There is a strong presumption that mental disorder injures a person's autonomy, understood as a set of capacities and as an ideal condition of agency which is worth striving for. However, recent multidimensional approaches to autonomy have revealed a greater diversity in ways of being autonomous than has previously been appreciated. This presumption, then, risks wrongly dismissing variant, neuro-atypical sorts of autonomy as non-autonomy. This is both an epistemic error, which impairs our understanding of (...) class='Hi'>autonomy as a phenomenon, and a moral error, which withholds recognition and respect that autonomous agents are due. I argue that careful attention to the different 'shapes' of agent's autonomy reveals that there are indeed distinctive kinds of neuro-atypical autonomy that are widely mistaken for non-autonomy. This project argues for two propositions. First, that there is a kind of autonomy, with a distinctive shape and texture, available to bipolar agents. This is a variant sort of autonomy, but not a defective or deficient sort. It is the ideal of autonomy that it is worth bipolar agents striving for, given the range and intensity of experiences that they will have to confront. Whilst bipolar autonomy will look unlike more neurotypical kinds of autonomy, it continues to be owed recognition. The second proposition is that we should understand the ideal of autonomy to be both pluralist and highly context sensitive. Given the range of starting points from which agents will strive to an ideal of autonomy, there will be some variation in the ideals worth striving for. The variation in ideals will reflect the existential realities they are local to. Theory of autonomy must be adapted to recognise bipolar, and other neuro-atypical, kinds of autonomy, and to reflect this wider pluralism. These propositions will be argued for with careful attention to the experiences and agency of people living with bipolar, or related, disorders. Understanding the ways that manic or depressive episodes, and the shifts between them, alter and apply pressure to our agency will inform an account of the distinctively bipolar autonomy that can be built on top of it. (shrink)

This paper argues that autonomy is an educational ideal. Since personal autonomy is essentially a matter of the person governing herself, a plausible account of autonomy presupposes an account of u person's identity. I support a conception of autonomy which presupposes a hierarchical theory of the self, yet allows rationality a significant place in a person's identity. I defend this conception of autonomy as an educational ideal from recent criticisms by Stone (1990) and (...) Cuypers (1992). (shrink)

Amongst traditionally-available frameworks within which end-of-life decisions in Intensive Care Units (ICU) are situated, we favour Ordinary versus Extra-ordinary care distinctions as the most helpful. Predicated on this framework, we revisit the concepts of personhood and autonomy. We argue that a full account of personhood locates its foundation in relationships with others, rather than merely in “rationality”. A full account of autonomy also recognises relationships with others, as well as the actual reality of the patient’s situation-in-the-world. The fact (...) that, when critically ill, the patient may no longer be able to take an active role in decision-making does not bring about the end of their personhood, or of their autonomy. Because the patient’s autonomy is intimately linked to their relationships with others, once critical illness supervenes, respect for their autonomy devolves to those others with whom the patient is in relationship. In practical application, this means that there must be a dialogue, as the end-of-life of the critically-ill patient in ICU comes into view. Such dialogue should be grounded on this understanding in order to conform best to moral philosophical principles. Ideally the dialogue will involve all those with whom the patient is in relationship and, practical difficulties within an ICU notwithstanding, will aim to be inclusive, non-coercive and reflective as it seeks to maximise the good of the patient in their unique context. (shrink)

This book advances a novel justification for the idea of "public reason": citizens within diverse societies can realize the ideal of shared political autonomy, despite their adherence to different religious and philosophical views, by deciding fundamental political questions with "public reasons." Public reasons draw upon or are derived from ecumenical political ideas, such as toleration and equal citizenship, and mutually acceptable forms of reasoning, like those of the sciences. This book explains that if citizens share equal political (...) class='Hi'>autonomy—and thereby constitute "a civic people"—they will not suffer from alienation or domination and can enjoy relations of civic friendship. Moreover, it contends that the ideal of shared political autonomy cannot be realized by alternative accounts of public justification that eschew any necessary role for public reasons. In addition to explaining how the ideal of political autonomy justifies the idea of public reason, this book presents a new analysis of the relation between public reason and "ideal theory": by engaging in "public reasoning," citizens help create a just society that can secure the free compliance of all. It also explores the distinctive policy implications of the ideal of political autonomy for gender equality, families, children, and education. (shrink)

Fears of alienation and anomie in liberal societies have driven many writers to emphasize care and commitment as essential ingredients of human well-being and as educational aims. Conceiving autonomy to be incompatible with these values, they have concluded that autonomy should be replaced with alternative conceptions of human well-being and of education that emphasize care and commitment. The claim I will try to defend in this paper is that, in contrast to these views, there is no contradiction between (...) autonomy on the one hand and care and commitment on the other; hence acknowledgment of the importance of the latter pair of values need not lead to the rejection of the ideal of autonomy. (shrink)

