According to many criteria, agency, intentionality, responsibility and freedom of decision, require conscious decisions. Freud already assumed that many of our decisions are influenced by dynamically unconscious motives or that we even perform unconscious actions based on completely unconscious considerations. Such actions might not be intentional, and perhaps not even actions in the narrow sense, we would not be responsible for them and freedom of decision would be missing. Recent psychological and neurophysiological research has added to this a number of (...) phenomena (the "new unconscious") in which behavior is completely unconscious or in which the decision or its execution is influenced by unconscious factors: priming, automatic behavior, habitualized behavior, actions based on plain unconscious deliberations, intrusion of information from the dorsal pathway, etc. However, since this makes up the largest part of the behavior which is generally regarded as action, intentionality, yet agency, responsibility and even compatibilist freedom of decision for the largest part of our behavior may be threatened. Such considerations have led to a lively debate, which, however, suffers from generalizations that lump all these unconscious phenomena together. In contrast, the aim of this article is to discuss individual unconscious influences on our behavior separately with respect to what extent they require changes in traditional conceptualizations. The first part (2-4) of the article outlines the "traditions" and their elaborations: the intentional causalist concept of action, an associated empirical theory of action and standard concepts of responsibility and compatibilist freedom of decision, as well as the challenges for them. In the second part (5-9), the aforementioned unconscious influences on our actions (except for automated and habitualized actions, which I discuss elsewhere) are examined: 1. unconscious priming, 2. dynamically unconscious motives, 3. dorsal pathway information influencing conscious decisions, 4. unconsciously altered execution of conscious intentions, 5. unconscious deliberations and decisions. To what extent do these phenomena C1. require a change in the concept of action, C2. curtail intentionality or agency, C3. responsibility and C4. freedom? The result is: The curtailments prove to be far less dramatic than they initially appear; they require more watchfulness but no conceptual change. (shrink)

The phenomenon of ambivalence is an important one for any philosophy of action. Despite this importance, there is a lack of a fully satisfactory analysis of the phenomenon. Although many contemporary philosophers recognize the phenomenon, and address topics related to it, only Harry Frankfurt has given the phenomenon full treatment in the context of action theory – providing an analysis of how it relates to the structure and freedom of the will. In this paper, I develop objections to Frankfurt's account, (...) all revolving around the charge that his account contains a serious ambiguity between willing and identifying. With such objections in place, I then develop an analysis that avoids the difficulties and ambiguities that Frankfurt's analysis is prey to. I briefly distinguish ambivalence from other types of internal conflict. This paper aims to offer conceptual clarification on the phenomenon of ambivalence, which will then allow for discussions about the normative merits and demerits of ambivalence, the effects of ambivalence on autonomous action, and methods of resolution of ambivalence. (shrink)

Are we being manipulated online? If so, is being manipulated by online technologies and algorithmic systems notably different from human forms of manipulation? And what is under threat exactly when people are manipulated online? This volume provides philosophical and conceptual depth to debates in digital ethics about online manipulation. The contributions explore the ramifications of our increasingly consequential interactions with online technologies such as online recommender systems, social media, user-friendly design, micro-targeting, default-settings, gamification, and real-time profiling. The authors in this (...) volume address four broad and interconnected themes: • What is the conceptual nature of online manipulation? And how, methodologically, should the concept be defined? • Does online manipulation threaten autonomy, freedom, and meaning in life, and if so, how? • What are the epistemic, affective, and political harms and risks associated with online manipulation? • What are legal and regulatory perspectives on online manipulation? The Philosophy of Online Manipulation brings these various considerations together to offer philosophically robust answers to critical questions concerning our online interactions with one another and with autonomous systems. It will be of interest to researchers and advanced students working in moral philosophy, digital ethics, philosophy of technology, and the ethics of manipulation. (shrink)

Ethical evaluation of deep brain stimulation as a treatment for Parkinson’s disease is complicated by results that can be described as involving changes in the patient’s identity. The risk of becoming another person following surgery is alarming for patients, caregivers and clinicians alike. It is one of the most urgent conceptual and ethical problems facing deep brain stimulation in Parkinson’s disease at this time. In our paper we take issue with this problem on two accounts. First, we elucidate what is (...) meant by “becoming another person” from a conceptual point of view. After critically discussing two broad approaches we concentrate on the notion of “individual identity” which centers on the idea of “core attitudes”. Subsequently we discuss several approaches to determine what distinguishes core attitudes from those that are more peripheral. We argue for a “foundational-function model” highlighting the importance of specific dependency relations between these attitudes. Our second aim is to comment on the possibility to empirically measure changes in individual identity and argue that many of the instruments now commonly used in selecting and monitoring DBS-patients are inappropriate for this purpose. Future research in this area is advised combining a conceptual and an empirical approach as a basis of sound ethical appraisal. (shrink)

