Gerald Dworkin's influential account of Personal Autonomy offers the following two conditions for autonomy: Authenticity - the condition that one identify with one's beliefs, desires and values after a process of critical reflection, and Procedural Independence - the identification in must not be "influenced in ways which make the process of identification in some way alien to the individual" . I argue in this thesis that there are cases which fulfil both of Dworkin's conditions, yet are clearly not (...) cases of autonomy. Specifically, I argue that we can best assess the adequacy of Dworkin's account of autonomy through literature, because it provides a unique medium for testing his account on the very terms he sets up for himself - ie. that autonomy apply to, and make sense of, persons leading lives of a certain quality. The examination of two novels - Kazuo Ishiguro's The Remains of the Day and Henry James's The Portrait of a Lady - shows that Dworkin's explanation of identification and critical reflection is inadequate for capturing their role in autonomy and that he does not pay enough attention to the role of external factors in preventing or supporting autonomy. As an alternative, I offer the following two conditions for autonomy: critical reflection of a certain kind - radical reflection, and the ability to translate the results of into action - competence. The novels demonstrate that both conditions are dependent upon considerations of the content of one's beliefs, desires, values etc. Certain of these will prevent or hinder the achievement of autonomy because of their content, so autonomy must be understood in relation to substantial considerations, rather than in purely formal terms, as Dworkin argues. (shrink)

Performance-Kunst ist mehr als ein kulturindustrielles Spektakel, denn sie will auf die Beteiligten existenziell einwirken. Hanna Heinrich entwickelt Analysekategorien, die die Kommunikationsmodi dieser Kunstform ebenso wie ihren gesellschaftstransformativen Anspruch philosophisch ergründen. Dazu bedient sie sich der ästhetischen Positionen G.W.F. Hegels, Friedrich Nietzsches, Martin Heideggers, Alain Badious und Michel Foucaults, die der Kunst große emanzipatorische und soziopolitische Kraft zusprechen sowie politischer Philosophien und Ethiken und zeigt damit auf: »Gelungene« Performances stellen sich als exemplarische Handlungsräume mit utopischem Potenzial der gegenwärtigen Entfremdung entgegen (...) und verweisen auf die (Mit-)Verantwortung und Freiheit jedes Einzelnen. (shrink)

Autonomy in Jewish Philosophy examines an important theme in Jewish thought from the Book of Genesis to the present day. Although it is customary to view Judaism as a legalistic faith leaving little room for free thought or individual expression, Kenneth Seeskin argues that this view is wrong. Where some see the essence of the religion as strict obedience to divine commands, Seeskin claims that God does not just command but forms a partnership with humans requiring the consent (...) of both parties. Looking at classic texts from Biblical, Rabbinic, and philosophical literature, Seeskin shows that Judaism has always respected freedom of conscience and assigned an important role to the power of human reason. The book considers both existing arguments and presents new ideas about the role of autonomy in Judaism. Clear and concise, it offers a refreshing alternative to the mysticism and dogmatism prevalent in much of the recent literature. (shrink)

Autonomy has recently become one of the central concepts in contemporary moral philosophy and has generated much debate over its nature and value. This 2005 volume brings together essays that address the theoretical foundations of the concept of autonomy, as well as essays that investigate the relationship between autonomy and moral responsibility, freedom, political philosophy, and medical ethics. Written by some of the most prominent philosophers working in these areas, this book represents research on the (...) nature and value of autonomy that will be essential reading for a broad swathe of philosophers as well as many psychologists. (shrink)

