The ideal of autonomy has a positive and a negative aim. Its positive aim is to create the conditions in which more and more people can be more and more autonomous. Its negative aim is to prevent actions that cause serious harm and are normally both immoral and criminal. These two aims are incompatible. Increasing autonomy increases the frequency of crimes and decreasing the frequency of crimes requires decreasing autonomy. The incompatibility of these two aims has (...) radical implications for much current thinking about criminal justice. (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.

Objectives: Evidence based patient choice seems based on a strong liberal individualist interpretation of patient autonomy; however, not all patients are in favour of such an interpretation. The authors wished to assess whether ideals of autonomy in clinical practice are more in accordance with alternative concepts of autonomy from the ethics literature. This paper describes the development of a questionnaire to assess such concepts of autonomy.Methods: A questionnaire, based on six moral concepts from the ethics literature, (...) was sent to aneurysm patients and their surgeons. The structure of the questionnaire was assessed by factor analysis, and item reduction was based on reliability.Results: Ninety six patients and 58 surgeons participated. The questionnaire consisted of four scales. Two of the scales reflected the paternalistic and consumerist poles of the liberal individualist model, one scale reflected concepts of Socratic autonomy and of procedural independence, and the fourth scale reflected ideals of risk disclosure.Discussion: The Ideal Patient Autonomy Scale is a 14 item normative instrument. It is clearly distinct from the generally used psychological preference questionnaires that assess preferences for physician-patient roles. (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)

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)

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)

T H Mclaughlin; Peter Gardner on Religious Upbringing and the Liberal Ideal of Religious Autonomy, Journal of Philosophy of Education, Volume 24, Issue 1, 30 Ma.

Some debates about the role of non-epistemic values in science discuss the so-called Value-Free Ideal together with the autonomy thesis, to the point that they may be assumed to be intertwined. As I will argue in this article, the two are independent from one another, are supported by different arguments, and ought to be disentangled. I will also show that the arguments against value-freedom and supporting a value-laden conception of science, are different from the arguments against autonomy, (...) which support democratized science. Moreover, while some of the arguments against autonomy and for democratized science may actually be consistent with value-freedom, they conflict with some philosophical views about the internal diversity of well-designed epistemic communities. This article distinguishes the Value-Free Ideal and the autonomy thesis, as well as their antitheses, and investigates their relations to some of the socio-epistemological models of the social organization of scientific research. Its aim is to make explicit some incompatibilities between different normative frameworks developed in philosophy of science. (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)

Peter Gardner; Religious Upbringing and the Liberal Ideal of Religious Autonomy, Journal of Philosophy of Education, Volume 22, Issue 1, 30 May 2006, Pages 89–1.

Stanisław Brzozowski formulated the ideal of modern man in the polemic with the contemporary man, who has ceased to believe in truth and moral values and is devoid of the will to act. For Brzozowski modernity involves the discovery of truth about the human condition: about man as an autonomous subject, a creator of values, who struggles with non-human reality. This truth was formulated in Kant’s idea of autonomy and in Marx’ idea of a collective conquest of the (...) world of nature. For Brzozowski, ideal modern man is “the conscious labourer,” who labours because he wants to proudly impose a human law on the non-human world. At the same time Brzozowski used the term “modernity” to describe life of constant change in the modern world, understood as a set of results of man’s reign over nature. For the sake of human maturity, Brzozowski expected the truly modern man to perceive modern life as an unquestionable value. Undoubtedly, there is an evident tension in Brzozowski’s ideal of modern man between the affirmation of creativity in the world of change and the necessity of disciplined production, including unchangeable moral foundations of labour. There is also a major shift in this ideal, stemming from Brzozowski’s change of attitude towards religion. (shrink)

