Criminal offenders may be offered to participate in voluntary rehabilitation programs aiming at correcting undesirable behaviour, as a condition of early release. Behavioural treatment may include direct intervention into the central nervous system (CNS). This article discusses under which circumstances voluntary rehabilitation by CNS intervention is justified. It is argued that although the context of voluntary rehabilitation is a coercive circumstance, consent may still be effective, in the sense that it can meet formal criteria for informed consent. (...) Further, for a consent to be normatively valid (“take the wronging out of the act”) under a coercive circumstance, the subject to be treated must (1) have the sovereign authority to consent, and (2) the offer-giver must be in the right normative position to make the offer. While I argue that subjects do have the sovereign authority to consent to treatment, I also argue that inappropriate offers yield invalid consents. Considerations on inappropriate offers should therefore inform which kinds of CNS intervention-based rehabilitation schemes the state may propose as part of the criminal justice system. Yet as I conclude in this paper, while there are some intrinsic constraints on voluntary rehabilitation programs, the main constraints on voluntary rehabilitation are likely to be contingent overriders. However, CNS intervention is not ruled out as such in the context of voluntary rehabilitation. (shrink)

We study imagination as reality-oriented mental simulation : the activity of simulating nonactual scenarios in one’s mind, to investigate what would happen if they were realized. Three connected questions concerning ROMS are: What is the logic, if there is one, of such an activity? How can we gain new knowledge via it? What is voluntary in it and what is not? We address them by building a list of core features of imagination as ROMS, drawing on research in cognitive (...) psychology and the philosophy of mind. We then provide a logic of imagination as ROMS which models such features, combining techniques from epistemic logic, action logic, and subject matter semantics. Our logic comprises a modal propositional language with non-monotonic imagination operators, a formal semantics, and an axiomatization. (shrink)

I discuss the argument of Persson and Savulescu that moral enhancement ought to accompany cognitive enhancement, as well as briefly addressing critiques of this argument, notably by John Harris. I argue that Harris, who believes that cognitive enhancement is largely sufficient for making us behave more morally, might be disposing too easily of the great quandary of our moral existence: the gap between what we do and what we believe is morally right to do. In that regard, Persson and Savulescu's (...) position has the potential to offer more. However, I question Persson and Savulescu's proposal of compulsory moral enhancement , proposing the alternative of voluntary moral enhancement. (shrink)

The degree of autonomy present in the choices made by individuals with an addiction, notably in the context of research, is unclear and debated. Some have argued that addiction, as it is commonly understood, prevents people from having sufficient decision-making capacity or self-control to engage in choices involving substances to which they have an addiction. Others have criticized this position for being too radical and have counter-argued in favour of the full autonomy of people with an addiction. Aligning ourselves with (...) middle-ground positions between these two extremes, we flesh out an account of voluntary action that makes room for finer-grained analyses than the proposed all-or-nothing stances, which rely on a rather static metaphysical understanding of the nature of the voluntariness of action. In contrast, a dynamic concept of voluntary action better accounts for varying levels of voluntariness of the person with an addiction which takes into consideration internal and external determinants of choice. Accordingly, like other components of autonomous choices such as level of information, voluntariness can fluctuate. Therefore, there are important implications for research and clinical ethics in matters of consent, recruitment, and therapeutic approaches. Overall, our proposal is inspired by a pragmatist understanding of voluntary action, notably with respect to how voluntariness is both informed by actions and experiences that shape one's view of the world. (shrink)

I discuss the argument of Persson and Savulescu that moral enhancement ought to accompany cognitive enhancement, as well as briefly addressing critiques of this argument, notably by John Harris. I argue that Harris, who believes that cognitive enhancement is largely sufficient for making us behave more morally, might be disposing too easily of the great quandary of our moral existence: the gap between what we do and what we believe is morally right to do. In that regard, Persson and Savulescu's (...) position has the potential to offer more. However, I question Persson and Savulescu's proposal of compulsory moral enhancement, proposing the alternative of voluntary moral enhancement. (shrink)