The notion of respect for autonomy dominates bioethical discussion, though what qualifies precisely as autonomous action is notoriously elusive. In recent decades, the notion of autonomy in medical contexts has often been defined in opposition to the notion of autonomy favoured by theoretical philosophers. Where many contemporary theoretical accounts of autonomy place emphasis on a condition of “authenticity”, the special relation a desire must have to the self, bioethicists often regard such a focus as irrelevant to the concerns of medical (...) ethics, and too stringent for use in practical contexts. I argue, however, that the very condition of authenticity that forms a focus in theoretical philosophy is also essential to autonomy and competence in medical ethics. After tracing the contours of contemporary authenticity-based theories of autonomy, I consider and respond to objections against the incorporation of a notion of authenticity into accounts of autonomy designed for use in medical contexts. By looking at the typical problems that arise when making judgments concerning autonomy or competence in a medical setting, I reveal the need for a condition of authenticity—as a means of protecting choices, particularly high-stakes choices, from being restricted or overridden on the basis of intersubjective disagreement. I then turn to the treatment of false and contestable beliefs, arguing that it is only through reference to authenticity that we can make important distinctions in this domain. Finally, I consider a potential problem with my proposed approach; its ability to deal with anorexic and depressive desires. (shrink)

In accordance with a recent statement released by the World Health Organization, the Canadian province of Ontario is moving to ban payment for plasma donation. This is partially based on contentions that remuneration for blood and blood products undermines autonomy and personal dignity. This paper is dedicated to evaluating this claim. I suggest that traditional autonomy-based arguments against commodification of human body parts and substances are less compelling in the context of plasma donation in Canada, but that there is another (...) autonomy-based objection to paid plasma donation that has not received sufficient attention. Namely, the stigma that surrounds exchanging plasma for payment makes it difficult to make an autonomous decision to engage in this activity. I suggest that this problem can be overcome in one of two ways; by banning payment for plasma, or by reducing the stigma surrounding this practice. I provide an indication of how we might work to achieve the latter, contending that this possibility should be taken seriously, due to the difficulties in achieving a sufficient supply of plasma without remuneration. (shrink)

A popular view among autonomy theorists is that facts about the history of a person's desires, and specifically facts about how they were formed or acquired, matter crucially to her autonomy. I argue that while there is an important relationship between a person's autonomy and the history of her desires, a person's autonomy does not depend on how her desires were formed or acquired. I argue that a desire's autonomy lies not in its origins but in whether its bearer has (...) a history of having engaged with it in the right sort of way. I argue that this view has important advantages, and no obvious disadvantages, over its historical and its non-historical rivals. (shrink)

Galen Strawson defends his pessimist position with his famous “Basic Argument”. He attempts to prove that no agent can meet the demands for the ultimate moral responsibility. I argue that the Basic Argument is not impressive because it commits to a linear justification framework under which not only the notion of free will and moral responsibility but every notion would inevitably involve a vicious infinite regress. Surprisingly, this point has not been significantly addressed in the literature of Strawson’s Basic Argument. (...) I scaffold my argument against “Basic Argument” by critically reviewing and comparing Frankfurt, Christman and Ekstrom’s approach to autonomy. I show that any approach, which commits to a linear justification framework, would inevitably involve an infinite regress problem. To make his argument more impressive, Strawson will have to show why he commits to a hierarchical justification framework in the Basic Argument in the first place. (shrink)

While there is much literature on autonomy and the conditions for its attainment, there is less on how those conditions reflect on agents’ ordinary careers. Most people’s careers involve a great deal of subservient activity that would prevent the kind of control over agents’ actions that autonomy would seem to require. Yet, it would seem strange to deny autonomy to every agent who regularly follows orders at work—to do so would make autonomy a futile ideal. Most contemporary autonomy accounts provide (...) purely theoretical analysis without reference to any practical goal that autonomy could serve. These accounts are likely to resolve this issue in one direction: either almost entirely including or excluding subservient workers from autonomy. Either solution would fail to distinguish agents who sufficiently control their lives, in spite of limited subservience, according to their own standards, from agents for whom subservience precludes a fulfilling life. I suggest the solution lies in a return to goal-oriented autonomy accounts, which can use the goal to distinguish when subservience overwhelms autonomy from when subservience and autonomy can coexist. I present an account that anchors autonomy in the happiness that it provides for agents who sufficiently control their lives as determined by their more important prudential standards. On this account, agents in subservient careers can be autonomous if they determine how to make their careers consistent with their happiness. (shrink)

