussion has tended to focus upon those traits that are relevant to the acquisition of knowledge. This acquisitionist focus ignores or downplays the importance of epistemic restraint: refraining from seeking knowledge. In contrast, in many periods of history, curiosity was viewed as a vice. By drawing upon critiques of curiositas in Middle Platonism and Early Christian philosophy, we gain useful (...) insights into the value and importance of epistemic restraint. The historical discussion paves the way for a clarification of epistemic restraint, one that distinguishes the morally relevant features of epistemic process, content, purpose, and context. Epistemic restraint is identified as an important virtue where our epistemic pursuits pose risks and burdens, where such pursuits have opportunity costs, where they are pursued for vicious purposes. But it is in the social realm where epistemic restraint has most purchase, epistemic restraint is important both because privacy is important and because being trusted are important. Finally, some suggestions are offered as to why epistemic restraint has not received the contemporary attention that it deserves. (shrink)

It appears that one of the aims of John Rawls' ideal of public reason is to provide people with good reason for exercising restraint on their nonpublic reasons when they are acting in the public political arena. I will argue, however, that in certain cases Rawls' ideal of public reason is unable to provide a person with good reason for exercising such restraint, even if the person is already committed to Rawls' ideal of public reason. Because it is (...) plausible to believe that such cases are widespread, the issue I am raising represents a serious problem for Rawls' account of public reason. After posing this problem, I consider potential responses on behalf of Rawls' view, and I reply to those responses. The moral of this story, as I see it, is that the kind of duty an ideal of public reason aims to place on citizens must be more modest than Rawls supposes. (shrink)

Restraint has been used within health care settings for many centuries. Initially physical restraint was the method of choice, in present times. Within critical care units PR and chemical rest...

Crutchfield and Redinger (2024) argue that, ceteris paribus, it is morally worse to deploy a restraint that undermines a basic liberty than one that does not.1 This is a plausible view, and is like...

Classical Culture and Society is a new series from Oxford that emphasizes innovative, imaginative scholarship by leading scholars in the field of ancient culture. Among the topics covered will be the historical and cultural background of Greek and Roman literary texts; the production and reception of cultural artifacts; the economic basis of culture; the history of ideas, values, and concepts; and the relationship between politics and/or social practice and ancient forms of symbolic expression. Interdisciplinary approaches and original, broad-ranging research form (...) the backbone of this series, which will serve classicists as well as appealing to scholars and educated readers in related fields. Emotion, Restraint, and Community examines the ways in w hich emotions, and talk about emotions, interacted with the ethics of the Roman upper classes in the late Republic and early Empire. By considering how various Roman forms of fear, dismay, indignation, and revulsion created an economy of displeasure that shaped society in constructive ways, the book casts new light both on the Romans and on cross-cultural understanding of emotions. (shrink)

This essay critically assesses the central claim of Kevin Vallier’s Liberal Politics and Public Faith: that public religious faith and public reason liberalism can be reconciled, because the values underlying public reason liberalism should lead us to endorse the ‘convergence view’, rather than the mainstream consensus view. The convergence view is friendlier to religious faith, because it jettisons the consensus view’s much-criticised ‘duty of restraint’. I present several challenges to Vallier’s claim. Firstly, if Vallier is right to reject the (...) duty of restraint then consensus theorists can also do so, and on the same grounds. Secondly, the independent force of the objections to the duty of restraint is unclear. Thirdly, Vallier has not successfully identified desiderata that unite all public reason liberals and favour convergence over consensus. Finally, even if convergence is in some ways friendlier to religious faith, this does not show that it will be attractive to religious citizens. (shrink)

Restraint has recently become an important legal and clinical issue in England and Wales with the introduction of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards introduced by the Mental Health Act 2007. The requirements of these two new pieces of legislation are complex, and therefore pose major challenges to the provision of high quality and patient-centred care, support and treatment in a range of health and social care settings. In this paper, the legal and ethical (...) aspects of physical restraint in an acute medical care environment are considered, and practical guidance is provided to individuals adopting methods of restraint to care for general hospital patients. Aspects of the Introduction below are written in the first person to reflect the personal experiences of the lead author. (shrink)