Abstract In this paper I set the debate between Kant and Schiller in terms of the role that an ideal of life can play within an autonomist ethic. I begin by examining the critical role Schiller gives to emotions in tackling specific motivational concerns in Kant's ethics. In the Kantian response I offer to these criticisms, I emphasise the role of metaphysics for a proper understanding of Kant's position whilst allowing that with respect to moral psychology, Kant and Schiller (...) are in agreement about the importance of emotions in our moral lives. I conclude by returning to the themes broached in the introduction to consider the extent to which the teleological concerns that motivate Schiller can be addressed within Kant's autonomist ethics. (shrink)

If we want to be autonomous, what do we want? The author shows that contemporary value-neutral and metaphysically economical conceptions of autonomy, such as that of Harry Frankfurt, face a serious problem. Drawing on Plato, Augustine, and Kant, this book provides a sketch of how "ancient" and "modern" can be reconciled to solve it. But at what expense? It turns out that the dominant modern ideal of autonomy cannot do without a costly metaphysics if it is to (...) be coherent. (shrink)

Authenticity has become a widespread ethical ideal that represents a way of dealing with normative gaps in contemporary life. This ideal suggests that one should be true to oneself and lead a life expressive of what one takes oneself to be. However, many contemporary thinkers have pointed out that the ideal of authenticity has increasingly turned into a kind of aestheticism and egoistic self-indulgence. In his book, Varga systematically constructs a critical concept of authenticity that takes into (...) account the reciprocal shaping of capitalism and the ideal of authenticity. Drawing on different traditions in critical social theory, moral philosophy and phenomenology, Varga builds a concept of authenticity that can make intelligible various problematic and potentially exhausting practices of the self. (shrink)

How to conceptualize loving relationships so as to accommodate that just love is geared toward preserving and fostering individual autonomy? To develop an answer, this paper draws on the recent debate on the rational role of experience to motivate a view dubbed Murdochian presentationalism. Murdochian presentationalism takes seriously two presentationalist ideas: 1) individuals harboring different world views who respond to identical situations differently can be equally rational; 2) our views and concepts develop under the constant pressure of experience. It (...) combines these ideas with Murdoch’s tenet that coming to know others (and thus being able to do well by them) requires unselfish love, construed as just attention that involves a continuous refinement of our evaluative concepts and makes us better attuned to what is real. Complemented with a broadly Kantian notion of autonomy, the resulting view fits the bill. The paper ends on a sketch of what is dubbed the ideal lovers’ pledge and a comment on what metaphor the view arrived at suggests for thinking about loving relationships. (shrink)

I seek to advance enquiry into the point of a public higher education institution by drawing on ideals salient in the sub-Saharan African philosophical tradition. There are relational, and specifically communal, values prominently held by African thinkers that I use to ground a promising rival to the dominant contemporary Western, and especially Anglo-American, accounts of what a university ultimately ought to strive to achieve, which focus mainly on autonomy, truth, and citizenship. My aims are not merely comparative, contrasting an (...) Afro-communal approach with other ones that have been more globally influential, but also substantive. Although the theory of a university’s point that I articulate and defend has an African pedigree, I work to show that it should be taken seriously by a global audience, for plausibly capturing a variety of intuitions and claims that are widely shared. (shrink)

Part III. Section 4. Full Autonomy - An Attainable Ideal: Maximal or full autonomy is an unrealistic goal for all people. Contrary to a common assumption, however, masculine socialization does not generally result in full autonomy, but rather in medial autonomy. Conformism is as much of an obstacle to the full autonomy of men as it is for women. Still, men in western cultures are more likely to be more autonomous than women, and this (...) discrepancy calls for change. (shrink)

This discussion aims to give a normative theoretical basis for a “best judgment” model of surrogate decision making rooted in a regulative ideal of love. Currently, there are two basic models of surrogate decision making for incompetent patients: the “substituted judgment” model and the “best interests” model. The former draws on the value of autonomy and responds with respect; the latter draws on the value of welfare and responds with beneficence. It can be difficult to determine which of (...) these two models is more appropriate for a given patient, and both approaches may seem inadequate for a surrogate who loves the patient. The proposed “best judgment” model effectively draws on the values incorporated in each of the traditional standards, but does so because these values are important to someone who loves a patient, since love responds to the patient as the specific person she is. (shrink)

In this paper I distinguish three degrees of epistemic egoism, each of which has an ethical analogue, and I argue that all three are incoherent. Since epistemic autonomy is frequently identified with one of these forms of epistemic egoism, it follows that epistemic autonomy as commonly understood is incoherent. I end with a brief discussion of the idea of moral autonomy and suggest that its component of epistemic autonomy in the realm of the moral is problematic.

