In this Introduction, I situate the underlying project “Autonomy and Mental Disorder” with reference to current debates on autonomy in moral and political philosophy, and the philosophy of action. I then offer an overview of the individual contributions. More specifically, I begin by identifying three points of convergence in the debates at issue, stating that autonomy is: 1) a fundamentally liberal concept; 2) an agency concept and; 3) incompatible with (severe) mental disorder. Next, I explore, in the (...) context of decisional capacity assessments, the difficulties to reconcile 1) and 2) with 3) which they at the same time seem to imply. Having clarified the centrality of a cogent notion of mental disorder for addressing these difficulties, I comment on three promising lines of inquiry about the nature and scope of autonomy that emerge from the following chapters. (shrink)
This chapter identifies and explores a series of challenges raised by the clinical concept of delusion for theories which conceive autonomy as an agency rather than a status concept. The first challenge is to address the autonomy-impairing nature of delusions consistently with their role as grounds for full legal and ethical excuse, on the one hand, and psychopathological significance as key symptoms of psychoses, on the other. The second challenge is to take into account the full logical range (...) of delusions, which may take the form of true or false factual beliefs, positive or negative evaluations, as well as the paradoxical delusion of mental illness. The third and final challenge is to make room for non-pathological or, autonomy-preserving delusions and to offer a credible way of distinguishing between these and pathological or, autonomy-impairing delusions. By setting out these challenges, we are able to, firstly, distinguish between two separate conceptions of objectivity that may be at work in existing accounts of delusions and, secondly, to put a spotlight on an elusive yet inescapable notion of agential success that underlies our thinking about autonomy as well as mental disorder. (shrink)
This paper explores the claim that someone can reasonably consider themselves to be under a duty to respect the autonomy of a person who does not have the capacities normally associated with substantial self-governance.
In this chapter, I articulate the structure of a general concept of autonomy and then reply to possible objections with reference to Ulysses arrangements in psychiatry. The line of argument is as follows. Firstly, I examine three alternative conceptions of autonomy: value-neutral, value-laden, and relational. Secondly, I identify two paradigm cases of autonomy and offer a sketch of its concept as opposed to the closely related freedom of action and intentional agency. Finally, I explain away the (...) class='Hi'>autonomy paradox, to which the previously identified pair of paradigm cases seems to give rise in the context of mental disorder. By addressing this paradox, we learn two valuable lessons. The first is about the relationships between the three conceptions of autonomy above. The second is about the relationship between autonomy and mental disorder. (shrink)
If the incompatibilist is right, determinism annuls free will, but not necessarily autonomy. The possibly deterministic origin of values and beliefs that are objectively grounded does not undermine the autonomy of agents who maintain these for the right reasons. Nonobjective perspectives—preferences about lifestyle, profession, choice of mate— cannot anyway be entirely removed even for an unlimited being. Moreover, if one were lucky to have inherited contingencies that mesh perfectly with the world one happened to inhabit even if it (...) is deterministic, one would have the capacity for perfect autonomy. The extreme incompatibilist position that autonomy requires creation of self ex nihilo is incoherent. (shrink)
Weak emergence has been offered as an explication of the ubiquitous notion of emergence used in complexity science (Bedau 1997). After outlining the problem of emergence and comparing weak emergence with the two other main objectivist approaches to emergence, this paper explains a version of weak emergence and illustrates it with cellular automata. Then it explains the sort of downward causation and explanatory autonomy involved in weak emergence.