Military activities with the framework of the IDF [Israel Defense Force] is carried out by citizens in a variety of positions. In addition to the ordinary positions of career officers and NCOs, the IDF consists of conscripted men and women as well as reservists. Some of the latter serve under an ordinary command to serve for a certain relatively short period. Other reservists, including pilots and special forces officers have served since they volunteered to serve. Facing the political clash between (...) the government, who have been viewed as trying to change the democratic nature of the state, and the popular opposition, who have tried to protect the judiciary and other elements of democracy, many officers who belong to the latter reservist group have suspended their voluntary service or even retired. Their decision has raised the obvious issue of whether such decisions can be justified, morally, ethically, and democratically. This is the topic of the present paper. (shrink)

Voluntariness of consent to research has not been sufficiently explored through empirical research. The aims of this study were to develop a more comprehensive approach to assessing voluntariness and to generate preliminary data on the extent and correlates of limitations on voluntariness. We developed a questionnaire to evaluate subjects’ reported motivations and constraints on voluntariness. 88 subjects in five different areas of clinical research—substance abuse, cancer, HIV, interventional cardiology, and depression—were assessed. Subjects reported a variety of motivations for participation. Offers (...) of financial incentives were common but not influential, pressures from others were rare, and no threats were reported. However, certain financial incentives and—paradoxically—altruistic motivations led some subjects to feel more constrained. Consistent with previous studies, no one pattern of motivation was common to all research subjects. There was little evidence of constrained voluntariness, but some suggestion of areas of concern. Voluntariness appears to be susceptible to systematic empirical investigation. (shrink)

In this paper, I examine Alston's arguments for doxastic involuntarism. Alston fails to distinguish (i) between volitional and executional lack of control, and (ii) between compatibilist and libertarian control. As a result, he fails to notice that, if one endorses a compatibilist notion of voluntary control, the outcome is a straightforward and compelling case for doxastic voluntarism. Advocates of involuntarism have recently argued that the compatibilist case for doxastic voluntarism can be blocked by pointing out that belief is never (...) intentional. In response to this strategy, I distinguish between two types of intentionality and argue that belief is no less intentional than action is. (shrink)

The Voluntary Simplicity Movement can be understood broadly as a diverse social movement made up of people who are resisting high consumption lifestyles and who are seeking, in various ways, a lower consumption but higher quality of life alternative. The central argument of this paper is that the Voluntary Simplicity Movement or something like it will almost certainly need to expand, organise, radicalise and politicise, if anything resembling a degrowth society is to emerge in law through democratic processes. (...) In a sentence, that is the 'grass-roots' or 'bottom up' theory of legal and political transformation that will be expounded and defended in this paper. The essential reasoning here is that legal, political and economic structures will never reflect a post-growth ethics of macro-economic sufficiency until a post-consumerist ethics of micro-economic sufficiency is embraced and mainstreamed at the cultural level. (shrink)

Poor working conditions remain a serious problem in supplier facilities in developing countries. While previous research has explored this from the developed buyers’ side, we examine this phenomenon from the perspective of developing countries’ suppliers and subcontractors. Utilizing qualitative data from a major knitwear exporting cluster in India and a stakeholder management lens, we develop a framework that shows how the assumptions of conventional, buyer-driven voluntary governance break down in the dilution of buyer power and in the web of (...) factors rooted in suppliers’ traditions, beliefs, local demands and resource dependency. We reveal out how success in governing collaborative global supply chains often falls short within the subcontracting stage, where a stakeholder management mindset is elusive to most participants. We suggest that success in governing collaborative global supply chains is dependent on concepts of stakeholder utility and the presence of shared value that is often at odds with the realities of power, information asymmetry and compliance/reward systems inherent in the non-market coordination of global supply chains. Our findings offer important insights for delineating the concepts of value creation from CSR concepts and practices, and for modifying the basic assumptions of conventional supply chain governance. (shrink)

This paper provides an overview of the societal impact of a rising dementia population and examines the legal and ethical implications posed by voluntary registries as a community-oriented solution to improve interactions between law enforcement and individuals with dementia. It provides a survey of active voluntary registries across the United States, with a focus on Arizona, which has the highest projected growth for individuals living with dementia in the country.

