In this essay, I shall discuss ethical issues that arise with our increasing ability to affect the genetic makeup of the human population. These effects can be produced directly by altering the genotype , or indirectly by aborting, not conceiving, or treating individuals because of their genetic makeup in ways made possible by genetic pharmacology. I shall refer to all of these sorts of procedures collectively as the Procedures. Some of the ethical issues the Procedures raise are old, arising quite (...) generally when we can affect the well-being of people, even in the absence of the ability to affect them in the ways just described. My examination of these issues is prompted by the recent at-length discussion of them, From Chance to Choice , by Allen Buchanan, Dan Brock, Norman Daniels, and Daniel Wikler. (shrink)

Principle-based formulations of bioethical theory have recently come under increasing scrutiny, particularly insofar as they give prominence to personal autonomy. This essay critiques the dominant conceptualization of autonomy and urges an alternative formulation freed from the individualistic assumptions that pervade the prevailing framework. Drawing on feminist perspectives, I discuss the need for a vision of patient autonomy that joins relational experiences to individuality and acknowledges the influence of patterns of power and authority on the exercise of patient agency. Deficiencies in (...) the current models of science and social relations guiding medical practice are analyzed, particularly (1) the tendency to disregard the patients self-knowledge and (2) failure to recognize limitations on the generalizability of medical knowledge. Models of social relations such as mothering and friendship are explored to advance a conception of autonomy better suited to the practical activities of medicine. In conclusion, I consider how acknowledgement of the specificity and complexity of social relations can contribute to reconfiguration of other principles comprising the standard framework of bioethics, particularly beneficence, justice, and equality. (shrink)

We are purposive agents; but we—adult humans in a broadly modern world—are more than that. We are reflective about our motivation. We form prior plans and policies that organize our activity over time. And we see ourselves as agents who persist over time and who begin, develop, and then complete temporally extended activities and projects. Any reasonably complete theory of human action will need in some way to advert to this trio of features—to our reflectiveness, our planfulness, and our conception (...) of our agency as temporally extended. These are, further, features that have great significance for the kinds of lives we can live. For these two reasons I will say that these are among the core features of human agency. A theory of human action needs to say what these core features consist in and how they are related to each other. And such a theory needs also to clarify the relation between these core features of our agency and the possibility that we are fully embedded in an event causal order. (shrink)

What happens to our conception of mind and rational agency when we take seriously future-directed intentions and plans and their roles as inputs into further practical reasoning? The author's initial efforts in responding to this question resulted in a series of papers that he wrote during the early 1980s. In this book, Bratman develops further some of the main themes of these essays and also explores a variety of related ideas and issues. He develops a planning theory of intention. Intentions (...) are treated as elements of partial plans of action. These plans play basic roles in practical reasoning, roles that support the organization of our activities over time and socially. Bratman explores the impact of this approach on a wide range of issues, including the relation between intention and intentional action, and the distinction between intended and expected effects of what one intends. (shrink)