This metatheoretical paper investigates mind wandering from the perspective of philosophy of mind. It has two central claims. The first is that, on a conceptual level, mind wandering can be fruitfully described as a specific form of mental autonomy loss. The second is that, given empirical constraints, most of what we call “conscious thought” is better analyzed as a subpersonal process that more often than not lacks crucial properties traditionally taken to be the hallmark of personal-level cognition - (...) such as mental agency, explicit, consciously experienced goal-directedness, or availability for veto control. I claim that for roughly two thirds of our conscious life-time we do not possess mental autonomy (M-autonomy) in this sense. Empirical data from research on mind wandering and nocturnal dreaming clearly show that phenomenally represented cognitive processing is mostly an automatic, non-agentive process and that personal-level cognition is an exception rather than the rule. This raises an interesting new version of the mind-body problem: How is subpersonal cognition causally related to personal-level thought? More fine-grained phenomenological descriptions for what we called “conscious thought” in the past are needed, as well as a functional decomposition of umbrella terms like “mind wandering” into different target phenomena and a better understanding of the frequent dynamic transitions between spontaneous, task-unrelated thought and meta-awareness. In an attempt to lay some very first conceptual foundations for the now burgeoning field of research on mind wandering, the third section proposes two new criteria for individuating single episodes of mind-wandering, namely, the “self-representational blink” (SRB) and a sudden shift in the phenomenological “unit of identification” (UI). I close by specifying a list of potentially innovative research goals that could serve to establish a stronger connection between mind wandering research and philosophy of mind. (shrink)

Autonomy is one of the central concepts of contemporary moral thought, and Kant is often credited with being the inventor of individual moral autonomy. But how and why did Kant develop this notion? The Emergence of Autonomy in Kant's Moral Philosophy is the first essay collection exclusively devoted to this topic. It traces the emergence of autonomy from Kant's earliest writings to the changes that he made to the concept in his mature works. The essays (...) offer a close historical and philosophical analysis of what prompted Kant to develop his conception of autonomy, charting the historical background which prompted his search, and thoroughly analysing different stages of his writings in order to see which element of autonomy was introduced at which point. The resulting volume will be of interest to both scholars and students of Kantian moral philosophy, as well as to anyone interested in the subject of autonomy. (shrink)

These remarkable essays include Cornelius Castoriadis's latest contributions to philosophy, political and social theory, classical studies, development theory, cultural criticism, science, and ecology. Examining the "co-birth" in ancient Greece of philosophy and politics, Castoriadis shows how the Greeks' radical questioning of established ideas and institutions gave rise to the "project of autonomy". The "end of philosophy" proclaimed by Postmodernism would mean the end of this project. That end is now hastened by the lethal expansion of technoscience, (...) the waning of political and social conflict, and the resignation of intellectuals who blindly defend Western culture as it is or who merely denounce or "deconstruct" it as it has been. Discussing and criticizing Plato, Aristotle, Leibniz, Kant, Hegel, Weber, Heidegger, and Habermas, the author of The Imaginary Institution of Society and Crossroads in the Labyrinth poses a radical challenge to our inherited philosophy. (shrink)

How social media impacts the autonomy of its users is a topic of increasing focus. However, much of the literature that explores these impacts fails to engage in depth with the philosophical literature on autonomy. This has resulted in a failure to consider the full range of impacts that social media might have on autonomy. A deeper consideration of these impacts is thus needed, given the importance of both autonomy as a moral concept and social media (...) as a feature of contemporary life. By drawing on this philosophical literature, we argue that autonomy is broadly a matter of developing autonomy competencies, having authentic ends and control over key aspects of your own life, and not being manipulated, coerced, and controlled by others. We show how the autonomy of users of social media can be disrespected and harmed through the control that social media can have over its users’ data, attention, and behaviour. We conclude by discussing various recommendations to better regulate social media. (shrink)

This stimulating collection of essays in ethics eschews the simple exposition and refinement of abstract theories. Rather, the author focuses on everyday moral issues, often neglected by philosophers, and explores the deeper theoretical questions which they raise. Such issues are: Is it wrong to tell a lie to protect someone from a painful truth? Should one commit a lesser evil to prevent another from doing something worse? Can one be both autonomous and compassionate? Other topics discussed are servility, weakness of (...) will, suicide, obligations to oneself, snobbery, and environmental concerns. A feature of the collection is the contrast of Kantian and utilitarian answers to these problems. The essays are crisply and lucidly written and will appeal to both teachers and students of philosophy. (shrink)

Introduction : the politics of our selves -- Foucault, subjectivity, and the enlightenment : a critical reappraisal -- The impurity of practical reason : power and autonomy in Foucault -- Dependency, subordination, and recognition : Butler on subjection -- Empowering the lifeworld? autonomy and power in Habermas -- Contextualizing critical theory -- Engendering critical theory.