Approximately 47 percent of women ages fifteen to forty‐four are currently without children, and slightly more than 20 percent of white women in America will never bear children, the highest percentage in modern history. Many fertile women who are childless are voluntarily so. Although any competent person twenty‐one years or older is legally eligible for voluntary sterilization, many doctors refuse to sterilize childfree women. This essay explores various reasons a woman would want to continue in her childfree lifestyle, evaluates (...) the accessibility of sterilization for women who are childfree by examining the reported reasons for denial of sterilization—both from the woman's and the physician's perspective—and assesses the legal status of voluntary sterilization for nonparous women. The essay also urges physicians to follow recommended guidelines for counseling women who, regardless of parity, desire sterilization and to provide this contraception if, after careful consideration, there are no outstanding health or other reasons that the procedure should not be performed. (shrink)

No laws or official guidelines govern medical assistance for dying in Japan. However, over the past several years, cases of assisted suicide or voluntary euthanasia, rarely disclosed until recently, have occurred in close succession. Inspired by these events, ethical, legal, and social debates on a patient’s right to die have arisen in Japan, as it has in many other countries. Several surveys of Japanese people’s attitudes towards voluntary assisted dying suggest that a certain number of Japanese prefer active (...) euthanasia. Against this background, it is important to discuss voluntary assisted dying cases in Japan and the Japanese views on them and to consider their implications. We review three recent Japanese voluntary assisted dying cases and discuss the various objections to voluntary assisted dying that have been published in response to these in various media outlets. Our counterarguments include the double suffering of people who are unable to give up their desire to die, individuality of death, variability of culture, problem of being an annoyance to (burden on) others, a slippery slope argument supporting voluntary assisted dying, and unfair claims about responsibility and excessive burden on people who are unable to give up their desire to die. We also point out the psychocultural and social problems in Japanese society that these objections reflect, and argue that voluntary assisted dying can be ethically acceptable under certain conditions. We conclude that Japanese society must change in order to enable those who sincerely wish to die to do so in a better way. (shrink)

The principle of wrongful benefits prescribes that beneficiaries from wrongdoing incur duties towards the victims of the wrongdoing. The principle focuses on involuntary beneficiaries, demanding that they disgorge their tainted benefit. However, it overlooks the duties of beneficiaries who are not straightforwardly involuntary. The article addresses this gap in the literature. It explores the duties of ‘voluntary beneficiaries’, who could avoid receiving the tainted benefit; and the duties of ‘welcoming beneficiaries’, who cannot avoid receiving the tainted benefit but welcome (...) it. The article demonstrates that in both cases, the duties of the beneficiary towards the victim of the original wrongdoing are not limited to the disgorgement of the benefit. Rather, voluntary and welcoming beneficiaries are themselves involved in the commission of wrongdoing against the victim of the original wrongdoing, and hence may owe the victim compensation that exceeds the level of their own benefit. This argument has various practical implications, e.g. in specifying the duties of companies who benefit from human rights violations down their supply chain. (shrink)

I agree with Nachev and Hacker’s general approach. However, their criticism of claims of covert automaticity can be strengthened. I first say a few words on what voluntary action involves and on the consequent limited relevance of brain research for the determination of voluntariness. I then turn to Nachev and Hacker’s discussion of possible covert automaticity and show why the case for it is weaker than they allow.

