Robert Veatch and others have questioned whether there are internal moral rules of medicine. This paper examines the legal regulatory model for governing professions as the autonomous exercise of professional skills and asks whether there is a theoretical basis for this model. Taking John Rawls’s distinction between the justification of a practice and justification of the rules internal to the practice, this paper argues that the autonomous exercise of professional skills is justified so long as it benefits society. (...) In opposition to Christopher Boorse, it is argued that medicine is pathocentric and that physicians exercise skills in treating pathologies. The autonomous treatmentof pathologies is justified because non-interference with physicians will lead to greater treatment of pathologies and so benefit society. Finally, the analysis of medicine as the autonomous exercise of skills in treating pathologies yields the rule that physicians not be forced to cause pathologies. (shrink)

This paper discusses the proposal made by Lombardi and Labarca (Found Chem 7:125–148, 2005) that internal realism can secure the ontological autonomy of chemistry. I argue that internal realism is not, by itself, sufficient to accomplish this task. The fact that conceptual schemes may differ with respect to their theoretical virtues, and the possibility that the relations between them may be reductive undermine the premise that each conceptual scheme has an equal right to define its own ontology, (...) which is a key premise in Lombardi and Labarca’s proposal. (shrink)

This paper analyses the way in which being in possession of an adequate range of options is an essential component of autonomy. I discuss the way in which the conceptualisation of options in terms of basic rights might assist this argument, and apply these ideas to HIV/AIDS clinical research in the developing world. Finally, I suggest that mechanisms should be put in place through which vulnerable research participants can express their views about the relationship between the research in which (...) they are involved, and needs of a worthwhile life. (shrink)

This book uses the example of informed consent guidelines for international research on human subjects to demonstrate how a philosophical analysis can assist in understanding how underlying concepts affect public policy; how and why such policies are exclusionary; and what methodology can be used to remedy injustices in public policy and practice. Epidemics, such as AIDS, have resulted in an increase in medical research in less developed countries. In an attempt to be more globally applicable, current international guidelines for research (...) on human subjects have attempted to acknowledge the importance of community. This book explains how these attempts fail to adequately acknowledge the importance community has for many people in less developed countries, and how these guidelines fail to attend to constraints to autonomy that oftentimes get magnified once community is involved in the informed consent process. The book further explains how these problems can be traced to a mistaken underlying notion of autonomy and what policymakers can do to remedy these problems . (shrink)

Several nation states have reasons to halt the import of genetically modified organisms. The current international trend towards a regime of free trade makes such bans problematic. Whether a nation state is deemed justified in banning a certain product is strongly connected to discussions about what are acceptable criteria for proof of risk. The determination of these criteria hinges upon considerations of individual and national autonomy. This paper compares two different points of view in the debate: the WTO opposed (...) to the UN. A distinction between internal and external autonomy explains the differences in approach between the UN and the WTO. The conclusion is reached that adequate respect for autonomy requires a certain amount of flexibility in the criteria for proof of risk. (shrink)

Two linked studies explored whether students’ perceptions differentiate between teachers’ autonomy support and control when presenting mastery goals, and the outcomes of these two practices, in terms of students’ internalization of mastery goals and their behavioral engagement. In two phases, Study 1 sought to validate a new instrument assessing students’ perceptions of teachers’ autonomy support and control when presenting mastery goals. Study 2 demonstrated that at both within- and between-classroom levels, perceptions of teachers’ autonomy support for mastery (...) goals were related to students’ mastery goals’ endorsement and behavioral engagement. These relations were mediated by students’ autonomous reasons to pursue learning activities. Perceptions of teachers’ control predicted disengagement through controlled reasons for learning, but only at the within-classroom level. This research joins a growing body of work demonstrating that combining achievement goal theory with SDT can further our understanding of the underpinnings of achievement motivation. It suggests that if teachers want their students to endorse mastery goals, they need to use more autonomy supportive practices and less controlling ones. (shrink)

International institutions are facing increasing criticism of the legitimacy of their authority. But what does it mean for an international institution to be legitimate? Arthur Applbaum’s latest book provides a convincing new concept of legitimacy, namely, the power-liability view, and a new normative conception, the free group agent account. However, it is not clear how they can be applied to the international level. First, this paper examines how different concepts of legitimacy can be applied to international institutions. Second, it assesses (...) three different conceptions of legitimacy, namely, the service conception, Applbaum’s free group agent account and the autonomy-based conception for the international level. It outlines how on the last conception, international institutions’ legitimacy depends on three different aspects required to protect autonomy: the political power of the institution; its purpose; and its relation to other institutions. Finally, the paper argues that the creation of an international institution should be seen as part of relational legitimacy and that state consent plays an important role to protect the political autonomy of peoples. (shrink)