Behavioural variant frontotemporal dementia (bvFTD) is characterized by an absence of obvious cognitive impairment and presence of symptoms such as disinhibition, social inappropriateness, personality changes, hyper-sexuality, and hyper-orality. Affected individuals do not feel concerned enough about their actions to be deterred from violating social norms, and their antisocial behaviours are most likely caused by the neurodegenerative processes in the frontal and anterior temporal lobes. BvFTD patients present a challenge for the traditional notion of autonomy and the medical and criminal (...) justice systems. Antisocial behaviour is often the earliest recognized manifestation of bvFTD. Given that the symptoms are not specific and that atrophy of the frontal lobes is only observable with structural neuroimaging in the later stages of the disease, it is hard to ascertain their autonomy. Recently proposed re-conceptualizations of autonomy (Dworkin’s, Jaworska’s, and Dubljević’s) can, however, be sufficiently redefined to provide explicit rules and offer nuanced guidance in such cases. A combination of notions of autonomy gives the most nuanced guidance with three modifications: 1) including socio-moral judgement in the notion of “normal cognitive competence,” 2) excluding in-principle un-endorsable ideals from the notion of “capacity to value,” and 3) redefining ideal-typical degrees of compulsion (mild, severe, and total). (shrink)

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)

Discusses the relationship between the exercise and development of autonomy and analyses their implications for liberalism and liberal education. Section 2.1 proves that since the liberal state values adults’ exercise of autonomy, it must also value children's development of autonomy. Section 2.2 argues that state paternalism towards children, in particular, state efforts to help children develop the capacity for autonomy even against their parents’ wishes, is consistent with liberal principles. Section 2.3 argues that parents have privileges (...) rather than rights to control their children's upbringing, but that these privileges nonetheless offer ample scope for parents to exert independent paternalistic control. Finally, Section 2.4 argues that the liberal ideal of autonomy not merely permits but requires the intrusion of the state into the child's life, specifically in the form of compulsory, ‘detached’, autonomy‐driven schools. (shrink)

This chapter presents a variety of considerations suggesting that autonomy is a valuable ideal, focusing on its value for women. The focus is on women for several reasons. First, autonomy has not always been idealized for women. Even though autonomy is more widely encouraged and supported in women than ever before, it is still not regarded as a particularly feminine value or virtue. If a case for autonomy can be made out for women in particular (...) against this history, then the case for autonomy in general should prove easier to secure. Second, feminist philosophers have figured prominently among those who have expressed doubts and reservations about the value of autonomy. Focusing on the case of women's autonomy in particular helps to answer those criticisms. (shrink)

This article argues that supported decision making is ideal for people with dynamic cognitive and functional impairments that place them at the margins of autonomy. First, we argue that guardianship and similar surrogate decision-making frameworks may be inappropriate for people with dynamic impairments. Second, we provide a conceptual foundation for supported decision making for individuals with dynamic impairments, which integrates the social model of disability with relational accounts of autonomy. Third, we propose a three-step model that specifies (...) the necessary conditions of supported decision making: identifying domains for support; identifying kinds of supports; and reaching a mutually acceptable and formal agreement. Finally, we identify a series of challenges for supported decision making, provide preliminary responses, and highlight avenues for future bioethics research. (shrink)

The majority of analyses investigating the professionalisation of scientific domains tend to assume the linear and general features of this transformation. These studies focus on the shift from a non-professionalised state to a professionalised state. This dual approach, however, crucially lacks some other aspects of the process of professionalisation. This issue is discussed within the context of the growth of prehistoric archaeology in France from the 1940s, by observing scientific societies, national research organisations and their social networks. Looking at the (...) scale of Georges Laplace’s career and that of his research group, which studied the typologie analytique method, this article demonstrates the benefits of a ternary model which also encompasses the modes of refusal of professionalisation. (shrink)