The permissibility of actions depends upon facts about the flourishing and separateness of persons. Persons differ from other creatures in having the task of discovering for themselves, by conjecture and refutation, what sort of life will fulfil them. Compulsory slavery impermissibly prevents some persons from pursuing this task. However, many people may conjecture that they are natural slaves. Some of these conjectures may turn out to be correct. In consequence, voluntary slavery, in which one person welcomes the duty to (...) fulfil all the commands of another, is permissible. Life-long voluntary slavery contracts are impermissible because of human fallibility; but fixed-term slavery contracts should be legally enforceable. Each person has the temporarily alienable moral right to direct her own life. (shrink)

Studies on informed consent to medical research conducted in low or middle-income settings have increased, including empirical investigations of consent to genetic research. We investigated voluntary participation and comprehension of informed consent among women involved in a genetic epidemiological study on breast cancer in an urban setting of Nigeria comparing women in the case and control groups.

This paper examines the extent to which the voluntary adoption of codes of conduct by multinational corporations (MNCs) renders MNCs accountable for the performance of actions specified in a code of conduct. In particular, the paper examines the ways in which codes of conduct coordinate the expectations of relevant parties with regard to the provision of assistance by MNCs on grounds of rescue or justice. The paper argues that this coordinative role of codes of conduct renders MNCs more accountable (...) for the performance of actions specified in a code of conduct than they would be without a code of conduct. This interpretation of the significance of codes of conduct is contrasted with the view that codes of conduct render MNCs accountable for performing actions specified in a code of conduct by grounding contractual obligations for the performance of such actions. (shrink)

The concept of voluntariness permeates the ethics and politics of migration and is commonly used to distinguish refugees from migrants. Yet, neither the precise nature and conditions of voluntariness nor its ethical significance for migrant rights and state obligations has received enough attention. The articles in this collection move the debate forward by demonstrating the complex ethical judgments involved in delineating voluntary from forced migration and in drawing out its political and institutional implications. In addition to highlighting the interplay (...) between the voluntary and nonvoluntary elements of migration over time and across different sites of the migration journey, they provide a nuanced account of the various conditions of voluntariness and they challenge common ideas about its normative political consequences. (shrink)

In an earlier article in this journal I argued that the question of whether heroin addicts can give voluntary consent to take part in research which involves giving them a choice of free heroin does not – in contrast with a common assumption in the bioethics literature – depend exclusively on whether or not they possess the capacity to resist their desire for heroin. In some cases, circumstances and beliefs might undermine the voluntariness of the choices a person makes (...) even if they do possess a capacity for self-control. Based on what I took to be a plausible definition of voluntariness, I argued that the circumstances and beliefs typical of many vulnerable heroin addicts are such that we have good reasons to suspect they cannot give voluntary consent to take part in such research, even assuming their desire for heroin is not irresistible. In a recent article in this journal, Uusitalo and Broers object to this on the grounds that I misdescribe heroin addicts' options set, that the definition of voluntariness on which I rely is unrealistic and too demanding, and, more generally, that my view of heroin addiction is flawed. I think their arguments derive from a misunderstanding of the view I expressed in my article. In what follows I hope therefore to clarify my position. (shrink)

An increasing number of bioethicists are raising concerns that young childless women requesting sterilisation as means of birth control are facing unfair obstacles. It is argued that these obstacles are inconsistent, paternalistic, that they reflect pronatalist bias and that men seem to face fewer obstacles. It is commonly recommended that physicians should change their approach to this type of patient. In contrast, I argue that physicians’ reluctance to eagerly follow an unusual request is understandable and that whatever obstacles result from (...) this reluctance serve as a useful filter for women who are not seriously committed to their expressed requests for sterilisation. As women already disproportionally bear the birth control burden, less resistance that men might be getting in terms of voluntary sterilisation works to women’s advantage, providing a much needed balance. Societal attitudes towards women and motherhood should not be confused with individual physicians’ reasonable reluctance to jump at a serious elective procedure at fairly mild expression of interest. (shrink)