This paper addresses whether universal, general education programs are enough to satisfy basic criteria of human rights, or whether comprehensive family planning programs, in conjunction with universal education programs, might also be morally required. Even before the Reagan administration instituted the ‘global gag rule’ at the 1984 conference in Mexico City, prohibiting funding to nongovernmental organizations that included providing information about abortion as a possible method of family planning, the moral acceptability of family planning programs has been called into question. (...) This paper makes a moral argument for family planning by appealing to both data and to theory: data about the efficacy of universal and comprehensive family planning education programs at reducing fertility and infant mortality, and theory about what is required for the establishment of autonomy. It reasons that universal educational programs are insufficient for the promotion of autonomy, and therefore argues on substantive autonomy grounds for comprehensive family planning programs in addition to universal education programs. (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)

In “Autonomy and the Feminist Intuition,” Natalie Stoljar asks whether a procedural or a substantive approach to autonomy is best for addressing feminist concerns. In this paper, I build on Stoljar’s argument that feminists should adopt a strong substantive approach to autonomy. After briefly reviewing the problems with a purely procedural approach, I begin to articulate my own strong substantive theory by focusing specifically on the problem of internalized oppression. In the final section, I briefly address some (...) of the concerns raised by procedural theorists who are leery of a substantive approach. (shrink)

(2013). Autonomy and the Normativity Question: Framing Considerations. International Journal of Philosophical Studies. ???aop.label???. doi: 10.1080/09672559.2012.727014.

Respect for personal autonomy in decision making is one of the four ethical principles in medical circumstances. This paper aims to present evidence that can be considered good exemplars in the clarification of the ethical viewpoints of the western and Shi’i Islamic perspectives on this issue. The method followed was originally a search in international indexing services in April 2016. Our findings point towards various controversies on individuals’ autonomy lead to different decision making outcomes by health workers in (...) both different traditions. We concluded that although Shi’i Islamic jurisprudence does not seem to allow for personal autonomy in the sense it is understood in a western context, evidence indicates that Shi’i Islamic jurisprudence respects personal autonomy. (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)

Background: The intensive care unit environment focuses on interventions and support therapies that prolong life. The exercise by nurses of their autonomy impacts on perception of the role they assume in the multidisciplinary team and on their function in the intensive care unit context. There is much international research relating to nurses’ involvement in end-of-life situations; however, there is a paucity of research in this area in Brazil. In the Brazilian medical scenario, life support limitation generated a certain reluctance (...) of a legal nature, which has now become unjustifiable with the publication of a resolution by the Federal Medical Council. In Brazil, the lack of medical commitments to end-of-life care is evident. Objective: To understand the process by which nurses exercise autonomy in making end-of-life decisions in intensive care units. Research design: Symbolic Interactionism and Corbin and Strauss theory methodology were used for this study. Participants and research context: Data were collected through single audio-recorded qualitative interviews with 14 critical care nurses. The comparative analysis of the data has permitted the understanding of the meaning of nurse’s experience in exercising autonomy relating to end-of-life decision-making. Ethical considerations: Institutional ethics approval was obtained for data collection. Participants gave informed consent. All data were anonymized. Findings: The results revealed that nurses experience the need to exercise autonomy in intensive care units on a daily basis. Their experience expressed by the process of increase opportunities to exercise autonomy is conditioned by the pressure of the intensive care unit environment, in which nurses can grow, feel empowered, and exercise their autonomy or else can continuously depend on the decisions made by other professionals. Conclusion: Nurses exercise their autonomy through care. They work to create new spaces at the same time that they acquire new knowledge and make decisions. Because of the complexity of the end-of-life situation, nurses must adopt a proactive attitude that inserts them into the decision-making process. (shrink)

The majority of current attention on the question of autonomy has focused on the internal reflection of the agent. The quality of an agent’s reflection on her potential action (or motivating desire or value) is taken to determine whether or not that action is autonomous. In this paper, I argue that there is something missing in most of these contemporary accounts of autonomy. By focusing overwhelmingly on the way in which the agent reflects, such accounts overlook the (...) importance of what the agent is reflecting upon. Whichever of these current formulations of autonomy we accept, reflection could be undertaken in full accordance with the conditions set, and yet the action fail to be autonomous. This will occur, I argue, if the agent is mistaken about the object of her reflection. More precisely, if she has a particular kind of false belief about the action she is contemplating undertaking, then no amount of reflection can render that action autonomous. This suggests the need for externalist conditions to be incorporated into an account of autonomy. (shrink)

