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)

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)

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)

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)

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)

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)

Women have historically been prevented from living autonomously by systematic injustice, subordination, and oppression. The lingering effects of these practices have prompted many feminists to view autonomy with suspicion. Here, Marilyn Friedman defends the ideal of feminist autonomy. In her eyes, behavior is autonomous if it accords with the wants, cares, values, or commitments that the actor has reaffirmed and is able to sustain in the face of opposition. By her account, autonomy is socially grounded yet (...) also individualizing and sometimes socially disruptive, qualities that can be ultimately advantageous for women. Friedman applies the concept of autonomy to domains of special interest to women. She defends the importance of autonomy in romantic love, considers how social institutions should respond to women who choose to remain in abusive relationships, and argues that liberal societies should tolerate minority cultural practices that violate women's rights so long as the women in question have chosen autonomously to live according to those practices. (shrink)

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)

Autonomie und mit ihr die Selbstbestimmung gelten als hohes Gut. Demnach hat jeder Mensch das Recht, selbst darüber zu entscheiden, wie er leben möchte, und seine persönlichen Entscheide in der eigenen Lebensführung zu realisieren - und das ohne die Einmischung von anderen, auch staatlichen Stellen. Doch Selbstbestimmung ist nicht grenzenlos. Sie hat auch Rücksicht auf andere zu nehmen, deren Rechte zu achten und ist immer mit Verantwortung verbunden. Die Beiträger*innen des Bandes stellen sich diesem Spannungsfeld und fragen: Was heißt es (...) unter diesen Vorzeichen, sich selbst zu bestimmen und ein gelungenes Leben zu führen? Und was bedeutet Autonomie für Entscheide am Lebensende und die personalisierte Medizin? (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)

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)

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

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)

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)

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

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

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)

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

Professional autonomy interferes at a structural level with the various aspects of the health care system. The health care systems that can be distinguished all feature a specific design of professional autonomy, but experience their own governance problems. Empirical health care systems in the West are a nationally coloured blend of ideal type healthcare systems. From a normative perspective, the optimal health care system should consist of elements of all the ideal types. A workable optimum taking (...) national values into account could be attained by governance structures that also introduce elements from other ideal type systems. Thus a normative approach to medical practice guaranteeing an essential degree of professional autonomy for a relationship of trust between the patient and the physician, could be combined with an efficient and equitable allocation of health care resources. (shrink)

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

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

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

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

A core challenge for contemporary bioethics is how to address the tension between respecting an individual’s autonomy and promoting their wellbeing when these ideals seem to come into conflict (Not...

The standard bioethics account is that respecting patient autonomy means ensuring that patients make their own decisions, and that requires that they give informed consent. In fact, respecting autonomy often has more to do with the overall shape and meaning of their health care regimes. Ideally, patients will sometimes take control of their health care but sometimes defer to medical authority. The physician's task is, in part, to inculcate patients into the appropriate good health care regimes.

Theoretical models for patient-physician communication in clinical practice are frequently described in the literature. Respecting patient autonomy is an ethical problem the physician faces in a medical emergency situation. No theoretical physician-patient model seems to be ideal for solving the communication problem in clinical practice. Theoretical models can at best give guidance to behavior and judgement in emergency situations. In this article the premises of autonomous treatment decisions are discussed. Based on a case-report we discuss different genuine efforts (...) the physician can do to uncover treatment refusal and respect patient autonomy in an emergency situation. Autonomy requires competence and in emergency medicine time does not allow intimate exploration of patient competence and reasons for treatment refusal. We find that the physician must base her decision on a firm theoretical base combined with a practical and realistic view of the patient's situation on a case to case basis. (shrink)

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

Recently, there have been attempts at offering new justifications of the Rawlsian idea of public reason. Blain Neufeld has suggested that the ideal of political autonomy justifies public reason, while R.J. Leland and Han van Wietmarschen have sought to justify the idea by appealing to the value of political community. In this paper, I show that both proposals are vulnerable to a common problem. In realistic circumstances, they will often turn into reasons to oppose, rather than support, public (...) reason. However, this counterintuitive result can be avoided if we conceive of autonomy and community differently. (shrink)

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

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.

Kögel et al propose a multicriteria alternative to the standard early clinical selection method for xenotransplantation trials. As they note, existing recommendations for inclusion criteria indicate that only the most seriously ill—those lacking any viable alternative—should be considered for xenotransplantation. Rather than basing selection on, to put it indelicately, a Hail Mary in the face of certain death, Kögel et al recommend a selection system based on four ethical criteria: medical need, capacity to benefit, patient choice and compliance (the latter (...) being an exclusion criterion). Taken together, they paint a picture of an ethically ideal first-in-human xenotransplantation clinical trial participant: someone ‘in need of a heart replacement with a good capacity to benefit from a xenotransplantation who [has] a choice in terms of alternative potentially life-sustaining treatment options.’1 In other words, they argue that potential xenotransplantation organ recipients (they specify heart, but said criteria would apply to any vital organ recipient) should not be facing their imminent demise as this would inherently constrain that person’s freedom of choice, thus rendering them vulnerable. Instead, Kögel et al argue that trial participants should be selected from groups possessing genuine alternatives to xenotransplantation but opt to receive an animal organ. Now, their concern regarding the presence of coercion in the context of what is an experimental medical intervention is fully justified, as is their claim that those facing limited viable choices at the end of their lives are an inherently vulnerable population. Autonomy and consent are largely uncontroversial bedrocks on which most medical and research ethics theories are built. We are, all of us, familiar with the horrors from history—both distant and recent—where participant consent has taken …. (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)

