The underlying thesis of the research in ethical autonomy for lethal autonomous unmanned systems is that they will potentially be capable of performing more ethically on the battlefield than are human soldiers. In this article this hypothesis is supported by ongoing and foreseen technological advances and perhaps equally important by an assessment of the fundamental ability of human warfighters in today's battlespace. If this goal of better-than-human performance is achieved, even if still imperfect, it can result in a reduction (...) in noncombatant casualties and property damage consistent with adherence to the Laws of War as prescribed in international treaties and conventions, and is thus worth pursuing vigorously. (shrink)

The autopoietic theory and the enactive approach are two theoretical streams that, in spite of their historical link and conceptual affinities, offer very different views on the nature of living beings. In this paper, we compare these views and evaluate, in an exploratory way, their respective degrees of internal coherence. Focusing the analyses on certain key notions such as autonomy and organizational closure, we argue that while the autopoietic theory manages to elaborate an internally consistent conception of living beings, (...) the enactive approach presents an internal tension regarding its characterization of living beings as intentional systems directed at the environment. (shrink)

Respecting the autonomy of disabled people is an important ethical issue for providers of long-term care. In this influential book, George Agich abandons comfortable abstractions to reveal the concrete threats to personal autonomy in this setting, where ethical conflict, dilemma and tragedy are inescapable. He argues that liberal accounts of autonomy and individual rights are insufficient, and offers an account of autonomy that matches the realities of long-term care. The book therefore offers a framework for carers (...) to develop an ethic of long-term care within the complex environment in which many dependent and aged people find themselves. Previously published as Autonomy and Long-term Care, this revised edition, in paperback for the first time, takes account of recent work and develops the author's views of what autonomy means in the real world. It will have wide appeal among bioethicists and health care professionals. (shrink)

On received philosophical doctrine, history is simply methodologically immature. History's autonomy can be established not by showing scientific explanations impossible for "history," but by coupling a demonstration that hypothetico-deductive explanation cannot exhaustively analyze historical knowledge with a critique of the proto-science view's assumption that legitimate modes of understanding must be analyzable by an explicit methodology. Certain views historians accept, e.g., that events are unique, while inadequate as a general theory of events, reveal historical understanding's distinctive feature: synoptic judgment, which, (...) irreducible to analytic techniques, interprets a complex process as a function of component events, their interrelationships, importance, and context. (shrink)

We seem less likely to endorse moral expertise than reasoning expertise or aesthetic expertise. This seems puzzling given that moral norms are intuitively taken to be at least more objective than aesthetic norms. One possible diagnosis of the asymmetry is that moral judgments require autonomy of judgement in away that other judgments do not. However, the author points out that aesthetic judgments that have been ‘borrowed’ by aesthetic experts generate the same autonomy worry as moral judgments which are (...) borrowed by moral experts. The author then explores various approaches to accepting the testimony of moral experts and concludes that the asymmetry may best be explained by (1) the conditions for moral expertise being more difficult to satisfy than those of aesthetic expertise and (2) the intuitive greater seriousness of accepting the moral judgments of others, since moral norms are generally viewed as more binding than aesthetic norms. (shrink)

Simon Lohse addresses the issue of the autonomy of social phenomena. He discusses the most important ontological arguments that have been mounted against methodological individualism in the social sciences. The author thereby attempts to contribute to a better understanding of a core ontological problem in the philosophy of the social sciences and to clarify the theoretical debate within the social sciences.

Like being able to drive a car, being autonomous is a socially attributed, claimed, and contested status. Normative debates about criteria for autonomy (and what autonomy entitles one to) are best understood, not as debates about what autonomy, at core, really is, but rather as debates about the relative merits of various possible packages of thresholds, entitlements, regulations, values, and institutions. Within different “regimes” of autonomy, different criteria for (degrees of) autonomy become authoritative. Neoliberal, solidaristic, (...) and perfectionist regimes entail conflicting understandings of what gets you autonomy and what autonomy gets you—for example, in relation to policies regarding physician-assisted suicide or financial support for senior citizens. In light of this, justifying a particular understanding of autonomy is inseparable from the task of arguing for the context-specific merits of a regime of autonomy as a whole and in relation to other ethical and political commitments. (shrink)

