This article examines preventive constraints on suspected terrorists that can lead to restrictions on liberty similar to imprisonment and disrespect the target’s autonomy. In particular, it focuses on two examples: travel bans and asset freezes. It seeks to develop guidelines for setting appropriate limits on their future use. Preventive constraints do not generate legal protections as constraints in response to conduct do. In addition, these constraints are often seen as a permissible alternative to imprisonment. Still, preventive de facto detentions, (...) or what I term “exprisonments”, imperil the free and autonomous life of the targeted person. With the recognition that such constraints can infringe on one’s ability to lead a free and autonomous life, this article argues that some of these constraints require similar protections as their counterparts that put persons under lock and key. (shrink)

Mill thinks our attitudes should be held in a way that’s active and ‘alive’. He believes attitudes that lack these qualities—those held dogmatically, or in unreflective conformity—are inimical to our well-being. This claim then serves as a premiss in his argument for overarching principles of liberty. He argues that attitudinal vitality, in the relevant sense, relies upon people experiencing attitudinal conflict, and that this necessitates a prioritization of personal liberties. I argue that, pace Mill, contestation isn’t required for attitudinal (...) vitality. I describe one species of attitudinal vitality that isn’t reliant upon conflict. (shrink)

In P v Cheshire West, Lady Hale stated that an act that would deprive an able-bodied or able-minded person of their liberty would do the same to a mentally or physically disabled person. Throughout the judgement, there is no definition of what liberty is, which makes defining an act that would deprive a person of it difficult. Ideas of liberty are described in terms of political liberty within a society, the state of being free from external (...) influence and individual autonomy. This essay explores various philosophical ideas of liberty and what a legitimate constraint of liberty is. It will be argued that defining liberty in terms external influence from other human agents undermines the impact of natural inability on a person’s ability to fulfil their intrinsic desires—a true constraint of liberty is any which prohibits a person from acting in the way they desire. If liberty is not the same for all, it follows that a deprivation of liberty differs between different agents. Although the government must protect personal liberty, it is important to recognise that an act that may deprive an able-bodied or minded person of their liberty, may in fact promote the liberty of a disabled persons. It will be argued that acts that allow a disabled person to act out desires that they ordinarily would not be able to perform, do not deprive them of their liberty. (shrink)

Scholars have addressed restrictions on individual liberty, or deprivations thereof, that do not entail prison or jail—including area restrictions, revoking driver’s licenses, and GPS bracelets. In all legal domains, the effects of these measures on the lives of targeted individuals can be significant, primarily with respect to their capability to guide their own behavior. Some are applied categorically rather than individually, do not involve a fair trial or hearing, or are applied preventively or after the targeted individual has completed (...) a prison sentence. My aim in this article is to extend our view from prison as the quintessential method of depriving individuals of their liberty to control of individuals without locking them up. I address degrees of individual liberty and inquire into legal protections for individuals who are partially free but deprived of liberty in some areas of life. (shrink)

Deprivation of liberty in psychiatric hospitals is common world-wide. The aim of this study was to find out whether patients had experienced deprivation of their liberty during psychiatric hospitalization and to explore their views about it. Patients (n = 51) in two acute psychiatric inpatient wards were interviewed in 2001. They were asked to describe in their own words their experiences of being deprived of their liberty. The data were analysed by inductive content analysis. The types (...) of deprivation of liberty in psychiatric hospital care reported by these patients were: restrictions on leaving the ward and on communication, confiscation of property, and various coercive measures. The patients' experiences of being deprived of their liberty were negative, although some saw the rationale for using these interventions, considering them as part of hospital care. (shrink)

This article is concerned with the deprivation of patients’ liberty while undergoing psychiatric treatment, with special reference to the situation in Finland. It is based on a review of Finnish law, health care statistics, and empirical and theoretical studies. Relevant research findings from other countries are also discussed. In Finland, it is required that patients are cared for by mutual understanding with themselves; coercive measures may be applied only if they are necessary for the treatment of the illness, or (...) for safeguarding patients’ safety or the safety of others. Involuntary psychiatric hospitalization is closely regulated by the Mental Health Act. However, the rules concerning the deprivation of liberty during inpatient treatment (by seclusion, restraint and restricted leave) are formulated in very general terms. Therefore, Finnish psychiatric hospitals have their own policies concerning when and how seclusion may be used. The practice of seclusion and the use of restraint therefore vary among the psychiatric hospitals in Finland. (shrink)

The Mental Health Act 2007 introduced Deprivation of Liberty safeguards into the Mental Capacity Act 2005 with potentially far reaching resource implications. There appears to be no scientific data regarding the prevalence of deprivation of liberty in clinical settings such as hospitals and nursing homes. We examined how many patients across a whole Trust area in Wales were subject to some lack of capacity, how well documented this was and how many were potentially deprived of their (...) class='Hi'>liberty. We found that no patient was deprived of their liberty, but 8% lacked capacity to make either basic or complex decisions; another 5% lacked capacity to make complex decisions. Documentation was good in mental health and community directorates, but there were gaps in documentation (not practice) in the medical and surgical directorates. Routine collection of data improved documentation regarding deprivation of liberty criteria. There is a high likelihood that senior nursing staff underestimate the number of patients who lack capacity. (shrink)

The loss of the federally protected constitutional right to an abortion is a threat to the already tenuous autonomy of pregnant people, and may augur future challenges to their right to refuse unwanted obstetric interventions. Even before Roe’s demise, pregnancy led to constraints on autonomy evidenced by clinician-led legal incursions against patients who refused obstetric interventions. In Dobbs v. Jackson Women’s Health Organization, the Supreme Court found that the right to liberty espoused in the Constitution does not extend to (...) a pregnant person’s right to an abortion. With Roe’s demise, the right to request specific types of care has been vitiated. The same argument underpinning that holding may now become ballast for attacks on the traditionally more robust right, the right to refuse. Here we discuss how the elevation of fetal and embryonic rights may lead to a cascade of medical intrusions and deprivations of liberty against pregnant persons, and offer an argument opposing these improprieties. (shrink)

The Deprivation of Liberty Safeguards (DOLS) were recently introduced into the Mental Capacity Act (MCA) via an amendment to mental health legislation in England and Wales. As Shah (2011) discusses, the rationale behind creating these protocols was to close what is commonly referred to as the ‘Bournewood gap’; a legislative loophole that allowed a severely autistic man (H.L.) who did not initially dissent to admission to be detained in a hospital and deprived of his liberty in his (...) ‘best interests’ as judged by his clinical team. Before the implementation of the DOLS, patients who lacked the capacity to consent to admission or treatment but who were nonetheless compliant could be admitted informally and treated as .. (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)

Principle 2 of the 2005 Mental Capacity Act (MCA) requires that decision-making capacity should be assumed, unless there is conclusive evidence, on a balance of probabilities, to the contrary (Department of Constitutional Affairs 2005). In his article “The Paradox of the Assessment of Capacity Under the Mental Capacity Act 2005,” Ajit Shah (2011) raises the concern that the new Deprivation of Liberty Safeguards (DOLS), introduced through the Mental Health Act (Department of Health 2007), conflict with this principle (henceforth, the (...) principle of presumed capacity) because, in practice, they will encourage the routine assessment of capacity even in the absence of any positive evidence of diminished capacity .. (shrink)

In this paper, I argue that a constitutionalized Harm Principle could ensure that people are not jailed unless they deserve it. I do not aim to outline every possible type of bad consequence beyond harm that might be sufficiently serious to justify criminalization. Instead, I focus on criminalization that is backed up with jail terms and I argue that wrongful harm to others provides the only moral and constitutional justification for sending people to jail. Imprisonment harms the prisoner, so she (...) should not be imprisoned unless she has caused proportionate harm to others. I argue that the sufficient conditions for sending an offender to jail are: (1) that the offender's actions have (or risk) bad consequences that are sufficiently harmful to make her commensurately deserving of penal detention; and (2) that the offender culpably (that is, with a state of mind somewhere along the intentional/reckless/gross negligence continuum) chose (aimed or attempted) to bring about those bad consequences or did so with reckless indifference. The lawmaker would need to demonstrate from the ex ante perspective that proposed offenses carrying jail sentences are a proportionate and fair way of dealing with the wrongs involved. Because jail (including short sentences of a few days) involves hard treatment (seriously harmful consequences for the prisoner) harm to others would be the only bad consequence of sufficient weight to justify a jail sentence. Jailing people for wrongful behavior that has harmless consequences would be an unjust and disproportionate response. In terms of understanding imprisonment (a physical deprivation of liberty) in the United States, it is better to refer to the Eighth Amendment of the Constitution than to the Due Process Clause. The Eighth Amendment, if read morally, could be invoked to strike down laws that carry prison sentences for wrongs that do not result in harm to others. This is because harming a person by subjecting her to the hard treatment that is involved in serving a jail term would be a disproportionate response unless the wrongdoer inflicted equivalent harm on others. I argue, that the Eighth Amendment should be interpreted in a way that accords with its overall moral aim or purpose. The Amendment's overall moral aim is to ensure that the state does not inflict unjust, oppressive, or disproportional punishments on its citizens. (shrink)

The relationship between the purposes of sentencing and imprisonment can be variously conceptualized. The paper theorizes and contrasts two models of sentencing and prison relations—continuity and separation. The continuity model assumes continuity between sentencing and prison regime. Under this model, all sentencing purposes may impact prison regime. The separation model distinguishes between the purposes of sentencing and of imprisonment. Under the separation model, the retributive element of imprisonment is completely fulfilled by depriving the prisoner of liberty. Retributive considerations can (...) affect only the duration of the sentence, while prison regime is determined solely according to rehabilitation/risk and prison security considerations. The paper problematizes the separation model as it suffers from two difficulties: (a) the idea that the retributive element of imprisonment is fully fulfilled by depriving the prisoner’s liberty undermines the “hard treatment” element of the retributive punishment. Relatedly, since no prison regime can deprive a person solely of liberty no custodial sentence can be justified; (b) given the inability to isolate the denial of liberty as the only deprivation of imprisonment, the separation model also encourages judges to underestimate and feel less responsible for the full meaning of their decision to imprison. Finally, the paper will argue that liberal prison conditions may (and should) be achieved even when seeing retribution as relevant for prison life and will offer possible ways to do so. (shrink)