In light of the variety of uses of the term autonomy in recent bioethics literature, in this paper, I suggest that competence, not being as contested, is better placed to play the anti-paternalistic role currently assigned to autonomy. The demonstration of competence, I will argue, can provide individuals with robust spheres of non-interference in which they can pursue their lives in accordance with their own values. This protection from paternalism is achieved by granting individuals rights to non-interference upon demonstration of (...) competence. In this paper, I present a risk-sensitive account of competence as a means of grounding rights to non-interference. On a risk-sensitive account of competence individuals demonstrate their competence by exercising three capacities to the extent necessary to meet a threshold determined by the riskiness of the decision. These three capacities are the capacity to acquire knowledge, use instrumental rationality, and form and revise a life plan. (shrink)

Choice architecture is heralded as a policy approach that does not coercively reduce freedom of choice. Still we might worry that this approach fails to respect individual choice because it subversively manipulates individuals, thus contravening their personal autonomy. In this article I address two arguments to this effect. First, I deny that choice architecture is necessarily heteronomous. I explain the reasons we have for avoiding heteronomous policy-making and offer a set of four conditions for non-heteronomy. I then provide examples of (...) nudges that meet these conditions. I argue that these policies are capable of respecting and promoting personal autonomy, and show this claim to be true across contrasting conceptions of autonomy. Second, I deny that choice architecture is disrespectful because it is epistemically paternalistic. This critique appears to loom large even against non-heteronomous nudges. However, I argue that while some of these policies may exhibit epistemically paternalistic tendencies, these tendencies do not necessarily undermine personal autonomy. Thus, if we are to find such policies objectionable, we cannot do so on the grounds of respect for autonomy. (shrink)

The Humean theory of motivation remains the default position in much of the contemporary literature in meta-ethics, moral psychology, and action theory. Yet despite its widespread support, the theory is implausible as a view about what motivates agents to act. More specifically, my reasons for dissatisfaction with the Humean theory stem from its incompatibility with what I take to be a compelling model of the role of motivating reasons in first-person practical deliberation and third-person action explanations. So after first introducing (...) some assumptions about the nature of agency in section one, I will turn to articulating and defending this account of motivating reasons in sections two through four of the paper. Section five then provides some background on the Humean theory before I argue directly against it in section six and critically examine the leading arguments for the view in section seven. Given limitations of space, however, I save the task of developing a positive anti-Humean view for another occasion. (shrink)

Formal views of autonomy rule out substantive rational capacities (reasons-responsiveness) as a condition of autonomous agency. I argue that such views face a number of underappreciated problems: they have trouble making sense of how autonomous agents could be robustly responsible for their choices, face the burden of explaining why there should be a stark distinction between the importance of factual and evaluative information within autonomous agency, and leave it mysterious why autonomy is the sort of thing that has value and (...) ought to be promoted. Moreover, I argue that the alternative view that includes substantive rational capacities need not have the unacceptable political implications it is sometimes thought to have. (shrink)

Definition of the problemThe article addresses the relationship between reproduction, time and the good life. Services offered by reproductive medicine and conceptions of the good life in time influence each other reciprocally. This interaction is characterised by implicit and explicit normative settings and expectations of appropriate temporality.ArgumentsWe first discuss the significance of time for the life course and for parenthood from a sociological and social psychological perspective. Reproductive medicine can increase the options for becoming a parent and thus for life-time (...) autonomy. However, in the context of societal imperatives for optimisation and efficiency, it can also have opposite effects and increase heteronomy. Overall, this leads to changed forms of adaptation and self-determination, new dilemmas and ambivalences in the temporal optimisation of parenthood.ConclusionsAgainst this background, we explain how the ethics of reproductive medicine could benefit from interdisciplinary research that focuses on life in its temporal course. (shrink)