This paper considers prominent forms of discourse in educational research, the nature of their appeal and the force of the idea of freedom within that appeal. For this, two different aspects of research are juxtaposed, aspects in which the value of freedom is articulated in contrasting ways. First, evidence-based education is considered as a prominent manifestation of faith in scientific method in education: in this, it might be said, there is an obsession with freedom – the freedom of the research (...) from bias. Second, and by contrast, in humanistic forms of educational research, freedom assumes a position of central importance, in the idea of autonomy. Here are two contrasting ethical priorities, respectively, the supposed neutrality that is achieved by excising individual judgement, and the vision of the good life that prioritises the rational exercise of that judgement. In this paper, I wish to discuss the kind of aura that is attached to these ideas, embedded as they are in a western metap... (shrink)

Abstract Modern reflection on the ideal of personal autonomy has its Western origin in the philosophy of Jean-Jacques Rousseau, where autonomy, or self-legislation, involves citizens joining together to make laws for themselves that reflect their collective understanding of the common good. Four features of this conception of autonomy continue to be relevant today. First, autonomy, a type of freedom, is introduced into modern philosophy in order to make up for a perceived deficiency, or incompleteness, in (...) merely ?negative? freedom (the right to do as one pleases, unimpeded by others). Second, autonomy is taken to be not merely a complement of negative freedom but a higher, more valuable species of freedom. Third, at its origin personal autonomy is not conceived individualistically; rather, on Rousseau's account, autonomy is achievable only if citizens surrender part of their status as individuals and think of their social membership as essential, not merely accidental, to who they are. Finally, Rousseau's conception of autonomy is distinct from the contemporary ideal of autonomy defined as judging or deciding for oneself (according to one's own reason). Nevertheless, there is an important sense in which autonomy as Rousseau conceives it also requires the developed capacity for independent, self-determined judgment. (shrink)

This chapter contains sections titled: A Brief History of Autonomy and the Philosophy of Education Questioning Autonomy Heteronomy Before Autonomy: Levinas and the Kantian Tradition Educating for Heteronomy? The Ideal of Autonomy Restated Notes.

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)

The question of the character of constitutional rights norms is complex and admits of no easy answer. Without reducing the complexity of the issue, I attempt in this paper to formulate some clear views on the matter. I shall argue that constitutional rights reasoning is a species of rational practical reasoning that combines both balancing (as Robert Alexy admits) and the grounds as to why balancing is appropriate (deontological constraints). Absent the latter type of reason, the application of constitutional principles (...) remains a pure instance of balancing. Each time those reasons are touched upon, however, balancing becomes subject to deontological constraints. Yet deontological reasons are neither self-proclaiming nor complete. Rather they require for their articulation the background of an already operational practice of practical (legal) reasoning. This practice exemplifies what I shall dubthe structure of autonomy, that is, a set of regulative ideals, not yet definitive norms, that derive from the reflective character of human agency. This structure comes to light when one turns to the agent’s point of view – to the point of view of someone who is engagedreflectivelywith practical questions (questions about rights arepar excellencequestions of this type). The structure of autonomy is more fundamental than any deontological or teleological reasons: it is in its light that deontology and teleology need to be understood as representing merely complementary forms of argument, which can be employed in reasoning that aims to maximise constitutional rights provisions. At the same time, the structure of autonomy as a regulative ideal generatesprima faciereasons for allocating greater weight to deontological arguments in the relevant contexts of balancing. Such prima-facie reasons do not prescribe fully-fledged deontological constraints, but merely set the burden of proof in favour of specific reasons and ensure that the structure of autonomy be respected overall. (shrink)