THOMAS NAGEL has argued that ‘true liberalism’ excludes appeals to conceptions of the good in political argument. According to Nagel, liberalism's impartiality is grounded not in skepticism but, rather, in its commitment to ‘epistemological restraint.’ As he puts it, ‘We accept a kind of epistemological division between the private and the public domains: in certain contexts I am constrained to consider my beliefs merely as beliefs rather than as truths, however convinced I may be that they are true, and (...) that I know it.’ Nagel's notion of epistemological restraint has been roundly criticized by perfectionist liberals and advocates of liberal neutrality alike. In fact, even Nagel has come to reject the epistemological argument—in part, because of the epistemological asymmetry that it presupposes. In this paper, I offer an answer to Nagel's critics, one that makes the notion of epistemological asymmetry coherent. In so doing, I show how to defend liberal neutrality without embracing skepticism. I structure the paper in the following way: Section II lays out the critique of epistemological restraint; Section III defends the coherence of this notion; and Section IV considers an objection to the analysis developed in Section III. (shrink)

Restraint is regularly used in somatic healthcare settings, and countries have chosen different paths to regulate restraint in somatic healthcare. One overarching problem when regulating restraint is to ensure that patients with reduced decision-making capacity receive the care they need and at the same time ensure that patients with a sufficient degree of decision-making capacity are not forced into care that they do not want. Here, arguments of justice, trust in the healthcare system, minimising harm and respecting (...) autonomy are contrasted with different national regulations. We conclude that a regulation that incorporates an assessment of patients’ decision-making capacity and considers the patient’s best interests is preferable, in contrast to regulations based on psychiatric diagnoses or regulations where there are no legal possibilities to exercise restraint at all in somatic care. (shrink)

Despite moves to enhance the autonomy of clients of health care services, the use of a variety of physical restraints on the freedom of movement of frail, elderly patients continues in nursing homes. This paper confronts the use of restraints on two grounds. First, it challenges the assumption that use of restraints is necessary to protect the welfare of frail, elderly patients by drawing on a range of data indicating the limited efficacy of restraints. Secondly, it argues that the duty (...) to respect individual autonomy extends to a duty to respect the autonomy of patients who are elderly, frail and living in nursing homes. (shrink)

Classical Culture and Society is a new series from Oxford that emphasizes innovative, imaginative scholarship by leading scholars in the field of ancient culture. Among the topics covered will be the historical and cultural background of Greek and Roman literary texts; the production and reception of cultural artifacts; the economic basis of culture; the history of ideas, values, and concepts; and the relationship between politics and/or social practice and ancient forms of symbolic expression. Interdisciplinary approaches and original, broad-ranging research form (...) the backbone of this series, which will serve classicists as well as appealing to scholars and educated readers in related fields. Emotion, Restraint, and Community examines the ways in which emotions, and talk about emotions, interacted with the ethics of the Roman upper classes in the late Republic and early Empire. By considering how various Roman forms of fear, dismay, indignation, and revulsion created an economy of displeasure that shaped society in constructive ways, the book casts new light both on the Romans and on cross-cultural understanding of emotions. (shrink)

The chapter suggests principles that are fairly flexible in context and that can give way in light of other powerful considerations. The chapter presents two incidents, personal illustrations that show how self-restraint works, why self restraint in advocacy is much more attainable than self-restraint in decision or judgment, and why exercising greater self-restraint in advocacy need not amount to insincerity. The chapter concludes that people have great difficulty trying to face particular political issues free of the (...) push of their religious or other comprehensive views. This requires an exceptional discipline to achieve this with any success. It is doubtful whether one should recommend to ordinary people a self-restraint that is so hard to perform. The chapter also set the stage for the following chapters by outlining briefly various roles and functions in liberal democratic governance. (shrink)

