Autonomy in Applied Ethics

Anne Donchin attended graduate school while raising four children, received her doctorate from the University of Texas in 1970, taught for 18 years in Texas and New York, then joined the philosophy department at Indiana University–Purdue University Indianapolis in 1982. Here she developed a Women’s Studies program, specialized and in numerous ways pioneered in feminist bioethics, and won two prestigious grants. She co-edited two books, published some forty articles, and co-founded and co-ordinated The International Network on Feminist Approaches to Bioethics. (...) Before and after retiring she served on the editorial boards of an encyclopedia, several international bioethics collections and nine prestigious journals. Her publications have influenced many scholars here and abroad. At the time of her death she was at work on a book: Procreation, Power and Personal Autonomy: Feminist Reflections, which is now available on IUPUIScholarWorks. Laura Purdy has generously edited, organized, and, where possible, updated the manuscript. (shrink)

Autonomy has been central to moral and political philosophy for millenia, and has been positioned as a critical aspect of both justice and wellbeing. Research in psychology supports this position, providing empirical evidence that autonomy is critical to motivation, personal growth and psychological wellness. Responsible AI will require an understanding of, and ability to effectively design for, human autonomy (rather than just machine autonomy) if it is to genuinely benefit humanity. Yet the effects on human autonomy of digital experiences are (...) neither straightforward nor consistent, and are complicated by commercial interests and tensions around compulsive overuse. This multi-layered reality requires an analysis that is itself multidimensional and that takes into account human experience at various levels of resolution. We borrow from HCI and psychological research to apply a model (“METUX”) that identifies six distinct spheres of technology experience. We demonstrate the value of the model for understanding human autonomy in a technology ethics context at multiple levels by applying it to the real-world case study of an AI-enhanced video recommender system. In the process we argue for the following three claims: 1) There are autonomy-related consequences to algorithms representing the interests of third parties, and they are not impartial and rational extensions of the self, as is often perceived; 2) Designing for autonomy is an ethical imperative critical to the future design of responsible AI; and 3) Autonomy-support must be analysed from at least six spheres of experience in order to approriately capture contradictory and downstream effects. (shrink)

The practice of medicine frequently involves the unconsented restriction of liberty. The reasons for unilateral liberty restrictions are typically that being confined, strapped down, or sedated are necessary to prevent the person from harming themselves or others. In this paper, we target the ethics of chemical restraints, which are medications that are used to intentionally restrict the mental states associated with the unwanted behaviors, and are typically not specifically indicated for the condition for which the patient is being treated. Specifically, (...) we aim to identify the conditions under which chemical restraints are ethically permissible. It is wrong to assume that what is morally true of physical restraints is also true of chemical restraints. Our aim is thus to identify the conditions under which chemical restraints are permissible while distinguishing these conditions from those of the application of physical restraints. (shrink)

It is well known that prisoners’ human rights are often violated. In this chapter we examine whether guidelines can be effective in preventing such violations and in helping physicians resolve the significant conflicts of interest that they often face in trying to protect prisoners’ rights. We begin by explaining the role of clinical and ethical guidelines outside prisons, in the context of healthcare for non-incarcerated prisoners, and then the specific role of such guidelines within prisons, where the main concerns are (...) ensuring respect for the principle of equivalence of care, and for a prisoner patient’s autonomy in health care decisions. After reviewing and analysing various national and international guidelines, we review the literature and assess whether the good practices set out in these guidelines actually translate into changes in professional behaviour and consequent benefits for prisoners. It emerges that physicians both outside and within prisons tend to be insufficiently familiar with the relevant guidelines, and that they too infrequently use the guidance to make decisions, preferring instead to use personal codes of conduct. Guidelines designed specifically for the prison context are important to ensure equivalence of care and should be better known by health care personnel and other professional groups working in prison. Further guidelines should be developed that describe challenging situations and provide concrete guidance as to how to deal with them. (shrink)

Decision-making capacity (DMC) plays an important role in clinical practice—determining, on the basis of a patient’s decisional abilities, whether they are entitled to make their own medical decisions or whether a surrogate must be secured to participate in decisions on their behalf. As a result, it’s critical that we get things right—that our conceptual framework be well-suited to the task of helping practitioners systematically sort through the relevant ethical considerations in a way that reliably and transparently delivers correct verdicts about (...) who should and should not have the authority to make their own medical decisions. Unfortunately, however, the standard approach to DMC does not get things right. It is of virtually no help in identifying and clarifying the relevant ethical considerations. And, embedded in the prevailing anti-paternalist paradigm, DMC assessments obfuscate and distort the underlying ethical justification for granting or withholding decisional authority. Here, we describe the core commitments of the standard approach to DMC and then highlight three problems with it. We then argue that these problems are significant enough that they call for more than merely tinkering and fine tuning—variations of the standard approach cannot adequately address them. Instead, we should ditch DMC. (shrink)

