Given the ubiquity and centrality of social and relational influences to the human experience, our conception of self-governance must adequately account for these external influences. The inclusion of socio-historical, externalist considerations into more traditional internalist accounts of autonomy has been an important feature of the debate over personal autonomy in recent years. But the relevant socio-temporal dynamics of autonomy are not only historical in nature. There are also important, and under-examined, future-oriented questions about how we retain autonomy while incorporating new (...) values into the existing set that guides our interaction with the world. In this paper, we examine these questions from two complementary perspectives: philosophy and neuroscience. After contextualizing the philosophical debate, we show the importance to theories of autonomous agency of the capacity to appropriately adapt our values and beliefs, in light of relevant experiences and evidence, to changing circumstances. We present a plausible philosophical account of this process, which we claim is generally applicable to theories about the nature of autonomy, both internalist and externalist alike. We then evaluate this account by providing a model for how the incorporation of values might occur in the brain; one that is inspired by recent theoretical and empirical advances in our understanding of the neural processes by which our beliefs are updated by new information. Finally, we synthesize these two perspectives and discuss how the neurobiology might inform the philosophical discussion. (shrink)

BackgroundRespect for autonomy is a paramount principle in end-of-life ethics. Nevertheless, empirical studies show that decision-making, exclusively focused on the individual exercise of autonomy fails to align well with patients’ preferences at the end of life. The need for a more contextualized approach that meets real-life complexities experienced in end-of-life practices has been repeatedly advocated. In this regard, the notion of ‘relational autonomy’ may be a suitable alternative approach. Relational autonomy has even been advanced as a foundational notion of palliative (...) care, shared decision-making, and advance-care planning. However, relational autonomy in end-of-life care is far from being clearly conceptualized or practically operationalized.Main bodyHere, we develop a relational account of autonomy in end-of-life care, one based on a dialogue between lived reality and conceptual thinking. We first show that the complexities of autonomy as experienced by patients and caregivers in end-of-life practices are inadequately acknowledged. Second, we critically reflect on how engaging a notion of relational autonomy can be an adequate answer to addressing these complexities. Our proposal brings into dialogue different ethical perspectives and incorporates multidimensional, socially embedded, scalar, and temporal aspects of relational theories of autonomy. We start our reflection with a case in end-of-life care, which we use as an illustration throughout our analysis.ConclusionThis article develops a relational account of autonomy, which responds to major shortcomings uncovered in the mainstream interpretation of this principle and which can be applied to end-of-life care practices. (shrink)

Outlaw emotions are emotions that stand in tension with one’s wider belief system, often allowing epistemic insight one may have otherwise lacked. Outlaw emotions are thought to play crucial epistemic roles under conditions of oppression. Although the crucial epistemic value of these emotions is widely acknowledged, specific accounts of their epistemic role(s) remain largely programmatic. There are two dominant accounts of the epistemic role of emotions: The Motivational View and the Justificatory View. Philosophers of emotion assume that these dominant ways (...) of accounting for the epistemic role(s) of emotions in general are equipped to account for the epistemic role(s) of outlaw emotions. I argue that this is not the case. I consider and dismiss two responses that could be made on behalf of the most promising account, the Justificatory View, in light of my argument, before sketching an alternative account that should be favoured. (shrink)