Socialization enforces gendered standards of politeness that encourage men to be dominating and women to be deferential in mixed-gender discourse. This gendered dynamic of politeness places women in a double bind. If women are to participate in polite discourse with men, and thus to avail of smooth and fortuitous social interaction, women demote themselves to a lower social ranking. If women wish to rise above such ranking, then they fail to be polite and hence, open themselves to a wellspring of (...) social discord, dissention, and antagonism. The possibility for women’s politeness in mixed-gender conversation threatens more than cooperation, it undermines the possibility for self-respect and autonomy. (shrink)
From the outset, critical social theory has sought to diagnose people’s participation in their own oppression, by revealing the roots of irrational and self-undermining choices in the complex interplay between human nature, social structures, and cultural beliefs. As part of this project, Ideologiekritik has aimed to expose faulty conceptions of this interplay, so that the objectively pathological character of what people are “freely” choosing could come more clearly into view. The challenge, however, has always been to find a way of (...) doing this without arrogantly assuming special access to what is good for people. And this danger of paternalism is one to which social theorists have all too often fallen prey. In this brief essay, I focus on contemporary instances of clearly self-defeating behavior in contexts of complex choices. I begin by discussing a recent attempt to diagnose and solve these failures of choices, namely the public policy recommendations of behavioral economist Richard Thaler and reform-minded legal theorist Cass Sunstein. Their influential “libertarian paternalist” approach is particularly interesting, both in what it includes (attention to the socially constructed nature of choice situations and the roots of the problems in human nature) and in what it leaves out (an understanding of the social construction of human nature and an adequate appreciation of the value of autonomy). After discussing it, I consider a broadly perfectionist alternative, to the effect that the problem lies in a failure to adequately appreciate the importance of developing autonomy. I then turn to sketching the outlines of a new approach, based on the concept of “autonomy gaps,” which approaches overly demanding policies in relational and action-theoretical terms. In the final section, I show how this provides the basis for an analysis both in terms of a critique of ideology and of social pathology. (shrink)
Kant’s ethics conceives of rational beings as autonomous–capable of legislating the moral law, and of motivating themselves to act out of respect for that law. Kant’s ethics also includes a notion of the highest good, the union of virtue with happiness proportional to, and consequent on, virtue. According to Kant, morality sets forth the highest good as an object of the totality of all things good as ends. Much about Kant’s conception of the highest good is controversial. This paper focuses (...) on the apparent conflict between Kant’s claim that we are autonomous, and passages in which he seems to suggest that we require belief in the possibility of the highest good to motivate moral action. I distinguish three distinct versions of these problematic claims that seem to be present in Kant’s texts: that the highest good serves as (1) a motivational supplement to respect for the moral law, (2) a fundamental spring of right action, and (3) a condition of the bindingness of moral requirements. I argue that the texts are better interpreted to yield alternatives to (2) and (3) that do not conflict with our autonomy. I also argue that, properly understood, (1) does not conflict with our autonomy. In arguing for the last claim, I explore Kant’s notion of radical evil and its implications for human agency and virtue. (shrink)
Jeremy Waldron has recently raised the question of whether there is anything approximating the creative self-authorship of personal autonomy in the writings of Immanuel Kant. After considering the possibility that Kantian prudential reasoning might serve as a conception of personal autonomy, I argue that the elements of a more suitable conception can be found in Kant’s Tugendlehre or Doctrine of Virtue--specifically, in the imperfect duties of self-perfection and the practical love of others. This discovery is important for at (...) least three reasons: first, it elucidates the relationship among the various conceptions of autonomy employed by personal-autonomy theorists and contemporary Kantians; second, it brings to the surface previously unnoticed or undernoticed features of Kant's moral theory; and third, it provides an essential line of defense against certain critiques of contemporary Kantian theories, especially that of John Rawls. (shrink)
This collection of original essays explores the social and relational dimensions of individual autonomy. Rejecting the feminist charge that autonomy is inherently masculinist, the contributors draw on feminist critiques of autonomy to challenge and enrich contemporary philosophical debates about agency, identity, and moral responsibility. The essays analyze the complex ways in which oppression can impair an agent's capacity for autonomy, and investigate connections, neglected by standard accounts, between autonomy and other aspects of the agent, including (...) self-conception, self-worth, memory, and the imagination. (shrink)
Although I agree with Sabine Muller’s conclusion that we should first seek to find alternatives to amputation for patients suffering from Body Integrity Identity Disorder (BIID), I disagree with one of the major premises that she uses to argue for her claim. Muller argues that patients with BIID are likely not autonomous when they request that the limb be amputated. Muller’s argument that BIID suffers are not autonomous is flawed because she conflates philosophical conceptions of autonomy with the conception (...) of autonomy that is operative in the context of medicine. (shrink)
This important new book develops a new concept of autonomy. The notion of autonomy has emerged as central to contemporary moral and political philosophy, particularly in the area of applied ethics. Professor Dworkin examines the nature and value of autonomy and used the concept to analyze various practical moral issues such as proxy consent in the medical context, paternalism, and entrapment by law enforcement officials.