Liberalism is the view that humans are independent, autonomous, and self-sufficient and, thus, institutional policy is warranted only when it advances these values. As an important thread in moral thought today, liberalism defines a good life as the complete freedom of all people to pursue their own desires, provided that little or no harm is done to others along the way.Moral liberalism also pervades the literature in philosophy of sport today. In this paper, I argue that liberalism as moral policy (...) in sport is wrong because liberalism as moral policy is wrong. Human autonomy implies social responsibility, which moral liberalism today disavows. At paper’s end, I sketch out a normative account of sport, aretism, that fleshes out the types of responsibilities that bind athletes to sport, properly construed as a social institution. (shrink)

Autonomy as a personal ideal presupposes a conception of the self who owns and rules in a life that exemplifies the ideal. Philosophical discussion of autonomy continues to be injuenced by the thesis that the governing core of the self resides in our capacities for disengaged rational reflection, even when the thesis is not explicitly avowed. This conception of autonomy is shown to be inadequate because it alienates us from what matters in our lives. An (...) alternative conception of autonomy is presented that accords a substantial role to rejection and choice within an autonomous life without falling preq, to the charge of alienation. Some divergent implications of the two rival conceptions of autonomy for an understanding of liberal education are examined. Finally, the question of the value of autonomy from a social perspective is briefly discussed. (shrink)

Autonomy as a personal ideal presupposes a conception of the self who owns and rules in a life that exemplifies the ideal. Philosophical discussion of autonomy continues to be injuenced by the thesis that the governing core of the self resides in our capacities for disengaged rational reflection, even when the thesis is not explicitly avowed. This conception of autonomy is shown to be inadequate because it alienates us from what matters in our lives. An (...) alternative conception of autonomy is presented that accords a substantial role to rejection and choice within an autonomous life without falling preq, to the charge of alienation. Some divergent implications of the two rival conceptions of autonomy for an understanding of liberal education are examined. Finally, the question of the value of autonomy from a social perspective is briefly discussed. (shrink)

This paper consists of an initial investigation about the meaning of a good childhood following the ethical ideal of authenticity. In this introduction to a philosophy of childhood and authenticity, the central theme is to investigate how the authenticity ideal is already presupposed in the contemporary discourse on what constitutes a good childhood. In the emerging field of philosophy of childhood, the capacities of children for agency, autonomy, and committing and the fundamental role of parents in guaranteeing (...) possibilities to exercise them are being increasingly highlighted, together with a discourse that there are some intrinsic goods of childhood. These developments parallel contemporary reconstructions of authenticity as an ethical ideal. Current debates emphasize the importance of a person finding, creating and constructing their originality, and how to realize it. At the same time, this search must recognize demands emanating from something more than human desires: from one’s culture and community. The parallel dynamics between these two discourses - children-parent and individual-society - point to a direction that applying the concept of authenticity to the construction of novel interpretations and practices of a good childhood can bring fruitful results. After examining such parallels, some of these practices that emerge from the analysis of good childhoods as authentic childhood are pointed out, such as the importance of cultivating children’s moments of caring and committing, and the development of personal projects. The paper concludes by exploring some limitations of the applied methodology and how it can be a strength in future research on this topic. (shrink)

This paper examines the prevalence of the ideal of “independence” in intellectual disability care in the Netherlands. It responds to a number of scholars who have interrogated this ideal through the lens of Michel Foucault’s vocabulary of governmentality. Such analyses hold that the goal of “becoming independent” subjects people with intellectual disabilities to various constraints and limitations that ensure their continued oppression. As a result, these authors contend, the commitment to the ideal of “independence” – the “ethic (...) of autonomy” – actually threatens to become an obstacle to flourishing in the group home. This paper offers an alternative analysis. It does so by drawing on a case study taken from an ethnographic study on group home life in the Netherlands. Briefly put, the disagreement stems from differing conceptualizations of moral life. Put in the vocabulary of moral anthropologist Cheryl Mattingly, the authors propose to approach the group home more from a “first-person” perspective rather than chiefly from a “third-person” perspective. They then draw on Mattingly to cast the group home as a “moral laboratory” in which the ethic of autonomy is not just reproduced but also enacted, and in which the terms of (in)dependence constantly get renegotiated in practice. What emerges is not only a new perspective on the workings of the “ethic of autonomy” in the group home, but also an argument about the possible limitations of the vocabulary of governmentality for analysing care practices. (shrink)

Can we measure and predict character with predictive analytics so a business can better assess, ideally objectively, whether to lend money or extend credit to that person, beyond current objective measures of credit scores and standard financial metrics like solvency and debt ratios? We and the analysts probably do not know enough about character to try to measure it, though it might be more useful to measure and predict a person’s temperance and prudence as virtues, or self-control as psychology, or (...) sense of obligation, particularly a moral commitment or sense of duty to honor a contract and re-pay a loan. The pervasive data surveillance of people that goes with “big data” and predictive analytics is not only an invasion of privacy in general, but an impairment of the aspect of privacy called autonomy that will constrict and alter a person’s choices and development of self. (shrink)