Health insurance coverage for incarcerated citizens is generally acceptable by Western standards. However, it creates internal tensions with the prevailing justifications for public healthcare. In particular, a conceptualization of medical care as a source of autonomy enhancement does not align with the decreased autonomy of incarceration and the needs-based conceptualization of medical care in cases of imprisonment; and rejecting responsibility as a criterion for assigning medical care conflicts with the use of responsibility as a criterion for assigning (...) punishment. The recent introduction of sofosbuvir in Germany provides a particularly instructive illustration of such tensions. It requires searching for a refined reflective equilibrium regarding the scope, limits, and justifications of publicly guaranteed care. (shrink)

This volume contains a selection of essays presented at the international conference on Cultural Crises in Art and Literature, held in Groningen in November 2002, in a special session on the question of the autonomy of the arts. Do we witness, in western culture, the end of the autonomy of the arts as it has been conceptualized and institutionalized since the eighteenth century? Indeed, developments of quite a different nature seem to have contributed to a blurring of boundaries (...) between art and non-art, art and the market, art and politics or ethics, as well as between the arts themselves, and between 'high' and 'low' art. Although this volume does not pretend to map this complex process in its entirety - partly because it is impossible to step out of one's own history - it is meant as a contribution to the elucidation of the process itself, offering some challenging explanations as to the heat of the current debate. (shrink)

This paper analysed the nature of autonomy, in particular respect for autonomy in medical ethics/bioethics in Japan. We have undertaken a literature survey in Japanese and English and begin with the historical background and explanation of the Japanese wordJiritsu (autonomy). We go on to identify patterns of meaning that researchers use in medical ethics / bioethics discussions in Japan, namely, Beauchamp and Childress’s individual autonomy, relational autonomy, and O’Neill’s principled autonomy as the three major (...) ways that autonomy is understood. We examine papers discussing these interpretations. We propose using the term ‘a form of autonomy’ first used by Edmund Pellegrino in 1992 and examine the nature of ‘a form of autonomy.’ We finally conclude that the crux of what Pellegrino calls ‘something close to autonomy,’ or ‘a form of autonomy' might best be understood as the minimization of physician paternalism and the maximization of respect for patient preference. Simultaneously, we introduce a family-facilitated approach to informed consent and respond to criticism by Laura Sullivan. Finally, we discuss cross-cultural approaches and global bioethics. Furthermore, we use the term ‘Bioethics across the Globe’ instead of ‘Global Bioethics’, calling for international scholars to write works to provide an in-depth understanding of each country. We conclude that deep understanding of others is pivotal for dialogue to be of value. We hope this article will deepen the reader’s understanding of Japan and will contribute to the progress of bioethics worldwide. (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)

While care ethics has frequently been criticized for lacking an account of autonomy, this paper argues that care ethics' relational model of moral agency provides the basis for criticizing the philosophical tradition's model of autonomy and for rethinking autonomy in relational terms. Using Diana Meyers's account of autonomy competency as a basis, a dialogical model of autonomy is developed that can respond to internal and external critiques of care ethics.

Individuals use their capacity for autonomy to express preferences regarding food choices. Food choices are fundamental, universal, and reflect a diversity of interests and cultural preferences. Traditionally, autonomy is cast in only epistemic terms, and the social and political dimension of it, where autonomy obstruction tends to arise, is omitted. This reflects problematic limits in the Cartesian notion of the individual. Because this notion ignores context and embodiment, the external and internal constraints on autonomy that (...) extend from social location are not considered. Therefore, reconceptions of the individual and autonomy which emphasize social location and relational interdependency are needed. To combat autonomy obstruction, individuals can appeal to community and community autonomy as a social mechanism. Communities are social groups characterized by people living in places with shared goals. Recognizing their interdependency, individuals can organize as communities in order to accomplish objectives that they cannot on their own. While community autonomy is valuable unto itself, it can also enhance individual autonomy. (shrink)