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A key question in the theory of migration and in public debates on immigration policies is when migration can be said to be voluntary and when, conversely, it should be seen as nonvoluntary. In a previous article, we tried to answer this crucial question by providing a list of conditions we view as sufficient for migration to be considered nonvoluntary. According to our account, one condition that makes migration nonvoluntary is when people migrate because they lack acceptable alternatives to (...) doing so. In this article, we take the opportunity to further explore and clarify this crucial condition. More specifically, we focus on two main sets of questions. First, we ask whether migration is always voluntary when it serves goals that are voluntarily chosen, and whether those who decide to migrate voluntarily but only have the option of choosing among a limited set of dangerous, harmful, or illegal means for doing so, can be said to be forced to choose those means. Second, we ask whether what counts as “nonacceptable” alternatives should also include cases in which people could have their needs and fundamental rights met, but at the cost of betraying their moral principles or conceptions of the good. (shrink)

ABSTRACT Belgium legalised voluntary euthanasia in 2002, thus ending the long isolation of the Netherlands as the only country in which doctors could openly give lethal injections to patients who have requested help in dying. Meanwhile in Oregon, in the United States, doctors may prescribe drugs for terminally ill patients, who can use them to end their life – if they are able to swallow and digest them. But despite President Bush's oft‐repeated statements that his philosophy is to ‘trust (...) individuals to make the right decisions’ and his opposition to ‘distant bureaucracies’, his administration is doing its best to prevent Oregonians acting in accordance with a law that its voters have twice ratified. The situation regarding voluntary euthanasia around the world is therefore very much in flux. This essay reviews ethical arguments regarding voluntary euthanasia and physician‐assisted suicide from a utilitarian perspective. I shall begin by asking why it is normally wrong to kill an innocent person, and whether these reasons apply to aiding a person who, when rational and competent, asks to be killed or given the means to commit suicide. Then I shall consider more specific utilitarian arguments for and against permitting voluntary euthanasia. (shrink)

Mark Halstead; Voluntary Apartheid? Problems of Schooling for Religious and Other Minorities in Democratic Societies, Journal of Philosophy of Education, Volume.

While various items closely associated with belief, such as speech?acts of assertion, or what have recently been termed acts of ?acceptance?, can clearly be voluntary, it is commonly supposed that belief itself, being intrinsically truth?directed, is essentially passive. I argue that while this may be true of belief proper, understood as a kind of disposition, it is not true of acts of assent or ?judgment?. Judgments, I contend, must be deemed voluntary precisely because of their truth?aimedness, for in (...) their case this feature entails that they can always be regarded as the subjects of a kind of implicit practical reasoning. By emphasizing the familiar point that voluntariness need not involve anything more than this, and by invoking the soft determinist option of holding causation to be compatible with choice, I seek to deflect some anticipated objections to this argument. (shrink)

A person presented with adequate but not conclusive evidence for a proposition is in a position voluntarily to acquire a belief in that proposition, or to suspend judgment about it. The availability of doxastic options in such cases grounds a moderate form of doxastic voluntarism not based on practical motives, and therefore distinct from pragmatism. In such cases, belief-acquisition or suspension of judgment meets standard conditions on willing: it can express stable character traits of the agent, it can be responsive (...) to reasons, and it is compatible with a subjective awareness of the available options. (shrink)

This book chapter aims at exploring how intentional a piece of behavior should be to count as an action, and how a minimal view on action, not requiring a richly intentional causation, may still qualify such a behavior as voluntary.