This chapter is dedicated to the study of John Rawls's principle of self-restraint by a distinction among political issues: citizens and legislators should limit themselves to common grounds in respect to some range of fundamental issues, but may employ religious and other comprehensive views in making ordinary political decisions. Rawls also introduced the concept of an overlapping consensus as to some issues, a concept challenged by the assertion that viable political philosophy must depend on at least a partial comprehensive (...) view of human good, that it cannot be free-floating. The concept of public reason is also introduced in the chapter. Rawls talks of public reason as the reason of citizens sharing equal citizenship. Justifications in terms of public reasons “appeal only to presently accepted general beliefs and forms of reasoning found in common sense, and the methods and conclusions of science when these are not controversial.” One employing public reasons does not appeal to comprehensive religious and philosophical doctrines, but rather “a reasonable balance of public political values.”. (shrink)

This article focuses on the reasons for using physical restraints, their prevalence and nurses’ experiences of their use. The data were collected by means of a questionnaire from nurses, trained nurse’s aids and auxiliary staff (n = 173) in seven Swiss nursing homes. The results showed that physical restraints are used in nursing units, the mean number of restrained residents in each being 3.7 (SD 3.9). However, nursing staff did not necessarily understand and consider the term ‘restraint’ as a (...) restrictive device in its negative sense. The most common reasons indicated for the use of restraint were related to the protection and safety of the residents themselves, the prevention of disturbance of other residents, and the residents’ restlessness and aggressiveness. As for the reasons related to staffing, reference was made to understaffing, a lack of competence on the part of nurses, and the demands of residents, their next of kin and doctors. It was not common practice to inform the elderly residents that they would be restrained, and therefore they were not always aware of what was happening to them and why. Twenty-nine per cent of the respondents reported that the flexibility of their work was affected by the use of physical restraint. (shrink)