There is concern that the use of neuroenhancements to alter character traits undermines consumer's authenticity. But the meaning, scope and value of authenticity remain vague. However, the majority of contemporary autonomy accounts ground individual autonomy on a notion of authenticity. So if neuroenhancements diminish an agent's authenticity, they may undermine his autonomy. This paper clarifies the relation between autonomy, authenticity and possible threats by neuroenhancements. We present six neuroenhancement scenarios and analyse how autonomy accounts evaluate (...) them. Some cases are considered differently by criminal courts; we demonstrate where academic autonomy theories and legal reasoning diverge and ascertain whether courts should reconsider their concept of autonomy. We argue that authenticity is not an appropriate condition for autonomy and that new enhancement technologies pose no unique threats to personal autonomy. (shrink)
The libertarian view of freedom has attracted considerable attention in the past three decades. It has also been subjected to numerous criticisms regarding its nature and effects on society. G. A. Cohen''s recent book, Self-Ownership, Freedom and Equality, continues this attack by linking libertarian views on freedom to their view of self-ownership. This paper formulates and evaluates Cohen''s major arguments against libertarian freedom and self-ownership. It contends that his arguments against the libertarian rights definition of freedom are inadequate and need (...) modification. Similarly, Cohen''s defense of restrictions on self-ownership on behalf of autonomy are also found wanting. Finally, I argue that the thesis of self-ownership (whether in its full or partial version) ought to be rejected. (shrink)
Three main claims are made in this paper. First, it is argued that Onora O’Neill has uncovered a serious problem in the way medical ethicists have thought about both respect for autonomy and informed consent. Medical ethicists have tended to think that autonomous choices are intrinsically worthy of respect, and that informed consent procedures are the best way to respect the autonomous choices of individuals. However, O’Neill convincingly argues that we should abandon both these thoughts. Second, it is argued (...) that O’Neill’s proposed solution to this problem is inadequate. O’Neill’s approach requires that a more modest view of the purpose of informed consent procedures be adopted. In her view, the purpose of informed consent procedures is simply to avoid deception and coercion, and the ethical justification for informed consent derives from a different ethical principle, which she calls principled autonomy. It is argued that contrary to what O’Neill claims, the wrongness of coercion cannot be derived from principled autonomy, and so its credentials as a justification for informed consent procedures is weak. Third, it is argued that we do better to rethink autonomy and informed consent in terms of respecting persons as ends in themselves, and a characteristically liberal commitment to allowing individuals to make certain categories of decisions for themselves. -/- Respect for autonomy is in trouble. In recent work in this journal1 and elsewhere,2 O’Neill has forcefully argued that respect for autonomy, as it has come to be used in medical ethics, is philosophically indefensible. If her arguments are sound, then, contrary to the standard view, respect for autonomy cannot be the source of the ethical requirement to seek informed consent before treating a patient or enrolling a participant in a trial. So her critique goes to the heart of contemporary medical ethics: if O’Neill is right, medical ethicists have systematically misunderstood two of the most fundamental concepts they deal with—respect for autonomy and informed consent. -/- This paper has four sections. Section 1 distinguishes between three different ways of talking about respect for autonomy, and looks in more detail at the one that has come to be central to bioethical writing on informed consent—namely, the idea that we should respect autonomous choices. Section 2 argues, following O’Neill, that it is implausible to think that the purpose of informed consent requirements is to respect autonomous choices. Section 3 argues that O’Neill’s proposed reworking of autonomy and informed consent is inadequate. O’Neill’s approach requires us to adopt a more modest view of the purpose of informed consent procedures. In her view, the purpose of informed consent procedures is simply to avoid deception and coercion, and the ethical justification for informed consent derives from a different ethical principle, which she calls principled autonomy. I argue that contrary to what O’Neill claims, we cannot derive the wrongness of coercion from principled autonomy, and so its credentials as a justification for informed consent procedures is weak. Section 4 argues that we do better to rethink autonomy and informed consent in terms of respecting persons as ends in themselves, and a characteristically liberal commitment to allowing individuals to make certain categories of decisions for themselves. (shrink)
My central thesis is that philosophers considering questions of epistemic value ought to devote greater attention to the enduring nature of beliefs. I begin by arguing that a commonly drawn analogy between beliefs and actions is flawed in important respects, and that a better, more fruitful analogue for belief would be desire, or a similarly enduring state of an agent. With this in hand, I argue that treating beliefs as enduring, constitutive states of agents allows us to capture the importance (...) of accessible, justified, and true beliefs to sustaining personal identity, autonomy, self-control, and authenticity. We thus arrive at a significant value to such beliefs through their crucial role in our personal, practical identities. (shrink)
In this paper, I address some of the shortcomings of established clinical ethics centring on personal autonomy and consent and what I label the Doctrine of Respecting Personal Autonomy in Healthcare. I discuss two implications of this doctrine: 1) the practice for treating patients who are considered to have borderline decision-making competence and 2) the practice of surrogate decision-making in general. I argue that none of these practices are currently aligned with respectful treatment of vulnerable individuals. Because of (...) 'structural arbitrariness' in the whole process of how we assess decision-making competence, this area is open to disrespectful treatment of people. The practice of surrogate decision- making on the basis of a single person's judgment is arguably not consistent with ethical and political requirements derived from the doctrine itself. In response to the inadequacies of the doctrine, I suggest a framework for reasonableness in surrogate decision-making which might allow practice to avoid the problems above. I conclude by suggesting an extended concept of Patient Autonomy which integrates both personal autonomy and the regulative idea of morality that is required by reasonableness in deciding for non-competent others. (shrink)
From Hippocrates to paternalism to autonomy : the new hegemony -- From autonomy to consent -- Consent, autonomy, and the law -- Autonomy at the end of life -- Autonomy and pregnancy -- Autonomy and genetic information -- Autonomy and organ transplantation -- Autonomy, consent, and the law.