In this article, I consider recent debates on the notion of procreative liberty, to argue that reproductive freedom can be understood as a form of positive freedom—that is, the freedom to make oneself according to various ethical and aesthetic principles or values. To make this argument, I draw on Michel Foucault’s later work on ethics. Both adopting and adapting Foucault’s notion of ethics as a practice of the self and of liberty, I argue that reproductive autonomy requires enactment to (...) gain meaning within the life contexts of prospective parents. Thus, I propose a shift away from the standard negative model of freedom that sees it solely as a matter of noninterference or nonimpedance, a view advocated by major commentators such as John Harris and John Robertson. Instead, reproduction should be understood as a deeply personal project of self-making that integrates both negative and positive freedom. (shrink)

Precision medicine promises to develop diagnoses and treatments that take individual variability into account. According to most specialists, turning this promise into reality will require adapting the established framework of clinical research ethics, and paying more attention to participants’ attitudes towards sharing genotypic, phenotypic, lifestyle data and health records, and ultimately to their desire to be engaged as active partners in medical research.Notions such as participation, engagement and partnership have been introduced in bioethics debates concerning genetics and large-scale biobanking to (...) broaden the focus of discussion beyond individual choice and individuals’ moral interests. The uptake of those concepts in precision medicine is to be welcomed. However, as data and medical information from research participants in precision medicine cohorts will be collected on an individual basis, translating a participatory approach in this emerging area may prove cumbersome. Therefore, drawing on Joseph Raz’s perfectionism, we propose a principle of respect for autonomous agents that, we reckon, can address many of the concerns driving recent scholarship on partnership and public participation, while avoiding some of the limitations these concept have in the context of precision medicine. Our approach offers a normative clarification to how becoming partners in precision is compatible with retaining autonomy.Realigning the value of autonomy with ideals of direct engagement, we show, can provide adequate normative orientation to precision medicine; it can do justice to the idea of moral pluralism by stressing the value of moral self-determination: and, finally, it can reconcile the notion of autonomy with other more communitarian values such as participation and solidarity. (shrink)

In several jurisdictions, irremediable suffering from a medical condition is a legal requirement for access to assisted dying. According to the expressivist objection, allowing assisted dying for a specific group of persons, such as those with irremediable medical conditions, expresses the judgment that their lives are not worth living. While the expressivist objection has often been used to argue that assisted dying should not be legalised, I show that there is an alternative solution available to its proponents. An autonomy-based (...) approach to assisted suicide regards the provision of assisted suicide (but not euthanasia) as justified when it is autonomously requested by a person, irrespective of whether this is in her best interests. Such an approach has been put forward by a recent judgment of the German Federal Constitutional Court, which understands assisted suicide as an expression of the person’s right to a self-determined death. It does not allow for beneficence-based restrictions regarding the person’s suffering or medical diagnosis and therefore avoids the expressivist objection. I argue that on an autonomy-based approach, assisted suicide should not be understood as a medical procedure but rather as the person’s autonomous action. (shrink)

Bioethicists are widely agreed that patients have a right of self-determination over how they are treated. Our duty to respect this is said to be based on the principle of respect for autonomy. In end-of-life care the patient may be incompetent and unable to exercise that right. One solution is to exercise it in advance. Advance directives, which include living wills and powers of attorney for health care, enable people to decide what medical treatment they will receive later, when (...) they become incompetent. Advance directives have been criticized in two general ways. First, many critics contend that advance directives fail on a practical level to effect a patient's autonomous choices because, for example, people cannot foresee their futures well enough to make informed decisions in advance. Second, many critics contend that, practical problems aside, there is no moral authority for exercising control over one's incompetent future self. (shrink)

No single concept has been more important in the contemporary development of bioethics, and the revival of medical ethics, than the concept of autonomy, and none better reflects both the philosophical and the political currents shaping the field. This article proposes to consider autonomy in three of its facets and functions: first, as a concept in ethical theory; second, as a concept in applied ethics; and finally, as what might be called an ideological concept — that is, one (...) that both draws from and reinforces non-philosophical interests at work in the profession of medicine, biomedical science and technology, and the broader liberal individualistic culture of Anglophone countries, particularly the United States, where a bioethical discourse centred on autonomy has flourished. (shrink)