The use of four-point physical restraints has long been controversial in psychiatry. But the most common objections against these restraints hinges on the idea that they would be imposed against patients. In light of the trend towards giving patients access to Advance Directives, why not allow patients to use such legal documents to arrange for restraints being used against them? Patients might do this if they feared an inability to make competent decisions in the future. Proper oversight over the requests (...) and the restraint-use would help psychiatric patients plan for their own care. Clearly, not all patients would qualify for such an expansion of their autonomy. Many would be unable to give adequately informed consent. Still, for the patients who could consent, being able to draw up such a “Ulysses Contract” could provide an improved balance of risks and benefits. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 36.1 (2003) 39-47 [Access article in PDF] Restraint and Emotion in Cicero's De Oratore Per Fjelstad In De Oratore Cicero has the revered orator Crassus ask, "Who then is the man who gives people a thrill? whom do they stare at in amazement when he speaks? who is interrupted by applause? who is thought to be so to say a god among men?" (1942a, III.53). (...) Crassus, who is asking his companions to think about emotional energy in speech, goes on, "It is those whose speeches are clear, explicit, and full, perspicuous in matter and language, and who in actual delivery achieve a sort of rhythm and cadence—that is, whose style I call 'ornate'."Several things are striking about the passage. First, it resolves its inquiry by invoking the concept of ornatus, a word widely used to translate the Greek idea of kosmos (DiLorenzo 1978). Cicero thus refers to a quality that joins the ideas of cosmic order, physical beauty, and earthly power. Second, the passage is delivered in the midst of Crassus's discussion of the fourth rhetorical canon, that referring to the elaboration of ideas in language, of selecting levels of style and modes of verbal embellishment. Third, the passage ranges across the entire field of rhetorical art, at least as indexed by the scope of the canons. The performative quality directly under discussion, that which gives people a thrill—initially associated with the Theophrastian virtues of style that Crassus has been enumerating, that is, clarity and explicitness—quickly is expanded to include copiousness of invention, perspicuity of language, and energetic beauty in delivery. Cicero's Crassus thus discusses a performative dynamic that appears to govern rhetoric as a whole.As the other characters in the dialogue discuss this quality of speech, which engages listeners emotionally and transforms their experience of the present, they bound beyond the preliminary categories of their analysis and describe a power of speech that is aesthetic and philosophical. As the [End Page 39] narrator of this dialogue, Cicero eventually associates the possibility of emotional transformation with a quality of performance we might identify as graceful or urbane. Cicero suggests that performative style can rise above particular details, conventions, and rules of standard rhetorical instruction. Ornate speech is, in sum, emotionally transformative. In detail, however, how does Cicero theorize this grand ability? What goals, resources, or models does he invoke?This essay argues that Cicero's theory of ornatus insists an orator display emotions relevant to the performance while responding to the need of listeners to hear emotional expression against a backdrop of relative calm. In developing this analysis, I claim that the dialogic format of De Oratore allows insight to emerge from juxtaposed perspectives, that Cicero's ideal of ornatus contains a limiting threshold for performative exuberance, and that his examples of emotional engagement illustrate the importance of context and aesthetic restraint. Theoretical tensions as sources for synthetic insight Theoretical tensions in Cicero's De Oratore are instructive. While Cicero's effort to reconcile Isocratean practice with Aristotelian teleology ultimately makes for a rough fit, the juxtaposition of those understandings within the dialogue also generates new insight, even about limits for rhetorical theory itself. Referring to this mode of theorizing as "ironic eloquence," Michael Leff holds that "through this merger of theory and practice, the rival conceptions of oratory as systematic art and oratory as synthetic practice coalesce within the text, the two perspectives interacting to produce a development that incorporates both" (1986, 323).A similar theoretical tension can be observed in De Oratore regarding the prospects and significance of emotional engagement in oratorical performance. In discussing the practices of emotional oratory Cicero draws on three distinct intellectual sources: a quasi-enthymematic model of emotional engagement, in which an orator need not share or display the sought-after emotional response; a mimetic theory of theatrical performance (that is, a typology of tonal and gestural "moods"); and a latent theory of "authenticity," according to which that which is being theatrically displayed is not "fakely" fictional, but somehow genuine.The conflicting theories suggest... (shrink)