Although euthanasia has been a pressing ethical and public issue, empirical data are lacking in Japan. We aimed to explore Japanese nurses’ attitudes to patients’ requests for euthanasia and to estimate the proportion of nurses who have taken active steps to hasten death. A postal survey was conducted between October and December 1999 among all nurse members of the Japanese Association of Palliative Medicine, using a self-administered questionnaire based on the one used in a previous survey with Australian nurses in (...) 1991. The response rate was 68%. A total of 53% of the respondents had been asked by patients to hasten their death, but none had taken active steps to bring about death. Only 23% regarded voluntary active euthanasia as something ethically right and 14% would practice it if it were legal. A comparison with empirical data from the previous Australian study suggests a significantly more conservative attitude among Japanese nurses. (shrink)

Anselm of Canterbury holds that freedom of the will is a necessary condition for moral responsibility. This condition, however, turns out to be trivially fulfilled by all rational creatures at all times. In order to clarify the necessary conditions for moral responsibility, we must look more widely at his discussion of the nature of the will and of willed action. In this paper, I examine his theory of voluntariness by clarifying his account of the sin of Satan in De casu (...) diaboli. Anselm agrees with Augustine that the sinful act cannot be given a causal explanation in terms of a distinct preceding act of will or desire or choice. He thus rejects volitionalist accounts of Satan's sin and thus of voluntary action in general. He moves beyond his predecessor, however, in insisting on the necessity of an explanation in terms of reasons, and his theory of the dual nature of the rational will is designed to meet this demand. A comparison of Satan's case with the case of the miser of De casu diaboli 3,... (shrink)

Some maintain that voluntariness is a value-neutral concept. On that view, someone acts involuntarily if subject to a controlling influence or has no acceptable alternatives. I argue that a value-neutral conception of voluntariness cannot explain when and why consent is invalid and that we need a moralized account of voluntariness. On that view, most concerns about the voluntariness of consent to participate in research are not well founded.

In philosophy, economics, and law, the idea of voluntary agreements plays a central role. But contractarianism in political philosophy stands on altogether different grounds from enthusi...

It is plausible that what possible courses of action patients may legitimately expect their physicians to take is ultimately determined by what medicine as a profession is supposed to do and, consequently, that we can determine the moral acceptability of voluntary euthanasia and physician-assisted suicide on the basis of identifying the proper goals of medicine. This article examines the main ways of defining the proper goals of medicine found in the recent bioethics literature and argues that they cannot provide (...) a clear answer to the question of whether or not voluntary euthanasia and physician-assisted suicide are morally acceptable. It is suggested that to find a plausible answer to this question and to complete the task of defining the proper goals of medicine, we must determine what is the best philosophical theory about the nature of prudential value. (shrink)

In paediatric oncology, research and treatments are often closely combined, which may compromise voluntary informed consent of parents. We identified two key scenarios in which voluntary informed consent for paediatric oncology studies is potentially compromised due to the intertwinement of research and care. The first scenario is inclusion by the treating paediatric oncologist, the second scenario concerns treatments confined to the research context. In this article we examine whether voluntary informed consent of parents for research is compromised (...) in these two scenarios, and if so whether this is also morally problematic. For this, we employ the account of voluntary consent from Nelson and colleagues, who assert that voluntary consent requires substantial freedom from controlling influences. We argue that, in the absence of persuasion or manipulation, inclusion by the treating physician does not compromise voluntariness. However, it may function as a risk factor for controlling influence as it narrows the scope within which parents make decisions. Furthermore, physician appeal to reciprocity is not controlling as it constitutes persuasion. In addition, framing information is a form of informational manipulation and constitutes a controlling influence. In the second scenario, treatments confined to the research context qualify as controlling if the available options are restricted through manipulation of options. Although none of the influences is morally problematic in itself, a combination of influences may create morally problematic instances of involuntary informed consent. Therefore, safeguards should be implemented to establish an optimal environment for parents to provide voluntary informed consent in an integrated research-care context. (shrink)

Many previous treatments of voluntary behavior have viewed intentions as causes of behavior. This has resulted in several dilemmas, including a dilemma concerning the origin of intentions. The present article circumvents traditional dilemmas by treating intentions as constraints that restrict degrees of freedom for behavior. Constraints self-organize as temporary dynamic structures that span the mind-body divide. This treatment of intentions and voluntary behavior yields a theory of intentionality that is consistent with existing findings and supported by current research.

