Jeremy Waldron has recently raised the question of whether there is anything approximating the creative self-authorship of personalautonomy in the writings of Immanuel Kant. After considering the possibility that Kantian prudential reasoning might serve as a conception of personalautonomy, 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)
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.
Two ways of understanding the notion of autonomy are outlined and discussed in this article, in order to clarify how and if informed consent requirements in biotechnological research are to be justified by the promotion of personalautonomy: A proceduralist conception linking autonomy with authenticity, and a substantivist conception linking autonomy with control. The importance of distinguishing autonomy from liberty is emphasised, which opens for a possible conflict between respecting the freedom and the (...) class='Hi'>autonomy of research participants. It is argued that this has implications for how consent requirements based on different criteria of specificity and understanding should be viewed and justified. (shrink)
Part I. The book begins with literary, cinematic, and historical scenarios that exemplify personalautonomy. Meyers uses these vignettes to distinguish personalautonomy from other, variously related types of autonomy and to show that other kinds of autonomy cannot adequately address the concern people have with their own personal decisions. Noting how profoundly social experience impinges on self-discovery, self-definition, and self-direction, Meyers characterizes autonomous individuals as persons who do what they really want, and (...) she undertakes to supply an account of an authentic self that acknowledges people's enmeshment in social relations as well as their psychological complexity. (shrink)
Should a growing market for genetic self-tests be welcomed or feared? From the point of view of personalautonomy the increasing availability of predictive health information seems promising. Yet it is frequently pointed out that genetic information about future health may cause anxiety, distress and even loss of life-hopes. In this article the argument that genetic self-tests undermine personalautonomy is assessed and criticized. I contend that opportunities for autonomous choice are not reduced by genetic information (...) but by misperceptions and misunderstandings of the results of genetic tests. Since the interpretation of genetic information is sometimes distorted by the information provided about the genetic products, more attention should be given to deceitful marketing that overblows the utility of genetic products. Yet personalautonomy is reduced neither by genetic tests nor by genetic information and there is consequently no compelling case for the conclusion that genetic self-tests should be prohibited. (shrink)
This paper explores the value of respect for personalautonomy in relation to clearly immoral and irrational acts committed freely and intentionally by competent people. Following Berlin's distinction between two kinds of liberty and Darwall's two kinds of respect, it is argued that coercive suppression of nonautonomous, irrational, and self-harming acts of competent persons is offensive to their human dignity, but not disrespectful of personalautonomy. Irrational and immoral choices made by competent people may claim only (...) the negative liberty to be left alone. Lives disposed to autonomy are worthy of solidarity and active support in addition to the right of free choice and action. Autonomous premeditated desires (distinguished from mere consent) may embody transcendental choices, which transcend consideration of physical and psychological well-being. Choices made by incompetent persons (e.g., children and the mentally disabled) are not related to autonomy, but to self-directedness. The value of human dignity confers protection to self-directedness, but not at the expense of other vital interests. (shrink)
The value and importance accorded to personalautonomy within liberalism would seem to suggest that cultural practices that severely constrain the choices of individuals through heavyhanded role socialization and restriction ought to be strongly discouraged in liberal societies. In this paper, I explore this claim in connection with the custom of arranged marriage, which has recently come under fire in some liberal democratic states, notably Britain. My aim is to try to complicate the liberal understanding of the relationship (...) between cultural traditions and personalautonomy. In the course of this discussion, I analyze and offer some criticisms of autonomy as a substantive ideal and requirement for flourishing. In revisiting and evaluating arguments in favor of a thick or substantive ideal of autonomy criticisms, I hope to show that a substantive ideal of autonomy as independence is culturally bounded in ways that are often overlooked by liberal philosophers. (shrink)
I argue in this paper that the development and convergence of information and communication technologies (ICT) is creating a global network of surveillance capabilities which affect the traveler. These surveillance capabilities are reminiscent of 18th century philosopher Jeremy Bentham’s panopticon, and as such the emerging global surveillance network has been referred to as the travel panopticon. I argue that the travel panopticon is corrosive of personalautonomy, and in doing so I describe and analyse various philosophical approaches to (...)personalautonomy. (shrink)
Currently, the most influential accounts of personalautonomy, at least in the English-speaking world, focus on providing conditions under which agents can be said to exercise self-control. Two distinct accounts of personalautonomy have emerged in this tradition: firstly, hierarchical models grounded in the work of Harry Frankfurt; and secondly, systems division models most famously articulated by Gary Watson. In this paper, I will show the inadequacies of both of these models by exploring the problematic views (...) of the self and self-control underlying each model. I will suggest that the problems faced by these models stem from the fact that they endorse a problematic fragmentation of the self. (shrink)
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)
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)
In healthcare ethics there is a discussion regarding whether autonomy of personal preferences, what sometimes is referred to as authenticity, is necessary for autonomous decision-making. It has been argued that patients’ decisions that lack sufficient authenticity could be deemed as non-autonomous and be justifiably overruled by healthcare staff. The present paper discusses this issue in relation certain psychiatric disorders. It takes its starting point in recent qualitative studies of the experiences and thoughts of patients’ with anorexia nervosa where (...) issues related to authenticity seem particularly relevant. The paper examines different interpretations of authenticity relevant for autonomy and concludes that the concept, as it has been elaborated in recent debate, is highly problematic to use as a criterion for autonomous decision-making in healthcare. (shrink)
Part IV. Section 1. The Personal and the Political Value of Autonomy: Disparities in autonomy competency number among the many ways in which women and men in western societies are unequal. Meyers holds that although personalautonomy is not the sole or paramount value, medial autonomy is not only a personal good, but is also a political good.