This chapter considers restraint from making arguments based on religious grounds as a premium self-restraint principle in politics. There is a claim that such reliance is contrary to fundamental premises of separation of church and state and religious liberty, or is particularly threatening to social life. The chapter discusses the principle of secular motivation—that one should not advocate or promote any legal or public policy restrictions on human conduct unless one not only has and is willing to offer, (...) but is also motivated by, adequate secular reason; the principle of secular rationale—that people should not construct secular rationalizations when they are really persuaded by religious considerations; and the principle of secular resolution—that political issues be finally resolved along secular lines. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 36.1 (2003) 39-47 [Access article in PDF] Restraint and Emotion in Cicero's De Oratore Per Fjelstad In De Oratore Cicero has the revered orator Crassus ask, "Who then is the man who gives people a thrill? whom do they stare at in amazement when he speaks? who is interrupted by applause? who is thought to be so to say a god among men?" (1942a, III.53). (...) Crassus, who is asking his companions to think about emotional energy in speech, goes on, "It is those whose speeches are clear, explicit, and full, perspicuous in matter and language, and who in actual delivery achieve a sort of rhythm and cadence—that is, whose style I call 'ornate'."Several things are striking about the passage. First, it resolves its inquiry by invoking the concept of ornatus, a word widely used to translate the Greek idea of kosmos (DiLorenzo 1978). Cicero thus refers to a quality that joins the ideas of cosmic order, physical beauty, and earthly power. Second, the passage is delivered in the midst of Crassus's discussion of the fourth rhetorical canon, that referring to the elaboration of ideas in language, of selecting levels of style and modes of verbal embellishment. Third, the passage ranges across the entire field of rhetorical art, at least as indexed by the scope of the canons. The performative quality directly under discussion, that which gives people a thrill—initially associated with the Theophrastian virtues of style that Crassus has been enumerating, that is, clarity and explicitness—quickly is expanded to include copiousness of invention, perspicuity of language, and energetic beauty in delivery. Cicero's Crassus thus discusses a performative dynamic that appears to govern rhetoric as a whole.As the other characters in the dialogue discuss this quality of speech, which engages listeners emotionally and transforms their experience of the present, they bound beyond the preliminary categories of their analysis and describe a power of speech that is aesthetic and philosophical. As the [End Page 39] narrator of this dialogue, Cicero eventually associates the possibility of emotional transformation with a quality of performance we might identify as graceful or urbane. Cicero suggests that performative style can rise above particular details, conventions, and rules of standard rhetorical instruction. Ornate speech is, in sum, emotionally transformative. In detail, however, how does Cicero theorize this grand ability? What goals, resources, or models does he invoke?This essay argues that Cicero's theory of ornatus insists an orator display emotions relevant to the performance while responding to the need of listeners to hear emotional expression against a backdrop of relative calm. In developing this analysis, I claim that the dialogic format of De Oratore allows insight to emerge from juxtaposed perspectives, that Cicero's ideal of ornatus contains a limiting threshold for performative exuberance, and that his examples of emotional engagement illustrate the importance of context and aesthetic restraint. Theoretical tensions as sources for synthetic insight Theoretical tensions in Cicero's De Oratore are instructive. While Cicero's effort to reconcile Isocratean practice with Aristotelian teleology ultimately makes for a rough fit, the juxtaposition of those understandings within the dialogue also generates new insight, even about limits for rhetorical theory itself. Referring to this mode of theorizing as "ironic eloquence," Michael Leff holds that "through this merger of theory and practice, the rival conceptions of oratory as systematic art and oratory as synthetic practice coalesce within the text, the two perspectives interacting to produce a development that incorporates both" (1986, 323).A similar theoretical tension can be observed in De Oratore regarding the prospects and significance of emotional engagement in oratorical performance. In discussing the practices of emotional oratory Cicero draws on three distinct intellectual sources: a quasi-enthymematic model of emotional engagement, in which an orator need not share or display the sought-after emotional response; a mimetic theory of theatrical performance (that is, a typology of tonal and gestural "moods"); and a latent theory of "authenticity," according to which that which is being theatrically displayed is not "fakely" fictional, but somehow genuine.The conflicting theories suggest... (shrink)

Background Despite its negative impact on patients and nurses, the use of restraint in somatic health care continues in many settings. Understanding the reasons and justifications for the use of restraint among nurses is crucial in order to manage this challenge. Aim To understand nurses’ justifications for restraint use in neurosurgical care. Research design A qualitative, descriptive design was used. Data were analysed with inductive qualitative content analysis. Participants and research context Semi-structured interviews with 15 nurses working (...) in three neurosurgical departments in Sweden. Ethical considerations Approved by The Regional Ethics Committee, Stockholm, Sweden. Findings The analysis resulted in three categories. The category Patient factors influencing restraint use describes patient factors that trigger restraint, such as a diminished decision-making competence, restlessness, and need for invasive devices. The category Specific reasons for justifying restraint describes reasons for restraining patients, such as restraint being used for the sake of the patient or for the sake of others. The category General reasoning in justifying restraint describes how nurses reason when using restraint, and the decision to use restraint was often based on a consequentialist approach where the nurses’ weighed the pros and cons of different alternatives. Discussion Nurses with experience of restraint use were engaged in a constant process of justifying and balancing different options and actions. Restraint was considered legitimate if the benefit exceeded the suffering, but decisions on which restraint measures to use and when to use them depended on the values of the individual nurse. Conclusion How nurses reason when justifying restraint, why they use restraint, and who they use restraint on must be considered when creating programs and guidelines to reduce the use of restraint and to ensure that when it is used it is used carefully, appropriately, and with respect. (shrink)