The conflict between courts and medicine is best shown in the mental health cases requiring judgment of whether a person should be confined, and whether they should be medicated or left free to decide for themselves. In such cases, deprivation of liberty for noncriminal offenders is at question, but if they are released, they may be exposed to injury or injure others. “Clear and convincing” evidence is hard to prove in such cases.The TOPOFF 2 terrorism preparedness exercise was two (...) years in planning, but the courts were involved only seven days before the exercise. Judge Murphy was put in charge of the Circuit Court building and was asked to stop all court proceedings to stop people from going into a building that might have been contaminated. (shrink)

La investigación pretende implementar una propuesta de intervención psicológica que fortalezca las estrategias de afrontamiento y habilidades sociales de las personas privadas de la libertad [PPL], internas en el complejo penitenciario y carcelario de Jamundí, que aporte al proceso de resocialización y prevención de conductas disruptivas y suicidas en el marco del programa institucional INPEC “Preservación de la vida”. La metodología cuenta con un enfoque mixto, diseño explicativo secuencial, alcance explicativo – exploratorio de corte transversal. La muestra: conformada por 80 (...) PPL seleccionada por conveniencia. Resultados esperados: Fortalecimiento estrategias de afrontamiento y habilidades para la vida, disminución de conductas disruptivas. (shrink)

The conflict between courts and medicine is best shown in the mental health cases requiring judgment of whether a person should be confined, and whether they should be medicated or left free to decide for themselves. In such cases, deprivation of liberty for noncriminal offenders is at question, but if they are released, they may be exposed to injury or injure others. “Clear and convincing” evidence is hard to prove in such cases.The TOPOFF 2 terrorism preparedness exercise was two (...) years in planning, but the courts were involved only seven days before the exercise. Judge Murphy was put in charge of the Circuit Court building and was asked to stop all court proceedings to stop people from going into a building that might have been contaminated. (shrink)

The concept of Rule of Law is the cornerstone of the proper functioning of the judicial system in any modern democratic society. It is a basic concept of defined rights and liberties to all persons, which offers protection from arbitrary prosecution and incarceration. This principle was firstly stipulated by the instrument of Magna Carta and it is considered as a key principle for good governance in any modern democratic society. The development of the rule of law principle is personified (...) through the independence of the Judiciary as a third branch of government. The contemporary democratic societies are faced with many challenges upon which in order to protect their values of the democratic system, often limit the rights and liberties of persons. It is the role of the courts and the judicial system to stop these injustices and protect the individual from any form of liberty deprivation and rights limitations. Before the promulgation of the Magna Carta in 1215, the rule of law was perceived as a divine justice, distributed solely by the monarch or the king or in this case - King John of England. Magna Carta doesn't have iconic status only in the British Society, which is perceived as an instrument with special constitutional status and cited by many judges, lawyers and politicians, but in any modern democratic states as well. The author in this article examines the development of the concept of Rule of Law in the modern democratic societies under the influence of the Magna Carta, and how it is perceived as a guarantee of fair trial and trial by jury of any persecuted persons whether the severity of their crimes. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Everyday Utopia: What 2,000 Years of Wild Experiments Can Teach Us About the Good Life by Kristen R. GhodseeMark A. AllisonKristen R. Ghodsee. Everyday Utopia: What 2,000 Years of Wild Experiments Can Teach Us About the Good Life. New York: Simon & Schuster, 2023. 352 pp., hardcover, $29.99. ISBN 9781982190217.Kristen R. Ghodsee has written a wide-ranging, highly readable, and commendably radical vindication of utopian thought and experimentation. Everyday (...) Utopia is aimed at the educated lay reader—itself, perhaps, a utopian projection—rather than specialists. Nevertheless, all but the most erudite and cosmopolitan of scholars will encounter unfamiliar and compelling utopiana within its pages. While her earlier book, Why Women Have Better Sex Under Socialism: And Other Arguments for Economic Independence (2018), concentrated on "state-sponsored solutions" to the deprivations of capitalism and patriarchy, the present volume sets its sights squarely on the private sphere, and utopian visions "for rearranging our domestic lives" (17).Ghodsee situates this turn to the domestic in two contexts. The first is the COVID-19 pandemic, which revealed the frangibility of the international commitment to gender equality. "Women around the globe woke up and realized that decades of feminism had done little to reverse the social expectation that mothers, sisters, wives, and daughters should provide care for young children, elderly parents, and sick relatives, as well as perform the emotional labors that hold families together in times of crisis," she laments (xii). Everyday Utopia's second context is the spate of recent works of "popular neo-utopianism," including Rutger Bregman's Utopia for Realists (2017), Aaron Bastani's Fully Automated Luxury Communism (2019), and Peter Diamandis and Steven Kotler's Abundance: The Future is Better Than You Think (2012) (14). What Ghodsee finds wanting in this discourse is its myopic focus on the public sphere, and its unspoken presupposition that our private and domestic lives have no such need of utopian renovation. But it is just this presupposition [End Page 285] that the COVID-19 lockdown discredited, although many other indicators (runaway housing and childcare costs, the environmental crisis, the epidemic of loneliness) already suggested as much. Ghodsee rightly insists that "where we reside, how we raise and educate our children, our personal relationship to things, and the quality of our connections to friends, families, and partners impact us as much as tax policies, the price of energy, or the way we organize formal employment" (14). As utopian thinkers from Plato forward have understood, moreover, it is short-sighted to suppose that sweeping economic and political transformations are possible without a concomitant rethinking of the "intimate worlds" that subtend these public domains (15).Accordingly, Everyday Utopia devotes its succeeding chapters to examining alternatives to the dominant institutions of the contemporary private sphere, including the single-family household, the monogamous couple paradigm of childrearing and mating, and the institution of private property. In each case, Ghodsee plumbs the past and limns the present to highlight utopian alternatives to contemporary norms. Among this book's greatest strengths is its consistently international range of examples and admirably sustained commitment to feature "experiments that have received relatively less attention" in the extant literature (xv).Take, for example, the chapter on communal alternatives to single-family homes. Ghodsee includes many of the usual (and eminently worthy) suspects: Buddhist and Christian cenobite monasteries, Fourierist phalansteries, Israeli kibbutzim, and the Corbusier-inspired "microdistricts" of the former Eastern bloc (47). But we also learn of less canonical phenomena, such as the Neolithic proto-city of Çatalhöyük, "one of the first major settlements in the world," where as many as eight thousand people lived in an essentially contiguous structure, in highly egalitarian and likely non-consanguineous households (32). Or consider the Beguine nuns, a lay order founded in 1190 that survived, albeit in attenuated form, into the twentieth century. The Beguine lived communally in urban areas, enjoying liberties unthinkable not only to their cloistered counterparts, but to virtually all their female contemporaries: they brewed beer, made lace, taught school—and traversed the streets unchaperoned. The chapter concludes with a discussion of contemporary cohousing. In Denmark, roughly one percent of the population was living in co... (shrink)

Theories of economic justice are characteristically based on abstract ethical concerns often unrelated to practical distributive results. Two decades ago, Rawls's theory of justice began as a reaction against the alleged ‘sacrifices’ condoned by utilitarian theory. One variant of this objection is that utilitarianism permits gross inequalities, severe deprivations of individual liberty, or even the enslavement of society's least well-off individuals. There are, however, more subtle forms of the objection. In Rawls, it is often waged without any claim that (...) utilitarianismdoesin fact imply such gross deprivations in actual realworld circumstances. A second variant hinges, rather, on the milder claim that utilitarianismcouldcondone such deprivations or sacrifices in somepossibleworld—the objection being that utilitarianism improperly makes justice contingent, or uncertain, in this way. A third, still more abstract, variant would be that utilitarianism is flawed—not because of any practical distributive result, actual or hypothetical, but intheory—due to the way it treats individuals' interests, or the ‘concept of persons’ it presupposes. (shrink)

Minkoff et al. (2024) discuss the potential deprivation of medical liberties against pregnant persons following Dobbs v. Jackson Women’s Health. Another consideration is how Dobbs may impact physic...

