Open Peer Commentary on P. Zawadzki and A. K. Adamczyk's target article in AJOB Neuroscience on the potential of optogenetics for memory modification. I argue for a radically pluralistic understanding of the notion of authenticity, and highlight the need to further clarify the specific nature of the authors' concern about authenticity, as well as its policy implications.

There is concern that the use of neuroenhancements to alter character traits undermines consumer's authenticity. But the meaning, scope and value of authenticity remain vague. However, the majority of contemporary autonomy accounts ground individual autonomy on a notion of authenticity. So if neuroenhancements diminish an agent's authenticity, they may undermine his autonomy. This paper clarifies the relation between autonomy, authenticity and possible threats by neuroenhancements. We present six neuroenhancement scenarios and analyse how autonomy accounts evaluate them. Some cases are considered (...) differently by criminal courts; we demonstrate where academic autonomy theories and legal reasoning diverge and ascertain whether courts should reconsider their concept of autonomy. We argue that authenticity is not an appropriate condition for autonomy and that new enhancement technologies pose no unique threats to personal autonomy. (shrink)

ABSTRACT There is concern that the use of neuroenhancements to alter character traits undermines consumer's authenticity. But the meaning, scope and value of authenticity remain vague. However, the majority of contemporary autonomy accounts ground individual autonomy on a notion of authenticity. So if neuroenhancements diminish an agent's authenticity, they may undermine his autonomy. This paper clarifies the relation between autonomy, authenticity and possible threats by neuroenhancements. We present six neuroenhancement scenarios and analyse how autonomy accounts evaluate them. Some cases are (...) considered differently by criminal courts; we demonstrate where academic autonomy theories and legal reasoning diverge and ascertain whether courts should reconsider their concept of autonomy. We argue that authenticity is not an appropriate condition for autonomy and that new enhancement technologies pose no unique threats to personal autonomy. (shrink)

Philosophy & Social Criticism, Ahead of Print. An ongoing debate between ‘procedural’ and ‘substantive’ theorists of personal autonomy addresses the following question: should agents have the final say on their own autonomy or should the objective circumstances in which agents live take prevalence when assessing their autonomy? Proceduralists favour the first strategy and substantive theorists restrict more explicitly the conditions under which autonomy is possible. I focus on forms of heteronomy which derive from oppressive circumstances and accept that substantive theorists (...) are correct in contending that forms of oppression common in contemporary liberal societies tend to increase heteronomy; and the heteronomy which derives from social oppression tends to fly below the radar of procedural accounts. Still, I argue that a revised procedural strategy could limit these forms of heteronomy as long as it avoids the injunctions to ‘authenticity’ common in procedural models. I proceed by reconstructing John Christman’s model which, I argue, constitutes the most promising procedural account to assess autonomy under oppression. Christman’s theory, however, needs to be reinforced to ensure self-problematisation in light of a social perspective. I show that the latter is necessary to experience the forms of alienation which are markers of heteronomy according to Christman. (shrink)

Philosophy & Social Criticism, Ahead of Print. An ongoing debate between ‘procedural’ and ‘substantive’ theorists of personal autonomy addresses the following question: should agents have the final say on their own autonomy or should the objective circumstances in which agents live take prevalence when assessing their autonomy? Proceduralists favour the first strategy and substantive theorists restrict more explicitly the conditions under which autonomy is possible. I focus on forms of heteronomy which derive from oppressive circumstances and accept that substantive theorists (...) are correct in contending that forms of oppression common in contemporary liberal societies tend to increase heteronomy; and the heteronomy which derives from social oppression tends to fly below the radar of procedural accounts. Still, I argue that a revised procedural strategy could limit these forms of heteronomy as long as it avoids the injunctions to ‘authenticity’ common in procedural models. I proceed by reconstructing John Christman’s model which, I argue, constitutes the most promising procedural account to assess autonomy under oppression. Christman’s theory, however, needs to be reinforced to ensure self-problematisation in light of a social perspective. I show that the latter is necessary to experience the forms of alienation which are markers of heteronomy according to Christman. (shrink)

An ongoing debate between ‘procedural’ and ‘substantive’ theorists of personal autonomy addresses the following question: should agents have the final say on their own autonomy or should the object...

An ongoing debate between ‘procedural’ and ‘substantive’ theorists of personal autonomy addresses the following question: should agents have the final say on their own autonomy or should the object...

