Respect for patient autonomy can apply at two levels: ensuring that patient care reflects their considered values and wishes and honoring patient preferences about how to make momentous decisions. Caregivers who seek to respect patient autonomy in the context of some end-of-life decisions face a dilemma. Because these decisions are fraught, patients may prefer to approach them sequentially, only making decisions at the time they arise. However, respecting patients’ preferences for a sequential approach can increase the likelihood that surrogates and (...) care teams wind up in situations in which they lack information needed to ensure patients receive care that conforms to their considered values after they are no longer competent to make decisions for themselves. Sequential decision-making can thus conflict with the goal of ensuring care reflects the wishes of patients. After illustrating how this dilemma can arise in the use of life-sustaining “bridge” technologies, we argue that care teams may be warranted in requiring patients to articulate their wishes in an advance care plan before treatment begins. In some cases, care teams may even be permitted to refuse to undertake certain courses of care, unless patients articulate their wishes in an advance care plan. (shrink)

Advance care planning refers to the process of determining how one wants to be cared for in the event that one is no longer competent to make one's own medical decisions. Some have argued that advance care plans often fail to be normatively binding on caretakers because those plans do not reflect the interests of patients once they enter an incompetent state. In this article, we argue that when the core medical ethical principles of respect for patient autonomy, honest and (...) adequate disclosure of information, institutional transparency, and concern for patient welfare are upheld, a policy that would allow for the disregard of advance care plans is self-defeating. This is because when the four principles are upheld, a patient's willingness to undergo treatment depends critically on the willingness of her caretakers to honor the wishes she has outlined in her advance care plan. A patient who fears that her caretakers will not honor her wishes may choose to avoid medical care so as to limit the influence of her caretakers in the future, which may lead to worse medical outcomes than if she had undergone care. In order to avoid worse medical outcomes and uphold the four core principles, caregivers who are concerned about the future welfare of their patients should focus on improving advance care planning and commit to honoring their patients’ advance care plans. (shrink)

In the past decade, several professors have advocated for the use of blogs in undergraduate courses in philosophy, arguing that blogs are beneficial for student learning, as blogs are forums for student collaboration and engagement with course material outside the classroom. In this paper I argue that blogging assignments can be beneficial for introductory-level undergraduate courses in philosophy for two reasons yet to be fully explored in the pedagogical literature. First, blogging assignments can act as low-stakes practice for paper writing. (...) Second, blogging assignments give students the freedom to explore the relevance of course content to real world problems and academic fields other than philosophy. I then provide an example of a blogging assignment from a course in applied political philosophy that, I argue, achieves both of these goals. (shrink)

In the past decade, several professors have advocated for the use of blogs in undergraduate courses in philosophy, arguing that blogs are beneficial for student learning, as blogs are forums for student collaboration and engagement with course material outside the classroom. In this paper I argue that blogging assignments can be beneficial for introductory-level undergraduate courses in philosophy for two reasons yet to be fully explored in the pedagogical literature. First, blogging assignments can act as low-stakes practice for paper writing. (...) Second, blogging assignments give students the freedom to explore the relevance of course content to real world problems and academic fields other than philosophy. I then provide an example of a blogging assignment from a course in applied political philosophy that, I argue, achieves both of these goals. (shrink)

In the biomedical and behavioral sciences, it is widely recognized that researchers conducting studies involving human participants must respect the autonomy of research subjects. There is significant debate in the clinical research ethics and bioethics literatures about what it means for an individual to be autonomous. According to proponents of the Liberal Conception of Autonomy, an autonomous person is an agent who has interests and opinions and the capacity to deliberate about them. In contrast, proponents of the Relational Conception of (...) Autonomy argue that because humans are social creatures, autonomy is a relational concept and ought to be recognized as such by medical professionals. In this article, I argue that the LCA/RCA debate is flawed, and that the notion of freedom as non-domination, rather than autonomy, ought to be adopted for biomedical research ethics policies regarding informed consent and research agenda-setting. I then argue that this view of freedom should also be adopted... (shrink)