How can we establish a political/legal order that in principle does not require the human flourishing of any person or group to be given structured preference over that of any other? Addressing this question as the central problem of political philosophy,_ Norms of Liberty_ offers a new conceptual foundation for political liberalism that takes protecting liberty, understood in terms of individual negative rights, as the primary aim of the political/legal order. Rasmussen and Den Uyl argue for construing individual rights (...) as metanormative principles, directly tied to politics, that are used to establish the political/ legal conditions under which full moral conduct can take place. These they distinguish from normative principles, used to provide guidance for moral conduct within the ambit of normative ethics. This crucial distinction allows them to develop liberalism as a metanormative theory, not a guide for moral conduct. The moral universe need not be minimized or morality grounded in sentiment or contracts to support liberalism, they show. Rather, liberalism can be supported, and many of its internal tensions avoided, with an ethical framework of Aristotelian inspiration—one that understands human flourishing to be an objective, inclusive, individualized, agent-relative, social, and self-directed activity. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Moral Philosophy on the Threshold of ModernityDouglas LangstonJill Kraye and Risto Saarinen, editors. Moral Philosophy on the Threshold of Modernity. New Synthese Historical Library, 57. Dordrecht: Springer, 2005. Pp. vi + 340. Cloth, €139.10.This is a collection of fifteen essays from a 2001 workshop, "Late Medieval and Early Modern Ethics and Politics," funded by the European Science Foundation as part of a network of meetings on Early Modern (...) Thought. The editors intend the volume to reflect current historical and philosophical scholarship about the moral thought of the fifteenth and sixteenth centuries. It is arranged into three sections, reflecting three different themes: 1. Scholastics and Neo-Scholasticism; 2. Theories of Human Rights and Dominion; 3. Reformers and Humanists. These themes demonstrate "the range and diversity of moral philosophy between 1400 and 1600" (5), and show "the continuity between late medieval and early modern thought" (2).The collection achieves these two aims. Essays treat such divergent schools of moral thought as Aristotelian scholasticism, casuistry, probabilism, post-Reformation Christian ethics, and neo-Stoicism. They discuss such figures as Suarez, Lessius, Gerson, Luther, Melanchthon, Daneau, Vives, and Muret. Each essay focuses on a figure or issue in the early modern period and connects the topic to relevant medieval material. So, for example, Risto Saarinen's "Ethics in Luther's Theology: The Three Orders" relates Luther's views of the three estates—church (ecclesia), household (œconomia), state (politia)—to the division medieval Aristotelian ethicists made between Aristotle's individual and social ethics.If one of the strengths of this collection is the range and diversity of material treated, it is also its principal weakness. It is difficult to imagine that most readers will be interested in the essays of all three sections. As the titles of the sections suggest, readers interested in the views of humanists or reformers will look to the essays of the third section primarily. Those who are interested in backgrounds to modern theories about human rights and property will look to the second section. And the first section will appeal to those interested in scholasticism, probabilism, and casuistry. This is not to suggest that the three sections [End Page 475] are unconnected. In fact, there are very strong connections between the first and second sections in showing how certain key notions of modern thought develop in the period from 1400 to 1600. And some of the essays of the third section present the views of certain reformers and humanists on related issues.In the second section, Roberto Lambertini's "Poverty and Power: Franciscans in Later Medieval Political Thought" and Virpi Mäkinen's "The Franciscan Background of Early Modern Rights Discussion: Rights of Property and Subsistence" argue that concepts of individual rights and property—hallmarks of modern thought—emerge in the controversies surrounding Franciscan poverty. Questions about whether property or only its use is natural are connected to issues about individual rights of subsistence, particularly whether Franciscan poverty is against the inalienable natural right of self-preservation everyone possesses. In "Conrad Summenhart on Natural Rights," Jussi Varkemaa shows how Summenhart used Jean Gerson's discussions of jus to argue that a person is dominus (lord) of his own person and can voluntarily enslave himself to another without violating his natural right of liberty. Issues about individual rights are also at play in several essays in the first section of the book. Sven K. Knebel's "Casuistry and the Early Modern Paradigm Shift in the Notion of Charity" discusses how an innocent person is to behave under torture. At issue is whether an innocent should suffer death by maintaining his innocence or preserve his life by sacrificing his reputation through lying. This conflict led to discussions about the status of one's reputation—is it the property of an individual?—as well as the nature of the right of self-preservation. Similarly, Rudolf Schüssler's "On the Anatomy of Probabilism" discusses how the "possidentis principle" became a cornerstone of probabilism at the end of the sixteenth century. According to this principle, "a bona fide possessor of a thing may not be deprived of it as long as the unlawfulness of his possession is not significantly established... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:594 Feminist Studies 41, no. 3. © 2015 by Feminist Studies, Inc. Liberty Walther Barnes and Christin L. Munsch The Paradoxical Privilege of Men and Masculinity in Institutional Review Boards In the 1939 Hollywood classic The Wizard of Oz, the great wizard admonishes Dorothy and her friends to “pay no attention to that man behind the curtain.” Dorothy and company turn to see a man standing before a (...) large control panel operating the smoke, holographic image, and voice of the great wizard. Realizing he has been discovered, the man gives up manipulating the switches and the nebulous wizard vanishes.1 Hegemonic masculinity is analogous to the “all-powerful” wizard.2 In order to maintain its grandeur, power, and mystique, the mechanics of masculine ideology—as well as the social actors who participate in its reproduction —must be kept hidden.3 A crucial aim of feminist research is to 1. The Wizard of Oz, directed by Victor Fleming (Culver City, CA: Metro-Goldwyn -Mayer, 1939). 2. See R. W. Connell, Masculinities: Knowledge, Power and Social Change (Berkeley : University of California Press, 1995); R. W. Connell and James W. Messerschmidt, “Hegemonic Masculinity: Rethinking the Concept,” Gender & Society 19 (2005): 829–61; Michael Kaufman, “Me, Feminism, and Men’s Contradictory Experiences of Power,” in Theorizing Masculinities, ed. Harry Brod and Michael Kaufman (Thousand Oaks, CA: Sage Publications, 1994), 142– 63; and Michael S. Kimmel, “Masculinity as Homophobia: Fear, Shame, and Silence in the Construction of Gender Identity” in Brod and Kaufman, Theorizing Masculinities, 119–42. 3. Michael Flood and Bob Pease, “Undoing Men’s Privilege and Advancing Gender Equality in Public Sector Institutions,” Policy and Society 24, no. 4 (2005): 119–38; Allan G. Johnson, The Gender Knot: Unraveling Liberty Walther Barnes and Christin L. Munsch 595 pull back the curtain on men’s lives and masculine institutions in order to demystify socially constructed masculinities, particularly in their most powerful forms. As early feminist scholars note, male privilege renders women’s lives invisible.4 But male privilege renders aspects of men’s lives invisible, too. In this article we highlight how institutional review boards (IRBs) in universities and hospitals erect barriers to research that render particular aspects of men’s lives invisible. We draw on our experiences of submitting ten applications for a series of methodologically diverse studies of masculinity to eight IRBs. First, we argue that, despite their original function of protecting subordinated groups, IRBs are gendered institutions in which members base their decisions on culturally dominant, normative images of women and men. We show how this results in the stringent protection of male research participants, the safeguarding of participants’ personal masculinity, and the shielding of men’s lives from social inquiry. Second, we argue that IRBs are gendering institutions. Our experiences reveal how the privileging and protection of masculinity results in mandatory protocol modifications that idealize hegemonic masculinity. These modifications require researcher-participant interactions that socialize men to engage in gender “appropriate” behavior and reify gendered expectations. Third, our experiences reveal the ways in which IRBs protect the institution itself and privilege the universities, hospitals, and (predominantly male) medical doctors they represent. Consequently, the ways they reproduce social inequality remain impervious to academic inquiry. IRBS AS GENDERED AND GENDERING INSTITUTIONS Every university and hospital in the United States where human research is conducted houses a human research protections program, or IRB, to oversee academic research. Universities with hospitals typically our Patriarchal Legacy (Philadelphia, PA: Temple University Press, 1997); Michael Kimmel, Guyland: The Perilous World Where Boys Become Men (New York: Harper Collins, 2008). 4. Simone de Beauvoir, The Second Sex, trans. Howard M. Parshley (New York: Knopf, 1951); Sandra Harding, The Science Question in Feminism (Ithaca, NY: Cornell University Press, 1986); Dorothy E. Smith, “Women’s Perspective as a Radical Critique of Sociology,” in Feminist Perspectives on Social Research, ed. Sharlene N. Hesse-Biber and Michelle L. Yaiser (New York: Oxford University Press, 2004), 84–96. 596 Liberty Walther Barnes and Christin L. Munsch maintain two types of IRB committees: a social-behavioral committee that oversees studies in the social sciences, and a biomedical committee to supervise clinical drug trials, experimental medical treatments, and tissue and blood research. The duty of the... (shrink)

What makes political freedom valuable to us? Two well-known arguments are that freedom contributes to our desire satisfaction and to our personal responsibility. Here, Boudewijn de Bruin argues that freedom is valuable when it is accompanied by knowledge. He offers an original and systematic account of the relationship between freedom and knowledge and defends two original normative ideals of known freedom and acknowledged freedom. -/- By combining psychological perspectives on choice and philosophical views on the value of knowledge, he shows (...) how known freedom is crucial to satisfy our desires and assume responsibility. Known freedom is compromised when salespeople deploy consumer-obfuscation, or when news outlets use contextual framing techniques to steer the way their audiences process information. Conversely, carefully developed consumer protection and information disclosure regulation can foster known freedom. Acknowledged freedom, from ethical and economic perspectives, offers protection and makes our freedoms more stable. It embodies an ideal of mutual recognition that underlies informed consent and the ethics of communication, and can also contribute to a flourishing corporate culture. -/- This book integrates and extends cutting-edge research from philosophy, economics, psychology, and law to reorient debates on privacy, neuromarketing, sustainable finance, corporate culture, consumer protection, media violence, and freedom of speech. -/- An original account of the relation between freedom and knowledge, integrating cutting-edge research from philosophy, economics, psychology, and law; defends the ideals of known and acknowledged freedom; offers new perspectives on debates surrounding privacy, corporate culture, consumer protection, freedom of speech, and more -/- Introduction: Why Freedom is Not Enough 1:From Choice Overload to Discrimination: Arguments for Freedom 2:From Brainwashing to Neuromarketing: Freedom of Belief 3:From the Value of Knowledge to Skills and Stereotypes: The Individual Ideal of Known Freedom 4:From Common Knowledge to the Ethics of Communication: The Social Ideal of Acknowledged Freedom 5:Sustainable Finance and Responsible Investors 6:Ethics Management and Informed Stakeholders 7:Freedom of Speech and Consumer Autonomy 8:Liberal Privacy and Legal Protection Conclusion: How Freedom Can Be Sufficient . (shrink)

For years now, unionization has been under vigorous attack. Membership has been steadily declining, and with it union bargaining power. As a result, unions may soon lose their ability to protect workers from economic and personal abuse, as well as their significance as a political force. In the Name of Liberty responds to this worrying state of affairs by presenting a new argument for unionization, one that derives an argument for universal unionization in both the private and public sector (...) from concepts of liberty that we already accept. In short, In the Name of Liberty reclaims the argument for liberty from the political right, and shows how liberty not only requires the unionization of every workplace as a matter of background justice, but also supports a wide variety of other progressive policies. (shrink)

One of the still unsolved problems in liberal anarchism is a definition of social constituency in positive terms. Partially, this had been solved by the advancements of liberal discourse ethics. These approaches, built on praxeology as a universal framework for social formation, are detached from the need of any previous or external authority or rule for the discursive partners. However, the relationship between action, personal identity, and liberty within the process of a community becoming solely generated from the praxeological (...) a priori remains largely disputed. In order to develop a testable constitutional model, this study revises how the “ontological turn” was introduced into liberal theories and redefines the concept of liberty. Liberty is usually understood as a moral goal or measurement for just actions, as the generative principle of all social existence - individual and interpersonal. For this purpose, the function of performative contradiction within the mechanism of interpersonal “encounter”, as part of the co-generative process of the individual becoming and social formation was explored through the production of a game-based narrative historiography grounded on 19th century life writings. This narrative historiography was developed in the context of Swiss history, with a “design-based” research approach, and resulted in a prototype for networked storytelling through which the transformative learning process could be visible and the negotiation of competing individual visions of the future could be re-enacted. (shrink)

