Biomedical innovations are making possible the enhancement of human capabilities. There are two philosophical stances on the role that medicine should play in this respect. On the one hand, naturalism rejects every medical intervention that goes beyond preventing and treating disease. On the other hand, welfarism advocates enhancements that foster subjective well-being. We will show that both positions have considerable shortcomings. Consequently, we will introduce a third characterization in which therapies and enhancements can be reconciled with the legitimate objectives of (...) medicine inasmuch as they improve the capabilities that enable the freedom to pursue personal well-being. (shrink)

Shared Decision Making (‘SDM’) is one of the most significant developments in Western health care practices in recent years. Whereas traditional models of care operate on the basis of the physician as the primary medical decision maker, SDM requires patients to be supported to consider options in order to achieve informed preferences by mutually sharing the best available evidence. According to its proponents, SDM is the right way to interpret the clinician-patient relationship because it fulfils the ethical imperative of respecting (...) patient autonomy. However, there is no consensus about how decisions in SDM contexts relate to the principle of respect for autonomy. In response, I demonstrate that in order to make decisions about what treatment they will or will not receive, patients will be required to meet different conditions depending on the approach proponents of SDM take to understanding personal autonomy. Due to the fact that different conceptions of autonomy yield different obligations, I argue that if physicians and patients satisfied all the conditions described in standard accounts of SDM, then SDM would undermine patient autonomy. (shrink)

Feasting on a plethora of social media platforms, news aggregators, and online marketplaces, recommender systems (RSs) are spreading pervasively throughout our daily online activities. Over the years, a host of ethical issues have been associated with the diffusion of RSs and the tracking and monitoring of users’ data. Here, we focus on the impact RSs may have on personal autonomy as the most elusive among the often-cited sources of grievance and public outcry. On the grounds of a philosophically nuanced notion (...) of autonomy, we illustrate three specific reasons why RSs may limit or compromise it: the threat of manipulation and deception associated with RSs; the RSs’ power to reshape users’ personal identity; the impact of RSs on knowledge and critical thinking. In our view, however, notwithstanding these legitimate concerns, RSs may effectively help users to navigate an otherwise overwhelming landscape. Our perspective, therefore, is not to be intended as a bulwark to protect the _status quo_ but as an invitation to carefully weigh these aspects in the design of ethically oriented RSs. (shrink)