This article focuses on the reasons for using physical restraints, their prevalence and nurses’ experiences of their use. The data were collected by means of a questionnaire from nurses, trained nurse’s aids and auxiliary staff ( n = 173) in seven Swiss nursing homes. The results showed that physical restraints are used in nursing units, the mean number of restrained residents in each being 3.7 (SD 3.9). However, nursing staff did not necessarily understand and consider the term ‘restraint’ as (...) a restrictive device in its negative sense. The most common reasons indicated for the use of restraint were related to the protection and safety of the residents themselves, the prevention of disturbance of other residents, and the residents’ restlessness and aggressiveness. As for the reasons related to staffing, reference was made to understaffing, a lack of competence on the part of nurses, and the demands of residents, their next of kin and doctors. It was not common practice to inform the elderly residents that they would be restrained, and therefore they were not always aware of what was happening to them and why. Twenty-nine per cent of the respondents reported that the flexibility of their work was affected by the use of physical restraint. (shrink)

The use of four-point physical restraints has long been controversial in psychiatry. But the most common objections against these restraints hinges on the idea that they would be imposed against patients. In light of the trend towards giving patients access to Advance Directives, why not allow patients to use such legal documents to arrange for restraints being used against them? Patients might do this if they feared an inability to make competent decisions in the future. Proper oversight over the requests (...) and the restraint-use would help psychiatric patients plan for their own care. Clearly, not all patients would qualify for such an expansion of their autonomy. Many would be unable to give adequately informed consent. Still, for the patients who could consent, being able to draw up such a “Ulysses Contract” could provide an improved balance of risks and benefits. (shrink)

Public reason liberals disagree about the relationship between public justification and deliberative democracy. My goal is to argue against the recent suggestion that public reason liberals seek a ‘divorce’ from deliberative democracy. Defending this thesis will involve discussing the benefits of deliberation for public justification as well as revisiting public reason’s standard Rawlisan restraint requirement. I criticize Kevin Vallier’s alternative convergence-based principle of restraint and respond to the worry that the standard Rawlsian restraint requirement reduces the likelihood (...) of public justification by limiting the diversity of inputs into the justificatory process. (shrink)

The question of what constitutional constraints should apply to government efforts to regulate scientific speech is frequently contrasted to the question of what constitutional constraints should apply to government efforts to regulate scientific research. This comment argues that neither question is well formulated for constitutional analysis, which should instead turn on the relationship to constitutional values of specific acts of scientific speech and research.

Once anesthetized, patients are inherently “compliant” with surgical interventions because they can no longer intervene on their own behalf. In their target article, Minkoff et al. (2024) reasonabl...

The practice of medicine frequently involves the unconsented restriction of liberty. The reasons for unilateral liberty restrictions are typically that being confined, strapped down, or sedated are necessary to prevent the person from harming themselves or others. In this paper, we target the ethics of chemical restraints, which are medications that are used to intentionally restrict the mental states associated with the unwanted behaviors, and are typically not specifically indicated for the condition for which the patient is being treated. Specifically, (...) we aim to identify the conditions under which chemical restraints are ethically permissible. It is wrong to assume that what is morally true of physical restraints is also true of chemical restraints. Our aim is thus to identify the conditions under which chemical restraints are permissible while distinguishing these conditions from those of the application of physical restraints. (shrink)

As mechanical restraints have never been proven effective in clinical practice, they should not be used routinely. They should be considered a non‐validated therapy requiring consent.