It is claimed by the future like ours anti-abortion argument that since killing adult humans is wrong because it deprives them of a future of value and the fetus has a future of value, killing fetuses is wrong in the same way that killing adult human beings is wrong. In The morality of abortion and the deprivation of futures (this journal, April 2000) I argued that the persuasive power of this argument rests upon an equivocation on the term “future of (...) value”. If the expression means “a potential future of value” then the moral claim is implausible because people do not in general have rights to what they need to fulfill their potential; if the expression means “self-represented future of value” then the argument fails because the fetus does not represent its future. Under no interpretation is the argument sound. In Deprivations, futures and the wrongness of killing (this journal, December 2001) Donald Marquis, author of the future like ours argument, responds at length to this objection. In the present essay the focus of the debate shifts to the proper interpretation of the right not to be killed. Donald Marquis argues that this liberty right entails the welfare right to the means necessary to sustain life; I argue that the right not to be killed does not entail unlimited welfare rights. On Marquis's view, the right not to be killed confers upon the fetus the right to whatever it takes to sustain life; on the view I defend, the right not to be killed does not confer upon the fetus or anyone else the right to another person's body. On Marquis's view, abortion is almost never permissible; on my view abortion is almost always permissible. (shrink)

INTRODUCTION We look to rights for protection. The hope of advocates of “human rights” has been that certain protections might be accorded to allof humanity. Even in a world only a minority of whose inhabitants live under liberal democratic regimes, the hope is, certain standards accepted in the liberal democracies will gain universal recognition and respect. These include liberty of persons as opposed to enslavement, freedom from cruelty, freedom from arbitrary execution, from arbitrary imprisonment, and from arbitrary deprivation (...) of property or livelihood, freedom of religion, and freedom of inquiry and expression. Philosophers, of course, concern themselves with the theory of rights, and that is partly because of the ways questions of rights bear on fundamental normative theory. By far the most highly developed general normative theory has been utilitarianism. Now many opponents of utilitarianism argue that considerations of rights discredit utilitarianism, that utilitarianism yields conclusions about rights that we would normally regard as faulty, and that moreover, the reasons for regarding those conclusions as faulty turn out, upon examination, to be stronger than the reasons forregarding utilitarianism as valid. A valid theory cannot have faulty conclusions, and so thinkingabout rights shows utilitarianism not to be a valid normative theory. Jeremy Bentham, the founder of the utilitarian movement in nineteenth century England, accepted the incompatibility of utilitarianism and “the rights of man, ” and rejected talkof the latter as “anarchical fallacies”. His great successor John Stuart Mill, however, argued that a perceptive and far–sighted utilitarianism supports strong rights both of democratic participation and of individual freedom of action. (shrink)

Photo by Tingey Injury Law Firm on Unsplash ABSTRACT The coverage of healthcare costs allegedly brought about by people’s own earlier health-adverse behaviors is certainly a matter of justice. However, this raises the following questions: justice for whom? Is it right to take people’s past behaviors into account in determining their access to healthcare? If so, how do we go about taking those behaviors into account? These bioethical questions become even more complex when we consider them in the context of (...) a commitment to publicly funded, universal healthcare coverage. INTRODUCTION Healthcare coverage of lifestyle-related conditions is certainly a matter of justice. However, this raises the following justice-related question: Is it right to consider people’s past behaviors in determining their access to healthcare? If so, the methods of taking those behaviors into account must be fair and justifiable. This bioethical question becomes even more complex when we consider it in the context of a commitment to publicly funded, universal healthcare coverage. This paper takes an old, classic debate, evaluates newer approaches, and offers an argument favoring a combined approach which alters the liberal-egalitarian solution to account for social justice. ANALYSIS I. Causes of Disease If healthcare coverage were universal, irrespective of socioeconomic status and lifestyle, people would contribute to the cost of remedying the lifestyle-induced health problems of others. In the West, lifestyle-related diseases are burdensome.[i] This paper approaches this concern from a western lens that incorporates both a European tradition of “social safety nets” and an American tradition of personal freedoms. By taking such an approach, solutions to the consequences of one’s past behavior burdening others must consider an individual’s personal freedom to choose to act as he or she wishes, with the distributive social and economic equality of the many. The concept of disease caused by lifestyle and diet is proven. Many health conditions include behavioral risk factors. Multi-pack smoking increases the risk of chronic lung disease, while obesity increases the risk of type 2 diabetes. Inattention to high blood pressure, high cholesterol, and a lack of exercise leads to increased risks of coronary artery disease.[ii] While poor lifestyle choices certainly influence these conditions, their causes are multifactorial, and it is difficult to say that any single string of poor choices led to their development. In a scenario where two men excessively eat fast food for 20 years, several discrete factors impact whether any of them might suffer an ischemic-embolic stroke or not. Genetics, circumstances, and activity will also contribute to outcomes. II. Alcohol-Related End-Stage Liver Disease One paper suggests that alcohol-related end-stage liver disease (ARESLD) differs from other multifactorial disorders as alcohol alone causes the disease.[iii] It justifies attributing personal responsibility to patients with ARESLD because the condition develops only after the cumulative effects of large quantities of alcohol consumed from years to decades.[iv] However, the paper undermines its position by admitting that even the susceptibility to becoming an alcoholic has some degree of genetic predisposition.[v] Given the extreme scarcity of donor livers, some patients may be prioritized over others on the transplant waiting list. Since donor livers cannot be given to everyone, transplanting a liver into an alcoholic may result in death for competing candidates whose liver disease was not their fault. All else being equal, if bioethicists avoid claiming moral deficiency or judgment, those with apparently self-inflicted ARESLD will not be deprived of treatment but will have a lower priority for transplant.[vi] In contrast, another position suggests that it is often difficult to define what behaviors are punishable as these are largely personal and value-laden.[vii] Still, people do not support using their own resources to support the consequences of others’ poor choices, no matter how objective.[viii] In democratic societies, one must take into consideration community morals and values.[ix] Even if we were to punish people for their health-adverse behaviors, we could not logistically employ the vigorous and sustained efforts necessary to determine whose actions are morally weak.[x] III. The Liberal-Egalitarian Proposal One past argument proposes a liberal-egalitarian solution to manage personal responsibility for so-called “lifestyle diseases.”[xi] This Rawlsian system combines the European-style “social safety net” commitment to social and economic equality with the American liberal notion of pluralist toleration and personal freedoms. This idealized system aims to hold people responsible for their choices rather than the consequences to mitigate the downside of blaming those who might not be blameworthy. The approach avoids determining the questionable nature of luck and personal responsibility for health outcomes, fairness in the distribution of economic burden, and the intrusiveness required to practically determine who acts in a morally wrong and health-adverse way. The liberal-egalitarian model, a theory of distributive justice, has two facets: the liberal principle that people should be held accountable for their choices and the egalitarian principle that people who make the same choices should have the same outcomes.[xii] This model attempts to fuse responsibility with equity by seeking to reward good behavior and tax bad behavior rather than punish the consequences of the action and navigate who deserves treatment. For instance, the hospital bedside is not the appropriate place to introduce responsibility for one’s health outcomes.[xiii] This appeals to the reality that, at that time, discerning the true causes of disease was not plausible and to humanity in avoiding a heartless and cruel approach. An argument in favor of the liberal-egalitarian model considers its method of implementation. This approach assumes that the healthcare system treats all individuals regardless of their choices or ability to cover costs. The liberal-egalitarian model also assumes that a certain adverse health condition is related, statistically speaking, to the consumption of a certain good and that good can be taxed. As such, it proposes to tax the consumption of that good to finance the collective burden which arises from that good’s consumption rather than require individuals to pay for their own treatment. In the example of ARESLD, the recommended solution would be taxing all alcohol. While a systematic infrastructure is not explicit, there is the implication that a per-unit tax can be imposed on alcohol so the total tax revenue would make up for the additional healthcare costs due to consumption.