This essay will address a general philosophical concern about autonomy, namely, that a conception of autonomy focused on freedom of the will alone is inadequate, once we consider the effects of oppressive forms of socialization on individuals’ formation of choices. In response to this problem, I will present a brief overview of Diana Meyers’s account of autonomy as relational and practical. On this view, autonomy consists in a set of socially acquired practical competencies in self-discovery, self-definition, (...) self-knowledge, and self-direction. This account provides a distinction between choices that express unreflectively internalized social norms and those that are the result of a critical ‘self-reading’. I conclude that this practical conception of autonomy makes much higher demands upon nurses (and patients) than has previously been thought. In fact, if nurses are to be expected to genuinely promote autonomy, they are going to need specific training in counselling-type communication skills. (shrink)

Habermas dialogically recasts the Kantian conception of moral autonomy. In a legal-political context, his dialogical approach has the potential to redress certain troubling features of liberal and communitarian approaches to democratic politics. Liberal approaches attach greater normative weight to negatively construed individual freedoms, which they seek to protect against the interventions of political authority. Communitarian approaches prioritize the positively construed freedoms of communal political participation, viewing legal-political institutions as a means for collective ethical self-realization. Habermas’ discourse theory of law (...) and democracy seeks to overcome this competition between the negative and positive liberties. Doing so entails reconciling private and public autonomy at a fundamental conceptual level. This is his co-originality thesis, which seeks to show that private and public autonomy are internally connected and evenly balanced. I support his aim but argue that he fails to achieve it due to an unsatisfactory account of private autonomy. I suggest an alternative dialogical conception of autonomy as ethically self-determining agency that would enable him to establish his thesis. (shrink)

This paper seeks to argue that although fair trial standards are commonly portrayed as a set of minimum coherent standards applicable across a range of different legal traditions, there is a tension between those standards that accentuate the importance of individual will and autonomy and those that emphasise the importance of accurate outcome through an effective defence. This tension has been managed for the most part by enabling individuals to be represented by legal counsel who present the defence on (...) the basis of their clients’ instructions. Human rights law has recognised the importance of legal assistance at trial and pre-trial stages of criminal procedures. Despite this certain developments in domestic and international criminal processes have led to a growing number of cases being decided without an effective defence being provided by legal counsel. Such cases have been disposed on the basis of defendants’ ‘consent’ and this supposed autonomy has held sway over any effective defence. The paper begins by tracing different dimensions of the fair trial standards and exposes a tension between the need for defendants to exercise autonomy over their case and the need for an effective defence. The paper then argues that the right to counsel has acted as a bridge between these two competing demands. Recent developments are then reviewed which have served to impede counsel from providing an effective defence in the interests of the client’s freedom to choose how her case should be handled. The examples examined are the growing number of cases that are pleaded or diverted out of court with no real examination of the strength of the prosecution case, the emergence of special advocates who do not take instructions from defendants and the increasing tendency for defendants to represent themselves in certain types of cases. The paper concludes by arguing that we need to make a sharper distinction between individual rights and procedural standards and argues for greater attention to be given to the latter on the design of criminal procedure. (shrink)

© 2015 The Authors. Journal of Applied Philosophy published by John Wiley & Sons Ltd on behalf of Society for Applied Philosophy. In this article, I argue that autonomy has to be conceived substantively in order to serve as the qualifying condition for receiving the full set of individual liberal rights. I show that the common distinction between content-neutral and substantive accounts of autonomy is riddled with confusion and ambiguities, and provide a clear alternative taxonomy. At least insofar (...) as we are concerned with liberal settings, the real question is whether or not the value and norm implied by an account of autonomy are acceptable to reasonable people, not whether these accounts are content-neutral, procedural or input-focused. Finally, I demonstrate how substantive constraints are compatible with, or even implied in, the notion of autonomy at play in political liberalism. Overall, I present a normative reconstruction, clarification, and internal critique of liberalism, drawing on case law and statutes from England and Wales. (shrink)

Critics have charged that John Stuart Mill''s discussion as of paternalism in On Liberty is internally inconsistent, noting, for example, the numerous instances in which Mill explicitly endorses examples of paternalistic coercion. Similarly, commentators have noted an apparent contradiction between Mill''s political liberalism – according to which the state should be neutral among competing conceptions of the good – and Mill''s condemnation of non-autonomous ways of life, such as that of a servile wife. More generally, critics have argued that while (...) Mill professes an allegiance to utilitarianism, he actually abandons it in favor of a view that values personal autonomy as the greatest intrinsic good. This paper presents an interpretation of Mill that provides a viable and consistent treatment of paternalism, thereby refuting each of the aforementioned critiques. Mill''s views, it argues, are consistently utilitarian. Moreover, the interpretation accounts for all of Mill''s departures from his otherwise blanket prohibition of paternalistic legislation. In particular, it explains his most notorious example, the condemnation of voluntary contracts for slavery. The interpretation emphasizes Mill''s conceptual linkage between autonomy and utility, noting his implicit use of at least three different senses of the notion of autonomy. (shrink)