Articulating the public's widespread unease about animal biotechnology has not been easy, and the first attempts have not been able to provide an effective tool for navigating the moral permissibility of this research. Because these moral intuitions have been difficult to cash out, they have been belittled as representing nothing more than fear or confusion. But there are sound philosophical reasons supporting the public's opposition to animal biotechnology and these arguments justify a default position of resistance I call the Presumption (...) of Restraint . The Presumption of Restraint constitutes a justificatory process that sets out the criteria for permitting or rejecting individual biotechnology projects. This Presumption of Restraint can be overridden by compelling arguments that speak to a project's moral and scientific merit. This strategy creates a middle-of-the-road stance that can embrace particular projects, while rejecting others. The Presumption of Restraint can also serve as a model for assessing moral permissibility in other areas of technological innovation. (shrink)

This article gives a brief overview of the state of the art concerning physical restraint use among older persons in nursing homes. Within this context we identify some essential values and norms that must be observed in an ethical evaluation of physical restraint. These values and norms provide the ethical foundation for a number of concrete recommendations that could give clinical and ethical support to caregivers when they make decisions about physical restraint. Respect for the autonomy and (...) overall wellbeing of older persons, a proportional assessment of the advantages and disadvantages, a priority focus on the alternatives to physical restraint, individualised care, interdisciplinary decision making, and an institutional policy are the central points that make it possible to deal responsibly with the use of physical restraint for older persons in nursing homes. (shrink)

Are liberalism and perfectionism compatible? In this study Steven Wall presents and defends a perfectionist account of political morality that takes issue with many currently fashionable liberal ideas but retains the strong liberal commitment to the ideal of personal autonomy. He begins by critically discussing the most influential version of anti-perfectionist liberalism, examining the main arguments that have been offered in its defence. He then clarifies the ideal of personal autonomy, presents an account of its value and shows that a (...) strong commitment to personal autonomy is fully compatible with an endorsement of perfectionist political action designed to promote valuable pursuits and discourage base ones. (shrink)

This study reviews the ethical dilemmas of nursing staff about using restraints on patients suffering from dementia in two types of health care settings in Israel: internal medicine wards of three general hospitals; and psychogeriatric wards of three nursing homes. The nurses’ level of knowledge about the Patient’s Rights Law, the Israeli Code of Ethics, and the guidelines on restraints was analysed. The purposes of restraints were defined as beneficial to: (1) the patient; (2) other patients; or (3) the institution. (...) The concept was evaluated in a realistic situation (expressing views of daily practice) and in an idealistic situation (expressing personal and professional beliefs and values). It was shown that nurses in internal medicine wards of general hospitals agreed more with the use of restraints than those in psychogeriatric wards in nursing homes. Differences were more pronounced when restraints were beneficial to the institution. In addition, nurses working in psychogeriatric wards of nursing homes had more knowledge about the guidelines on restraints and were less inclined than their counterparts to agree with the use of restraints for the benefit of other patients or the institution. (shrink)

Normative political theorists have been growing more and more aware of the many difficult questions raised by the discretionary power inevitably left to public administrators. This article aims to advance a novel normative principle, called ‘principle of restraint’, regulating reform of established administrative agencies. I argue that the ability of public administrators to exercise their power in accordance with the requirements of public reason is protected by an attitude of restraint on the part of potential reformers. Specifically, they (...) should refrain from any reform of an administrative agency that involves a switch to a considerably more loosely interconnected system of values underlying the work of that agency. To illustrate the importance of the principle of restraint, I examine a case from British health policy, showing that a recent reform of the National Institute for Health and Care Excellence well exemplifies the serious problems brought by any violation of that principle. (shrink)

I begin this essay by articulating an argument in support of the claim that theistic citizens ought not to support coercive policies for which they lack an adequate secular rationale. That argument employs various claims regarding God's nature to show: (i) that theistic citizens should expect to discern secular corroboration for each religiously grounded moral truth to which they adhere; and (ii) theistic citizens should doubt any religiously grounded moral claim for which they cannot discern an adequate secular rationale. I (...) dispute both (i) and (ii) and conclude that theistic citizens may reasonably reject the claim that they ought not to support coercive policies for which they lack an adequate secular rationale. (shrink)