This article examines the relationship between women entrepreneurs’ job autonomy and work–life balance, with a particular focus on how this relationship might be augmented by environments that discriminate against women, whether socio-economically, institutionally, or culturally. Multisource data pertaining to 5334 women entrepreneurs from 37 countries indicate that their sense of job autonomy increases the likelihood that they feel satisfied with their ability to balance the needs of their work with those of their personal life. This process is particularly (...) prominent when they operate in countries characterized by discriminatory socio-economic and institutional conditions, though a mitigating instead of invigorating effect arises in culturally discriminatory settings. For business ethics scholars and practitioners, these findings indicate how the extent to which women entrepreneurs, seeking to combine professional and private responsibilities, derive benefits from initiatives aimed at enhancing their job-related freedom critically depends on whether they operate in adverse external environments. (shrink)

Personal autonomy is often taken to consist in self-government or self-determination. Personal autonomy thus seems to require self-control. However, there is reason to think that autonomy is compatible with the absence of self-control. Akratic action, i.e., action performed against the agent’s better judgement, can be free. And it is also plausible to think that free actions require autonomy. It is only when you determine what you do yourself that you act freely. It follows that akratic actions (...) can be autonomous. At least in some cases, it is the agent herself, and not some alien part of her, who determines her akratic actions. But akratic actions are usually thought to be paradigm cases of self-control failure. Thus, we have reason both to conclude that autonomy requires self-control and that autonomy is compatible with the absence of self-control. My aim is to discuss the main solutions to this paradox. (shrink)

Next SectionFollowing the influential Gifford and Reith lectures by Onora O’Neill, this paper explores further the paradigm of individual autonomy which has been so dominant in bioethics until recently and concurs that it is an aberrant application and that conceptions of individual autonomy cannot provide a sufficient and convincing starting point for ethics within medical practice. We suggest that revision of the operational definition of patient autonomy is required for the twenty first century. We follow O’Neill in (...) recommending a principled version of patient autonomy, which for us involves the provision of sufficient and understandable information and space for patients, who have the capacity to make a settled choice about medical interventions on themselves, to do so responsibly in a manner considerate to others. We test it against the patient–doctor relationship in which each fully respects the autonomy of the other based on an unspoken covenant and bilateral trust between the doctor and patient. Indeed we consider that the dominance of the individual autonomy paradigm harmed that relationship. Although it seems to eliminate any residue of medical paternalism we suggest that it has tended to replace it with an equally (or possibly even more) unacceptable bioethical paternalism. In addition it may, for example, lead some doctors to consider mistakenly that unthinking acquiescence to a requested intervention against their clinical judgement is honouring “patient autonomy” when it is, in fact, abrogation of their duty as doctors. (shrink)

In recent years, an increasing number of theoretical biologists and philosophers of biology have been opposing reductionist research agendas by appealing to the concept of biological autonomy which draws on the older concept of autopoiesis. In my paper, I investigate some of the ontological implications of this approach. The emphasis on autonomy and autopoiesis, together with the associated idea of organisational closure, might evoke the impression that organisms are to be categorised ontologically as substances: ontologically independent, well-individuated, discrete (...) particulars. However, I argue that this is mistaken. Autopoiesis and biological autonomy, properly understood, require a rigorous commitment to a process ontological view of life. (shrink)

Disease radically changes the life of many people and satisfies formal criteria for being a transformative experience. According to the influential philosophy of Paul, transformative experiences undermine traditional criteria for rational decision-making. Thus, the transformative experience of disease can challenge basic principles and rules in medical ethics, such as patient autonomy and informed consent. This article applies Paul’s theory of transformative experience and its expansion by Carel and Kidd to investigate the implications for medical ethics. It leads to the (...) very uncomfortable conclusion that disease involves transformative experiences in ways that can reduce people’s rational decision-making ability and undermine the basic principle of respect for autonomy and the moral rule of informed consent. While such cases are limited, they are crucial for medical ethics and health policy and deserve more attention and further scrutiny. (shrink)