An informed consent and voluntary assent in biomedical research with adolescents is contingent on a variety of factors, including adolescent and parent perceptions of research risk, benefit, and decision-making autonomy. Thirty-seven adolescents with asthma and their parents evaluated a high or low aversion form of a pediatric asthma research vignette and provided an enrollment decision; their perceptions of family influence over the participation decision; and evaluations of risk, aversion, benefit, and burden of study procedures. Adolescents and their parents agreed (...) on research participation decisions 74% of the time, yet both claimed ultimate responsibility for the participation decision. Both rated most study procedures as significantly more aversive than risky. Parents were more likely to rate aspects of the hypothetical study as beneficial and to provide higher risk ratings for procedures. Disagreements concerning research participation decisions and decision-making autonomy have implications for the exercise of voluntary assent in biomedical research. (shrink)

This paper examines the relative voluntariness of three types of virtue: 'epistemic' virtues like open-mindedness; 'motivational' virtues like courage, and more robustly 'moral' virtues like justice. A somewhat novel conception of the voluntariness of belief is offered in terms of the limited, but quite real, voluntariness of certain epistemic virtues.

This paper examines the relative voluntariness of three types of virtue: ‘epistemic’ virtues like open-mindedness; ‘motivational’ virtues like courage, and more robustly ‘moral’ virtues like justice. A somewhat novel conception of the voluntariness of belief is offered in terms of the limited, but quite real, voluntariness of certain epistemic virtues.

We all know what a voluntary action is - we all think we know when an action is voluntary, and when it is not. Yet, performing and action and defining it are different matters. What counts as an action? When does it begin? Does the conscious desire to perform an action always precede the act? If not, is it really a voluntary action? This is a debate that crosses the boundaries of Philosophy, Neuroscience, Psychology, and Social Science. (...) This book brings together some to the leading thinkers from these disciplines to consider this deep and often puzzling topic. The result is a fascinating and stimulating debate that will challenge our fundamental assumptions about our sense of free-will. (shrink)

In paediatric oncology, research and treatments are often closely combined, which may compromise voluntary informed consent of parents. We identified two key scenarios in which voluntary informed consent for paediatric oncology studies is potentially compromised due to the intertwinement of research and care. The first scenario is inclusion by the treating paediatric oncologist, the second scenario concerns treatments confined to the research context. In this article we examine whether voluntary informed consent of parents for research is compromised (...) in these two scenarios, and if so whether this is also morally problematic. For this, we employ the account of voluntary consent from Nelson and colleagues, who assert that voluntary consent requires substantial freedom from controlling influences. We argue that, in the absence of persuasion or manipulation, inclusion by the treating physician does not compromise voluntariness. However, it may function as a risk factor for controlling influence as it narrows the scope within which parents make decisions. Furthermore, physician appeal to reciprocity is not controlling as it constitutes persuasion. In addition, framing information is a form of informational manipulation and constitutes a controlling influence. In the second scenario, treatments confined to the research context qualify as controlling if the available options are restricted through manipulation of options. Although none of the influences is morally problematic in itself, a combination of influences may create morally problematic instances of involuntary informed consent. Therefore, safeguards should be implemented to establish an optimal environment for parents to provide voluntary informed consent in an integrated research-care context. (shrink)

Margaret Otlowski investigates the complex and controversial issue of active voluntary euthanasia. She critically examines the criminal law prohibition of medically administered active voluntary euthanasia in common law jurisdictions, and carefully looks at the situation as handled in practice. The evidence of patient demands for active euthanasia and the willingness of some doctors to respond to patients' requests is explored, and an argument for reform of the law is made with reference to the position in the Netherlands (where (...) active voluntary euthanasia is now openly practiced). (shrink)