A collection of 17 essays on Kantian moral theory and practical ethics, including papers on autonomy, human dignity, utopian thinking, O'Neill and Rawls on constructivism, tragic choices, philanthropy, conscientious object, suicide, respect, self-respect, and an ideal attitude of appreciation beyond art, nature, and gratitude. TABLE OF CONTENTS Abbreviations for Kant’s Works INTRODUCTION PART II: KANT AND KANTIAN PERSPECTIVES (1) The Groundwork (2) Kant on Imperfect Duties to Oneself (3) Kantian Autonomy and Contemporary Ideas of Autonomy (4) (...) Rüdiger Bittner on Autonomy (5) Kantian Perspectives on the Rational Basis of Human Dignity (6) In Defense of Human Dignity (7) The Kingdom of Ends as an Ideal and Constraint on Legislation (8) Kantian Ethics and Utopian Thinking (9) Varieties of Constructivism PART II: PRACTICAL ETHICS (10) Human Dignity and Tragic Choices (11) Duties and Choices in Philanthropic Giving: A Kantian Perspective (12) Killing Ourselves (13) Conscientious Conviction and Conscience (14) Stability, A Sense of Justice, and Self-Respect (15) Two Conceptions of Virtue (16) Beyond Respect and Beneficence: An Ideal of Appreciation (17) Ideals of Appreciation and Expressions of Respect REFERENCES INDEX . (shrink)

Respect for autonomy is a central moral principle in bioethics. The concept of autonomy can be construed in various ways. Under the non-ideal conceptualization proposed by Beauchamp and Childress, everyday choices of generally competent persons are autonomous to the extent that they are intentional and are made with understanding and without controlling influences. It is sometimes suggested that authenticity is important to personal autonomy, so that inauthenticity prevents otherwise autonomous persons from making autonomous decisions. Building from (...) Beauchamp and Childress’s theory, this article develops a non-ideal authenticity-based conceptualization of personal autonomy. Factors that indicate inauthentic decision-making are explicated, and the full concept is defended from three expected objections. The theory is then tested on a paradigm case which has concerned theorists and practitioners for some time, namely the possible inauthenticity of anorexia nervosa patients’ decision-making. It is concluded that the theory seems to be fruitful in analyses of the degree of autonomy of patients’ decision-making, and that it succeeds in providing reliable action-guidance in practical contexts. (shrink)

Autonomy is a concept that holds much appeal to social and legal philosophers. Within a medical context, it is often argued that it should be afforded supremacy over other concepts and interests. When respect for autonomy merely requires non-intervention, an adult’s right to refuse treatment is held at law to be absolute. This apparently simple statement of principle does not hold true in practice. This is in part because an individual must be found to be competent to make (...) a valid refusal of consent to medical treatment, and capacity to decide is not an absolute concept. But further to this, I argue that there are three relevant understandings of autonomy within our society, and each can demand in differing cases that different courses of action be followed. Judges, perhaps inadvertently, have been able to take advantage of the equivocal nature of the concept to come tacitly to decisions that reflect their own moral judgments of patients or decisions made in particular cases. The result is the inconsistent application of principle. I ask whether this is an unforeseen outcome or if it reflects a wilful disregard for equal treatment in favour of silent moral judgments in legal cases. Whatever the cause, I suggest that once this practice is seen to occur, acceptable justification of it in some cases is difficult to find. (shrink)

The article examines the collaborations between the pensionnaires of the Villa Medici in Rome and the members of the French School of Athens, shedding light on the complex relationships between architecture, art, and archeology. The second half of the 19th century was a period during which the exchanges and collaborations between archaeologists, artists, and architects acquired a reinvented role and a dominant place. Within such a context, Athens was the place par excellence, where the encounter between these three disciplines took (...) place. The main objective of the article is to render explicit how the revelations of archeology, actively disseminated by the members of the French School of Athens—the “Athéniens”—had an important impact on the approach of certain pensionnaires of the Villa Medici in Rome. Particular emphasis is placed on certain pensionnaires, who decided to devote their envois to ancient monuments of Greece. In parallel, the article intends to shed light on the methods that helped the pensionnaires-architects of the Villa Medici in Rome appropriate archaeological discoveries concerning Greek antiquities. The article takes, as a starting point, the following hypothesis: to better understand the figure of the architect-archaeologist, of whom Jacques Ignace Hittorff is an emblematic example, it is pivotal to bear in mind that before the second half of the 19th century neither the figure of Hellenic archeology nor the figure of the architect had yet acquired their autonomy. Taking into account that Johann Joachim Winckelmann, in the middle of the 18th century, forged an ideal Greek model, which was criticized during the second half of the 19th century, the article also sheds light on the fact that the revelations of archaeologists have called into question the Winckelmannian image of Greece. Another aspect that is explored in the article is Jacques Ignace Hittorff’s studies concerning the polychromy of ancient Greek monuments, paying special attention to his Restitution du temple d’Empédocle à Sélinonte ou l’Architecture polychrome chez les Grecs. The article also explores how the shifts of the status of philhellenism are related to the mutations of the meaning of travel to Greece. In parallel, it investigates the impact of Greek independence on the ideals of beauty and nature in arts, as well as how Greek independence is related to the intensification of the interest in the excavations of Greek antiquities. (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)