Research on autonomy exhibits a constellation of variegated perspectives, from the problem of the crude deprivation of it to the study of the distinction between personal and moral autonomy, and from the problem of the role of a “self as narrator”, who classifies its own actions as autonomous or not, to the importance of the political side and, finally, to the need of defending and enhancing human autonomy. My precise concern in this article will be the examination (...) of the role of the human cognitive processes that give rise to the most important ways of tracking the external world and human behavior in their relationship to some central aspects of human autonomy, also to the aim of clarifying the link between autonomy and the ownership of our own destinies. I will also focus on the preservation of human autonomy as an important component of human dignity, seeing it as strictly associated with knowledge and, even more significantly, with the constant production of new and pertinent knowledge of various kinds. I will also describe the important _paradox of autonomy_, which resorts to the fact that, on one side, cognitions (from science to morality, from common knowledge to philosophy, etc.) are necessary to be able to perform autonomous actions and decisions because we need believe in rules that justify and identify our choices, but, on the other side, these same rules can become (for example, as a result of contrasting with other internalized and approved moral rules or knowledge contents) oppressive norms that diminish autonomy and can thus, paradoxically, defeat agents’ autonomous capacity “to take ownership”. (shrink)

Agency is the human capacity to freely choose one’s thoughts, motivations and actions without undue internal or external influences; it is distinguished from decisional capacity. Four well-known conditions that can deeply affect agency are depression, demoralization, existential distress, and family dysfunction. The study reviews how they may diminish agency in persons whose circumstances may lead them to consider or request euthanasia or assisted suicide. Since agency has been a relatively neglected dimension of autonomous choice at the end of life, (...) it is argued that to respect the autonomy of individuals, it is essential to establish their agency. (shrink)

This article challenges a prominent claim in moral philosophy: that autonomy is a personal ideal, according to which individuals are authors of their own lives. This claim is philosophically dubious and ethically pernicious, having excluded women from positions of rational authority. A reading of Ibsen's A Doll's House illustrates how this conception of the ideal of autonomy misrepresents the reality of individuals' lived experiences and imposes a gendered identity which subordinates women to a masculine narcissism. In Ibsen's play (...) the woman, as a doll confined to home, remains dependent on an autonomous man. It would seem that men in modern philosophy could see only their own image as rational agents reflected in their ethics; but, in fact, this position is self-defeating. The recognition of our contingencies and so, vulnerability, motivated Kant himself to try to make the moral realm secure with something necessarily common to all human beings: our capacity to reason. The unwitting upshot of Kant's ethics has been the restriction of reason to a purely formal function; but this autonomy of reason undermines itself in being unable to guide the writing of the rational agent's own life. I propose instead to preserve the capacities of moral rationality, while urging the incorporation of ethical practices previously devalued by their association with vulnerability, such as attention, affection and relationality. My philosophical challenge is, first, to develop an internal critique of ethics which exposes its authoritative imposition of a gender identity and, next, to propose a revised conception of autonomy, namely, not just writing our own story, but reading the stories in which we find ourselves. (shrink)

The perennial appeal of Kantian ethics surely lies in its conception of autonomy. Kantianism tells us that the good life is fundamentally about acting in accordance with an internal rather than an external authority: a good will is simply a will in agreement with its own rational, self-constituting law. In this paper, I argue against Kantian autonomy, on the grounds that it excessively narrows our concept of the good, it confuses the difference between practical and theoretical modes (...) of knowing the good, and it cannot respect the essential efficacy of the principles of practical reason. (shrink)

The rule of law is a moral ideal that protects distinctive legal values such as generality, equality before the law, the independence of courts, and due process rights. I argue that one of the main goals of an international rule of the law is the protection of individual and state autonomy from the arbitrary interference of international institutions, and that the best way to codify this protection is through constitutional rules restraining the reach of international law into the (...) class='Hi'>internal affairs of a state. State autonomy does not have any intrinsic value or moral status of its own. Its value is derivative, resulting from the role it plays as the most efficient means of protecting autonomy for individuals and groups. Therefore, the goal of protecting state autonomy form the encroachment of international law will have to be constrained by, and balanced against the more fundamental goal of an international rule of law, the protection of the autonomy of individual persons, best realized through the entrenchment of basic human rights. (shrink)