This paper investigates the Turkish Constitutional Court (TCC)’s treatment of legal challenges brought against Turkey’s legal responses to the COVID-19 pandemic. Drawing on a detailed examination of the TCC’s institutional features, political origins and jurisprudential trajectory, and taking three politically salient judgments of the TCC concerning Turkey’s executive-dominated pandemic control as the point of departure, the paper argues that the TCC chose to exercise judicial restraint both in protecting fundamental rights and reviewing pandemic policies of the executive. It also (...) argues that the TCC’s judicial restraint during the pandemic was simply the re-manifestation of its ‘play-it-safe’ strategy — a judicial stance the TCC willingly adopted in the aftermath of the 2016 attempted coup despite possessing strong constitutional powers of judicial review, and its established attitude of assertive scrutiny in the past. From a more theoretical perspective, the analysis also explores how the passive role to which the TCC is consigned in an increasingly authoritarian regime since the 2016 failed coup relates to the global phenomenon of judicialization of authoritarian politics. (shrink)

I focus on the mutual advantage conception of justice and on a related Humean argument according to which “the circumstances of justice” obtain only when there is a conflict of ends, a suitable level of scarcity, and rough equality of power. I add to the challenges facing the argument by using a Millian illustration whose significance has not been appreciated in prior discussions of the circumstances of justice to show that, contrary to a key premise of the Humean argument, restraining (...) ground rules concerning entitlement can be mutually advantageous even if there is no conflict of ends or rough equality of power. It follows from my reasoning that, if justice has a place and point when restraining ground rules concerning entitlement would be mutually advantageous, the circumstances of justice can obtain without a conflict of ends or rough equality of power. (shrink)

In this chapter, a challenge to the idea of ecumenical exchange is set forth from explicit religious premises. One made by David Smolin critiques Michael Perry's ideas on religious dialogue. Based mainly on the conservative traditionalist view, Smolin rejects the idea of a rational reexamination of religious beliefs. Smolin regards liberal Christianity as unstable, because the attempted mix of modernist premises with loyalty to God is bound to result in an increasingly secular identity. Smolin urges that the very nature of (...) scriptural religions like Christianity, Judaism, and Islam is that they posit an extremely public and accessible revelation of God, from this Christian perspective, the main barrier to acceptance of Christianity is not insufficient understanding but a failure of will stemming from sinful human nature. Perry's reply to this critique presents a shift in position which Perry says that one should not posit an ideal that would render beliefs like David Smolin's an inappropriate basis for political choice. Instead, those beliefs need to be met on their merits. (shrink)

The article discusses retributive justice and punitive restraint in response to the worst types of crime. I take the Breivik Case as a starting point. Anders Behring Breivik was sentenced to 21 years of preventive detention for killing 69 people, mainly youths, at Utøya and 8 people in Oslo on July 22nd, 2011. Retributivist theories as well as commonly held retributive intuitions suggest that much harsher punishment is required for such crimes. According to some retributivist theories, most notably on (...) the influential theories of Kant and Hegel, the death penalty is warranted for murderers like Breivik. This suggests that the rationale for punitive restraint in a case like the Breivik Case can only be found in forward- looking, consequentialist theories of punishment, or by adding to retributivist theories a side-constraint in the form of a principle of parsimony. However, I argue that if we look closer at the function of punishment in the retributivist theories of Kant and Hegel, they too imply a rationale for punitive restraint, even for such horrific crimes as here discussed. Against Kant and Hegel’s own views on the death penalty, I argue that their broader “freedom theories” of retributive justice do not imply the justice of the death penalty or life imprisonment. In the last part of the article, I explore differences in the concepts of freedom entailed by Kant and Hegel’s theories, and I relate these to some of the background factors relevant to the Breivik Case. (shrink)