Multiculturalism as a public policy and philosophy has become increasingly controversial in many democracies over the last decade. While the specific issues can vary across national contexts, a common anxiety is that multiculturalism sanctions minority practices that conflict with prevailing social values or legal norms. Central to this concern is the value liberal societies place on the autonomy of the individual. Many of our most charged public controversies involve a perception that certain minority practices jeopardize the autonomy of their individual (...) members and, especially, their women and children. Just as the value of autonomy is central to these disputes, so the idea of 'authenticity' is often pivotal to the understanding of autonomy in such cases. The autonomous individual acts on reasons that are truly his or her own. But the issue of authenticity also arises in claims for cultural recognition regarding whether a particular minority practice is a genuine or authoritative expression of that minority's culture. Geoffrey Brahm Levey and his distinguished group of philosophers, political theorists, and anthropologists critically explore these twin notions of 'authenticity' – of autonomous persons and of cultures – in our multiculturalism debates. Discussing a wide range of illustrative cases and controversies drawn from Britain and continental Europe, North America, Australia, and the Middle East, they address various issues raised by the complex interactions between authenticity, autonomy, and the accommodation of minority cultural practices. Moving beyond theoretical discussion to consider the practical and policy implications, Autonomy, Authenticity and Multiculturalism challenges and complicates conventional assumptions about authenticity that inform liberal responses to minority cultural claims in Western democracies today. A helpful resource to scholars worldwide in Political and Social Theory, Political Philosophy, Legal Anthropology, Multiculturalism, and, more generally, of cultural identity and diversity in liberal democracies today. (shrink)

An ongoing debate between ‘procedural’ and ‘substantive’ theorists of personal autonomy addresses the following question: should agents have the final say on their own autonomy or should the objective circumstances in which agents live take prevalence when assessing their autonomy? Proceduralists favour the first strategy and substantive theorists restrict more explicitly the conditions under which autonomy is possible. I focus on forms of heteronomy which derive from oppressive circumstances and accept that substantive theorists are correct in contending that (i) forms (...) of oppression common in contemporary liberal societies (e.g. gender or racial oppression) tend to increase heteronomy; and (ii) the heteronomy which derives from social oppression tends to fly below the radar of procedural accounts. Still, I argue that a revised procedural strategy could limit these forms of heteronomy as long as it avoids the injunctions to ‘authenticity’ common in procedural models. I proceed by reconstructing John Christman’s model which, I argue, constitutes the most promising procedural account to assess autonomy under oppression. Christman’s theory, however, needs to be reinforced to ensure self-problematisation in light of a social perspective. I show that the latter is necessary to experience the forms of alienation which are markers of heteronomy according to Christman. (shrink)

My central thesis is that philosophers considering questions of epistemic value ought to devote greater attention to the enduring nature of beliefs. I begin by arguing that a commonly drawn analogy between beliefs and actions is flawed in important respects, and that a better, more fruitful analogue for belief would be desire, or a similarly enduring state of an agent. With this in hand, I argue that treating beliefs as enduring, constitutive states of agents allows us to capture the importance (...) of accessible, justified, and true beliefs to sustaining personal identity, autonomy, self-control, and authenticity. We thus arrive at a significant value to such beliefs through their crucial role in our personal, practical identities. (shrink)

In healthcare ethics there is a discussion regarding whether autonomy of personal preferences, what sometimes is referred to as authenticity, is necessary for autonomous decision-making. It has been argued that patients’ decisions that lack sufficient authenticity could be deemed as non-autonomous and be justifiably overruled by healthcare staff. The present paper discusses this issue in relation certain psychiatric disorders. It takes its starting point in recent qualitative studies of the experiences and thoughts of patients’ with anorexia nervosa where issues related (...) to authenticity seem particularly relevant. The paper examines different interpretations of authenticity relevant for autonomy and concludes that the concept, as it has been elaborated in recent debate, is highly problematic to use as a criterion for autonomous decision-making in healthcare. (shrink)