This article defends a nonstandard position on free will that is based on three topics linked to contemporary debates about free will: autonomy, self-control, and weakness of will. It argues that autonomy, and hence also free will, requires more than self-control, including ideal self-control. It considers the additional conditions required, showing how contemporary discussions of autonomy are intertwined with debates about free will. These additional conditions for genuine autonomy do not require us to choose between (...) compatibilist and incompatibilist accounts of autonomy, because one can give a “robust, satisfiable” set of adequate conditions for both compatibilist autonomy and incompatibilist autonomy. One can thus remain agnostic on the Compatibility Question regarding autonomy and free will without giving up the belief that there are autonomous human beings. This view is called “agnostic autonomism”. (shrink)

The objective of this article is to establish an alternative doctor-patient relationship model and describe its importance in the case of the doctor-patient relationship in Bangladesh. There is a lot of diversity in the religious beliefs, social norms and values in Bangladesh. Likewise, the development of biological science as well as medical technology, the allocation of healthcare resources must be considered as an important issue. That is why the autonomy of both doctor and patient is a relational factor here. (...) Besides, the four traditional doctor-patient relationship models offered by Ezekiel J. Emanuel and Linda L. Emanuel are not beyond criticism. So, we need an ideal doctor-patient relationship model for Bangladesh to protect every patient’s autonomy which will give freedom to the patient in choosing their own treatment as well as which will not conflict with the patient’s social or cultural values. In this article, I have selected the relational model of autonomy as the method of alternative doctor-patient relationship model. Hopefully, this alternative model will work better since it considers care first concerning a patient’s autonomy. Besides, doctors would treat their patients as a ‘care seeker’ rather than ‘client’ or ‘customer’, and simultaneously, patients would perceive their physicians as ‘caregivers’. But, applying the relational model of autonomy in the case of doctor-patient relationship is more challenging in Bangladesh due to some obstacles like large numbers of population, illiteracy, insufficiency of skilled doctors and hospitals, corruption in medical sectors, social prejudices and so on. But, if we can overcome these problems, the relational model of autonomy will be considered as a suitable doctor-patient relationship model in Bangladesh. (shrink)

This article explores the meaning of the task of teaching students to formulate critique in relation to the so-called ‘pedagogical paradox’, according to which the educational ideal of individual autonomy is contradicted by the practice of planning and control, which is particularly pronounced in the influential model of ‘constructive alignment’. Taking Kant’s idea of enlightenment and autonomy as a starting point, I introduce Luc Boltanski’s concept of reflexivity and link it to Jon Elster’s discussion of ‘states that (...) are essentially by-products’. In doing so, I advance the view that genuine critique typically emerges from a shift in perspective, from the pragmatic realization of goals according to institutionalized practices to a metapragmatic reflection on those practices. Since teaching is itself an institutionalized practice, personal reflexivity can only be understood as a by-product of teaching, and, contra the logic of models like constructive alignment, it cannot be set as a direct objective. Emerging from the subject itself, rather than from the influence of an educational technique, personal reflexivity should be recognized as an important aspect of the subject’s transition from youth to maturity. (shrink)