In this article some of the presuppositions that underly the current ideas about decision making capacity, autonomy and independence are critically examined. The focus is on chronic disorders, especially on chronic physical disorders. First, it is argued that the concepts of decision making competence and autonomy, as they are usually applied to the problem of legal (in)competence in the mentally ill, need to be modified and adapted to the situation of the chronically (physically) ill. Second, it is argued (...) that autonomy and dependence must not be considered as two mutually exclusive categories. It is suggested that decision making may take on the form of a more or less conscious decision not to be involved in making all kinds of explicit and deliberate decisions. Elaborating on Agich's distinction between ideal and actual autonomy, the concept of Socratic autonomy is introduced. (shrink)

This article examines whether autonomy as an educational aim should be defended at the global scale. It begins by identifying the normative issues at stake in global autonomy education by distinguishing them from the problems of autonomy education in multicultural nation-states. The article then explains why a planet-wide expansion of the ideal of autonomy is conceivable on the condition that the concept of autonomy is widened in a way that renders its precise meaning flexibly (...) adjustable to a variety of distinct social and cultural contexts. A context-transcendent, core meaning of autonomy remains in place, however, according to which a person is only autonomous if she relates to the values and goals that direct her life in a way so that she sees them as her own and is able to identify and critically assess her principal reasons for action. Finally, the article addresses two challenges to the global expansion of autonomy education: the objection that autonomy is presently not the most important educational aim and the objection that global autonomy education is a form of cultural imperialism. It finds both objections wanting. (shrink)

Some feminists have been critical about the dominant conception of autonomy, questioning, for example, its conception of persons and ideal of personhood. Tom Beauchamp and James Childress (BC), the major proponents of the dominant conception of autonomy, believe that these feminists have misunderstood their theory and, moreover, that their theory is immune to feminist attack. Their response to feminist critics, however, has been dismissive and does nothing to assuage these critics concerns. In this paper I briefly review (...) the state of play in this debate about autonomy, showing that BC are not without positive rejoinders to objections raised by feminist critics. These rejoinders rest on the notion that feminist concerns are a matter of what is logically entailed by BCs theory of autonomy and attempt to show that feminist commitments are logically consistent with that theory. However, these rejoinders are less than convincing for reasons illuminated by Cheshire Calhoun. Calhoun reminds us that feminists are sensitive to ways in which the shape of discourse is influenced by non-epistemic considerations. In particular, Calhoun draws our attention to the cumulative effect of a whole tradition of moral reasoning that focuses on too narrow a range of moral problems and too narrow an understanding of people and the human condition. BCs conception of autonomy relies on and reinforces ideologies of the moral life created in just this way. Following Calhoun, I show that criticism of their theory as ideology is not criticism of its logical implications, but something far more damaging, something without available rejoinders. (shrink)

In this article I wish to show how care ethics puts forward a fundamental critique on the ideal of independency in human life without thereby discounting autonomy as a moral value altogether. In care ethics, a relational account of autonomy is developed instead. Because care ethics is sometimes criticized in the literature as hopelessly vague and ambiguous, I shall begin by elaborating on how care ethics and its place in ethical theory can be understood. I shall stipulate (...) a definition of care ethics as a moral perspective or orientation from which ethical theorizing can take place. This will mean that care ethics is more a stance from which we can theorize ethically, than ready-made theory in itself. In conceiving care ethics in this way, it becomes possible to make clear that, for instance, a moral concept of autonomy is not abandoned, but instead is given a particular place and interpretation. In the final part of this article I will show how ‘relational autonomy’ can be applied fruitfully in the practice of psychiatric care. (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)

There is a long-standing debate in the philosophy of mind and philosophy of science regarding how best to interpret the relationship between neuroscience and psychology. It has traditionally been argued that either the two domains will evolve and change over time until they converge on a single unified account of human behaviour, or else that they will continue to work in isolation given that they identify properties and states that exist autonomously from one another (due to the multiple-realizability of psychological (...) states). In this paper, I argue that progress in psychology and neuroscience is contingent on the fact that both of these positions are false. Contra the convergence position, I argue that the theories of psychology and the theories of neuroscience are scientifically valuable as representational tools precisely because they cannot be integrated into a single account. However, contra the autonomy position, I propose that the theories of psychology and neuroscience are deeply dependent on one another for further refinement and improvement. In this respect, there is an irreconcilable codependence between psychology and neuroscience that is necessary for both domains to improve and progress. The two domains are forever linked while simultaneously being unable to integrate. (shrink)