Morality, as Immanuel Kant understands it, depends on the capacity of a person to be the agent and owner of his own actions, not merely a conduit for social and psychological forces and influences over which he has little or no control. As a result, Kant’s moral philosophy focuses primarily on the topic of individual freedom and the necessary preconditions of the possibility of that freedom. In the Groundwork and second Critique, Kant’s discussion of the connection between morality and freedom (...) centers on autonomy of the will. He identifies autonomy as the supreme principle of morality and defines it as “choos[ing] only in such a way that the maxims of your choice are also included as universal law in the same volition” (Gr 4:440). In this paper I argue that according to Kant the possibility of autonomous action requires that certain preconditions be met. Satisfying these preconditions requires an individual to be a member of civil society (status civilis), and, specifically, a civil society maintained by a strong, sovereign power. This connection between freedom and civil society exists on two levels. First, one precondition of autonomy (i.e., internal freedom) is liberty (i.e., external freedom), and an individual can secure his liberty only once he is a member of civil society. Second, an individual is free only when others recognize him as a being with the capacity for autonomous action, and joining civil society is the process by which this recognition takes place. (shrink)

Attempts to articulate the ways in which membership in socially subordinated social identities can impede one's autonomy have largely unfolded as part of the debate between different types of internalist theories in relation to the problem of internalized oppression. The different internalist positions, however, employ a damage model for understanding the role of social subordination in limiting autonomy. I argue that we need an externalist condition in order to capture the ways in which membership in a socially subordinated (...) identity can constrain one's autonomy, even if one is undamaged in one's autonomy competencies and self-reflexive attitudes. I argue that living among those practically empowered to harass, to engage in racial profiling, and to treat as expendable is incompatible with a freedom-condition required for unconstrained global self-determination. (shrink)

Autonomy and responsibility are interrelated concepts crucial to the moral analysis of professional persons, organizations and institutions, and for the purpose of this paper, I focus on the persons, organizations, and institution of journalism. My paper’s thesis hinges on the notion that the confluence of the concepts of autonomy and responsibility creates a natural conceptual foundation for understanding moral praise and blame. Though in moral philosophy this notion has long been accepted, it has not yet been carefully applied (...) to the practice of journalism. Applying these concepts to journalism, I will argue, is crucial for accurately determining moral praise and blame, as it adds a structure to evaluating ethical behavior in a way that has not yet been put forward. (shrink)

Bioethicists have for quite some time discussed the right to know and the right not to know personal health information, such as genetic information acquired in health care and incidental health-related findings in research. Several international ethical guidelines explicitly defend these rights.My own interest in these matters stems from my participation in ethics-related research tied to a longitudinal screening study on Type I diabetes involving young children. A few of the participating parents did not want to be informed if the (...) study revealed their child had a high risk of developing diabetes. This response was troublesome, not least since the information would concern the child's and not the parents’ health. Our inclination was that there cannot be a right not to know that should be granted without qualifications. Furthermore, other contextual factors, e.g., that parents experienced pressure to participate and felt concern about some of the personal data handled in the study, gave reason to question whether autonomous decisions were made regarding participation. The autonomy of their expressed desire not to know was therefore questionable. (shrink)

The central focus of this essay is Isaiah Berlin’s arguments about the concepts of negative freedom and positive freedom, developed in his philosophical work Two Concepts of Liberty. By adopting a philosophical standpoint, this essay explores the application of Berlin’s notions of freedom at the organizational level, within the workplace, and in the management field. This essay presents three philosophical arguments that provide some clarifications about the potential challenges associated with autonomy in organizations. These arguments incorporate Berlin’s ideas of (...) freedom with philosophical insights from Heidegger, Sartre, Frankfurt, and Confucius to highlight the missing elements of autonomy in management literature and its implementation in organizations, explaining the challenges of autonomy and the reasons for some unexpected results. Recommendations for future studies and managerial implications are discussed. (shrink)