There has been a growing interest in research concerning memory modification technologies (MMTs) in recent years. Neuroscientists and psychologists are beginning to explore the prospect of controllable and intentional modification of human memory. One of the technologies with the greatest potential to this end is optogenetics—an invasive neuromodulation technique involving the use of light to control the activity of individual brain cells. It has recently shown the potential to modify specific long-term memories in animal models in ways not yet possible (...) with other MMTs. As the therapeutic potential of optogenetics has already prompted approval of the first human trials, it is especially important and timely to consider the opportunities and dangers this technology may entail. In this article, we focus on possible consequences of optogenetics as an MMT by analyzing fundamental threats potentially associated with memory modifications: the potential disruption of personality and authenticity. (shrink)

There has been a growing interest in research concerning memory modification technologies (MMTs) in recent years. Neuroscientists and psychologists are beginning to explore the prospect of controllable and intentional modification of human memory. One of the technologies with the greatest potential to this end is optogenetics—an invasive neuromodulation technique involving the use of light to control the activity of individual brain cells. It has recently shown the potential to modify specific long-term memories in animal models in ways not yet possible (...) with other MMTs. As the therapeutic potential of optogenetics has already prompted approval of the first human trials, it is especially important and timely to consider the opportunities and dangers this technology may entail. In this article, we focus on possible consequences of optogenetics as an MMT by analyzing fundamental threats potentially associated with memory modifications: the potential disruption of personality and authenticity. (shrink)

The aims of this paper are to: (1) identify the best framework for comprehending multidimensional impact of deep brain stimulation on the self; (2) identify weaknesses of this framework; (3) propose refinements to it; (4) in pursuing (3), show why and how this framework should be extended with additional moral aspects and demonstrate their interrelations; (5) define how moral aspects relate to the framework; (6) show the potential consequences of including moral aspects on evaluating DBS’s impact on patients’ selves. Regarding (...) (1), I argue that the pattern theory of self can be regarded as such a framework. In realizing (2) and (3), I indicate that most relevant issues concerning PTS that require resolutions are ontological issues, including the persistence question, the “specificity problem”, and finding lacking relevant aspects of the self. In realizing (4), I identify aspects of the self not included in PTS which are desperately needed to investigate the full range of potentially relevant DBS-induced changes—authenticity, autonomy, and responsibility, and conclude that how we define authenticity will have implications for our concept of autonomy, which in turn will determine how we think about responsibility. Concerning (5), I discuss a complex relation between moral aspects and PTS—on one hand, they serve as the lens through which a particular self-pattern can be evaluated; on the other, they are, themselves, products of dynamical interactions of various self-aspects. Finally, I discuss (6), demonstrating novel way of understanding the effects of DBS on patients’ selves. (shrink)

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

Minors with attention-deficit-hyperactivity disorders are liable to use pharmacological treatment against their will and may find their authentic “I” modified. Thus, their use is widely criticized. In this study, the effect of ADHD drugs on adolescents’ personal experience is examined. The goal is to understand how psychological changes that young people experience when they take these medications interrelate with their attitude toward being medicated. Methylphenidate is the most common pharmacological treatment for ADHD. We look into the change that Israeli adolescents (...) undergo when they use it; their experience in controlling the change, and their assessment of the meaning of the change for their lives. Thirty-eight adolescents participated in semi-structured interviews. The findings, analyzed using grounded theory, show that methylphenidate affects the participants’ demeanor, mood, and even preferences. The participants, aware of these effects, apply discretion in taking methylphenidate and thus influence their traits and their willingness to engage in various activities. When needing to prepare for a matriculation exam, for example, they take methylphenidate; when they need to be creative or sociable, they avoid it and enjoy what they consider the advantages of ADHD, such as creativity and spontaneity. As discretionary users, they shape their life stories in a way that makes them more meaningful and diverse, better tailored to their social surroundings, and more useful in maintaining personal autonomy in the course of pharmacological treatment of ADHD. (shrink)

For nearly two decades, ethicists have expressed concerns that the further development and use of memory modification technologies (MMTs)—techniques allowing to intentionally and selectively alter memories—may threaten the very foundations of who we are, our personal identity, and thus pose a threat to our well-being, or even undermine our “humaneness.” This paper examines the potential ramifications of memory-modifying interventions such as changing the valence of targeted memories and selective deactivation of a particular memory as these interventions appear to be at (...) the same time potentially both most promising clinically as well as menacing to identity. However, unlike previous works discussing the potential consequences of MMTs, this article analyzes them in the context of the narrative relational approach to personal identity and potential issues related to autonomy. I argue that such a perspective brings to light the ethical aspects and moral issues arising from the use of MMTs that have been hidden from previously adopted approaches. In particular, this perspective demonstrates how important the social context in which an individual lives is for the ethical evaluation of a given memory-modifying intervention. I conclude by suggesting that undertaking memory modifications without taking into account the social dimension of a person’s life creates the risk that she will not be able to meet one of the basic human needs—the autonomous construction and maintenance of personal identity. Based on this conclusion, I offer some reflections on the permissibility and advisability of MMTs and what these considerations suggest for the future. (shrink)