This article asks how people come to interpret themselves and others as autonomous given their multiple dependencies. We draw on a cross-case comparison of ethnographic studies with two populations for whom autonomy is both central and problematic: elderly patients in post-acute care, and young adults with disabilities in an independent living program. Analyzing the institutional efforts to make their clients “as independent as possible,” we find that staff members at each organization formulate autonomy as a temporal project through (...) an ongoing calibration of open futures, ideal pasts, and situational competence. Constantly adjusting and fine-tuning where in time autonomy “really” is, workers arrange present dependence so that the contours of the future remain open for their clients. In other words, they make use of temporal markers to produce recognizable autonomous subjects whose dependencies are momentary. Theorizing this temporal project enables us to see more clearly how all of us engage in the constant business of “doing” autonomy, and to better understand the role of institutions in producing autonomous selves. (shrink)

Autonomy is increasingly rejected as a fundamental principle by liberal political theorists because it is regarded as incompatible with respect for diversity. This article seeks, via an analysis of the Danish cartoon controversy, to show that the relationship between autonomy and diversity is more complex than often posited. Particularly, it asks whether the autonomy defense of freedom of expression encourages disrespect for religious feelings. Autonomy leads to disrespect for diversity only when it is understood as a (...) character ideal that must be promoted as an end in itself. If it by contrast is understood as something we should presume everyone possesses, it provides a strong basis for equal respect among people from diverse cultures. A Kantian conception of autonomy can justify the right to freedom of expression while it at the same time requires that we in the exercise of freedom of expression show respect for others as equals. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Ideas 63.3 (2002) 483-500 [Access article in PDF] Greek Origins and Organic Metaphors: Ideals of Cultural Autonomy in Neohumanist Germany from Winckelmann to Curtius Brian Vick That the educated classes of late eighteenth- and nineteenth-century Germany were increasingly captivated by images of both nationality and Greek antiquity is a fact long noted and long puzzled over. This seemingly strange confluence of cultural tendencies (...) does, however, help explain why studying the drawn-out debates among German neohumanist scholars on the cultural origins of the Greeks ultimately offers a fresh perspective on certain problems of German national identity—in this case, on the ambivalent relationship to things foreign in that period of German history.Scholarly attention has recently been drawn to this question as part of the conflict over Martin Bernal's Black Athena, the first volume of which argued that nineteenth-century German classicists' denial of an Egyptian contribution to early Greek cultural development revealed their xenophobic tendencies. While Bernal pointed to racism as the prime motive for this repudiation of African and later of Semitic influence on the Greeks, he also invoked several of the other "-isms" that have proven so fruitful yet confusing for efforts to understand the intellectual and cultural climate of late eighteenth and early nineteenth-century Germany: romanticism, historicism, organicism, and of course neohumanism. 1 [End Page 483]The present essay is not intended to be another of the past decade's many responses to Bernal. Attention must be paid to that discussion, but it is important to recognize the extent to which this debate reflects a much broader disagreement about German attitudes in the romantic and nationalist eras. Some scholars portray the more cosmopolitan side of the romantic inheritance and stress its continued fascination with foreign literatures and cultures. Others, however, seem more like Bernal in citing the historicist turn to nature and nationality either to illustrate or to explain an alleged German xenophobia and hypersensitivity to issues of ethnic and cultural purity. 2It is to this wider question of the cultural legacy of German classicism and romanticism, historicism and organicism, that I would like to direct attention in this essay. Rather than invoking these "-isms" in an effort to explain the various positions taken in the debate about Greek origins, I hope to reverse the process and examine the relevant texts in an effort to clarify the broader implications of these issues of cultural purity and cultural borrowing, from the time of Winckelmann's first assertion of Greek originality through the rise of new kinds of nationalism and racism in the Wilhelmine era. 3 I shall show that belief in the importance of Greek civilization's Asian and even Egyptian cultural heritage remained strong for decades, even after Karl Otfried Müller's seemingly definitive rejection of such a connection in the 1820s. Moreover, most of the figures engaged on both sides of the debate made remarkably similar use of historicizing organic metaphors to help reconcile the twin values of national autonomy and cultural transmission, both so central to the self-conception and national identity of the German Bildungsbürgertum in this period. Continuity and connection with the environment, not purity and isolation from it, were the hallmarks of such organicist thinking across a wide spectrum of romantic, neohumanist, and idealist commentators. Only in the second half of the nineteenth century, with the passing of romantic values, the transformation of historicism into historicist positivism, and the development of new meanings attached to images of biology and race, would this situation slowly begin to change. The Greeks, History, and Culture: Foundational Perspectives Many of the considerations central to discussions about the origins of the Greeks and about the role of cultural mixing generally can be seen in the debate's [End Page 484] two most important early statements, the denial of Egyptian influence by Johann Joachim Winckelmann in his History of Ancient Art of 1764 and the successive sharp critiques of this view by an otherwise admiring Johann Gottfried... (shrink)