[xiv] Upholding the principle that all people who make the same choices should face the same costs, all consumers of alcohol would pay the same tax, regardless of factors such as genetic predisposition to alcoholism, lifestyle, or expected cost of treatment. Upholding the principle of individual responsibility, this model does not deny treatment to anyone, neutralizing factors outside that individual’s control by imposing the tax ex-ante. Other people are not burdened by those who consume the good. People who consume alcohol face a burden proportional to the amount consumed. This tax-based implementation is justified so long as the tax is not prohibitively high for the average consumer. Further, the model mitigates concerns over the intrusiveness of ascribing morality to health-adverse behaviors. IV. Moral and Social Arguments Against the Liberal-Egalitarian Position Arguments against the liberal-egalitarian model concerns its many assumptions. First, this model assumes that consumption of such goods is directly related to the health outcome and that these goods can be taxed.[xv] Certain people genetically predisposed to alcoholism would be predisposed to consume more alcohol. The model falls short when applied to scenarios where health outcomes are not consumption-based, such as engaging in unsafe sex or abstaining from healthy lifestyle choices like exercise. Second, some might argue that the liberal-egalitarian model fails to remain neutral. Residual moral judgments tied to consumption choices introduce non-neutrality. Although taxation in free societies is determined by democratic procedures rather than by individuals in the healthcare system, moral and value-based judgments will be implicit in deciding what behaviors are taxable, such as the purchase of cigarettes. Third, the liberal-egalitarian model fails to determine whether one’s behavior is autonomous, as socio-cultural-economic factors may influence it and behavior is more a product of society, peer pressure, or income. Those also may reflect systemic inequalities. Therefore, this model, which rewards, or taxes based solely on decisions, regardless of their consequences and motivations, fails to consider that a person’s decisions may not be completely autonomous. V. Libertarian Arguments Against the Liberal-Egalitarian Model a. State Intrusiveness as Counter to the Liberal-Egalitarian Model Last, there is a libertarian worry that if the state guarantees universal healthcare coverage to all people, the state will have to become highly intrusive and investigate people’s morals.[xvi] At least one-third of all disease burden in North America, Europe, and the Asia-Pacific is attributable to lifestyle measures such as tobacco smoking, alcohol consumption, high cholesterol, and obesity.[xvii] With these various lifestyles, it is not likely to agree on what conduct to tax or condemn.[xviii] The fine-toothed comb required to determine whether each citizen has been engaging in these behaviors would intrude on daily life and personal freedom. Libertarians champion the argument that impractical intrusiveness would result from universal healthcare, and such a degree of intrusiveness would likely be universally unacceptable.[xix] The liberal-egalitarian model mitigates the libertarian worry about state intrusiveness as it does not involve prying into one’s life and choices other than taxing goods. A liberal state should ideally be neutral to how people decide to live their lives. In all, libertarians can rest assured that the liberal-egalitarian tax-based model, through its ex-ante implementation, will require no prying state eyes. States that provide universal healthcare coverage and wish to condemn certain misconduct do not need to become overly intrusive to carry out measures to hold individuals accountable. b. Fairness Another libertarian worry regarding the guarantee of universal healthcare coverage in the context of lifestyle-driven diseases is that the public will be burdened unfairly with covering others’ ill-advised mistakes or bad luck. An ideal system to address this worry would link treatment or payment for treatment with whatever behavior caused that need.[xx] The distribution of burdens should be linked to how different individuals contributed to the creation of those burdens. Applied to health policy, we should ask how the need for a certain treatment arose when determining how to distribute its cost.[xxi] The liberal-egalitarian model aspires to hold individuals responsible for their choices, not for the consequences of such choices. This model significantly mitigates the libertarian worry over unfair burdens for covering other people’s mistakes or social conditions, which lead to those bad outcomes, by ensuring to not burden others with any of the costs for the treatment of people who decide to engage in certain health-adverse behaviors. The aforementioned taxation-based system would only tax those who also engage in the health-adverse behavior through consumption, and that tax directly pays for the necessary collective treatment. As such, those who do not consume the good are not involved with the payment scheme, while those who do consume the good are responsible for payment in a matter proportional to the amount of the good they have consumed. VI. Universal Coverage Taking a step back, one should consider whether these worries regarding the coverage of apparently self-inflicted health conditions in the context of universal healthcare are worthwhile issues. One perspective raises what is called the culturally imagined objection — an idea erroneously held by many that sick people, especially those who are poor and uneducated, bring these illnesses upon themselves due to poor decision-making and irresponsible risk-taking.[xxii] This perspective critiques the uniquely American view that, since individuals are free to choose their lifestyles, they should bear the costs of their lifestyle.[xxiii] Taking this argument further, some (perhaps the strongly libertarian) would say that the poor health status among many individuals is the price individuals must pay for their American way of life and the liberty and freedom to live as they wish. However, people should not completely punish individuals for their health-adverse behaviors because these choices are largely pre-determined by a person’s socioeconomic influences.[xxiv] The outcomes from these allegedly ill-advised behaviors, which largely affect poorer people, are not just poor behavior but rather a public health crisis. Perhaps the state and its people should take collective responsibility and cover the costs of treatment for those health outcomes without question, as a form of public service. Rather than worrying about accountability and taxing bad behavior or intrusiveness into personal decisions, some might argue that people need to collectively take responsibility for reducing the overarching systemic inequalities and covering the associated treatment costs as a measure of public health. VII. Proposed Solution Given the strengths of the liberal-egalitarian model and taking into account libertarian and social justice-oriented objections, an ideal solution for the coverage of lifestyle-related health problems needs to consider the complex relationship between a person’s behaviors and their apparent health outcomes. It must consider how society as a whole passes judgment on behaviors and how to take into account that many health-adverse decisions are not truly autonomous decisions, as various genetic and socioeconomic factors influence them. An ideal solution combines the liberal-egalitarian tax-based model with the social justice concerns of universal coverage. Whatever the cost for the treatment of medical issues resulting in part or entirely from lifestyle and diet, taxes collected from spending associated with the behavior (like the purchase of alcohol, junk food, and cigarettes) ex-ante should fund 50 percent of the cost of treatment, while the universal healthcare taxation scheme should include the other 50 percent. Such a system would provide an incentive to avoid the purchases that can lead to unhealthy consumption and make healthier choices, slightly punish and discourage such purchases through taxation, yet not overly punish people whose outcomes may have more to do with socioeconomic factors and genetics. Adding public responsibility demonstrates acknowledgement that health care is in the public interest and can mitigate public health inequalities. This solution would fuse personal responsibility with the public responsibility of state-sponsored social improvement while ensuring that all people have fair access to necessary treatment, no matter their ability to pay. CONCLUSION The 50-50 system this paper proposes reflects both justice and personal responsibility in covering healthcare costs allegedly brought about by people’s own health-adverse behaviors. By allocating tax revenue from consumption that contributes or even alone causes poor health outcomes, such a system incorporates personal responsibility. By using general tax revenue for health care, such a system would meet the libertarian requirement of providing care without any moral investigation of past behaviors and the social justice consideration of providing health care to those who may have unwittingly ventured into ill-health due to systemic injustice, socioeconomics, or genetics. - [i] Cappelen, A. W. (2005). Responsibility in health care: A liberal egalitarian approach. Journal of Medical Ethics, 31(8), 476–480. https://doi.org/10.1136/jme.2004.010421 [ii] Moss, A. H. (1991). Should alcoholics compete equally for liver transplantation? JAMA: The Journal of the American Medical Association, 265(10), 1295–1298. https://doi.org/10.1001/jama.1991.03460100097032 [iii] Moss, p. 1295-1298. [iv] Moss, p. 1296. [v] Moss, p. 1295-1298. [vi] Moss, p. 1295-1298. [vii] Cohen, C. IS THIS SUPPOSED TO BE COHEN AND BENJAMIN (1991). Alcoholics and liver transplantation. JAMA: The Journal of the American Medical Association, 265(10), 1299–1301. https://doi.org/10.1001/jama.1991.03460100101033 [viii] Cohen, p. 1299-1301. [ix] Moss, p. 1297. [x] Cohen, p. 1300. [xi] Cappelen, p. 478-480. [xii] Cappalen, p. 478-480. [xiii] Cappelen, p.479. [xiv] Cappelen, p. 479. [xv] Cappelen, p. 479 [xvi] Cohen, p. 1301. [xvii] Cappelen, p. 478. [xviii] Cohen, p. 1299-1301. [xix] Cohen, p. 1301. [xx] Cappelen, p. 476-480. [xxi] Cappelen, p. 476-480. [xxii] Kawachi, I. (2005). Why the United States is not number one in Health. Healthy, Wealthy, and Fair, 18–33. https://doi.org/10.1093/acprof:oso/9780195170665.003.0013 [xxiii] Kawachi, p. 18-33. [xxiv] Kawachi, p. 18-33. (shrink)