This chapter contains sections titled: Rationalist and Existentialist Views of Autonomy and Authenticity Autonomy, Authenticity, and Volitional Necessity Authenticity, Existential Meaning, and Personal Identity Which Rationality? Which Orthodoxy? Autonomy, Authenticity, and Community Authenticity, Responsibility, and Education.

Neuroscientific research on the removal of unpleasant and traumatic memories is still at a very early stage, but is making rapid progress and has stirred a significant philosophical and neuroethical debate. Even if memory is considered to be a fundamental element of personal identity, in the context of memory-erasing the autonomy of decision-making seems prevailing. However, there seem to be situations where the overall context in which people might choose to intervene on their memories would lead to view those actions (...) as counterproductive. In this article, I outline situations where the so-called composition effects can produce negative results for everyone involved, even if the individual decisions are not as such negative. In such situations medical treatments that usually everyone should be free to take, following the principle of autonomy, can make it so that the personal autonomy of the individuals in the group considered is damaged or even destroyed. In these specific cases, in which what is called the “conformity to context” prevails, the moral admissibility of procedures of memory-erasing is called into question and the principle of personal autonomy turns out to be subordinate to social interests benefitting every member of the group. (shrink)

The question of when we have justification for overriding ordinary, everyday decisions of persons with dementia is considered. It is argued that no single criterion for competent decision-making is able to distinguish reliably between decisions we can legitimately override and decisions we cannot legitimately override.

Deep Brain Stimulation (DBS) is an invasive therapeutic method involving the implantation of electrodes and the electrical stimulation of specific areas of the brain to modulate their activity. DBS brings therapeutic benefits, but can also have adverse side effects. Recently, neuroethicists have recognized that DBS poses a threat to the very fabric of human existence, namely, to the selves of patients. This article provides a review of the neuroethical literature examining this issue, and identifies the crucial dimensions related to the (...) self which DBS may endanger—personal identity, authenticity, and autonomy. The most influential theories accounting for these dimensions are analyzed herein, and it is argued that most of these theories require further refinement. This paper also demonstrates the interrelation between personal identity, authenticity, and autonomy, and concludes that one can only fully understand the impact of DBS on the self when all of these factors are taken into account. (shrink)

While deep brain stimulation (DBS) for patients with Parkinson's disease has typically raised ethical questions about autonomy, accountability and personal identity, recent research indicates that we need to begin taking into account issues surrounding the patients’ feelings of authenticity and alienation as well. In order to bring out the relevance of this dimension to ethical considerations of DBS, I analyse a recent case study of a Dutch patient who, as a result of DBS, faced a dilemma between autonomy and authenticity. (...) This case study is meant to point out the normatively meaningful tension patients under DBS experience between authenticity and autonomy. (shrink)

Self-tracking devices point to a future in which individuals will be more involved in the management of their health and will generate data that will benefit clinical decision making and research. They have thus attracted enthusiasm from medical and public health professionals as key players in the move toward participatory and personalized healthcare. Critics, however, have begun to articulate a number of broader societal and ethical concerns regarding self-tracking, foregrounding their disciplining, and disempowering effects. This paper has two aims: first, (...) to analyze some of the key promises and concerns that inform this polarized debate. I argue that far from being solely about health outcomes, this debate is very much about fundamental values that are at stake in the move toward personalized healthcare, namely, the values of autonomy, solidarity, and authenticity. The second aim is to provide a framework within which an alternative approach to self-tracking for health can be developed. I suggest that a practice-based approach, which studies how values are enacted in specific practices, can open the way for a new set of theoretical questions. In the last part of the paper, I sketch out how this can work by describing various enactments of autonomy, solidarity, and authenticity among self-trackers in the Quantified Self community. These examples show that shifting attention to practices can render visible alternative and sometimes unexpected enactments of values. Insofar as these may challenge both the promises and concerns in the debate on self-tracking for health, they can lay the groundwork for new conceptual interventions in future research. (shrink)