This article contends that the environmental release of genetically engineered (GE) animals with heritable traits that are patented will present a challenge to the efforts of nations and indigenous peoples to engage in self‐determination. The environmental release of such animals has been proposed on the grounds that they could function as public health tools or as solutions to the problem of agricultural insect pests. This article brings into focus two political‐economic‐legal problems that would arise with the environmental release of such (...) organisms. To address those challenges, it is proposed that nations considering the environmental release of GE animals must take into account the underlying circumstances and policy failures that motivate arguments for the use of the modified animals. Moreover, countries must recognize that the UN International Covenant on Civil and Political Rights and the UN International Covenant on Economic, Social and Cultural Rights place on them an obligation to ensure that GE animals with patented heritable traits are not released without the substantive consent of the nations or indigenous peoples that could be affected. (shrink)

The organizational theory literature is reasonably unanimous that team autonomy is a key factor for employee well-being and motivation as well as organizational performance. However, team autonomy is challenged when its processes and outputs need to be aligned with actors and factors external to a team. There are likely challenges and conflicts between team autonomy and the need for coherence in the wider system. Team autonomy has a range of implications and is challenged by a number (...) of factors, such as knowledge complexity and decision-making, learning, large-scale problems, product and technical interdependencies, the use of platforms, virtual collaboration and diversity. Alignment with the external is particularly necessary in multi-team environments with many technical interdependencies, where a single team’s failure to deliver a sufficient level of quality may lead to system-wide consequences. Therefore, teams in complex environments increasingly need to regulate and manage their work in cooperation with internal and external partners and systems. Such dependencies challenge team autonomy. In this special issue of AI&S, we want to address these topics in more detail, particularly in the context of software-intensive organizations and digital transformations. The scope and, thus, the consequences of a team’s work can be far-reaching when the team’s effort and output take place partially or completely in fully digitized contexts and processes. The articles in this special issue show various ways of dealing with the challenge of balancing autonomy and alignment with the external. A key focus is to show the buffering function: how teams, with the help of processes, technology, new organizational forms and time and space are able to find the buffer needed for maintaining team autonomy. (shrink)

The autopoietic theory and the enactive approach are two theoretical streams that, in spite of their historical link and conceptual affinities, offer very different views on the nature of living beings. In this paper, we compare these views and evaluate, in an exploratory way, their respective degrees of internal coherence. Focusing the analyses on certain key notions such as autonomy and organizational closure, we argue that while the autopoietic theory manages to elaborate an internally consistent conception of living (...) beings, the enactive approach presents an internal tension regarding its characterization of living beings as intentional systems directed at the environment. (shrink)