Public health is often distinguished from heaslth care in that it is said to serve more 'collective' goals, such as 'the common good' rather than the good of individual people. However, it is not clear what this good is supposed to be (although it is supposed to be 'common'). In regular health care we see in the West a gradual expansion of traditional goals exclusively in terms of length and quality of life to goals having to do more with (...) class='Hi'>autonomy - the ability of people to control and direct their own lives. This has lead to a number of questions regarding how such an ethical ideal of promotion of autonomy may be construed, whether or not it really is an ideal, what practical consequences it has etc. (shrink)

What is the moral value of formal democratic decision-making? Egalitarian accounts of democracy provide a powerful answer to this question. They present formal democratic procedures as a way for a society of equals to arrive at collective decisions in a transparent and mutually acceptable manner. More specifically, such procedures ensure and publicly affirm that all members of a political community, in their capacity as autonomous actors, are treated as equals who are able and have a right to participate in collective (...) decision-making. Recently, a number of authors have raised what I describe as the ‘no impact’ objection. This objection focuses on the egalitarian emphasis on autonomy to cast doubt on the moral value of formal democratic procedures. It holds that individual participation in formal democratic decision-making has no impact on the eventual result, and therefore cannot be understood as an exercise in autonomy. Consequently, the ‘no impact’ objection claims that the moral value of formal democracy cannot be explained with reference to an egalitarian ideal of ‘rule by the people’. In this article, I refute this objection by complementing an egalitarian account of democracy with an account of basic 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)

Since the 1970s, prenatal testing has been integrated into many health care systems on the basis of two competing and largely irreconcilable rationales. The reproductive autonomy rationale focuses on nondirective counseling and consent as ways to ensure that women's decisions about testing and subsequent care are informed and free of undue pressures. It also represents an easily understandable and ethically convincing basis for widespread access to prenatal testing, since the value of autonomy is well established in Western bioethics (...) and widely recognized by funders of health care. In contrast, the public health rationale approaches prenatal testing as designed to reduce the incidence of certain conditions in the population to reduce the burden of disease. This rationale emphasizes the societal consequences of reproduction and the aggregate impact of women's individual reproductive decisions on the overall health of future populations. In this essay, I argue that, despite what could be seen as a persistent failure to meet the ideals of reproductive autonomy, resisting the public health rationale as a basis for prenatal screening is ethically and pragmatically crucial. I recommend policy mechanisms that can enhance reproductive autonomy at a societal level to support choice at the individual level. (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)

Authenticity has become one of the defining ideals of the modern world. It is the quality we are meant to demand in that which we consume; a value to be opposed to all that is ‘fake’ or ‘phoney’ or ‘artificial’. Above all, it is what an individual is meant to aspire to be: true to one’s self, self-actualising and self-expressing. Authenticity today has an almost ethical force. It underpins identity politics, legitimises transgenderism and informs the ubiquitous demand for often legal (...) recognition and informal respect. But what does its elevation say about the condition of modernity? What is its historical and conceptual relationship to ideas of freedom and autonomy? And to what extent is it really possible or even desirable, as Shakespeare’s Polonius insisted it was, to be true to thine own self? (shrink)

Authenticity has become one of the defining ideals of the modern world. It is the quality we are meant to demand in that which we consume; a value to be opposed to all that is ‘fake’ or ‘phoney’ or ‘artificial’. Above all, it is what an individual is meant to aspire to be: true to one’s self, self-actualising and self-expressing. Authenticity today has an almost ethical force. It underpins identity politics, legitimises transgenderism and informs the ubiquitous demand for often legal (...) recognition and informal respect. But what does its elevation say about the condition of modernity? What is its historical and conceptual relationship to ideas of freedom and autonomy? And to what extent is it really possible or even desirable, as Shakespeare’s Polonius insisted it was, to be true to thine own self? (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)