In recent years the concepts of individual autonomy and political liberalism have been the subjects of intense debate, but these discussions have occurred largely within separate academic disciplines. Autonomy and the Challenges to Liberalism contains for the first time new essays devoted to foundational questions regarding both the notion of the autonomous self and the nature and justification of liberalism. Written by leading figures in moral, legal and political theory, the volume covers inter alia the following topics: the (...) nature of the self and its relation to autonomy, the social dimensions of autonomy and the political dynamics of respect and recognition, and the concept of autonomy underlying the principles of liberalism. (shrink)
Contrary to what we might initially think, domestic violence is not simply a violation of respect. This characterization of domestic violence misses two key points. First, the issue of respect in connection with domestic violence is not as straightforward as it appears. Second, domestic violence is also a violation of care. These key points explain how domestic violence negatively affects a victim’s autonomy and agency—the ability to choose and pursue her own goals and life plan.We have a moral responsibility (...) to respond to the problem of domestic violence as individuals. But the state also has a responsibility to respond. According to Kant in the Doctrine of Right, one of the purposes of the state is to secure just treatment for everyone. I argue that this includes an obligation to put in place policies and services that will promote the autonomy and agency of victims of domestic violence. (shrink)
Why has autonomy been a leading idea in philosophical writing on bioethics, and why has trust been marginal? In this important book, Onora O'Neill suggests that the conceptions of individual autonomy so widely relied on in bioethics are philosophically and ethically inadequate, and that they undermine rather than support relations of trust. She shows how Kant's non-individualistic view of autonomy provides a stronger basis for an approach to medicine, science and biotechnology, and does not marginalize untrustworthiness, while (...) also explaining why trustworthy individuals and institutions are often undeservingly mistrusted. Her arguments are illustrated with issues raised by practices such as the use of genetic information by the police or insurers, research using human tissues, uses of new reproductive technologies, and media practices for reporting on medicine, science and technology. Autonomy and Trust in Bioethics will appeal to a wide range of readers in ethics, bioethics and related disciplines. (shrink)
Relational conceptions of autonomy attempt to take into account the social aspects of autonomous agency. Those views that incorporate not merely causally, but constitutively necessary relational conditions, incorporate a condition that has the form: (RelAgency) A necessary condition for autonomous agency is that the agent stands in social relations S. I argue that any account that incorporates such a condition (irrespective of how the relations, S, are spelt out) cannot play one of autonomy’s key normative roles: identifying those (...) agents who ought to be protected from (hard) paternalistic intervention. I argue, against objections from Oshana, that there are good reasons for maintaining the notion of autonomy in this role, and thus that such relational conceptions should not be accepted. This rejection goes beyond that from John Christman, which holds only for those relational conditions which are value-laden. (shrink)
In this paper, I examine two versions of the so-called “hierarchical” approach to personal autonomy, based on the notion of “second-order desires”. My primary concern will be with the question of whether these approaches provide an adequate basis for understanding the dynamics of autonomy-ascription. I begin by distinguishing two versions of the hierarchical approach, each representing a different response to the oft-discussed “regress” objection. I then argue that both “structural hierarchicalism” (e.g., Frankfurt, Bratman) and “procedural hierarchicalism” (e.g., Dworkin, (...) Christman, Mele) have difficulties accommodating the dynamics of how the attribution of autonomy to persons is claimed, disputed, and resolved. Although they differ in details, both shortcomings can be traced to viewing autonomy as a metaphysical rather than a normative, practical matter. I conclude by suggesting that these difficulties underscore the advantages of a more constructivist and pragmatist. (shrink)
In patient-centred care, shared decision-making is advocated as the preferred form of medical decision-making. Shared decision-making is supported with reference to patient autonomy without abandoning the patient or giving up the possibility of influencing how the patient is benefited. It is, however, not transparent how shared decision-making is related to autonomy and, in effect, what support autonomy can give shared decision-making. In the article, different forms of shared decision-making are analysed in relation to five different aspects of (...)autonomy: (1) self-realisation; (2) preference satisfaction; (3) self-direction; (4) binary autonomy of the person; (5) gradual autonomy of the person. It is argued that both individually and jointly these aspects will support the models called shared rational deliberative patient choice and joint decision as the preferred versions from an autonomy perspective. Acknowledging that both of these models may fail, the professionally driven best interest compromise model is held out as a satisfactory second-best choice. (shrink)