Throughout the 20th century, market capitalism was defended on parallel grounds. First, it promotes freedom by enabling individuals to exploit their own property and labor-power; second, it facilitates an efficient allocation and use of resources. Recently, however, both defenses have begun to unravel—as capitalism has moved into its “platform” phase. Today, the pursuit of allocative efficiency, bolstered by pervasive data surveillance, often undermines individual freedom rather than promoting it. And more fundamentally, the very idea that markets are necessary to achieve (...) allocative efficiency has come under strain. Even supposing, for argument’s sake, that the claim was true in the early 20th century when von Mises and Hayek pioneered it, advances in computing have rekindled the old “socialist calculation” debate. And this time around, markets—as information technology—are unlikely to have the upper hand. -/- All of this, we argue, raises an important set of governance questions regarding the political economy of the future. We focus on two: How much should our economic system prioritize freedom, and to what extent should it rely on markets? The arc of platform capitalism bends, increasingly, toward a system that neither prioritizes freedom nor relies on markets. And the dominant critical response, exemplified by Shoshana Zuboff’s work, has been to call for a restoration of market capitalism. Longer term, however, we believe it would be more productive to think about how “postmarket” economic arrangements might promote freedom—or better yet, autonomy—even more effectively than markets, and to determine the practical steps necessary to realize that possibility. (shrink)

I seek to advance enquiry into the point of a public higher education institution by drawing on ideals salient in the sub-Saharan African philosophical tradition. There are relational, and specifically communal, values prominently held by African thinkers that I use to ground a promising rival to the dominant contemporary Western, and especially Anglo-American, accounts of what a university ultimately ought to strive to achieve, which focus mainly on autonomy, truth, and citizenship. My aims are not merely comparative, contrasting an (...) Afro-communal approach with other ones that have been more globally influential, but also substantive. Although the theory of a university’s point that I articulate and defend has an African pedigree, I work to show that it should be taken seriously by a global audience, for plausibly capturing a variety of intuitions and claims that are widely shared. (shrink)

In this paper I argue that liberal proponents of mandatory autonomy education tend to overlook or underestimate the potential threats that such an education poses to the overall well-being of children (including, ironically, threats to the development of genuine autonomy). They do so by paying insufficient attention to the importance of moral virtue as a constitutive element of and precondition for genuine autonomy, and by failing to recognize how the development and consolidation of moral virtue may be (...) undermined by the sort of autonomy education they recommend. I develop my argument through engagement with the work of Eamonn Callan and Ian MacMullen, drawing on Aristotelian ethics to highlight the shortcomings in their accounts. (shrink)

Doctors routinely refuse donation offers from prospective living kidney donors with certain comorbidities such as diabetes or obesity out of concern for donor wellbeing. This refusal occurs despite the ongoing shortage of kidney transplants and the superior performance of living donor kidney transplants compared to those from deceased donors. In this paper, we argue that this paternalistic refusal by doctors is unjustified and that, within limits, there should be greater acceptance of such donations. We begin by describing possible weak and (...) strong paternalistic justifications of current conservative donor acceptance guidelines and practices. We then justify our position by outlining the frequently under-recognised benefits and the routinely overestimated harms of such donation, before discussing the need to respect the autonomy of willing donors with certain comorbidities. Finally, we respond to a number of possible objections to our proposal for more liberal kidney donor acceptance criteria. We use the situation in Australia as our case study, but our argument is applicable to comparable situations around the world. (shrink)

C an actions caused by emotions be free and autonomous? The so-called rationalist conception of autonomy denies this. Only actions done in the light of reflexive choices can be autonomous and hence free. I argue that the rationalist conception does not make room for akratic actions, that is, free and intentional actions performed against the agent’s best judgement. I then develop an account inspired by Harry Frankfurt and David Shoemaker, according to which an action is autonomous when it is (...) determined by the agent’s most central cares, where cares are defined in terms of emotional dispositions. (shrink)

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

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

MacKay and Robinson (2016) provide a critical analysis of four organ donation registration options using an expanded conception of manipulation introduced by Jennifer Blumenthal-Barby (Blumenthal-B...

As cognitive enhancement research advances, important ethical questions regarding individual autonomy and freedom are raised. Advocates of cognitive enhancement frequently adopt a procedural approach to autonomy, arguing that enhancers improve an individual’s reasoning capabilities, which are quintessential to being an autonomous agent. On the other hand, critics adopt a more nuanced approach by considering matters of authenticity and self-identity, which go beyond the mere assessment of one’s reasoning capacities. Both positions, nevertheless, require further philosophical scrutiny. In this paper, (...) we investigate the ethics of cognitive enhancement through the lenses of political and philosophical arguments about autonomy and freedom. In so doing, we contend that a substantive, relational account of individual autonomy offers a more holistic understanding of the ethical concerns of cognitive enhancement. (shrink)