One of the most pervasive criticisms of nudges has been the claim that they violate, undermine or decrease people’s autonomy. This claim, however, is seldom backed up by an explicit and detailed conception of autonomy. In this paper, we aim to do three things. First, we want to clear up some conceptual confusion by distinguishing the different conceptions used by Cass Sunstein and his critics in order to get clear on how they conceive of autonomy. Second, we (...) want to add to the existing discussion by distinguishing between ‘autonomy’ as the ability to set your own ends and ‘autocracy’ as the ability to actually realize those ends. This will allow for a more careful ethical evaluation of specific nudge interventions. Third, we will introduce the idea of ‘perimeters of autonomy’ in an attempt to provide a realistic account of personal autonomy and we will argue that it can alleviate most of the worries about nudging being autonomy-undermining. (shrink)

The phenomenon of regression toward the mean is notoriously liable to be overlooked or misunderstood; regression fallacies are easy to commit. But even when regression phenomena are duly recognized, it remains perplexing how they can feature in explanations. This article develops a philosophical account of regression explanations as “statistically autonomous” explanations that cannot be deepened by adducing details about causal histories, even if the explananda as such are embedded in the causal structure of the world. That regression explanations have statistical (...) autonomy was first suggested by Ian Hacking and has recently been defended and elaborated by André Ariew, Yasha Rohwer, and Collin Rice. However, I will argue that these analyses fail to capture what regression’s statistical autonomy consists in and how it sets regression explanations apart from other kinds of explanation. The alternative account I develop also shows what is amiss with a recent denial of regression’s statistical autonomy. Marc Lange has argued that facts that can be explained as regression phenomena can in principle also be explained by citing a conjunction of causal histories. The account of regression explanation developed here shows that his argument is based on a misunderstanding of the nature of statistical autonomy. (shrink)

This remarkable book is the most comprehensive study ever written of the history of moral philosophy in the seventeenth and eighteenth centuries. Its aim is to set Kant's still influential ethics in its historical context by showing in detail what the central questions in moral philosophy were for him and how he arrived at his own distinctive ethical views. The book is organised into four main sections, each exploring moral philosophy by discussing the work of many influential (...) philosophers of the seventeenth and eighteenth centuries. In an epilogue the author discusses Kant's view of his own historicity, and of the aims of moral philosophy. In its range, in its analyses of many philosophers not discussed elsewhere, and in revealing the subtle interweaving of religious and political thought with moral philosophy, this is an unprecedented account of the evolution of Kant's ethics. (shrink)

This paper presents a conception of the self partially in terms of a particular notion of preference. It develops a coherentist account of when one's preferences are "authorized", or sanctioned as one's own, and presents a coherence theory of autonomous action. The view presented solves certain problems with hierarchical accounts of freedom, such as Harry Frankfurt's.

COVID-19 has turned many ethical principles and presuppositions upside down. More precisely, the principle of respect for autonomy has been shown to be ill suited to face the ethical challenges posed by the current health crisis. Individual wishes and choices have been subordinated to public interests. Patients have received trial therapies under extraordinary procedures of informed consent. The principle of respect for autonomy, at least in its mainstream interpretation, has been particularly questioned during this pandemic. Further reflection on (...) the nature and value of autonomy is urgently needed. Relational autonomy has been proposed as an alternative account of autonomy that can more adequately respond to contemporary ethical issues in general and to a pandemic such as the one we are currently facing in particular. As relational autonomy is an emerging notion in current bioethics, it requires further consideration and development to be properly operationalized. This paper aims to show how six different philosophical branches––namely, philosophy of nature, philosophical anthropology, existential phenomenology, discourse ethics, hermeneutics, and cultural anthropology––have incorporated the category of relation throughout the twentieth century. We first delve into primary philosophical sources and then apply their insights to the specific field of medical ethics. Learning from the historical developments of other philosophical fields may provide illumination that will enable bioethics to experience a successful “relational turn”, which has been partially initiated in contemporary bioethics but not yet achieved. (shrink)