Abstract This paper examines a convergence between Heidegger's reconceptualization of subjectivity and intersubjectivity and some recent work in feminist philosophy on relational autonomy. Both view the concept of autonomy to be misguided, given that our capacity to be self-directed is dependent upon our ability to enter into and sustain meaningful relationships. Both attempt to overturn the notion of a subject as an isolated, atomistic individual and to show that selfhood requires, and is based upon, one's relation to and (...) dependence upon others. The paper argues that Heidegger's notion of authentic Mitsein (being-with) rejects traditional notions of autonomy and subjectivity in favor of a relational model of selfhood. Ultimately, it provides a new point of entry into contemporary debates within feminist philosophy on Heidegger's thinking and defends Heidegger from certain feminist critiques. (shrink)
This article argues that immoralists do not fully enjoy autonomous agency because they are not capable of engaging in the proper form of practical reflection, which requires relating to others as having equal standing. An adequate diagnosis of the immoralist’s failure of agential authority requires a relational account of reflexivity and autonomy. This account has the distinctive merit of identifying the cost of disregarding moral obligations and of showing how immoralists may become susceptible to practical reason. The compelling quality (...) of reason should not be represented as the capacity to force them to abide by morality on pain of incoherence. Rather, its authority (and objectivity) is shown when it presents them with the prospect of a transition that makes sense for them to undertake. (shrink)
I once heard a colleague opine that we would be better off if there were a 50-year moratorium on philosophers using the word 'autonomy'. He went on to argue that we could get along just fine without the word, and that a good number of confusions would be dispelled along the way. This collection of new papers goes a long way toward responding to this challenge in ways that both undercut and vindicate aspects of this complaint.
The Hypothesis of Extended Cognition (HEC)—that many cognitive processes are carried out by a hybrid coalition of neural, bodily and environmental factors—entails that the intentional states that are reasons for action might best be ascribed to wider entities of which individual persons are only parts. I look at different kinds of extended cognition and agency, exploring their consequences for concerns about the moral agency and personal responsibility of such extended entities. Can extended entities be moral agents and bear responsibility for (...) actions, in addition to or in place of the individuals typically held responsible? What does it mean to be autonomous when one’s cognition is influenced and supported by a milieu of environmental factors? To answer these questions, I explore strong parallels between HEC’s critique of individualism in cognition, and feminist critiques of individualist accounts of self, agency, and autonomy. This relational and social conception of autonomous agency, as scaffolded and supported (or undermined and impaired) by a milieu of social, relational, and normative factors, has important lessons for HEC. Drawing together these two visions of distributed and decentralized aspects of personhood highlights how cognition, action, and responsibility are inextricably linked. It also encourages a reconceptualization of all cognition and all concerns about responsibility for actions, not simply as sometimes extended around individuals, but as fundamentally communal, social, and normative, with individual cognition and individual moral responsibility being derivative special cases, not the paradigm examples. Individuals are merely one of many possible loci of cognition, action, and responsibility. (shrink)
Respect for autonomy is problematic in relation to public health programmes such as vaccination, as the success of such programmes depends on widespread compliance. European countries have different policies for dealing with objectors to vaccination programmes. In some countries compliance is compulsory, while in others objectors are exempted or allowed to enter the programme under specific conditions. In this paper I argue that the objectors should not be treated as a homogenous group as is done in the above-mentioned policies. (...) Objectors have different arguments for not participating in vaccination programmes. Considering the value of respect for autonomy, some but not all of these arguments need to be accommodated by authorities. The concept of 'narrative autonomy' provides criteria to distinguish between tenable and untenable claims to the right to refuse vaccination. Narrative autonomy understands autonomy as essentially linked to identity, as this provides the moral framework with which we assess our first-order preferences. The above-mentioned concept of autonomy is derived from the concept of narrative identity as described by Marya Schechtman. She suggests that the application of the Articulation Constraint and the Reality Constraint enables us to establish the validity of personal narratives. Additionally, form and content features of identity, as proposed by Anthony Laden, will be used as criteria to establish the compatibility of the defectors' arguments with shared scientific and political values. Such compatibility is essential to accommodate respect for autonomy in the context of public health. (shrink)