The quest for real democracy is one of the components of sustainable degrowth. But the incipient debate on democracy and degrowth suffers from general definitions and limited connections to political philosophy and democracy theory. This article offers a critical review of democracy theory within the degrowth literature, taking as its focal point a relevant debate between Serge Latouche and Takis Fotopoulos. We argue that the core of their contention can be traced back to the relationship between the concepts of democracy (...) and autonomy as defined by philosopher Cornelius Castoriadis, which both authors and generally the degrowth movement consider as one of their theoretical reference points. We show how both Latouche and Fotopoulos hold a misconception of Castoriadis' notions of autonomy, the social imaginary and politics, which in turn limits their cognisance of democracy and hence confuses their debate concerning the possibilities for a degrowth transition within the confines of a liberal parliamentary democracy. With a clarified theoretical understanding of the interconnected democracy-autonomy assemble, we proceed to an evaluation of the revolutionary potential of the degrowth movement and to a better understanding of a possible relationship between democracy and degrowth. (shrink)

This article tries to shed light on the difference between human autonomy and AI-driven machine autonomy. The breadth of the studies concerning this topic is constantly increasing, and for this reason, this discussion is very narrow and limited in its extent. Indeed, its hypothesis is that it is possible to distinguish two kinds of autonomy by analysing the way humans and robots narrate stories and the types of stories that, respectively, result from their capability of narrating stories (...) on their own. To approach the question of autonomy and its different interpretations in robots and humans, using narratives and stories as a lens, I proceed through four steps. First, I provide a brief summary concerning the state of the art with regard to issues concerning autonomy and AI. Second, I focus on specific issues concerning AI that are applied to storytelling. Third, I progressively approach narrative autonomy through what could seem a useless digression by addressing the problem of human creativity in relation to machine creativity. Fourth, I hypothesize a radical difference between narrative autonomy—which is proper to humans—and storytelling capability, which can be observed in both humans and machines. (shrink)

In numerous accounts of both autonomy and freedom, social or relational elements have been offered as conceptual requirements in addition to purely procedural conditions. In addition, it is claimed that social recognition of the normative authority or self-trust of the agent is conceptually required for autonomy. In this paper I argue that in cases where people find themselves completely dislocated from the social and cultural homes that had provided them with the language in which to formulate and express (...) their values, it is clear that social recognition of the sort defended in relational models is causally but not conceptually required for agency to be (re-)established. This is shown by noting that often victims of human tracking or smuggling find themselves in foreign settings where it is quite up for grabs where and how they will attempt to reconstruct a life narrative which they can generally embrace. Therefore, seeing social recognition as conceptually required for autonomous agency or freedom would ignore the variability in the ways that such recognition must be expressed. (shrink)

Gilabert argues that the humanist conception of duties of global justice and the principle of cosmopolitan justifiability will lead us to accept an egalitarian definition of individual autonomy. Gilabert further argues that realizing conditions of individual autonomy can serve as the cut-off point to duties of global justice. I investigate his idea of autonomy, arguing that in order to make sense of this claim, we need a concept of autonomy. I propose 4 possible definitions of (...) class='Hi'>autonomy, none of which seem to necessitate Gilabert’s duties of egalitarian global justice. Instead, I propose that he may have in mind Autonomy 5, which requires that individuals have access to a maximum number of options and not simply a sufficient range of options to choose from. I criticize this premise as too demanding in the global world characterized by fundamental inequality. Second, I argue that if we were to endorse the preconditions for Autonomy 5, we would have to accept that Gilabert’s theory of global justice doesn’t provide for a cut-off point of duties of global justice. (shrink)

Hope has been neglected as a topic by philosophers interested in families, children, and children's autonomy. Hope may be confused with adjacent phenomena, such as optimism and wishful thinking. However, hope, when understood to involve goals, exploration of pathways to achieving those goals, and motivation to explore the pathways, is necessary for autonomy. It is also importantly related to children's resilience in response to challenges and stressors. In the course of explaining what I take autonomy to involve, (...) why I think children can have areas of local autonomy, and connections between hope, autonomy and resilience, I examine evidence that supports my claims about these connections. I then conclude with a brief discussion of implications of these connections for social policy, especially in the educational context, and for personal interactions with children. (shrink)