Definition of the problem The present article focuses on the current international ethical debate on “responsible implementation” of expanded carrier screening to public healthcare systems. Expanded carrier screening is a novel genetic test which aims to provide information to couples about whether both partners carry a genetic variation for the same recessively inherited condition. It was introduced to the market by commercial laboratories in the U.S. in 2010; since about 2015, however, international debates have emerged on how and why to (...) offer the screening as a public health service. Arguments It is shown that, initially, enhancement of couples’ reproductive autonomy, not prevention of recessive disorders, has been established as the ethically well-founded aim and guiding principle of responsible implementation. Recently, however, in 2019, three well-known Dutch bioethicists argued that this aim has been embraced without much reflection and should therefore be replaced with the guiding principle of “responsible parenthood”. According to the latter, autonomous reproductive decision-making of couples or women is morally acceptable solely when carrier screening is done only during pregnancy. Before pregnancy, by contrast, couples are held to have a moral duty to take preventive measures if their future children are at risk of being affected by one of the “worst” recessive conditions. In the present paper, both of these conflicting ethical framings of expanded carrier screening are critically examined. Conclusions While the aim of reproductive autonomy also has problematic aspects, the notion of “responsible parenthood” is much more objectionable since it challenges voluntary participation in carrier screening, argues for directive genetic counseling, limits reproductive self-determination of women and couples, and introduces dubious concepts to the debate. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Autonomy, Well-Being, Disease, and DisabilityJulian Savulescu (bio)Keywordsautonomy, well-being, mental disorder, psychiatric disease, disability, welfare, body integrity identity disorderVarelius seeks to redefine what constitutes mental disorder or mental illness. (I use these terms interchangeably.) "According to this account, 'a person is mentally disordered when her psychological capacity for autonomy is diminished as compared with that of a typical member of our species of her age-group" (Varelius 2009). This (...) is a stimulating and important paper. Varelius describes fruitfully the relationship between mental illness and autonomy, specifically the ways in which mental disorder can undermine autonomy. This is valuable in understanding the impact of mental illness on the lives of people who suffer from it, which is a serious issue in practical ethics. But is it what constitutes mental disorder or illness? There are logical, conceptual reasons why we should not redefine mental illness in this way.Incomplete Account of Mental DisorderThere are a family of related concepts: disease, injury, disorder, illness, disability. There are old and entrenched disputes about how we should define these concepts. Varelius' paper is a contribution to the definition of mental disorder and illness.The primary classificatory category that defines medical practice is that of health and disease. Disease, broadly construed, involves the presence of pathology. Pathology can result from processes primarily or predominantly internal to the organism, such as genetic disease (although external factors affect their expression), or from processes primarily or predominantly external to the organism, such as injuries.The concepts of disorder and illness relate to the concept of disease. Disorder could be defined in terms of the functional effect of pathology. Illness could be defined in terms of the experiential impact of disease.1 How these terms are precisely defined and related need not concern us at the present. What matters is that the primary category is disease.Psychiatry has evolved in its use of terminology. What used to be called psychiatric diseases are now often called mental disorders. I now claim, for the purposes of illustration of the argument (though it does not require this claim), that the dominant category is disease. Indeed, what are called mental disorders appear in the International Classification of Diseases.Disease can be divided into the mental and physical. I believe that the mental will one day be [End Page 59] shown to be shown to be entirely a subset of the physical. That is, that brain pathology will be a cause, if not the only cause, of mental disease. But others may believe the sets of mental and physical disease are intersecting but not coextensive.What matters is that mental disease is a subcategory of the more general category of disease. It must have the same definitional features as "disease" plus some extra ones specific to the "mental," or mind. (The same points apply if you use "disorder" as the dominant category rather than "disease.")One problem for Varelius is this: how does this autonomy account of "mental disease" relate to an account of "physical disease," and "disease" in general? If mental disease is defined in terms of its impact on the psychological capacities necessary for autonomy, how is "disease" in general, or physical disease, to be defined? One obvious response is to define these related concepts in a similar way:Disease: "a person is diseased when her capacity for autonomy is diminished as compared to that of a typical member of our species of her age-group." Physical disease: "a person is physically disordered when her physical capacity for autonomy is diminished as compared to that of a typical member of our species of her age-group."This interpretation is suggested by the following passage from Varelius:As contrasted with the actual condition of being autonomous, as a capacity of an individual autonomy means that a person has the psychological and bodily abilities that being autonomous... requires.(2009)It would be radical to define disease in general in terms of capacity for autonomy. There is no doubt that disease affects our autonomy, and that is morally significant, but these seem clearly separable concepts. Varelius could respond that he is not defining mental disease but rather the mental component... (shrink)

Individualistic traditions of autonomy have long been critiqued by feminists for their atomistic and asocial presentation of human agents. Relational approaches to autonomy were developed as an alternative to these views. Relational accounts generally capture a more socially informed picture of human agents, and aim to differentiate between social phenomena that are conducive to our agency versus those that pose a hindrance to our agency. In this article, I explore the various relational conceptualizations of autonomy profferred to (...) date. I critically review some of the ongoing internal disputes within the relational autonomy literature, and conclude the article by taking stock of the value of relational autonomy despite these unresolved debates. (shrink)

This essay attempts to understand the search for authenticity in terms of the breakdown of authority in the modern world. The sense of autonomy, I argue, emerges from the need to choose the authorities one will accept. The ever-increasing difficulty of choosing from among authorities is internalized and is experienced as a difficulty of choosing, or “finding” oneself. The shattered authorities on the outside become a fragmented self on the inside. The search for the authentic self, then, is the (...) search for an authority on the inside that has been broken and lost on the outside. The prospects for achieving such selfhood are criticially evaluated. (shrink)

This essay attempts to understand the search for authenticity in terms of the breakdown of authority in the modern world. The sense of autonomy, I argue, emerges from the need to choose the authorities one will accept. The ever-increasing difficulty of choosing from among authorities is internalized and is experienced as a difficulty of choosing, or “finding” oneself. The shattered authorities on the outside become a fragmented self on the inside. The search for the authentic self, then, is the (...) search for an authority on the inside that has been broken and lost on the outside. The prospects for achieving such selfhood are criticially evaluated. (shrink)

This paper critically examines Alan Patten’s theory of neutrality of treatment. It argues that the theory assumes an inadequate conception of personal autonomy that undermines its plausibility. Because of this assumption the theory is unable to account for various configurations of power that work against personal autonomy. However, I suggest that the theory can resolve the problem by developing and reinterpreting its conception of autonomy and introducing an additional strategy for addressing the power misbalances that result from (...) the market-based interactions between individuals and their conceptions of the good. (shrink)