In this article, I consider whether the advance directive of a person in minimally conscious state ought to be adhered to when its prescriptions conflict with her current wishes. I argue that an advance directive can have moral significance after its issuer has succumbed to minimally conscious state. I also defend the view that the patient can still have a significant degree of autonomy. Consequently, I conclude that her advance directive ought not to be applied. Then I briefly assess (...) whether considerations pertaining to respecting the patient's autonomy could still require obedience to the desire expressed in her advance directive and arrive at a negative answer. (shrink)
It is both an ideal and an assumption of traditional conceptions of justice for liberal democracies that citizens are autonomous, self-governing persons. Yet standard accounts of the self and of self-government at work in such theories are hotly disputed and often roundly criticized in most of their guises. John Christman offers a sustained critical analysis of both the idea of the 'self' and of autonomy as these ideas function in political theory, offering interpretations of these ideas which avoid such (...) disputes and withstand such criticisms. Christman's model of individual autonomy takes into account the socially constructed nature of persons and their complex cultural and social identities, and he shows how this model can provide a foundation for principles of justice for complex democracies marked by radical difference among citizens. His book will interest a wide range of readers in philosophy, politics, and the social sciences. (shrink)
This book addresses two related topics: self-control and individual autonomy. In approaching these issues, Mele develops a conception of an ideally self-controlled person, and argues that even such a person can fall short of personal autonomy. He then examines what needs to be added to such a person to yield an autonomous agent and develops two overlapping answers: one for compatibilist believers in human autonomy and one for incompatibilists. While remaining neutral between those who hold that (...) class='Hi'>autonomy is compatible with determinism and those who deny this, Mele shows that belief that there are autonomous agents is better grounded than belief that there are not. (shrink)
Much of the literature devoted to the topics of agent autonomy and agent responsibility suggests strong conceptual overlaps between the two, although few explore these overlaps explicitly. Beliefs of this sort are commonplace, but they mistakenly conflate the global state of being autonomous with the local condition of acting autonomously or exhibiting autonomy in respect to some act or decision. Because the latter, local phenomenon of autonomy seems closely tied to the condition of being responsible for an (...) act, we tend to think of the former, global phenomenon as a condition of responsibility as well. But one can act autonomously, or manifest autonomy with respect to some occurrent state, without satisfying the conditions for autonomous agency. Autonomous agency and responsible agency are logically distinct in part due to the varient conceptions of rationality each calls for. Both agent responsibility and holding a person responsible imply a fairly ``thick'''' form of rationality, where rationality embodies a normative component and is a matter of satisfying criteria that are objective in the sense that they are independent of what a person happens to want or to value. But autonomous agency calls for a quite different, ``thin'''' conception of instrumental rationality. (shrink)
Concerns about advertising take one of two forms. Some people are worried that advertising threatens autonomous choice. Others are worried not about autonomy but about the values spread by advertising as a powerful institution. I suggest that this bifurcation stems from misunderstanding autonomy. When one turns from autonomous choice to autonomy of persons, or what is often glossed as self-rule, then one has reason to think that advertising poses a moral problem of a sort so far unrecognized. (...) I diagnose this problem using Charles Taylor''s work on "strong evaluation". This problem turns out to have political ramifications that have been only dimly recognized in business ethics circles. (shrink)
Concepts We thank all three commentators for extremely constructive, insightful, and gracious commentaries. We cannot address all their valuable points. In this response, we elucidate and relate the concepts of addiction, disease, disability, autonomy, and well-being. We examine some of the implications of these relationships in the context of the helpful responses made by our commentators. We begin with the definitions of the relevant concepts which we employ: ¥? ? ? Addiction (Liberal Concept): An addiction is a strong appetite. (...) ¥? ? ? Appetites: An appetite is a disposition that generates desires that are urgent, oriented toward some rewarding behavior, periodically recurring, often in predictable circumstances, sated temporarily by their fulfillment, and generally provide pleasure. ¥? ? ? Disease (Naturalistic Concept): A disease is some biological or psychological state that results in subfunctioning of the organism in a given set of environmental and social circumstances, C. The reference class is a natural class of organisms of uniform functional design; specifically, an age group of a sex of a species. A normal function is a part or process within members of the reference class and is a statistically typical contribution by it to their individual survival and reproduction (Boorse 1977, 1997). ¥? ? ? Disability (Welfarist Concept): A disability is a relatively stable biological or psychological state that tends to reduce the amount of well-being that this person will enjoy in a given set of environmental and social circumstances (Savulescu and Kahane 2009; Kahane and Savulescu, 2009). ¥? ? ? Autonomy (Rationalist Concept): A person rationally desires or values some state of affairs if and only if he or she desires that state of affairs while (1) being in possession of all relevant. (shrink)