This paper concerns the relationship between two questions. The first is a question about inner freedom: What is it to be rendered unfree, not by external obstacles, but by aspects of oneself? The second is a question about agency: What is it to fail at being a thing that genuinely acts, and instead to be a thing that is merely acted upon, passive in relation to its own behaviour? It is widely believed that answers to the first question must rest (...) on or be partly explained by answers to the second. Here I argue that this is a mistake: losses of inner freedom are not, after all, explicable in terms of failures of agency. To establish this conclusion, I consider three familiar lines of thought that appear to tie ideas about inner freedom to ideas about agency, each relating to a different conception of inner freedom: absence of inner constraint, self-government, and absence of determination by external forces. I argue that, in each case, any apparent conceptual reliance on a special conception of agency is merely illusory, the result being that we must allow clear water between our theories of inner freedom and our theories of agency. This conclusion is of significance for contemporary theories of agency and personal autonomy, as well as for ‘positive’ conceptions of political liberty. (shrink)

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

For those who maintain that free will is incompatible with causal determinism, a persistent problem is to give a coherent characterization of action that is neither determined by prior events nor random, arbitrary, lucky or in some way insufficiently under the control of the agent to count as free action. One approach—that of Roderick Chisholm and others—is to say that a third alternative is for an action to be caused by an agent in a way that is not reducible to (...) event causal terms. A different approach than the Chisholmian appeal to primitive substance causation is one that, instead, involves causal relations purely among events. This paper presents a particular event-causal indeterminist account of free action, describing both its attractions and recent objections to it, and then proposes a revised version, with the aim of supporting the plausibility of an event-causal indeterminist approach to free will. (shrink)

This paper defends an account of compassion and argues for the centrality of compassion to the proper practice of medicine. The argument proceeds by showing that failures of compassion can lead to poor medical treatment and disastrous outcomes. Several case studies are discussed, exemplifying the difference between compassionate and noncompassionate responses to patients seeking help. Arguments are offered in support of approaching reports of persistent pain with a trusting attitude, rather than distrust or skepticism. The article concludes by suggesting educational (...) improvements to encourage compassion. (shrink)

Credit theories of knowledge have to explain the conditions under which beliefs are attributable to cognitive agents. The most promising way to explain these conditions is to offer an account of cognitive agency that is a plausible development of the uncontroversial notion that we are believing subjects. This article develops and defends a Structuralist model of cognitive agency.

According to credit theories of knowledge, S knows that p only if S deserves credit for truly believing that p. This article argues that any adequate credit theory has to explain the conditions under which beliefs are attributable to subjects. It then presents a general account of these conditions and defends two models of cognitive agency. Finally, the article explains how an agent-based approach rescues the credit theory from an apparent counterexample. The article's defense of the credit theory is qualified, (...) however, for one lesson that emerges is that credit theories are theories of subjective justification, not theories of knowledge. (shrink)

This paper responds to Sven Bernecker’s argument that agent reliabilism cannot accommodate internalist intuitions about clarvoyance cases. In section 1 we clarify a version of agent reliabilism and Bernecker’s objections against it. In section 2 we say more about how the notion of cognitive integration helps to adjudicate clairvoyance cases and other proposed counterexamples to reliabilism. The central idea is that cognitive integration underwrites a kind of belief ownership, which in turn underwrites the sort of responsibility for belief required for (...) subjective justification. In section 3 we say more about what cognitive integration amounts to, drawing on some recent accounts of desire ownership from the literature on autonomy and moral responsibility. (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)

Part I of the dissertation examines the cognitive aspects of autonomy. The central question concerns what kind of cognitive capacity autonomy is. It will be argued that the concept of autonomy is best understood in terms of a metacognitive capacity of the individual. It is argued that metacognition has two components: procedural reflexivity and metarepresentation. Metarepresentation in turn can be divided into inferential reflexivity and other-attributiveness. These two components are essential for autonomy. Particular emphasis is put on procedural reflexivity. Further, (...) since the essential function of metacognition is control, it is argued that the concept of autonomy, understood as a metacognitive capacity, can be interpreted in terms of control. Issues arising from empirical data from neuroscience on functional, as well as impaired, metacognition, and on undermined autonomy, are dealt with. It is argued that autonomy cannot be determined with respect to subjective conditions. Neurological impairments, like Anton’s Syndrome, dementia, and thought insertion in schizophrenia, are put forward in support of this claim. To determine autonomy we require external conditions. In order to determine whether an individual is autonomous, both the metacognitive status of the individual and the external setting must be considered, since they are in interplay and consequently influence each other. In Part II, the analysis put forward in Part I is applied to Swedish healthcare. It is argued that the distinction between autonomy as a right and as a capacity must be explicit in order to understand what autonomy means and to deal with it effectively in healthcare practice. A discussion about whether or not the patient’s right to autonomy sometimes tends to be over-emphasized in healthcare is put forward. Special emphasis is placed on psychitaric issues such as deinstitutionalization and participation. Following the closure of the mental hospitals, deinstitutionalization and community-based care have become central topics in psychiatry. At the same time, the implementation of such care can be demanding for patients suffering from a persistent mental disorder. In part II it is also suggested that the metacognitive account of the concept of autonomy might help clarify the criteria governing coercive care. Finally, some suggestions concerning developments and improvements in Swedish healthcare, especially in psychiatry, where the concept of autonomy is important but problematic, are put forward. (shrink)