The paper offers a qualified defense of religious indoctrination, pursuing three primary lines of argument. First, it contends that it can be virtuous to indoctrinate, even if the doctrines one instils are wrong. Second, it argues that religious indoctrination per se does not undercut a person’s autonomy. Finally, it defends the claim that, as a general practice, religious indoctrination does not make the world worse off than it would otherwise be, even if believing in a particular doctrine or being brought (...) up in a particular religious community sometimes may. (shrink)

An overarching aim of education is the promotion of children's personal well-being. Liberal educationalists also support the promotion of children's personal autonomy as a central educational aim. On some views, such as John White's, these two goals—furthering well-being and cultivating autonomy—can come apart. Our primary aim in this paper is to argue for a species of a stronger view: assuming preferentism as our axiology, we suggest that there is an essential association between the autonomy of our springs of action, such (...) as desires and beliefs, on the one hand, and personal well-being, on the other. If we are right about this link, then we have at our disposal a partial (non-instrumental) validation of the liberal ideal of autonomy. (shrink)

An overarching aim of education is the promotion of children’s personal well-being. Liberal educationalists also support the promotion of children’s personal autonomy as a central educational aim. On some views, such as John White’s, these two goals—furthering well-being and cultivating autonomy—can come apart. Our primary aim in this paper is to argue for a species of a stronger view: assuming preferentism as our axiology, we suggest that there is an essential association between the autonomy of our springs of action, such (...) as desires and beliefs, on the one hand, and personal well-being, on the other. If we are right about this link, then we have at our disposal a partial (non-instrumental) validation of the liberal ideal of autonomy. (shrink)

In the recent neuroethics literature, there has been vigorous debate concerning the ethical implications of the use of neurotechnologies that may alter a person’s identity. Much of this debate has been framed around the concept of authenticity. The argument of this chapter is that the ethics of authenticity, as applied to neurotechnological treatment or enhancement, is conceptually misleading. The notion of authenticity is ambiguous between two distinct and conflicting conceptions: self-discovery and self-creation. The self-discovery conception of authenticity is based on (...) a problematic conception of a static, real inner self. The notion of self-creation, although more plausible, blurs the distinction between identity and autonomy. Moreover, both conceptions are overly individualistic and fail sufficiently to account for the relational constitution of personal identity. The authors propose that a relational, narrative understanding of identity and autonomy can incorporate the more plausible aspects of both interpretations of authenticity, while providing a normatively more illuminating theoretical framework for approaching the question of whether and how neurotechnologies threaten identity. (shrink)

The ethical debate about neurotechnologies—including both drugs and implanted devices—has been largely framed around the questions of whether and when these technologies could damage or promote authenticity. Patients can experience changes in mood, behavior, emotion, or preferences—seemingly, changes in character or personality. Some describe such changes by saying they feel like different people; that they have become either more or less themselves; or that they feel as though some of their moods, behaviors, emotions or preferences are not their own. (...) These kinds of statements are used to describe both changes that a drug or device is... (shrink)

In this paper, we argue that boredom can be an important experience that contributes to personal autonomous agency by providing authentic motivation, and that strategies of social media providers to bind users’ attention to their platforms undermine this authenticity. As discussed in social epistemology and media ethics for a while now, such strategies can lead to so-called epistemic or filter bubbles. Our analysis of the relation between boredom and social media use focuses on a similarly impairing effect of social media (...) on users’ autonomy, which we call authenticity bubbles. (shrink)

Two ways of understanding the notion of autonomy are outlined and discussed in this article, in order to clarify how and if informed consent requirements in biotechnological research are to be justified by the promotion of personal autonomy: A proceduralist conception linking autonomy with authenticity, and a substantivist conception linking autonomy with control. The importance of distinguishing autonomy from liberty is emphasised, which opens for a possible conflict between respecting the freedom and the autonomy of research participants. It is argued (...) that this has implications for how consent requirements based on different criteria of specificity and understanding should be viewed and justified. (shrink)