The majority of current attention on the question of autonomy has focused on the internal reflection of the agent. The quality of an agent’s reflection on her potential action (or motivating desire or value) is taken to determine whether or not that action is autonomous. In this paper, I argue that there is something missing in most of these contemporary accounts of autonomy. By focusing overwhelmingly on the way in which the agent reflects, such accounts overlook the importance (...) of what the agent is reflecting upon. Whichever of these current formulations of autonomy we accept, reflection could be undertaken in full accordance with the conditions set, and yet the action fail to be autonomous. This will occur, I argue, if the agent is mistaken about the object of her reflection. More precisely, if she has a particular kind of false belief about the action she is contemplating undertaking, then no amount of reflection can render that action autonomous. This suggests the need for externalist conditions to be incorporated into an account of autonomy. (shrink)
Communitarians like Alasdair MacIntyre, Charles Taylor, and Michael Sandel, defend what we may call the ‘social constitution thesis.’ This is the view that participation in society makes us what we are. This claim, however, is ambiguous. In an attempt to shed some light on it and to better understand the impact its truth would have on our beliefs regarding autonomy, I offer four possible ways it could be understood and four corresponding senses of individual independence and autonomy. I (...) also indicate what senses liberals can accept that we are socially constituted and in what sense I take communitarians to argue we are socially constituted. (shrink)
There is mounting evidence that methylphenidate (MPH; Ritalin) is being used by healthy college students to improve concentration, alertness, and academic performance. One of the key concerns associated with such use of pharmaceuticals is the degree of freedom individuals have to engage in or abstain from cognitive enhancement (CE). From a pragmatic perspective, careful examination of the ethics of acts and contexts in which they arise includes considering coercion and social pressures to enhance cognition. We were interested in understanding how (...) university students, parents of university students, and healthcare providers viewed autonomy and coercion in CE using MPH. We found that perspectives converged on the belief that CE is a matter of personal and individual choice. Perspectives also converged on the existence of tremendous social pressures to perform and succeed. Parents emphasized personal responsibility and accountability for CE choices, and expressed feelings of worry, sadness and fear about CE. Students emphasized the importance of personal integrity in CE, expressed tolerance for personal choices of others, and highlighted the challenge that CE poses to maintaining one’s personal integrity. Healthcare providers emphasized the health consequences of CE. These results illustrate: (1) the importance of understanding how context is viewed in relation to perspectives on autonomous choice; (2) the limitations of individualistic libertarian approaches that do not consider social context; and (3) the ethical implications of public health interventions in a value-laden debate where perspectives diverge. (shrink)
It is often thought that the computational paradigm provides a supporting case for the theoretical autonomy of the science of mind. However, I argue that computation is in fact incompatible with this alleged aspect of intentional explanation, and hence the foundational assumptions of orthodox cognitive science are mutually unstable. The most plausible way to relieve these foundational tensions is to relinquish the idea that the psychological level enjoys some special form of theoretical sovereignty. So, in contrast to well known (...) antireductionist views based on multiple realizability, I argue that the primary goal of a computational approach to the mind should be to facilitate a translation of the psychological to the neurophysiological. (shrink)
The concepts of autonomy and of critical thinking play a central role in many contemporary accounts of the aims of education. This book analyses their relationship to each other and to education, exploring their roles in mortality and politics before examining the role of critical thinking in fulfilling the educational aim of preparing young people for autonomy. The author analyses different senses of the terms 'autonomy' and 'critical thinking' and the implications for education. Implications of the discussion (...) for contemporary practice are also considered. (shrink)