Some of the most significant policy responses to cases of fraudulent and questionable conduct by scientists have been to strengthen professionalism among scientists, whether by codes of conduct, integrity boards, or mandatory research integrity training programs. Yet there has been little systematic discussion about what professionalism in scientific research should mean. In this paper I draw on the sociology of the professions and on data comparing codes of conduct in science to those in the professions, in order to examine what (...) precisely the model of professionalism implies for scientific research. I argue that professionalism, more than any other single organizational logic, is appropriate for scientific research, and that codes of conduct for scientists should strengthen statements concerning scientific autonomy and competence, as well as the scientific service ideal. (shrink)

Autonomy is, among other things, an actual psychological condition, a capacity that can be developed, and an educational ideal. This paper contextualises, analyses, criticises and extends the theory of Richard S. Peters on these three aspects of autonomy.

Autonomy, self-determination, self-affirmation, emancipation: all these words refer to an ideal that orients the way in which our contemporary culture speaks about many moral and political problems. The importance of this ideal for us can be seen in the way we accept as obvious a number of ideas that follow from it. Most of us would certainly tend to accept that no universally valid answer can be given to the question of what kind of human life is (...) truly meaningful or valuable and that, because of this, people should be granted as much freedom as possible to pursue a life that best corresponds with their own personal tastes and preferences. Many would go a step further and claim that people should also be encouraged to live as much as possible according to what they have themselves chosen, and that they should give up traditional forms of life and role patterns.One aspect of this cult of individual freedom or autonomy is the idea that we should develop a critical attitude towards anything established, accepted or traditional: every form of power or authority, prevailing moral norms and educational customs, traditional role patterns, etc. A further feature of this is the tendency to describe any improvement in the fortunes of the weak, the vulnerable and the less well off as an ‘emancipation’. The idea that the poor, the handicapped and the elderly should receive more support, assistance, respect and attention is translated by the assertion that they, too, should be ‘liberated’.The ideals that we associate with words like ‘emancipation’ or ‘self-affirmation’ were at one time innovative and revolutionary, but they gradually became established as accepted ways of thinking and thus became part of a new common sense. Nowadays, anyone wanting to be provocative will attain their goal more easily by scoffing at everything falling under the rubric of emancipation than by speaking out in its defence.This fact is characteristic of an ambiguity in our culture. While the ideals of self-affirmation and emancipation enjoy enormous popularity, in certain intellectual circles they are treated with suspicion. At stake here is the general image of humanity associated with these ideals. Thinkers such as Wittgenstein, Heidegger, Lacan, Derrida or Baudrillard have, each in their own way, attacked the idea of the autonomous subject and stressed that people’s most intimate thoughts and desires are determined by something that transcends them: by the language they speak or the culture to which they belong.Rejecting the idea of the autonomous subject is usually one aspect of a more general critique of ideas inherited from the Enlightenment. The question whether and to what extent this critique is justified occupies a central position in many contemporary philosophical discussions, and much of what goes on in contemporary philosophy can be described in terms of the opposition between those who would defend Enlightenment ideals and those who would reject or cast doubt on those ideals.What I would like to discuss here undoubtedly fits into a framework that could be called ‘antiliberal’ or ‘anti-humanist’. However, it is certainly not my intention to criticize humanism or liberalism directly and systematically. (shrink)

Selon la philosophe américaine Lydia Goehr, l’idéal romantique de « l’œuvre d’art totale » ( Gesamtkunstwerk ) fraye la voie d’un « formalisme transcendentalement élargi » ( transcendentally enhanced formalism ) capable de procurer « un usage contemporain renouvelé et acceptable » aux termes des premières revendications formalistes d’autonomie. Nous soutenons que le type de formalisme défendu par Goehr est incapable de rendre compte du sens inédit dans lequel la musique moderniste atteint à l’autonomie. Elle n’y atteint, ni en demeurant (...) confinée à l’intérieur des limites de son médium (comme le voudrait un formalisme étriqué), ni en faisant signe vers l’extramusical gisant au-delà de ces limites (comme le voudrait le formalisme élargi), mais en dissolvant l’apparence même selon laquelle ses ressources expressives seraient limitées a priori. L’autonomie revendiquée par le modernisme passe par une émancipation de la composition à l’égard de toute norme préexistante. (shrink)

Autonomy is an ideal of self‐creation, or self‐authorship; it consists in an agent's successful pursuit of willingly embraced, valuable options, where the agent's activities are not dominated by worries about mere survival. Autonomy in its primary sense is to be understood as the actual living of an autonomous life; autonomy in its secondary sense is to be understood as the capacity to live autonomously. To be autonomous, agents have to meet three conditions: they must possess certain (...) mental capacities, they must have an adequate range of valuable options, and they must enjoy independence from coercion and manipulation. Autonomy should be distinguished from self‐realization, as autonomous persons may choose not to realize their capacities. Autonomy itself, in an environment that supports autonomy, is not similarly optional, as living autonomously is the only way of flourishing within an autonomy‐supporting environment. (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)

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

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)