Theories of identification explain which elements in our mental economy determine our authoritative standpoint and which elements are external. My evaluative theory explains this special authority by considering the holistic pattern of emotional evaluations and evaluative judgments without excluding Jaworska's so-called "marginal cases".

The purpose of this dissertation is to identify some of the most pressing problems in the dominant contemporary approach to research ethics, and to devise an alternative approach that avoids these problems. I contend that the fundamental ethical values invoked in human research are often appealed to in contradictory or ambiguous ways, or in ways that do not adequately capture or do not show an adequate understanding of the specific ethical concerns of human research. One significant problem in this domain (...) is that values for ethical research are often unreflectively imported from medical therapy, producing ill-suited guidelines that cannot capture the different ethical situations that arise in the context of research. Furthermore, ethical guidelines in this area are often not developed with a sufficient understanding of the deep philosophical issues that they invoke. I suggest that we can address these problems through examining the fundamental ethical concerns of research on a philosophical level. This method will reveal severe problems with the approach to two of the ethical values underlying research; beneficence and respect for autonomy (or respect for persons). Once the nature of these problems has been revealed, and with reference to ethical problems that typically arise in the domain of research, I construct a coherent philosophical foundation for research ethics, which both avoids these deep-seated problems and better captures the ethical issues that arise in the domain of human research. I argue that we need to radically depart from the values of beneficence and autonomy/respect for persons as they are currently understood in the guidelines. We need an idea of beneficence that is clearly distinct from that which is used in the therapeutic medical context from which this notion is currently drawn. I also contend that we need to move away from autonomy as a central value in research ethics. I posit an alternative choice-based approach to informed consent which is concerned both with respecting agents’ freedom of choice, and also with their wellbeing, as providing a good means of protecting and promoting the interests of the individual research subject. Although these two imperatives are often thought to clash on a fundamental level, I will show that, in research ethics, they can be reconciled with minimal conflict. Though this represents a departure from the ethics of medical therapy, this approach is far more suited to the context of research. This theoretical basis for informed consent can help to clarify the ethical problems that are specific to this domain and provide us with relevant ethical guidance in research ethics. (shrink)

When women become perpetrators of suicide bombing, their agency – their ability to act upon and affect the world – is often denied. There are a number of reasons for this and one this thesis considers is that – as females – they are not expected to be violent. Accordingly, such women are judged to be coerced or incompetent, and so unable to rule themselves sufficiently as agents. Models of autonomy propose various frameworks for assessing whether acts or persons are (...) self-governing, and the relational approach in particular has garnered much support recently. However, some aspects of the relational account remain under-theorised, including how autonomy might be measured. In this thesis, I aim to bring these two elements together by examining whether an extension of the relational model may offer a way in which to estimate the autonomy of the bombers in a more nuanced fashion. I make two claims. First, that the relational conception of the agent and autonomy ‘fits’ the bombers. Second, that my spectrum view, which is rooted in the relational approach, maps the bomber’s autonomy approximately but in detail. As such, my spectrum view is a befitting notion of autonomy and allows a graded and comparative representation of the bomber’s autonomy. (shrink)

Recent studies in psychosocial oncology that seek to address the social, psychological, emotional, spiritual, quality of life, and functional impacts of cancer, report positive findings for meaning-making interventions designed to help cancer patients cope with their illness experience. These interventions are successful in decreasing depression among cancer patients and increasing life satisfaction, self-esteem, coping, physical functioning, and optimism. Yet, despite these positive findings meaning-making interventions and, more generally psychosocial care, are not well integrated into hospital or healthcare organization routine cancer (...) patient care.This thesis explores practical, theoretical, and bioethical barriers to integrating psychosocial care, focusing primarily on the latter considerations. I will argue that meaning-making interventions fall within the bounds of healthcare professionals’ capacities and duty to care, more to the point, as necessary for quality cancer patient care. The bioethical principle of respect for autonomy, when reconsidered from a feminist standpoint, morally requires the intervention’s inclusion in routine care. (shrink)