Theorists treat liberty as a great equalizer. We can’t easily distribute equal welfare, but we can purport to distribute equal liberty. In fact, however, nothing about “equal liberty” is meaningfully equal. To demonstrate, I turn not to familiar cases of distributing positive goods but to the distribution of a negative good, namely carceral punishment. Many theorists believe we should impose proportional punishment by depriving offenders of liberty in proportion to their blameworthiness. In this manner, equally blameworthy (...) offenders are said to receive equal punishment when incarcerated for the same period of time. Equal periods of incarceration do not yield equal punishments, however, because liberty cannot serve as the great equalizer theorists hope for. Pretending it can prevents us from justifying the full harms of punishment or leads to such counterintuitive results that it makes proportional punishment an unattractive goal. (shrink)

Photo by Tingey Injury Law Firm on Unsplash ABSTRACT The coverage of healthcare costs allegedly brought about by people’s own earlier health-adverse behaviors is certainly a matter of justice. However, this raises the following questions: justice for whom? Is it right to take people’s past behaviors into account in determining their access to healthcare? If so, how do we go about taking those behaviors into account? These bioethical questions become even more complex when we consider them in the context of (...) a commitment to publicly funded, universal healthcare coverage. INTRODUCTION Healthcare coverage of lifestyle-related conditions is certainly a matter of justice. However, this raises the following justice-related question: Is it right to consider people’s past behaviors in determining their access to healthcare? If so, the methods of taking those behaviors into account must be fair and justifiable. This bioethical question becomes even more complex when we consider it in the context of a commitment to publicly funded, universal healthcare coverage. This paper takes an old, classic debate, evaluates newer approaches, and offers an argument favoring a combined approach which alters the liberal-egalitarian solution to account for social justice. ANALYSIS l. Causes of Disease If healthcare coverage were universal, irrespective of socioeconomic status and lifestyle, people would contribute to the cost of remedying the lifestyle-induced health problems of others. In the West, lifestyle-related diseases are burdensome.[1] This paper approaches this concern from a western lens that incorporates both a European tradition of “social safety nets” and an American tradition of personal freedoms. By taking such an approach, solutions to the consequences of one’s past behavior burdening others must consider an individual’s personal freedom to choose to act as he or she wishes, with the distributive social and economic equality of the many. The concept of disease caused by lifestyle and diet is proven. Many health conditions include behavioral risk factors. Multi-pack smoking increases the risk of chronic lung disease, while obesity increases the risk of type 2 diabetes. Inattention to high blood pressure, high cholesterol, and a lack of exercise leads to increased risks of coronary artery disease.[2] While poor lifestyle choices certainly influence these conditions, their causes are multifactorial, and it is difficult to say that any single string of poor choices led to their development. In a scenario where two men excessively eat fast food for 20 years, several discrete factors impact whether any of them might suffer an ischemic-embolic stroke or not. Genetics, circumstances, and activity will also contribute to outcomes. ll. Alcohol-Related End-Stage Liver Disease One paper suggests that alcohol-related end-stage liver disease (ARESLD) differs from other multifactorial disorders as alcohol alone causes the disease.[3] It justifies attributing personal responsibility to patients with ARESLD because the condition develops only after the cumulative effects of large quantities of alcohol consumed from years to decades.[4] However, the paper undermines its position by admitting that even the susceptibility to becoming an alcoholic has some degree of genetic predisposition.[5] Given the extreme scarcity of donor livers, some patients may be prioritized over others on the transplant waiting list. Since donor livers cannot be given to everyone, transplanting a liver into an alcoholic may result in death for competing candidates whose liver disease was not their fault. All else being equal, if bioethicists avoid claiming moral deficiency or judgment, those with apparently self-inflicted ARESLD will not be deprived of treatment but will have a lower priority for transplant.[6] In contrast, another position suggests that it is often difficult to define what behaviors are punishable as these are largely personal and value-laden.[7] Still, people do not support using their own resources to support the consequences of others’ poor choices, no matter how objective.[8] In democratic societies, one must take into consideration community morals and values.[9] Even if we were to punish people for their health-adverse behaviors, we could not logistically employ the vigorous and sustained efforts necessary to determine whose actions are morally weak.[10] lll. The Liberal-Egalitarian Proposal One past argument proposes a liberal-egalitarian solution to manage personal responsibility for so-called “lifestyle diseases.”[11] This Rawlsian system combines the European-style “social safety net” commitment to social and economic equality with the American liberal notion of pluralist toleration and personal freedoms. This idealized system aims to hold people responsible for their choices rather than the consequences to mitigate the downside of blaming those who might not be blameworthy. The approach avoids determining the questionable nature of luck and personal responsibility for health outcomes, fairness in the distribution of economic burden, and the intrusiveness required to practically determine who acts in a morally wrong and health-adverse way. The liberal-egalitarian model, a theory of distributive justice, has two facets: the liberal principle that people should be held accountable for their choices and the egalitarian principle that people who make the same choices should have the same outcomes.[12] This model attempts to fuse responsibility with equity by seeking to reward good behavior and tax bad behavior rather than punish the consequences of the action and navigate who deserves treatment. For instance, the hospital bedside is not the appropriate place to introduce responsibility for one’s health outcomes.[13] This appeals to the reality that, at that time, discerning the true causes of disease was not plausible and to humanity in avoiding a heartless and cruel approach. An argument in favor of the liberal-egalitarian model considers its method of implementation. This approach assumes that the healthcare system treats all individuals regardless of their choices or ability to cover costs. The liberal-egalitarian model also assumes that a certain adverse health condition is related, statistically speaking, to the consumption of a certain good and that good can be taxed. As such, it proposes to tax the consumption of that good to finance the collective burden which arises from that good’s consumption rather than require individuals to pay for their own treatment. In the example of ARESLD, the recommended solution would be taxing all alcohol. While a systematic infrastructure is not explicit, there is the implication that a per-unit tax can be imposed on alcohol so the total tax revenue would make up for the additional healthcare costs due to consumption.[14] Upholding the principle that all people who make the same choices should face the same costs, all consumers of alcohol would pay the same tax, regardless of factors such as genetic predisposition to alcoholism, lifestyle, or expected cost of treatment. Upholding the principle of individual responsibility, this model does not deny treatment to anyone, neutralizing factors outside that individual’s control by imposing the tax ex-ante. Other people are not burdened by those who consume the good. People who consume alcohol face a burden proportional to the amount consumed. This tax-based implementation is justified so long as the tax is not prohibitively high for the average consumer. Further, the model mitigates concerns over the intrusiveness of ascribing morality to health-adverse behaviors. lV. Moral and Social Arguments Against the Liberal-Egalitarian Position Arguments against the liberal-egalitarian model concerns its many assumptions. First, this model assumes that consumption of such goods is directly related to the health outcome and that these goods can be taxed.[15] Certain people genetically predisposed to alcoholism would be predisposed to consume more alcohol. The model falls short when applied to scenarios where health outcomes are not consumption-based, such as engaging in unsafe sex or abstaining from healthy lifestyle choices like exercise. Second, some might argue that the liberal-egalitarian model fails to remain neutral. Residual moral judgments tied to consumption choices introduce non-neutrality. Although taxation in free societies is determined by democratic procedures rather than by individuals in the healthcare system, moral and value-based judgments will be implicit in deciding what behaviors are taxable, such as the purchase of cigarettes. Third, the liberal-egalitarian model fails to determine whether one’s behavior is autonomous, as socio-cultural-economic factors may influence it and behavior is more a product of society, peer pressure, or income. Those also may reflect systemic inequalities. Therefore, this model, which rewards, or taxes based solely on decisions, regardless of their consequences and motivations, fails to consider that a person’s decisions may not be completely autonomous. V. Libertarian Arguments Against the Liberal-Egalitarian Model a. State Intrusiveness as Counter to the Liberal-Egalitarian Model Last, there is a libertarian worry that if the state guarantees universal healthcare coverage to all people, the state will have to become highly intrusive and investigate people’s morals.[16] At least one-third of all disease burden in North America, Europe, and the Asia-Pacific is attributable to lifestyle measures such as tobacco smoking, alcohol consumption, high cholesterol, and obesity.[17] With these various lifestyles, it is not likely to agree on what conduct to tax or condemn.[18] The fine-toothed comb required to determine whether each citizen has been engaging in these behaviors would intrude on daily life and personal freedom. Libertarians champion the argument that impractical intrusiveness would result from universal healthcare, and such a degree of intrusiveness would likely be universally unacceptable.[19] The liberal-egalitarian model mitigates the libertarian worry about state intrusiveness as it does not involve prying into one’s life and choices other than taxing goods. A liberal state should ideally be neutral to how people decide to live their lives. In all, libertarians can rest assured that the liberal-egalitarian tax-based model, through its ex-ante implementation, will require no prying state eyes. States that provide universal healthcare coverage and wish to condemn certain misconduct do not need to become overly intrusive to carry out measures to hold individuals accountable. b. Fairness Another libertarian worry regarding the guarantee of universal healthcare coverage in the context of lifestyle-driven diseases is that the public will be burdened unfairly with covering others’ ill-advised mistakes or bad luck. An ideal system to address this worry would link treatment or payment for treatment with whatever behavior caused that need.[20] The distribution of burdens should be linked to how different individuals contributed to the creation of those burdens. Applied to health policy, we should ask how the need for a certain treatment arose when determining how to distribute its cost.[21] The liberal-egalitarian model aspires to hold individuals responsible for their choices, not for the consequences of such choices. This model significantly mitigates the libertarian worry over unfair burdens for covering other people’s mistakes or social conditions, which lead to those bad outcomes, by ensuring to not burden others with any of the costs for the treatment of people who decide to engage in certain health-adverse behaviors. The aforementioned taxation-based system would only tax those who also engage in the health-adverse behavior through consumption, and that tax directly pays for the necessary collective treatment. As such, those who do not consume the good are not involved with the payment scheme, while those who do consume the good are responsible for payment in a matter proportional to the amount of the good they have consumed. Vl. Universal Coverage Taking a step back, one should consider whether these worries regarding the coverage of apparently self-inflicted health conditions in the context of universal healthcare are worthwhile issues. One perspective raises what is called the culturally imagined objection — an idea erroneously held by many that sick people, especially those who are poor and uneducated, bring these illnesses upon themselves due to poor decision-making and irresponsible risk-taking.[22] This perspective critiques the uniquely American view that, since individuals are free to choose their lifestyles, they should bear the costs of their lifestyle.[23] Taking this argument further, some (perhaps the strongly libertarian) would say that the poor health status among many individuals is the price individuals must pay for their American way of life and the liberty and freedom to live as they wish. However, people should not completely punish individuals for their health-adverse behaviors because these choices are largely pre-determined by a person’s socioeconomic influences.[24] The outcomes from these allegedly ill-advised behaviors, which largely affect poorer people, are not just poor behavior but rather a public health crisis. Perhaps the state and its people should take collective responsibility and cover the costs of treatment for those health outcomes without question, as a form of public service. Rather than worrying about accountability and taxing bad behavior or intrusiveness into personal decisions, some might argue that people need to collectively take responsibility for reducing the overarching systemic inequalities and covering the associated treatment costs as a measure of public health. Vll. Proposed Solution Given the strengths of the liberal-egalitarian model and taking into account libertarian and social justice-oriented objections, an ideal solution for the coverage of lifestyle-related health problems needs to consider the complex relationship between a person’s behaviors and their apparent health outcomes. It must consider how society as a whole passes judgment on behaviors and how to take into account that many health-adverse decisions are not truly autonomous decisions, as various genetic and socioeconomic factors influence them. An ideal solution combines the liberal-egalitarian tax-based model with the social justice concerns of universal coverage. Whatever the cost for the treatment of medical issues resulting in part or entirely from lifestyle and diet, taxes collected from spending associated with the behavior (like the purchase of alcohol, junk food, and cigarettes) ex-ante should fund 50 percent of the cost of treatment, while the universal healthcare taxation scheme should include the other 50 percent. Such a system would provide an incentive to avoid the purchases that can lead to unhealthy consumption and make healthier choices, slightly punish and discourage such purchases through taxation, yet not overly punish people whose outcomes may have more to do with socioeconomic factors and genetics. Adding public responsibility demonstrates acknowledgement that health care is in the public interest and can mitigate public health inequalities. This solution would fuse personal responsibility with the public responsibility of state-sponsored social improvement while ensuring that all people have fair access to necessary treatment, no matter their ability to pay. CONCLUSION The 50-50 system this paper proposes reflects both justice and personal responsibility in covering healthcare costs allegedly brought about by people’s own health-adverse behaviors. By allocating tax revenue from consumption that contributes or even alone causes poor health outcomes, such a system incorporates personal responsibility. By using general tax revenue for health care, such a system would meet the libertarian requirement of providing care without any moral investigation of past behaviors and the social justice consideration of providing health care to those who may have unwittingly ventured into ill-health due to systemic injustice, socioeconomics, or genetics. - [1] Cappelen, A. W. (2005). Responsibility in health care: A liberal egalitarian approach. Journal of Medical Ethics, 31(8), 476–480. https://doi.org/10.1136/jme.2004.010421 [2] Moss, A. H. (1991). Should alcoholics compete equally for liver transplantation? JAMA: The Journal of the American Medical Association, 265(10), 1295–1298. https://doi.org/10.1001/jama.1991.03460100097032 [3] Moss, p. 1295-1298. [4] Moss, p. 1296. [5] Moss, p. 1295-1298. [6] Moss, p. 1295-1298. [7] Cohen, C. IS THIS SUPPOSED TO BE COHEN AND BENJAMIN (1991). Alcoholics and liver transplantation. JAMA: The Journal of the American Medical Association, 265(10), 1299–1301. https://doi.org/10.1001/jama.1991.03460100101033 [8] Cohen, p. 1299-1301. [9] Moss, p. 1297. [10] Cohen, p. 1300. [11] Cappelen, p. 478-480. [12] Cappalen, p. 478-480. [13] Cappelen, p.479. [14] Cappelen, p. 479. [15] Cappelen, p. 479 [16] Cohen, p. 1301. [17] Cappelen, p. 478. [18] Cohen, p. 1299-1301. [19] Cohen, p. 1301. [20] Cappelen, p. 476-480. [21] Cappelen, p. 476-480. [22] Kawachi, I. (2005). Why the United States is not number one in Health. Healthy, Wealthy, and Fair, 18–33. https://doi.org/10.1093/acprof:oso/9780195170665.003.0013 [23] Kawachi, p. 18-33. [24] Kawachi, p. 18-33. (shrink)