This collection of new essays examines philosophical issues at the intersection of feminism and autonomy studies. Are autonomy and independence useful goals for women and subordinate persons? Is autonomy possible in contexts of social subordination? Is the pursuit of desires that issue from patriarchal norms consistent with autonomous agency? How do emotions and caring relate to autonomous deliberation? Contributors to this collection answer these questions and others, advancing central debates in autonomy theory by examining basic components, (...) normative commitments, and applications of conceptions of autonomy. Several chapters look at the conditions necessary for autonomous agency and at the role that values and norms -- such as independence, equality, inclusivity, self-respect, care and femininity -- play in feminist theories of autonomy. Whereas some contributing authors focus on dimensions of autonomy that are internal to the mind -- such as deliberative reflection, desires, cares, emotions, self-identities and feelings of self-worth -- several authors address social conditions and practices that support or stifle autonomous agency, often answering questions of practical import. These include such questions as: What type of gender socialization best supports autonomous agency and feminist goals? When does adapting to severely oppressive circumstances, such as those in human trafficking, turn into a loss of autonomy? How are ideals of autonomy affected by capitalism? and How do conceptions of autonomy inform issues in bioethics, such as end-of-life decisions, or rights to bodily self-determination? (shrink)

Professional autonomy is often described as a claim of professionalsthat has to serve primarily their own interests. However, it can also beseen as an element of a professional ideal that can function as astandard for professional, i.e. medical practice. This normativeunderstanding of the medical profession and professional autonomy facesthree threats today. 1) Internal erosion of professional autonomy due toa lack of internal quality control by the medical profession; 2)the increasing upward pressure on health care expenses that (...) calls for ahealth care policy that could imply limitations for the professionalautonomy of physicians; 3) a distorted understanding of theprofession as being based on a formal type of knowledge and relatedtechnology, in which other normative dimensions of medical practice areneglected and which frustrates meaningful communication betweenphysicians and patients. To answer these threats a normative structureanalysis of medical practice is presented, that indicates whichprinciples and norms are constitutive for medical practice. It isconcluded that professional autonomy, normatively understood, should bemaintained to avoid the lure of the technological imperative and toprotect patients against third parties' pressure to undertreatment.However, this professional autonomy can only be maintained if members ofthe profession subject their activities and decisions to a criticalevaluation by other members of the profession and by patients and ifthey continue to critically reflect on the values that regulate today'smedicine. (shrink)

Precision medicine promises to develop diagnoses and treatments that take individual variability into account. According to most specialists, turning this promise into reality will require adapting the established framework of clinical research ethics, and paying more attention to participants’ attitudes towards sharing genotypic, phenotypic, lifestyle data and health records, and ultimately to their desire to be engaged as active partners in medical research.Notions such as participation, engagement and partnership have been introduced in bioethics debates concerning genetics and large-scale biobanking to (...) broaden the focus of discussion beyond individual choice and individuals’ moral interests. The uptake of those concepts in precision medicine is to be welcomed. However, as data and medical information from research participants in precision medicine cohorts will be collected on an individual basis, translating a participatory approach in this emerging area may prove cumbersome. Therefore, drawing on Joseph Raz’s perfectionism, we propose a principle of respect for autonomous agents that, we reckon, can address many of the concerns driving recent scholarship on partnership and public participation, while avoiding some of the limitations these concept have in the context of precision medicine. Our approach offers a normative clarification to how becoming partners in precision is compatible with retaining autonomy.Realigning the value of autonomy with ideals of direct engagement, we show, can provide adequate normative orientation to precision medicine; it can do justice to the idea of moral pluralism by stressing the value of moral self-determination: and, finally, it can reconcile the notion of autonomy with other more communitarian values such as participation and solidarity. (shrink)

Miller analyzes the relationship between consent and autonomy by offering three pictures. For autonomy, Miller distinguishes between procedural, substantive, and weak substantive autonomy. The corresponding views of consent are what Miller has termed as consensual minimalism, consensual idealism, and consensual realism. The requirements of sexual consent under consensual minimalism are a voluntary informed agreement. However, feminist critiques reveal the inadequacies of this simple position. Consensual idealism, which corresponds with substantive autonomy, offers a robust picture where consent (...) and autonomy must be based on non-oppression. However, this view is considered too ideal and it ignores context. Weak substantive autonomy takes into account the context in the sexual domain. Correspondingly, consensual realism takes into account the context and still fulfills the requirements of consent. (shrink)