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

“Bodily autonomy” has received significant attention in bioethics, medical ethics, and medical law in terms of the general inviolability of a patient’s bodily sovereignty and the rights of patients to make choices (e.g., reproductive choices) that concern their own body. However, the role of the body in terms of how it can or does contribute to a patient’s capacity for, or exercises of their autonomy in clinical decision-making situations has not been explicitly addressed. The approach to autonomy (...) in this paper is aligned with traditional theories that conceive autonomy in terms of an individual’s capacities for, and exercises of rational reflection. However, at the same time, this paper extends these accounts by arguing that autonomy is, in part, embodied. Specifically, by drawing on phenomenological conceptions of the experience of autonomy, we argue that, in principle, the body is a necessary component of the capacity for autonomy. Secondly, through the presentation of two different cases, we highlight ways in which a patient’s body can contribute to the autonomy of treatment choices. Ultimately, we hope to encourage others to explore additional conditions under which a concept of embodied autonomy should be employed in medical decision making, how its underlying principles might be operationalised in clinical situations, and its consequences for approaches to patient autonomy in healthcare practice, policy, and law. (shrink)

In this paper, I discuss a subset of preferences in which a person desires the fulfillment of a choice they have made, even if it involves the violation of their desires, as in rape fantasies. I argue that such cases provide us with a unique insight into personal autonomy from a proceduralist standpoint. In its first part, I analyze some examples in light of Frankfurt's endorsement theory and argue that even when we cannot endorse a practical decision that involves (...) being violated, we nonetheless regard those cases as instances of autonomy. Therefore, autonomy does not necessarily require endorsement. Instead, I propose that the nature of the relevant highest-order volition dictates the procedure that should be established in one’s desire structure for its fulfillment. In the second part, I discuss how an agent may effectively consent to the violation of their decision by another person. Ordinary consent typically refers to actions but fails to communicate one's higher-order desires or commitments. To address this limitation, I propose a practical tool that accomplishes this by signaling shifts in the normative context where the agents are interacting. (shrink)

One of the most influential views in privacy scholarship is that privacy protects individual autonomy. On the early liberal view, the exercise of autonomy requires detachment from social and political life and privacy facilitates it. This view of privacy still informs current legal and political practice. As this view of privacy presupposes a tension between privacy and society, it is responsible for the underrating of privacy in legal and political practice. Over the last decades, liberal reflection on (...) class='Hi'>autonomy has shifted from the early liberal understanding of autonomy as calling for detachment from social life to the idea of autonomy as socially embedded. This development has brought about a corresponding adjustment in the liberal concept of privacy: privacy has come to be seen as a social rather than merely an individual interest. The social turn in thinking about privacy has gone a long way to change the problematic image of privacy in legal and political practice. It has not gone far enough, however, to draw conclusions regarding the political relevance of privacy. I argue that we should understand autonomy as politically embedded. Revised along these lines, privacy has a political value: when we claim privacy, we do not make a claim to withdraw from political life, but rather make a claim to protect certain forms of political engagement. (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)