Moral bioenhancement is the attempt to improve human behavioral dispositions, especially in relation to the great ethical challenges of our age. To this end, scientists have hypothesised new molecules or even permanent changes in the genetic makeup to achieve such moral bioenhancement. The philosophical debate has focused on the permissibility and desirability of that enhancement and the possibility of making it mandatory, given the positive result that would follow. However, there might be another way to enhance the overall moral behavior (...) of us humans, namely that of targeting people with lower propensity to trust and altruism. Based on the theory of attachment, people who have a pattern of insecure attachment are less inclined to prosocial behavior. We know that these people are influenced by negative childhood memories: this negative emotional component may be erased or reduced by the administration of propranolol when the bad memory is reactivated, thereby improving prosocial skills. It could be objected that memory-editing might be a threat for the person’s identity and authenticity. However, if the notion of rigid identity is replaced by that of extended identity, this objection loses validity. If identity is understood as something that changes over time, moral bioenhancement through memory-editing seems indeed legitimate and even desirable. (shrink)

In this article I argue that it does not make sense – either empirically or normatively – to speak of ‘authentic’ cultures. All we need when talking about cultures is a relatively weak concept that still carries enough normative weight to function as the meaningful background of a person’s identity, autonomy and good life. Discussing the authentic culture, I refer to the debates around the German Leitkultur as well as the Dutch populist movement as examples. However, I am interested not (...) only in the concept of the authenticity of a culture but also in the concept of the authenticity of persons: if an ‘authentic culture’ is not feasible, does this have repercussions on the concept of the autonomy and authenticity of persons? In suggesting that this might be the case, I argue that persons can be autonomous without always being fully authentic. (shrink)

In 2017, Tom Gruber held a TED talk, in which he presented a vision of improving and enhancing humanity with AI technology. Specifically, Gruber suggested that an AI-improved personal memory (APM) would benefit people by improving their “mental gain”, making us more creative, improving our “social grace”, enabling us to do “science on our own data about what makes us feel good and stay healthy”, and, for people suffering from dementia, it “could make a difference between a life of isolation (...) and a life of dignity and connection”. -/- In this paper, Gruber’s idea will be critically assessed. Firstly, it will be argued that most of his pro-arguments for the APM are questionable. Secondly, the APM will also be criticized for other reasons, including the risks and affects to the users’ and other’s privacy and the users’ autonomy. (shrink)

This dissertation provides a philosophical analysis of personal autonomy. Personal autonomy is defined as the condition of being self-directed. The conditions which make such self-direction possible are then explored. ;Self-direction requires that one's actions are motivated by authentic reasons for action. One makes some of one's desires authentic by critically reflecting upon and identifying with them. One identifies with a particular desire when one approves of it as a reason for action, thus desiring that it be an effective desire. Provided (...) that one's identification with a desire is decisive and one is not ambivalent with respect to it, identification is sufficient for the authenticity of one's desires. ;This capacity to adopt authentic reasons for action cannot be sufficient for the autonomy of one's desires or actions, though. For authenticity is a function solely of the psychological states of an individual; yet autonomy cannot be adequately explicated solely by reference to an agent's subjective states. I refer to those theories which make the autonomy of a person's desires solely a function of her psychological states as "internalist", and argue that such theories must be rejected. An "externalist" is one who denies that autonomy is wholly a function of the psychological states of the individual, and so holds that the autonomy of a desire is determined, at least in part, by facts which are independent of the subjective attitudes of the agent. ;I defend a form of externalism, which makes the autonomy of a desire depend upon the following conditions: the agent must approve of it as a reason for action; the agent must have the capacity to respond appropriately to whatever reasons there are for and against it; the agent must have been able to avoid falling into error concerning the object of the desire and the desire itself; the agent's approval of it is not caused solely by a restriction of her feasible options or coercion. ;I argue that this is a more plausible theory than other externalist positions, and it can meet the objections which have beset internalist theories. (shrink)

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

Respect for personal autonomy and authenticity is a very important principle in late modern political and applied ethics. In the context of medicine and nursing, for example, a great deal of ethical research is devoted to this principle, both theoretical and empirical, raising many hotly debated questions, both conceptual – on the concepts of autonomy and authenticity – practical – on the application of the principle of respect for autonomy and authenticity – and methodological – on using empirical methods in (...) ethical research. In the present contribution I present two of the results of my doctoral research concerning personal autonomy and authenticity in the practice of personal pastoral care, using empirical methods.The first consists of a formulation of the goals of pastoral care as they were found in the cases analysed, the second of the different forms of personal autonomy and authenticity that were identified. Our primary aim is to argue for the importance of a) conducting empirical research into what is actually morally relevant and not just at the surface, and of b) assigning a privileged position in empirical ethical research to practices and the tacit knowing of advanced, reflective practitioners. (shrink)