To be autonomous is to be a law to oneself; autonomous agents are self-governing agents. Most of us want to be autonomous because we want to be accountable for what we do, and because it seems that if we are not the ones calling the shots, then we cannot be accountable. More importantly, perhaps, the value of autonomy is tied to the value of self-integration. We don't want to be alien to, or at war with, ourselves; and it seems (...) that when our intentions are not under our own control, we suffer from self-alienation. What conditions must be satisfied in order to ensure that we govern ourselves when we act? Philosophers have offered a wide range of competing answers to this question. (shrink)
: Debates on precedent autonomy and some forms of paternalistic interventions, which are related to questions of personal identity, are analyzed. The discussion is based on the distinction between personal identity as persistence and as biographical identity. It first is shown that categorical objections to advance directives and "Ulysses contracts" are based on false assumptions about personal identity that conflate persistence and biographical identity. Therefore, advance directives and "Ulysses contracts" are ethically acceptable tools for prolonging one's (...)autonomy. The notions of personality and biographical identity are used to analyze the ethically relevant features. Thereby, it is shown that these concepts are operative in and useful for thinking in biomedical ethics. The overall conclusion is that categorical arguments against precedent autonomy or "Ulysses contracts" are based on misleading theories of personal identity and that advance directives are an ethically respectable tool for prolonging individuals' autonomy in cases of dementia and mental illness. (shrink)
This is the most detailed, sophisticated and comprehensive treatment of autonomy currently available. Moreover it argues for a quite different conception of autonomy from that found in the philosophical literature. Professor Berofsky claims that the idea of autonomy originating in the self is a seductive but ultimately illusory one. The only serious way of approaching the subject is to pay due attention to psychology, and to view autonomy as the liberation from the disabling effects of physiological (...) and psychological afflictions. A sustained critique of concepts such as moral autonomy, self-realisation, ideal autonomy, and identification is offered. The author replaces these with an alternative model that reveals how spontaneity, vitality and competence enable human beings to act in the real world. (shrink)
I argue that the moral right to privacy is the moral right to consent to access by others to one’s personal information. Although this thesis is relatively simple and already implicit in considerations about privacy, it has, nevertheless, been overlooked by philosophers. In the paper, I present and defend my account of the moral right to privacy, respond to possible objections to it, and attempt to show its advantages over two recent accounts: one by Steve Matthews and the other (...) by Adam Moore. I also offer reasons to think that my account can be assimilated into a broad range of fundamental ethical approaches (i.e., a variety of consequentialist,deontological, and natural law approaches). Given the number and variety of such approaches, however, I can only attempt to make a prima facie case for the adaptability of the proposed account. (shrink)
A response to Susan Hekman's article "Reconstituting the Subject: Feminism, Modernism, and Postmodernism" and to her review of Diana T. Meyers' book Self, Society, and Personal Choice both of which appeared in Hypatia 6(2).
Autonomy and authority are often regarded as opposites. In this paper, I argue that autonomy should be conceived of as a specific form of (practical) authority and that this perspective is useful for identifying the conditions of personalautonomy. I will first highlight some structural analogies in the functioning of the concepts "autonomy" and "authority" and explain the resulting constraints on accounts of personalautonomy. I will then show that the problems of certain (...) internalist and externalist accounts of autonomy are rooted in a false understanding of the foundation on which the authority that is characteristic of autonomy rests. To conclude, I present an account in which this foundation is given by a person’s maturity (Mündigkeit), defensiveness (Wehrhaftigkeit) and participation (Mitsprache): Thus, a person is autonomous to the extent that she can cope with her own affairs, can defend herself against external encroachments and can participate in common affairs. (shrink)
It has been argued - most prominently in Harry Frankfurt's recent work - that the normative authority of personal commitments derives not from their intrinsic worth but from the way in which one's will is invested in what one cares about. In this essay, I argue that even if this approach is construed broadly and supplemented in various ways, its intrasubjective character leaves it ill-prepared to explain the normative grip of commitments in cases of purported self-betrayal. As an alternative, (...) I sketch a view that focuses on intersubjective constraints of intelligibility built into social practices and on the pragmatics of how those norms are contested in an ongoing fashion. (shrink)
The advent of new genetic and genomic technologies may cause friction with the principle of respect for autonomy and demands a rethinking of traditional interpretations of the concept of informed consent. Technologies such as whole-genome sequencing and micro-array based analysis enable genome-wide testing for many heterogeneous abnormalities and predispositions simultaneously. This may challenge the feasibility of providing adequate pre-test information and achieving autonomous decision-making. At a symposium held at the 11th World Congress of Bioethics in June 2012 (Rotterdam), organized (...) by the International Association of Bioethics, these challenges were presented for three different areas in which these so-called ‘new genetics’ technologies are increasingly being applied: newborn screening, prenatal screening strategies and commercial personal genome testing. In this article, we build upon the existing ethical framework for a responsible set-up of testing and screening offers and reinterpret some of its criteria in the light of the new genetics. As we will argue, the scope of a responsible testing or screening offer should align with the purpose(s) of testing and with the principle of respect for autonomy for all stakeholders involved, including (future) children. Informed consent is a prerequisite but requires a new approach. We present preliminary and general directions for an individualized or differentiated set-up of the testing offer and for the informed consent process. With this article we wish to contribute to the formation of new ideas on how to tackle the issues of autonomy and informed consent for (public) healthcare and direct-to-consumer applications of the new genetics. (shrink)