We argue that individual and institutional caregivers have a defeasible moral duty to provide dependent children with plant-based diets and related education. Notably, our three arguments for this claim do not presuppose any general duty of veganism. Instead, they are grounded in widely shared intuitions about children’s interests and caregivers’ responsibilities, as well as recent empirical research relevant to children’s moral development, autonomy development, and physical health. Together, these arguments constitute a strong cumulative case against inculcating in children the dietary (...) practice of regularly eating meat (and other animal products)—a practice we call “carnism.”. (shrink)

BDSM is no longer treated as a manifestation of the darkest twists of the human soul but rather as a sexual activity like many others. Moreover, the philosophy of sex and much of popular culture has come to embrace BDSM for its models of consent, exploration, and freedom. Yet celebrating BDSM without deeper reflection can obscure some serious moral issues. In this chapter, I present an overview of the moral issues raised by BDSM, and I argue that it is reductive (...) to see BDSM as a simple or straightforward model for how to practice egalitarian sex. Yet, BDSM communities grapple with issues of consent, autonomy, and power in important ways, which can help us think through broader issues in sexual ethics. Either way, BDSM must be understood in its full complexity. (shrink)

This argument map represents an argumentation from Heyns, C. . Report of the Special Rapporteur on extrajudicial, summary or arbitrary executions, Christof Heyns . S.l.: United Nations. Human Rights Council. The argument map is open for debate in AGORA-net, search for map ID 9206.

It is usually appropriate for adults to make significant decisions, such as about what kinds of medical treatment to undergo, for themselves. But sometimes impairments are suffered - either temporary or permanent - which render an individual unable to make such decisions. The Mental Capacity Act 2005 sets out the conditions under which it is appropriate to regard an individual as lacking the capacity to make a particular decision (and when provisions should be made for a decision on their behalf). (...) -/- To what extent does having capacity require the endorsement of certain values? Drawing on Owens et al (2009), I assess the extent to which understanding relevant information and weighing it in coming to a decision requires certain evaluative commitments. With reference to literature on anorexia nervosa and decisions informed by religious beliefs, I argue that it is difficult to avoid the conclusion that the conditions for capacity are value-laden, and that if this is so it is important to open discussion about which patterns of distorted valuing undermine capacity, and why. (shrink)

An important topic in the ethics of technology is the extent to which recent digital technologies undermine user autonomy. Supporting evidence includes the fact that recent digital technologies are known to have an impact on attention, which balances "bottom-up" and "top-down" influences on cognition. As described in numerous papers, these technologies manipulate bottom-up influences through cognitive fluency, intermittent variable rewards, and other techniques, making them more attractive to the user. We further reason that recent digital technologies reduce the user’s ability (...) to exert top-down attention due to the scale of the content—they provide far more content at a much faster pace than other technologies, which over time reweights the balance of attention in favor of bottom-up influences. After reviewing evidence for these effects, including their temporal duration, we consider their downstream effects on both autonomy and creativity. We find that while the impact of recent digital technologies on top-down attention may allow for more idea generation, that creativity also depends on control, which is undermined by these technologies. We are more circumspect with autonomy, reasoning that in certain cases it might not make sense to see user autonomy as harmed through these effects. We conclude with other ways that recent digital technologies may improve creativity, which may act as an offset to the detrimental impacts of these technologies. (shrink)

Every day, wild animals suffer and die from myriad natural causes. For those committed to non-speciesism, what wild animal suffering entails for us morally is a question of the utmost importance, and yet there remains significant disagreement at the level of normative theory. In this paper I argue that in situations of moral urgency environmental managers and policy makers should refer to widely-agreeable moral principles for guidance. I claim that the principles of beneficence, non-maleficence, autonomy and justice do well to (...) capture our widely-held values, and that the first three principles all support large-scale interventions in nature. I then argue that balancing these against non-maleficence will still allow for the careful consideration of interventions, although is unlikely to support lethal methods. This argument is intended to provide a reasonable starting point for theory-agnostic decision makers, and places the burden of proof on those who oppose intervention. -/- . (shrink)