According to one influential view, requirements to elicit consent for medical interventions and other interactions gain their rationale from the respect we owe to each other as autonomous, or self-governing, rational agents. Yet the popular presumption that consent has a central role to play in legitimate intervention extends beyond the domain of cases where autonomous agency is present to cases where far from fully autonomous agents make choices that, as likely as not, are going to be against their own best (...) interest. The question how we should understand the rationale for eliciting consent in this range of ‘non-ideal’ cases is comparatively ill understood. In this paper, I explore the prospects of accounting for consent requirements in such ‘non-ideal’ cases by appealing to a set of agency-based interests; including an interest in playing a meaningful part in joint decisions affecting ourselves and others. (shrink)

While there is much literature on autonomy and the conditions for its attainment, there is less on how those conditions reflect on agents’ ordinary careers. Most people’s careers involve a great deal of subservient activity that would prevent the kind of control over agents’ actions that autonomy would seem to require. Yet, it would seem strange to deny autonomy to every agent who regularly follows orders at work—to do so would make autonomy a futile ideal. (...) Most contemporary autonomy accounts provide purely theoretical analysis without reference to any practical goal that autonomy could serve. These accounts are likely to resolve this issue in one direction: either almost entirely including or excluding subservient workers from autonomy. Either solution would fail to distinguish agents who sufficiently control their lives, in spite of limited subservience, according to their own standards, from agents for whom subservience precludes a fulfilling life. I suggest the solution lies in a return to goal-oriented autonomy accounts, which can use the goal to distinguish when subservience overwhelms autonomy from when subservience and autonomy can coexist. I present an account that anchors autonomy in the happiness that it provides for agents who sufficiently control their lives as determined by their more important prudential standards. On this account, agents in subservient careers can be autonomous if they determine how to make their careers consistent with their happiness. (shrink)

Philosophers have various reasons to be interested in individual autonomy. Individual self-rule is widely recognized to be important. But what, exactly, is autonomy? In what ways is it important? And just how important is it? This book introduces contemporary philosophical thought about the nature and significance of individual self-rule. -/- Andrew Sneddon divides self-rule into autonomy of choice and autonomy of persons. Unlike most philosophical treatments of autonomy, Sneddon addresses empirical study of the psychology of (...) action. The significance of autonomy is displayed in connection with such issues as paternalism, political liberalism, advertising and physician-assisted suicide. Sneddon both introduces the themes of contemporary autonomy studies and defends a novel account of its nature and significance. Autonomy is an ideal introduction for advanced-level undergraduate and postgraduate students to the issues and debates surrounding individual self-rule. (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)

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)

Recent epistemology has been notable for an emphasis, or a variety of emphases, upon the social dimension of knowledge. This has provided a corrective to the heavily individualist account of knowledge previously holding sway. It acknowledges the ways in which an individual is deeply indebted to the testimony of others for his or her cognitive endowments, both with respect to capacities and information. But the dominance of the individualist model was connected with a concern for the value of cognitive (...) class='Hi'>autonomy. It is unclear how due recognition of the social dimension can allow for this value. It is argued here that there are ways of construing intellectual autonomy that not only can make it consistent with these new emphases but also respect its status as an epistemic concept. The author’s approach is contrasted with Alvin Goldman’s recent development of an approach to social knowledge via the idea of maximising truths. This seems to leave insufficient scope for intellectual character and autonomy. So concepts of independence, mastery, intellectual self-creation and intellectual integrity are explored in order to develop a perspective on cognitive autonomy adequate to the insights of social epistemology.Author Keywords: Autonomy; Testimony; Ideals; Epistemology; Mackie; Goldman. (shrink)

The concept of autonomy is one of Kant's central legacies for contemporary moral thought. We often invoke autonomy as both a moral ideal and a human right, especially a right to determine oneself independently of foreign determinants; indeed, to violate a person's autonomy is considered to be a serious moral offence. Yet while contemporary philosophy claims Kant as the originator of its notion of autonomy, Kant's own conception of the term seems to differ in important (...) respects from our present-day interpretation. Kant on Moral Autonomy brings together a distinguished group of scholars who explore the following questions: what is Kant's conception of autonomy? What is its history and its influence on contemporary conceptions? And what is its moral significance? Their essays will be of interest both to scholars and students working on Kantian moral philosophy and to anyone interested in the subject of autonomy. (shrink)