There is a long-standing debate in the philosophy of mind and philosophy of science regarding how best to interpret the relationship between neuroscience and psychology. It has traditionally been argued that either the two domains will evolve and change over time until they converge on a single unified account of human behaviour, or else that they will continue to work in isolation given that they identify properties and states that exist autonomously from one another (due to the multiple-realizability (...) of psychological states). In this paper, I argue that progress in psychology and neuroscience is contingent on the fact that both of these positions are false. Contra the convergence position, I argue that the theories of psychology and the theories of neuroscience are scientifically valuable as representational tools precisely because they cannot be integrated into a single account. However, contra the autonomy position, I propose that the theories of psychology and neuroscience are deeply dependent on one another for further refinement and improvement. In this respect, there is an irreconcilable codependence between psychology and neuroscience that is necessary for both domains to improve and progress. The two domains are forever linked while simultaneously being unable to integrate. (shrink)

Respect for Autonomy has been a mainstay of medical ethics since its enshrinement as one of the four principles of biomedical ethics by Beauchamp and Childress’ in the late 1970s. This paper traces the development of this modern concept from Antiquity to the present day, paying attention to its Enlightenment origins in Kant and Rousseau. The rapid C20th developments of bioethics and RFA are then considered in the context of the post-war period and American socio-political thought. The validity and (...) utility of the RFA are discussed in light of this philosophical-historical account. It is concluded that it is not necessary to embrace an ethic of autonomy in order to guard patients from coercion or paternalism, and that, on the contrary, the dominance of autonomy threatens to undermine those very things which have helped doctors come to view and respect their patients as persons. (shrink)

In Ethics and the Autonomy of Philosophy, Bernard Walker sets out with two objectives. First, Walker argues that ethics is autonomous as a discipline. Oftentimes ethics books, from a Christian perspective, lean toward grounding ethics in theology or in biblical proof texting. Walker departs from this tradition. Ethics grounded in theology entails a limited scope for those doing ethics in that the Christian God must be assumed for both Christian and non-Christian when at the table of ethical dialogue. (...) For the non-Christian, this loads the dice and shuts down ethical consensus and dialogue, if not ethical truth. With that said, this book does not depart from Christian ethical views on such issues as the sanctity of life, antiracism, the death penalty, the objectivity of ethics, and the importance of integrating faith into ethics; however, Walker does so from a common denominator of philosophy rather than theology. Second, Walker ventures into the streets and engages the man/woman on the streets approach to ethics and ethical decision-making. He points out the shortcomings of the ubiquitous views of the man/woman on the streets, viz., cultural relativism, skepticism, and the attitude that ethics is merely a matter of personal choice. (shrink)

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)

Should society intervene to prevent the risky behavior of precocious teenagers even if it would be impermissible to intervene with adults who engage in the same risky behavior? The problem is well illustrated by the legal case of the 13-year-old Dutch girl Laura Dekker, who set out in 2009 to become the youngest person ever to sail around the world alone, succeeding in January 2012. In this paper we use her case as a point of entry for discussing the fundamental (...) question of how to demarcate childhood from adulthood. After summarizing the case, we identify a ‘demarcation dilemma’ that frames much of the public and expert debate. On the one hand, it seems morally imperative ‘to treat like alike’, which means that both children and adults should be allowed to undertake all actions for which they have the relevant competences. On the other hand, requiring proportional treatment of children and adults seems to neglect the special nature of childhood as a distinct stage in life that ends at a specific age. We introduce the notion of a ‘regime of childhood’ to deal with this problem. This regime includes several dimensions, including the limited liability for children, the supervisory responsibilities of parents, the role of age-based thresholds, and the overarching purpose of childhood as a context for developing autonomy. We argue that, all things considered, there are good reasons not to shift to a regime that offers individual children the option of qualifying for adulthood on the basis of age-neutral criteria. (shrink)