Principles of autonomy and self-determination have been upheld as vital to modern-day medical and ethical practice. However, the complexities of current health care and changes in the expectation of some patients and their families justify a review of such concepts. Their limitations and relativities may suggest that other descriptions of partnership and negotiated goal-setting, while based on respect for autonomy, reflect more modern and ideal multi-disciplinary practices. Discussion should extend beyond the 'classic' participants of patient and doctor (...) to a more realistic picture where other health carers are included. It is therefore apposite that other professional relationships are considered as they affect areas of doctors' and patients' responsibilities. Such partnership between members of the team may not be without problems and conflict, but the principle of negotiated agreements could result in more long-term harmony, and greater patient welfare. (shrink)

Informed consent bears significant relevance as a legal basis for the processing of personal data and health data in the current privacy, data protection and confidentiality legislations. The consent requirements find their basis in an ideal of personal autonomy. Yet, with the recent advent of the global pandemic and the increased use of eHealth applications in its wake, a more differentiated perspective with regards to this normative approach might soon gain momentum. This paper discusses the compatibility of a (...) moral duty to share data for the sake of the improvement of healthcare, research, and public health with autonomy in the field of data protection, privacy and medical confidentiality. It explores several ethical-theoretical justifications for a duty of data sharing, and then reflects on how existing privacy, data protection, and confidentiality legislations could obstruct such a duty. Consent, as currently defined in the General Data Protection Regulation – a key legislative framework providing rules on the processing of personal data and data concerning health – and in the recommendation of the Council of Europe on the protection of health-related data – explored here as soft-law – turns out not to be indispensable from various ethical perspectives, while the requirement of consent in the General Data Protection Regulation and the recommendation nonetheless curtails the full potential of a duty to share medical data. Also other legal grounds as possible alternatives for consent seem to constitute an impediment. (shrink)

This paper explores issues that arise between Adorno and Marcuse over the potentials and implications of Freudian theory. These concern whether it is possible to expound a non-repressive relationship between what Freud calls the life and death drives, on the one hand, and the ego, on the other, that does not collapse into abstract utopianism or clear heteronomy. After detailing the theory of instincts and ego formation that early critical theory draws from Freud, I argue that neither Adorno nor Marcuse (...) is successful in articulating the possibility of such a non-repressive form of subjectivity: Adorno produces a powerful conception of freedom as non-reductive, communicative reconciliation between ego and instinctual nature, but remains committed to a Freudian conception of the interplay between elements of the psyche that makes it difficult to see how reconciliation could be actualized therein. Marcuse, on the other hand, develops a conception of liberation that largely abandons the ideal of ego autonomy by rendering the ego a spectator to the unfurling of instinctual impulses. In the concluding section, I argue that a more judicious evaluation of the death drive’s contribution to critical thought could clear space for a rapprochement between Adorno and Marcuse, and a more successful incorporation of Freud into critical theory. (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)

Lyotard defines being postmodern as an ‘incredulity toward metanarratives’. Such incredulity includes, in particular, skepticism vis-à-vis Enlightenment ideals like autonomy. Motivated by such skepticism, several educational scholars put into question education for autonomy as it is practiced in the formal settings of national school systems. More specifically, they criticize that practices of autonomy education can have certain normalizing and ideological e￿ects that undermine the aim of creating autonomous subjects. This article examines these critiques of education for (...) class='Hi'>autonomy and argues that they are best understood as calls for reforming educational practices, and not as outright rejections of education for autonomy. Thus, since the allegedly ‘postmodern’ critiques of autonomy education cannot be plausibly understood as radical ruptures with Enlightenment ideals, the article concludes that these critiques represent (merely) constructive self-critical reflections on what Habermas dubbed the ‘unfinished project of modernity’. (shrink)