Part I. The book begins with literary, cinematic, and historical scenarios that exemplify personal autonomy. Meyers uses these vignettes to distinguish personal autonomy from other, variously related types of autonomy and to show that other kinds of autonomy cannot adequately address the concern people have with their own personal decisions. Noting how profoundly social experience impinges on self-discovery, self-definition, and self-direction, Meyers characterizes autonomous individuals as persons who do what they really want, and she undertakes to supply an account of (...) an authentic self that acknowledges people's enmeshment in social relations as well as their psychological complexity. (shrink)

In this paper I argue for what I call ‘the inherency thesis’: the thesis that an autonomous choice that succeeds in expressing an agent’s authentic identity is inherently prudentially valuable for the choosing agent. I argue that this is the case because autonomous choice is a vehicle for the expression of authentic identity, the satisfaction of which is intrinsically prudentially valuable. Moreover, I argue that no such inherent relation exists between fulfilled autonomous choice and the exemplification of moral, aesthetic or (...) perfectionist value. These conclusions suggest that accounts of the normativity of personal autonomy should focus on the notion that the demand to respect personal autonomy is grounded on the demand to promote the prudential value – and hence well-being – of others. (shrink)

Mary Walker and Catriona Mackenzie's "Neurotechnologies, Relational Autonomy, and Authenticity" provides much needed reflection on the lens through which ethical concerns about the use of neurotechnologies are usually viewed. There is a general worry about the sometimes rapid and radical effects that such technologies can have on personalities and values. These concerns are often described as worries about how such technologies might alter our identities or compromise our authenticity. Clear theorizing of the notoriously slippery notions of "identity" and "authenticity" is, (...) however, surprisingly rare in these discussions. Walker and Mackenzie's paper undertakes that theoretical work, arguing that the major... (shrink)

The development of predictive brain implant (PBI) technology that is able to forecast specific neuronal events and advise and/or automatically administer appropriate therapy for diseases of the brain raises a number of ethical issues. Provided that this technology satisfies basic safety and functionality conditions, one of the most pressing questions to address is its relation to the autonomy of patients. As Frederic Gilbert in his article asks, if autonomy implies a certain idea of freedom, or self-government, how can an individual (...) be considered to decide freely if the implanted device stands at the inception of the causal chain producing his decisions? He claims that PBIs threaten persons’ autonomy by diminishing their post-operative experience of self-control. In this commentary, I wish to discuss this claim. Contrary to Gilbert, I will suggest that PBIs do not pose a significant threat to patient’s autonomy, as self-control, but rather to his/her sense of authenticity. My claim is that the language of authenticity, already introduced in the recent bioethical literature, may offer a better way to voice some of the concerns with PBIs that Gilbert recognized. (shrink)

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

Deep brain stimulation has been of considerable interest to bioethicists, in large part because of the effects that the intervention can occasionally have on central features of the recipient’s personality. These effects raise questions regarding the philosophical concept of authenticity. In this article, we expand on our earlier work on the concept of authenticity in the context of deep brain stimulation by developing a diachronic, value-based account of authenticity. Our account draws on both existentialist and essentialist approaches to authenticity, (...) and Laura Waddell Ekstrom’s coherentist approach to personal autonomy. In developing our account, we respond to Sven Nyholm and Elizabeth O’Neill’s synchronic approach to authenticity, and explain how the diachronic approach we defend can have practical utility, contrary to Alexandre Erler and Tony Hope’s criticism of autonomy-based approaches to authenticity. Having drawn a distinction between the authenticity of an individual’s traits and the authenticity of that person’s values, we consider how our conception of authenticity applies to the context of anorexia nervosa in comparison to other prominent accounts of authenticity. We conclude with some reflections on the prudential value of authenticity, and by highlighting how the language of authenticity can be invoked to justify covert forms of paternalism that run contrary to the value of individuality that seems to be at the heart of authenticity. (shrink)