Following the revival in the last decades of the concept of “organism”, scholarly literature in philosophy of science has shown growing historical interest in the theory of Immanuel Kant, one of the “fathers” of the concept of self-organisation. Yet some recent theoretical developments suggest that self-organisation alone cannot fully account for the all-important dimension of autonomy of the living. Autonomy appears to also have a genuine “interactive” dimension, which concerns the organism’s functional interactions with the environment and (...) does not simply derive from its internal organisation. Against this background, we focus on a family of natural philosophical approaches that historically have already strongly taken in account this aspect of autonomy, notably going beyond Kant’s perspective on self-organisation. We thus review Hegel, Plessner, and Jonas’ different perspectives on living beings, focussing in particular on four points: the distinction between organic and inorganic, the theory of biological organisation, the processuality of the living, and the “boundary” between inside and outside, through which the organism establishes its relationship to the environment. We, then, compare the three perspectives on these four points, and finally address the question of what advantages their contribution present—especially compared to Kant’s theory—with respect to the topic of organism’s autonomy. This could help—we hope—to better understand what is at the stake still today. (shrink)

Using the example of an unconsented mouth swab I criticise the view that an action of this kind taken in itself is wrongful in respect of its being a violation of autonomy. This is so much inasmuch as autonomy merits respect only with regard to ‘critical life choices’. I consider the view that such an action is nevertheless harmful or risks serious harm. I also respond to two possible suggestions: that the action is of a kind that violates (...) autonomy; and, that the class of such actions violates autonomy. I suggest that the action is wrongful in as much as it is a bodily trespass. I consider, and criticise, two ways of understanding how morally I stand to my own body: as owner and as sovereign. In respect of the latter I consider Arthur Ripstein's recent defence of a sovereignty principle. Finally I criticise an attempt by Joel Feinberg to explain bodily trespass in terms of personal autonomy. (shrink)

The phenomenology of a priori intuition is explored at length (where a priori intuition is taken to be not a form of belief but rather a form of seeming, specifically intellectual as opposed to sensory seeming). Various reductive accounts of intuition are criticized, and Humean empiricism (which, unlike radical empiricism, does admit analyticity intuitions as evidence) is shown to be epistemically self-defeating. This paper also recapitulates the defense of the thesis of the Autonomy and Authority of Philosophy given (...) in the author’s “A Priori Knowledge and the Scope of Philosophy” (Philosophical Studies, 1996). (shrink)

Pauline Kleingeld has argued persuasively that Kant’s Principle of Autonomy draws an analogy between two relationships: 1) that between an individual agent and their maxim, and 2) that between a legislator and their legislation. She also suggests that Kant’s evolving views on the normative significance of popular elections made his analogy inapt, which explains its disappearance from his later writings. This comment concurs with Sorin Baiasu that the merits of Kant’s analogy were untouched by his evolving political views. The (...) analogy presupposes that when lawmakers legislate, they do so as representatives of the people, but even Kant’s mature writings posit that unelected lawmakers are representatives of the people in the necessary sense. Facts about whether a lawmaker acquired legislative authority by election, heredity, or conquest do have normative implications in the larger context of Kant’s political theory, but such facts are necessarily temporally upstream of the relation between legislator and legislation, just as facts about how an agent became rational are upstream of the relation between individual agent and maxim. Because the analogy focuses exclusively on these two relationships, it cannot be damaged by such upstream facts. Moreover, we should consider the possibility that Kant’s Principle of Autonomy compares a human will to the united general will of the people itself rather than to the will of a fallible public official or institution. On this alternative reading, it is even more clear that Kant’s evolving views on the significance of elections could have no possible relevance to the Principle of Autonomy. (shrink)

I shall draw on my experience of being an ICU patient to make some practical, ethical, and philosophical points about the care of the critically ill. The recurring theme in this paper is ICU psychosis. I suggest that discharged patients ought to be educated about it; I discuss the obstacles in the way of accurately measuring it; I argue that we must rethink autonomy in light of it; and I suggest that the self disintegrates in the face of it.