Respecting the autonomy of agents grounds various obligations to others such as non-interference, deference to her authority over self-regarding decisions, limitations on paternalism, and so on. According to a broadly liberal moral sensibility, respecting others in this way implies accepting the valuesValue they autonomously hold even if they are judged problematic, immoral, self-destructive, or otherwise non-ideal. In discussions of such respect, it is generally assumed that persons expressing that respect have no direct bearing on whether the subject of (...) that respect is herself autonomous. However, in many situations, persons interact in a way that helps establish or re-establish the autonomy of one or both of these agents themselves.For example, the would-be paternalist may be a therapist whose professional obligationObligations is to facilitate the process of re-establishing autonomy for vulnerable victims of traumaTrauma. In such scenarios, the usual lines between hardPaternalismhard and softPaternalismsoft paternalism, as well as the standard liberal rejection of the former, do not apply. Still, it would be wrong for the aid workerAid workers to simply impose her views of a decent life on the struggling person. How, then, do we reformulate restrictions on paternalism and other such normative strictures grounded in respect forAutonomyrespect for autonomy in scenarios where the relationshipRelationships between client and aid workerAid workers is itself a crucial part of the process that results in the self-governingSelf-governing agency of the client?This paper explores these issues and argues that such scenarios indicate that conceptions of autonomy must view the self as diachronic as well as socially constituted but also must be sensitive to the ways that autonomy can sometimes be established only with others’ help. In particular, the obligationObligations to remain relatively neutralNeutral toward the content of others’ values in showing respect forPersonsrespect for their autonomy must be reformulated to take into account the way interpersonal dynamics themselves help establish the autonomy with which persons hold the values that they hold. These observations are applied to certain cases of aid and care where such questions are central. (shrink)

The ideal of personal autonomy faces a challenge from advocates of orthonomy, who think good government should displace self-government. These critics claim that autonomy is an arbitrary kind of psychological harmony and that we should instead concentrate on ensuring our motivations and deliberations are responsive to reasons. This paper recasts these objections as part of an intramural debate between approaches to autonomy that accept or reject the requirement for robust rational capacities. It argues that autonomy (...) depends upon such responsiveness to reasons, countering objections that ‘externalist’ rationalist criteria strip the self from self-government. (shrink)

Recognition that the Principle of Respect for Autonomy fails to work in family-centric societies such as Singapore has recently led to the promotion of relational autonomy as a suitable framework within which to place healthcare decision making. However, empirical data, relating to patient and family opinions and the practices of healthcare professionals in Confucian-inspired Singapore, demonstrate clear limitations on the ability of a relational autonomy framework to provide the anticipated compromise between prevailing family decision-making norms and adopted (...) Western led atomistic concepts of autonomy. Evidence suggests that despite a growing infusion of Western influence, there is still little to indicate any major shift to individual decision making, particularly in light of the way society and healthcare are structured. Similarly, the lack of employing a shared decision-making model and data that discredit the notion that the complex psychosocial and cultural factors that affect the decision making may be considered “content neutral” not only prevents the application of relational autonomy but questions the viability of the values behind the Principle of Respect for Autonomy. Taking into account local data and drawing upon a wider concept of personhood that extends beyond prevailing family-centric ideals along with the complex interests that are focused upon the preservation of the unique nature of personhood that arises from the Ring Theory of Personhood, we propose and “operationalize” the employing of an authoritative welfare-based approach, within the confines of best interest decision making, to better meet the current care needs within Singapore. (shrink)

The value and importance accorded to personal autonomy 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 personal autonomy. 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)

Yoga is a nonspeciesist liberalism, founded in a moral non-naturalism, which identifies the essence of personhood as the Lord, defined by unconservative self-governance—an abstraction from each of us that is non-proprietary. According to Yoga, the right is defined as the approximation of the regulative ideal (the Lord) and the good is the perfection of this practice, which delivers us from a life of coercion into a personal world of freedom. It is an alternative to Deontology, Consequentialism, and Virtue Ethics, (...) which provides a unitary account of moral well-being and worldly well-being. The seeming antinomy of freedom and determinism is resolved in the ethical life. I argue that Yoga provides a critical and instructive response to alternative ethical theories and the problem of collective harm. (shrink)

In contemporary political philosophy, reflections on poverty demand careful treatment in the light of key ethical concepts—especially autonomy. While the negative effects of poverty on autonomy are acknowledged, the welfare dependency of the poor is seen as an autonomy-undermining factor, which I call the “autonomy–poverty dilemma.” This chapter discusses contemporary political theories about autonomy and poverty in terms of how they relate to this dilemma. The features and problems of three pertinent theories are addressed in (...) such a way as to resolve the autonomy–poverty dilemma. The first is luck egalitarianism, which weighs individual responsibility in defining just distributions, but may leave some of the incapacitated unattended in order not to annul their personal responsibility and may stigmatize those who are dependent (such as people with mental disabilities) who are not personally responsible. Such stigmatization is also a problem with relational egalitarianism, which bases egalitarian justice on the equal standing of individuals, in that the ideal of socially embedded autonomous agents could be degrading to the dependent. While the capability approach overcomes that problem by providing a powerful buttress for the dependent and allowing them to emerge from poverty, it runs the risk of a paternalistic, perfectionist idealism. In closing, this chapter proposes an alternative view, which I call the “radical pluralist view of egalitarian justice,” based on a consideration of the features and problems of these three key theories. (shrink)