The Council for Secular Humanism identifies Secular Humanism as a "way of thinking and living" committed to rejecting authoritarian beliefs and embracing "individual freedom and responsibility ... and cooperation." The paradigmatic practices of psychiatry are civil commitment and insanity defense, that is, depriving innocent persons of liberty and excusing guilty persons of their crimes: the consequences of both are confinement in institutions ostensibly devoted to the treatment of mental diseases. Black's Law Dictionary states: "Every confinement of the (...) person is an 'imprisonment,' whether it be in a common prison, or in private house, or in the stocks, or even by forcibly detaining one in the public streets." Accordingly, I maintain that Secular Humanism is incompatible with the principles and practices of psychiatry. (shrink)

The Council for Secular Humanism identifies Secular Humanism as a "way of thinking and living" committed to rejecting authoritarian beliefs and embracing "individual freedom and responsibility... and cooperation." The paradigmatic practices of psychiatry are civil commitment and insanity defense, that is, depriving innocent persons of liberty and excusing guilty persons of their crimes: the consequences of both are confinement in institutions ostensibly devoted to the treatment of mental diseases. Black's Law Dictionary states: "Every confinement of the person (...) is an 'imprisonment,' whether it be in a common prison, or in private house, or in the stocks, or even by forcibly detaining one in the public streets." Accordingly, I maintain that Secular Humanism is incompatible with the principles and practices of psychiatry. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Underplayed Ethics and the Dilemmas of Psychiatric CareChong Siow Ann and Tamra LysaghtThe practice of psychiatry is fraught with uncertainty. The exact causes and the biological substrates underlying mental disorders remain to be elucidated; even the diagnosis of these disorders is descriptive and not based on an etiological understanding and no biological diagnostic markers have been validated. The manifestation of almost all mental disorders results from a complex interaction (...) of biological and environmental factors which encompasses the patient’s unique life history, experiences and relationship with others and the community. In the face of such uncertainties — at times extending to the types of treatment (psychiatry is generally acknowledged not be an exact science) — it has been argued that adopting a pragmatic approach is necessary.1 Accordingly, this approach necessitates high ethical standards among mental health practitioners.Some mental illnesses are associated with varying degrees and types of cognitive impairments. Others have certain symptoms like auditory hallucinations and delusions that might severely compromise the patients’ autonomy, distort their sense of reality, increase the risk of harm to themselves or others and render them incapable of making informed decisions in their treatment and participation in research.Consequently, there are issues that are particular to the provision of mental healthcare. These include the need for enforced involuntary treatment with the corollary of depriving a patient of his personal liberty even [End Page 173] though it is often justified on the grounds that it is in the patient’s best interests. However, at times, it is the legal and societal obligation of mental health practitioners to protect those who might be harmed from the patient’s action that might seem to be more pressing. In this situation of double agency, lies the tension of providing confidential care for patients and acting as “an agent of the state” where that patient’s confidentiality might be breached and his liberty infringed upon. This situation is further aggravated by the stigma that clings ever so tenaciously to those who suffer from mental disorders and where it is the norm to stereotype them as dangerous and unpredictable.Consideration of a patient’s autonomy is also challenged by characteristics that are unique to the practice of psychiatry. The prescription of certain psychotropic medications can alter how people think and feel, while psychotherapy works towards changing the patient’s views and values. The philosopher, Jennifer Radden, describes this process as “re-forming the patient’s whole self or character … akin to the responsibilities of raising children”.2 The psychotherapeutic relationship is thus particularly personal and intimate because patients are asked to provide information that often reveals their innermost feelings, fears and fantasies. This information is provided on the basis of trust and assurance of confidentiality, and with expectation of being helped.Jeremy Holmes and Gwen Adshead have elaborated on the vulnerability of patients seeking psychotherapy: they might be particularly susceptible to exploitation because their past experiences of being exploited have led to their distress and help seeking — their dependency and the extreme privacy of the therapeutic relationship make any transgression difficult to be uncovered.3 There is a calamitous combination of the “unconscious wish in the patient to be used” with the complicity of an unethical therapist seeking to fulfil his own interests.4As in any other doctor-patient relationship, the relationship between the mental healthcare practitioner and the patient is one of unequal power where the former is ascendant. While that power should be exercised to heal and to relieve suffering, it also gives the practitioner tremendous power “to harm, reject, misunderstand, or exploit patients who struggle with the experience of mental illness, which itself may generate helplessness, despair, distress, and exceptional dependence on the clinician”.5 Given the potential of doing good and harm coupled with the likelihood of being so significant in the life of the patient,6 providing care for those with mental disorders and distress is necessarily ethically exacting — arguably more so than in other medical practice settings. [End Page 174]This precariousness has led to the suggestion that ethics in psychiatry should have a special status and that the more general principles of biomedical ethics are too limited in scope to... (shrink)

While many theories of well-being are able to capture some of our central intuitions about well-being, e.g. avoiding alienation worries, they typically do so at the cost of not being able to capture others, e.g. explaining deprivation. However, both of these intuitions are important and any comprehensive theory of well-being ought to attempt to strike the best balance in responding to both concerns. In light of this, I develop and defend a theory of well-being which holds that our well-being depends, (...) in part, on the nature of our well-being qua person, a class whose members are defined by their possessing certain cognitive and volitional capacities including those capacities constitutive of autonomy. I argue that this theory of well-being is able to address concerns about alienation and deprivation, along with capturing the importance of autonomy to well-being, better than many popular subjective and objective theories of well-being. (shrink)

The Author offers three interpretations of the Rawlsian conception of liberty. At the same time he compares this formal version of civil and political liberty with the substantive version produced by the republican theory of liberty. The first question is this: Can liberties be unequal? Here the liberal concept of liberty is discussed linking human will of liberty and equality. The second question is: Can liberties be equal when their respective values are not? The Author (...) stresses the Rawlsian distinction between liberty and the value of liberty showing the risk of reducing the less powerful to dependency. The third question is: Can political liberty be limited for the sake of personal liberties? From a republican perspective the answer to the Rawlsian instrumental conception of political liberty is that all personal liberties are necessarily founded on political liberty.*. (shrink)

The idea of antithetical human nature and the concept of man as a bivalent creature are heuristic to reveal the problem of human being.The traditional antinomic splitting of anthropological features into one’s own – another’s, immanent – transcendent, freedom – necessity, good – evil, happiness –misfortune, etc. acquires a specific coloring in the Ukrainian realities. Purpose is to reveal the ambivalence of the image of a person, which acquires special features in the Ukrainian realities. Methodological basis are the principles of (...) the phenomenological description of subjective experience, the means of historical and philosophical analysis, hermeneutical methods of understanding and interpretation.Discussion. These or those anthropological modes constitute the variability of the human (O.Bollnov, C.Jung, K.Jaspers, J.-P.Sartre, E.Fromm). The reasons for the mosaic nature of the human image are rooted in the existential inexhaustibility of the anthropological palette. The existence of man in the overtones of antinomies is evident in the studies of both domestic classics (V.Lypynsky, I.Franko) and modern Ukrainian philosophers (V.Malakhov, D.Sepety), and Western thinkers (V.Frankl, V.Tatarkevych, G.Hofstede). Conclusion. Controversial nature of the classical opposition of freedom – necessity turns in the Ukrainian realities into the opposition of “will” as an expressive meaningful constant and depressingly deathly “bondage”, and acquires tension of the binarism “freedom – death”. “Will” as the only state acceptable to a person, the authentically own, native way of being turns to a spectrum of modulations of the anthropological attribute of “oneself” as a native oecumene, a truly familiar and close space, opposed to the “alien” – land, people, language, custom, etc.The idea of parity of both – male and female – cores is quite adequate, since in Ukraine the Cossacks was an embodiment of perfect masculinity, “chivalrous nature”, similar to Western chivalry – with similar to chivalrous cult foundations (for example, the cult of the Mother of God and the cult of the Virgin Mary). After all, the ideology of the Cossacks demanded the convergence of the concepts of “nobleman” and “Cossack” as one who was “granted the liberties of a knightly people”.Controversial nature of the modes of life meaning, happiness disappears, losing expressive signs of confrontation and turning into a tense uniqueness of the constants of meaning of life, fate, finiteness of a person as a whole.The concept of happiness, extrapolating into the opposition of happiness /fate – disaster /sorrow (deprivation, misfortune), powerful for Ukrainian culture, is connotative with “will” (after all, “what kind of freedom is such a fate...”), on the one hand, and “underweight” – an evil fate, on the other hand. However, on the existential plane, the life-meaning ethical component of happiness loses its dramatic controversial vector: happiness with its internal semantic and moral modulations is a selfsufficient value. (shrink)

Beccaria’s penal philosophy hinges on the doctrinal paradigm of liberty through law. Inconceivable in the absence of laws and unattainable in the presence of arbitrary powers, liberty is profiled as the legal situation of the person who may act, within the sphere of what is not forbidden and not bound, without suffering illicit interference from private individuals or organs of the state. Thus, the form of law becomes an essential matter in the construction of the political space suitable (...) for free living. In the analysis proposed in this article, the notion of “political liberty”–which Beccaria takes from Montesquieu–is declined in relation to the legal order, criminal law and the social contract. (shrink)