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)

The common liberal understanding of reproductive autonomy – characterized by free choice and a principle of non-interference – serves as a useful way to analyse the normative appeal of having certain choices open to people in the reproductive realm, especially for issues like abortion rights. However, this liberal reading of reproductive autonomy only offers us a limited ethical understanding of what is at stake in many kinds of reproductive choices, particularly when it comes to different uses of reproductive (...) technologies and third-party reproduction. This is because the liberal framework does not fully capture who benefits from which reproductive options, the extent of the risks and harms involved in various reproductive interventions, and the reasons for why people are driven to make certain reproductive choices. (shrink)

Enhancement of autonomous choice may be considered as an important reason for facilitating the use of genetic tests such as preimplantation genetic diagnosis. The principle of respect for autonomy is a crucial component not only of Western liberal traditions but also of Western bioethics. This is especially so in bioethical discussions and analyses of clinical encounters within medicine. On the basis of an analysis of qualitative research interviews performed with British, Italian and Swedish geneticists and gynaecologists on ethical aspects (...) of preimplantation genetic diagnosis, the plausibility of the notion of autonomy within reproductive medicine is discussed. The analysis of interviews indicates not only that there is a gap between theoretical discussions and concrete practice, but also that an increase in choice — paradoxically — can hamper couples' choice. (shrink)

For the purpose of advancing the feminist commitment to inclusion and nonliberal articulations of pluralism, in this essay I conceptualize the Native account of individual autonomy that itself evolves from a commitment to pluralism. I demonstrate that Native individual autonomy is concurrently strong and feminist in nature—what I call “radical-cum-relational.” That is, Native autonomy is more radical than the traditional liberal conception and is simultaneously grounded in relationality, which is the basis of much of feminist ethics. I (...) demonstrate that the Native conception of autonomy is radical and promotes the highest degree of individual self-determination and independence qua individuality and particularity. Yet this radical self-determination depends on intense social interdependency. The grounding metaphysics and epistemology of the Native framework are conceived entirely in terms of ethical relationships between and responsibilities to other individuals, animals, and the Earth. That is, no part of the Native paradigm can be understood outside of the ethical connections persons have by virtue of their primary position as community members. It is by situating radical autonomy against a background of ethical social interdependence, together with thebackground condition of gender equality of Native practices, that the radical construal of Native individual freedom is feminist. To shore up and illustrate the connection between Native autonomy and feminism, I argue that an identification between the Native social practice of gifting and feminist reciprocity can be made, specifically Iris Marion Young’s notion of asymmetrical reciprocity. Finally, I argue that this connection avoids the problem of incommensurability and so is theoretically possible, responsible, and fits the criterion of respectfulness also at the foundation of the Native framework. Broadly speaking, the problem of incommensurability is concerned with theorists’ inability to recognize foundational incompatibilities between paradigms and their forced attempts to mergethem, often at the price of ignoring inconsistencies, inaccuracies, and contradictions that result from impossible translations and conversions. Historically and to the present day, Western philosophy has been egregiously guilty of distorting Native theories and practices. In this essay I argue that since translation takes place at the level of praxis rather than at the level of language, my argument circumvents problems that arise from failed attempts to map cultural concepts onto others that do not share similar foundations. (shrink)

Sophocles' Antigone contains the first recorded instance of the word αὑτ ό νομος, the source for our word “autonomous”. I argue that reflection upon the human aspiration toward autonomy is central to that work. I begin by focusing on the difficulty readers of the play have determining whether Antigone's actions in the play should be considered autonomous and then suggest that recognizing this difficulty is crucial to a proper understanding of the play. The very aspects of Antigone's character that (...) seem to militate against understanding her actions within the play as autonomous—her rejection of life, her intimacy with death and the way she seems defined by her incestuous heritage— serve to illustrate the inherently problematic character of a moral ideal that we can provisionally call Antigone's autonomy. I show how the movement of the play can be understood in terms of Antigone's progress from what Kant would characterize as a heteronomous representation of her irremissible duty to bury her dead brother, to a self-conception defined by a recognition and embrace of her autonomy understood as, in Kant's words, “a respect for something entirely different from life”. Antigone's autonomy is exemplified by her choice to be dead, the choice to bear the burden of responsibility to her own. This choice, I argue, must be understood as the choice of herself as defined by her obligation to her own. Sophocles' Antigone suggests that the moral ideal Antigone represents is unliveable, but that this ideal is nonetheless essential to human moral aspiration. (shrink)

This essay explores the prospects of developing a satisfying account of group autonomy without rejecting value-individualism. That is, I will examine whether one can adequately explain the moral reasons to respect a group's claim to self-determination while insisting that only individual persons are of ultimate moral value.