This article summarizes some of the results of the BIOMED II project “Basic Ethical Principles in European Bioethics and Biolaw” (1995–1998)connected to a research project of the Danish Research Councils “Bioethics and Law” (1993–1998). The BIOMED project was based on cooperation between 22 partners in most EU countries. The aim of the project was to identify the ethical principles of respect for autonomy, dignity, integrity and vulnerability as four important ideas or values for a European bioethics and biolaw. The (...) research concluded that the basic ethical principles cannot be understood as universal everlasting ideas or transcendental truths but they rather function reflective guidelines and important values in European culture. The method of the research was conceptual, philosophical analysis of the cultural background of the four values or normative ideas that people use and find important in their existence. Moreover, this was combined with analysis of empirical legal material and policy documents. Also, a number of qualitative interviews with relevant experts were carried out. Another important result of the BIOMED project was the partner's Policy Proposals to the European Commission, the Barcelona Declaration, unique as a philosophical and political agreement between experts in bioethics and biolaw from many different countries. The Policy Proposals are reprinted here at the end of the article. (shrink)
Women have historically been prevented from living autonomously by systematic injustice, subordination, and oppression. The lingering effects of these practices have prompted many feminists to view autonomy with suspicion. Here, Marilyn Friedman defends the ideal of feminist autonomy. In her eyes, behavior is autonomous if it accords with the wants, cares, values, or commitments that the actor has reaffirmed and is able to sustain in the face of opposition. By her account, autonomy is socially grounded yet also (...) individualizing and sometimes socially disruptive, qualities that can be ultimately advantageous for women. Friedman applies the concept of autonomy to domains of special interest to women. She defends the importance of autonomy in romantic love, considers how social institutions should respond to women who choose to remain in abusive relationships, and argues that liberal societies should tolerate minority cultural practices that violate women's rights so long as the women in question have chosen autonomously to live according to those practices. (shrink)
The aim of this paper is to suggest that a necessary condition of autonomy has not been sufficiently recognized in the literature: the capacity to critically reflect on one’s practical attitudes (desires, preferences, values, etc.) in the light of new experiences . It will be argued that most prominent accounts of autonomy—ahistorical as well as history-sensitive—have either altogether failed to recognize this condition or at least failed to give an explicit account of it.
Andrews Reath presents a selection of his best essays on various features of Kant's moral psychology and moral theory, with particular emphasis on his conception of rational agency and his conception of autonomy. Together the essays articulate Reath's original approach to Kant's views about human autonomy, which explains Kant's belief that objective moral requirements are based on principles we choose for ourselves. With two new papers, and revised versions of several others, the volume will be of great interest (...) to all students and scholars of Kant and of moral philosophy. (shrink)
This paper examines the notion that psychology is autonomous. It is argued that we need to distinguish between (a) the question of whether psychological explanations are autonomous, and (b) the question of whether the process of psychological discovery is autonomous. The issue is approached by providing a reinterpretation of Robert Cummins's notion of functional analysis (FA). A distinction is drawn between FA as an explanatory strategy and FA as an investigative strategy. It is argued that the identification of functional components (...) of the cognitive system may draw on knowledge about brain structure, without thereby jeopardizing the explanatory autonomy of psychology. (shrink)
Despite receiving considerable philosophical attention, the concept of autonomy remains contested. In this paper, we diagnose one source of the continuing problem—an excessive emphasis on reflective self-appraisal in the dominant procedural models of autonomy—and suggest a solution. We argue that minimalist conceptions of rational self-appraisal are subject to fatal counterexamples. Yet, attempts to provide a more robust account of rational self-appraisal are too demanding to capture our intuitions about who counts as an autonomous agent. We argue that no (...) procedure of rational reflection will confer autonomy; rather autonomy is a matter of an agent’s actions flowing from her substantive commitments. Instead of rational self-reflection, autonomous actions are the product of the motive of care, which anchors an agent’s occurent desires to her system of value. (shrink)
In this paper, I try to show that externalist compatibilism in the debate on personal autonomy and manipulated freedom is as yet untenable. I will argue that Alfred R. Mele’s paradigmatic, history-sensitive externalism about psychological autonomy in general and autonomous deliberation in particular faces an insurmountable problem: it cannot satisfy the crucial condition of adequacy “H” for externalist theories that I formulate in the text. Specifically, I will argue that, contrary to first appearances, externalist compatibilism does not resolve (...) the CNC manipulation problem. After briefly reflecting on the present status of responses to the manipulation problem in the debate between compatibilists and incompatibilists of various stripes, I will draw the over-all pessimistic conclusion that no party deals with this problem satisfactorily. (shrink)