Recommender Systems (RecSys) have been around since the early days of the Internet, helping users navigate the vast ocean of information and the increasingly available options that have been available for us ever since. The range of tasks for which one could use a RecSys is expanding as the technical capabilities grow, with the disruption of Machine Learning representing a tipping point in this domain, as in many others. However, the increase of the technical capabilities of AI-powered RecSys did not (...) come with a thorough consideration of their ethical implications and, despite being a well-established technical domain, the potential impacts of RecSys on their users are still under-assessed. This paper aims at filling this gap in regards to one of the main impacts of RecSys: personal autonomy. We first describe how technology can affect human values and a suitable methodology to identify these effects and mitigate potential harms: Value Sensitive Design (VSD). We use VSD to carry out a conceptual investigation of personal autonomy in the context of a generic RecSys and draw on a nuanced account of procedural autonomy to focus on two components: competence and authenticity. We provide the results of our inquiry as a value hierarchy and apply it to the design of a speculative RecSys as an example. (shrink)

In this article, I explore select case studies of Parkinson patients treated with deep brain stimulation in light of the notions of alienation and authenticity. While the literature on DBS has so far neglected the issues of authenticity and alienation, I argue that interpreting these cases in terms of these concepts raises new issues for not only the philosophical discussion of neuro-ethics of DBS, but also for the psychological and medical approach to patients under DBS. In particular, I suggest that (...) the experience of alienation and authenticity varies from patient to patient with DBS. For some, alienation can be brought about by neurointerventions because patients no longer feel like themselves. But, on the other hand, it seems alienation can also be cured by DBS as other patients experience their state of mind as authentic under treatment and retrospectively regard their former lives without stimulation as alienated. I argue that we must do further research on the relevance of authenticity and alienation to patients treated with DBS in order to gain a deeper philosophical understanding, and to develop the best evaluative criterion for the behavior of DBS patients. (shrink)

The analysis of identity in cases of memory loss, particularly in Alzheimer’s disease, sheds light on relevant philosophical and practical concerns, such as decision-making processes, autonomy, and the improvement of interaction with patients. Literature on psychological continuity recognizes identity when there are no disruptions in memory, which is certainly not the case in Alzheimer´s disease. Narrative identity, particularly in its relational and non-relational versions, delivers tools which are not exempt from difficulties. Either the caregivers’ narrative or the patient’s narrative is (...) dismissed. Furthermore, if there is a contradiction of narratives in relational theories, we are advised to either find the best narrative or seek agreement. However, one option rejects one narrative, while the other is unattainable in practice for the case in question. Hence, we propose drawing from ironism (Rorty, 1989), which suggests duality of dialogues when dealing with problems. This will be used to defend that the narratives of both, a person with Alzheimer and those close to them, are valid when constituting identity of the former. In this case, we will articulate and defend relational ironism, which allows us to embrace inconsistent narratives without seeking agreements. According to this, personal identity in this case is in constant tension between the narratives of those who suffer Alzheimer’s disease and the narratives of those close to them. We close illustrating possible benefits for how best to interact with patients. (shrink)

The aim of this doctoral thesis is to bridge the gap between theoretical ideals of authenticity and practical authenticity-related problems in healthcare. In this context, authenticity means being "genuine," "real," "true to oneself," or similar, and is assumed to be closely connected to the autonomy of persons. The thesis includes an introduction and four articles related to authenticity. The first article collects various theories intended to explain the distinction between authenticity and inauthenticity in a taxonomy that enables oversight and analysis. (...) It is argued that (in-)authenticity is difficult to observe in others. The second article offers a solution to this difficulty in one theory of authenticity. It is proposed that under certain circumstances, it is morally justified to judge that the desires underlying a person's decisions are inauthentic. The third article incorporates this proposition into an already established theory of personal autonomy. It is argued that the resulting conceptualization of autonomy is fruitful for action-guidance in authenticity-related problems in healthcare. The fourth article collects nine cases of possible authenticity-related problems in healthcare. The theory developed in the third article is applied to the problems, when this is allowed by the case-description, to provide guidance with regard to them. It is argued that there is not one universal authenticity-related problem but many different problems, and that there is thus likely not one universal solution to such problems but various particular solutions. (shrink)

According to bioethics orthodoxy, the question, “What would the patient choose?” is a question about the patient's autonomy. is at stake. In fact, what underpins the moral force of that question is a value different from either autonomy or best interests. This is the value of doing things in a way that is authentic to the person.

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