This book explores the steady decline in the status of the individual in recent years and addresses common misunderstandings about the concept of individuality. Drawing from psychology, neuroscience, technology, economics, philosophy, politics, and law, White explains how and why the individual has been devalued in the eyes of scholars, government leaders, and the public. He notes that developments in science have led to doubts about our cognitive competence, while assumptions made in the humanities have led to questions about our (...) moral competence. In this book, White goes on to argue that both of these views are mistaken and that they stem from overly simplistic ideas about how individuals make choices, however imperfectly, in their interests, which are multifaceted and complex. In response, he proposes a new way to look at individuals that preserves their essential autonomy while emphasizing their responsibility to others, inspired by the moral philosophy of Immanuel Kant and the legal and political philosophy reflected in the Bill of Rights to the U.S. Constitution. This book explains how individuality combines both rights and responsibilities, reconciles the popular yet false dichotomy between individual and society, and provides the basis for a humane and respectful civil society and government. This book is part of White's trilogy on the individual and society, which includes The Manipulation of Choice and The Illusion of Well-Being. (shrink)

Over the last decade, several European countries and the Council of Europe itself have strongly supported the use of advance directives as a means of protecting patients’ autonomy, and adopted specific norms to regulate this matter. However, it remains unclear under which conditions those regulations should apply to people who are placed in correctional settings. The issue is becoming more significant due to the increasing numbers of inmates of old age or at risk of suffering from mental disorders, all (...) of whom might benefit from using advance directives. At the same time, the closed nature of prisons and the disparate power relationships that characterise them mean that great caution must be exercised to prevent care being withdrawn or withheld from inmates who actually want to receive it. This paper explores the issue of prisoners’ advance directives in the European context, starting with the position enshrined in international and European law that prisoners retain all their human rights, except the right to liberty, and are therefore entitled to self-determination regarding health care decisions. (shrink)

Ernst Mayr’s concept of dual causality in biology with the two forms of causes continues to provide an essential foundation for the philosophy of biology. They are equivalent to functional and evolutionary causes with both required for full biological explanations. The natural sciences can be classified into nomological, historical nomological and historical dual causality, the last including only biology. Because evolutionary causality is unique to biology and must be included for all complete biological explanations, biology is autonomous from the (...) physical sciences. (shrink)

University of North Carolina at Chapel Hill.

Based on an empirical study regarding ethical challenges within intercultural health care, the focus of this article is upon autonomy and disclosure, discussed in light of philosophy and anthropology. What are the consequences for patients if the patients’ right to be autonomous and to participate in treatment and care decisions by health care workers is interpreted as an obligation to participate? To force a person to make independent choices who is socio-culturally unprepared to do so, may violate his/her (...) integrity. This may in turn jeopardise the respect, integrity and human worth the principle of autonomy was meant to ensure, and if so, may damage any relationship of trust that may exist between patient and health care worker. There is necessarily a link between autonomy and disclosure. Western disclosure practices may make the relationship between patients and health care workers difficult -- even distrustful. To confront a patient with a very serious diagnosis may be seen not only as a tactless action, but also an unforgivable one. Hence, among many ethnic groups it is a family member’s duty to shield patients from bad or disquieting news, e.g., a cancer diagnosis. If a family member is used to interpret in such situations, will the information given equal the information communicated by that interpreter? Even though respect for a person’s autonomy is part of the respect for a person, one’s respect for the person in question should not depend on his/her ability or aptitude to act autonomously. (shrink)