The analysis of approaches to understanding of jural facts is accomplished in the article. The definition of right depriving jural facts in civil law is brought. It’s researched the classical for Roman-Germany legal system reasons for deprivation of right of property and the concrete actions or events that deprive such a right are analyzed. All examined facts of property rights deprivation could be classified and arranged into four basic groups: cessation of the property existance (destruction of property), cessation of the (...) owner existance (death of a natural person, liquidation of the legal entity), transaction on alienation (alienation of the property by the owner, requisition), administrative act (abandonement of the property by the owner, foreclosure on the property for the owner obligations, seizure). Such deprivation of property rights as termination of the right to property, which can not belong to the person, and the compulsory acquisition may occur through jural facts like seizure or administrative act. In the case of requisition termination of right takes place directly at the moment the relevant administrative act comes into force. In other words only destruction of property, death of a natural person or legal entity liquidation can be regarded totally as depriving jural facts. All jural facts of right of property deprivation can be grouped but can not be reduced to basic groups. The law model must determine the circumstances under which the model will lead to the desired legal result, otherwise the legal facts were too extensive and could take place even in undesirable cases. In this context these circumstances are conditions of jural fact o occurence. That is why, for example, "termination of the right to property, which can not belong to the person" is only a general name of right-depriving jural fact or even a specific mechanism of depriving the right itself, and therefore includes in its content as well as the actual jural fact and conditions of its occurence. In conclusion all the right-depriving jural facts are divided into unconditional, those which occurence is not associated with additional conditions established by rule of law (death of natural person, destruction of property) and conditional, the result of which is achieved only under certain circumstances (conditions). (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Air of Liberty:A Transatlantic PerspectiveKieran M. Murphy (bio)"En somme le rôle du critique serait sans cesse de faire de l'air dans le plein du monde mais non pas forcement de faire du vide."—Roland Barthes"Dèyè mòn, gen mòn" ["Behind mountains, there are mountains"]—Haitian proverbThe phrase "I can't breathe" has become a worldwide rallying cry against injustice. Ben Okri deems "I can't breathe" the "mantra of oppression" that should (...) "spark the real change our world so desperately needs." He attributes the phrase's remarkable impact to how it taps into our primal fear of suffocation, encouraging empathy for "seemingly insignificant people." He also brings attention to how, as a slogan, "I can't breathe" subverts institutional racism through poetic means: "Not even William Shakespeare, Walt Whitman, James Baldwin or Toni Morrison at their most eloquent came out with anything as simple in the genius of its truth as: 'I can't breathe.'" This truth is airborne: "'I can't breathe' suddenly equates racism with the deprivation of air, which is what it always was." The chokehold of racism emerged with the transatlantic slave trade and, Okri concludes, has been ever since the prohibition of breathing "freedom."The powerful convergence of poetics and politics in the slogan "I can't breathe" comes from its essential truth: the aerial nature of freedom. More than just a concept or metaphor, freedom is also something you breathe. Freedom is a kind of concept-image that depends on our intimate, life-sustaining relationship with the atmosphere. "I can't breathe" brings attention to this relationship to help redress the failure of our institutions to bestow freedom equally.The aerial nature of freedom is even more apparent in the related slogan "the air of liberty." References to "the air of liberty" occurred frequently during the French Revolution to convey the origin of the "human rights" that have become the bedrock of our democratic institutions. Today, these human rights continue to exert their legal weight for the defense of equality. Yet, when confronted with the evasive mechanism of institutional racism, they keep falling short. This predicament is partly due to [End Page 200] their supposed airtight foundation. "The air of liberty" offers a window to the turbulent time when human rights sprang conspicuously from the atmosphere, that we can reopen to shift the focus from the legal to the aerial origin of freedom. This strategy unleashes historical winds that swept across the Atlantic world, including a critical undercurrent from the Haitian Revolution that prefigured the "I can't breathe" movement and its critique of the white chokehold on freedom. Click for larger view View full resolutionFigure 1.Detail of Jean-Jacques-François Le Barbier, Déclaration des droits de l'homme et du citoyen, circa 1789 (Source: Wikimedia Commons)The best-known depiction of the 1789 Declaration of the Rights of Man and of the Citizen (Fig. 1) portrays the origin of liberty in a scene unfolding in the sky. Spreading its light and dissipating the clouds of error, the Enlightenment's eye of reason levitates like an aerostat. Its liberating power illuminates the law symbolized by a winged figure pointing to the tablets below containing the articles proclaiming that "men" are born free and equal. Despite the prominence given to the eye of reason, it is in the atmosphere in which it elevates that we must look for the elemental spring of liberty.References to the aerial nature of liberty most intriguingly surfaced in contemporary debates concerning the universality of the Declaration of the Rights of Man. The revolutionary and abolitionist Jacques Pierre [End Page 201] Brissot characterized the 1791 slave rebellion that ravaged the colony of Saint-Domingue (now Haiti) as a fight for a purer, healthier air. In a speech delivered the same year at the National Assembly, he argued that, following the storming of the Bastille and the Declaration of the Rights of Man, the "atmosphere" of inequality hovering over the plantations of Saint-Domingue had become noxious not only for the enslaved but also for the troops that France might dispatch to restore order in the colony... (shrink)

The concept of personal autonomy is central to discussions about democratic rights, personal freedom and individualism in the marketplace. This book, first published in 1986, discusses the concept of personal autonomy in all its facets. It charts historically the discussion of the concept by political thinkers and relates the concept of the autonomy of the individual to the related discussion in political thought about the autonomy of states. It argues that defining personal autonomy as freedom to act without external constraints (...) is too narrow and emphasises instead that personal autonomy implies individual self-determination in accordance with a chosen plan of life. It discusses the nature of personal autonomy and explores the circumstances in which it ought to be restricted. In particular, it argues the need to restrict the economic autonomy of the individual in order to promote the value of community. (shrink)

Charles de Gaulle once famously complained about the difficulty of governing a nation with 250 different kinds of cheese. His comment is a true description of France’s diversity and its population. We are like a loud, unruly family always arguing among ourselves. However, as much as we disagree, there is one thing on which we French stand united—we love our healthcare system and do not want it changed, even as economic realities make it increasingly difficult to maintain.

Innovatively combining existentialist philosophy with cutting edge post-structuralist and psychoanalytic perspectives, this book boldly reconsiders market freedom. Bloom argues that present day capitalism has robbed us of our individual and collective ability to imagine and implement alternative and more progressive economic and social systems; it has deprived us of our radical freedom to choose how we live and what we can become. Since the Great Recession, capitalism has been increasingly blamed for rising inequality and feelings of mass social and (...) political alienation. In place of a deeper liberty, the free market offers subjects the opportunity to continually reinvest their personal and shared hopes within its dogmatic ideology and policies. This embrace helps to temporarily alleviate growing feelings of anxiety and insecurity at the expense of our fundamental human agency. What has become abundantly clear is that the free market is anything but free. Here, Bloom exposes our present day bad faith in the free market and how we can break free from it. (shrink)

로크 철학의 주된 내용인 인간 본성 백지설, 원자적 개인관, 반원죄설, 관용론, 교육론은 서로 긴밀하게 연결되어 있다. 순응성 테제(malleability thesis)로 요약할 수 있는 로크의 교육론은 인간 본성 백지설과 인격 동일성 이론에 의해 뒷받침된다. 그 중에서 특히 로크 철학의 상징처럼 되어 버린 인간 본성 백지설은 상당히 왜곡되고 과장되었다는 비판을 받아 왔다. 로크가 조기 교육에서 강조하는 습관은 너무나 강력해서 아이를 습관의 제국(the empire of habit)의 신하가 되게 한다. 아이의 이성 자체가 보호자와 공동체가 요구하는 습관적 사고와 행동의 토대 위에 형성된다. 여기서 다른 사람들의 의견에 (...) 철저하게 의존하는 것이 아이를 자유롭게 한다는 ‘자유의 역설’(Paradox of Liberty)이 성립된다. 자유는 훈련의 산물이고 아이는 보호자에 의해 제시된 공동체의 덕의 모델에 따르기를 선택하는 행위자라는 의미에서만 자유롭다. 로크 교육론의 구축된 자유에 비추어 볼 때 자연적 자유는 어떤 의미를 갖는지 결코 분명하지 않다. (shrink)

It is commonly held that respect for autonomy is one of the most important principles in medical ethics. However, there are a number of interpretations as to what that respect actually entails in practice and a number of constraints have been suggested even on our self-regarding choices. These limits are often justified in the name of autonomy. In this paper, it is argued that these different interpretations can be explained and understood by looking at the discussion from the viewpoints of (...) positive and negative liberty and the various notions of a “person” that lay beneath. It will be shown how all the appeals to positive liberty presuppose a particular value system and are therefore problematic in multicultural societies. (shrink)

In an influential essay entitled Why abortion is wrong, Donald Marquis argues that killing actual persons is wrong because it unjustly deprives victims of their future; that the fetus has a future similar in morally relevant respects to the future lost by competent adult homicide victims, and that, as consequence, abortion is justifiable only in the same circumstances in which killing competent adult human beings is justifiable.1 The metaphysical claim implicit in the first premise, that actual persons have (...) a future of value, is ambiguous. The Future Like Ours argument (FLO) would be valid if “future of value” were used consistently to mean either “potential future of value” or “self-represented future of value”, and FLO would be sound if one or the other interpretation supported both the moral claim and the metaphysical claim, but if, as I argue, any interpretation which makes the argument valid renders it unsound, then FLO must be rejected. Its apparent strength derives from equivocation on the concept of “a future of value”. (shrink)

The idea that healthcare should become more person-centred is extremely influential. By using recent English policy developments as a case study, this article aims to critically analyse an important element of person-centred care, namely, the belief that to treat patients as persons is to think that care should be ‘co-produced’ by formal healthcare providers and patients together with unpaid carers and voluntary organizations. I draw on insights from political philosophy to highlight overlooked tensions between co-production and values like equality (...) and liberty. Regarding equality, I argue that co-production compounds both problems of gender inequality in the distribution of care labour and the challenges associated with securing equal access to care. Turning to liberty, I identify important commonalities between co-production and republicanism in political philosophy, given their shared insistence on common citizens’ civic virtue. Then, I use against co-production some liberal arguments against republicanism, to highlight a problem of over-demandingness. In bringing my argument to a close, however, I wish to caution against hastily rejecting co-production as a policy programme. (shrink)

In his ‘The Identity Objection to the future‐like‐ours argument’ (Bioethics, 2019, 33: 287–293), Brill argues that Marquis's 'future of value' account of the wrong of abortion is still vulnerable to the identity objection—the claim that the foetus and the later person are not numerically identical, so the later person's valuable experiences are not the foetus's future experiences—even if it is conceded that the future organism, as well as the person, has experiences. This is because the organism has these experiences in (...) a different way from the person. The person has them directly, and the organism has them only derivatively. This implies, he maintains, that the organism cannot be deprived of those experiences in a way that is wrong. Only the person can be deprived in this morally relevant way. But, I argue, if the organism genuinely has those experiences, it is not at all clear why its being deprived of them would be permissible. I argue that the reason why Brill can claim that having those experiences derivatively makes this moral difference is because the sense in which the organism has experiences is not a genuine sense. But that is a problem for this theory of personal identity, not for Marquis's account of the wrong of abortion. I also argue that supposing that one cannot morally harm the human organism has various implausible implications, which cast doubt on the idea that having experiences derivatively means that the organism is not morally harmed by being deprived of them. (shrink)