ABSTRACT Autonomy is foundational to ethics, political philosophy, philosophy of mind, and it has been closely associated with argumentation. What is curious about autonomy is that it has traditionally been explained in terms of reasoning and argument: autonomy involves reasoning because, standardly, someone who’s autonomous is one who thinks things through, who has reasons for their actions. Autonomy regards argument because to respect the autonomy of someone who thinks things through, one must offer them reasons, (...) that is, argue with them. One common thought is that provided one’s arguments meet certain criteria (e.g., they’re not sophistries or clever manipulations), then argument respects autonomy. But is this really so? No. Properly understood, argument is a kind of paternalism, for to argue with someone means to enter into and manage their stream of reasons, the very things that account for their autonomy. (shrink)

This article explores some issues associated with Philip Kitcher's unificationist theory of explanation, including the contrast between epistemic and ontic approaches to explanation, and the implications of Kitcher’s theory for the autonomy of the special sciences.

This paper explores the value of respect for personal autonomy in relation to clearly immoral and irrational acts committed freely and intentionally by competent people. Following Berlin's distinction between two kinds of liberty and Darwall's two kinds of respect, it is argued that coercive suppression of nonautonomous, irrational, and self-harming acts of competent persons is offensive to their human dignity, but not disrespectful of personal autonomy. Irrational and immoral choices made by competent people may claim only the negative (...) liberty to be left alone. Lives disposed to autonomy are worthy of solidarity and active support in addition to the right of free choice and action. Autonomous premeditated desires (distinguished from mere consent) may embody transcendental choices, which transcend consideration of physical and psychological well-being. Choices made by incompetent persons (e.g., children and the mentally disabled) are not related to autonomy, but to self-directedness. The value of human dignity confers protection to self-directedness, but not at the expense of other vital interests. (shrink)

Free and informed consent is generally acknowledged as the legal andethical basis for living organ donation, but assessments of livingdonors are not always an easy matter. Sometimes it is necessary toinvolve psychosomatics or ethics consultation to evaluate a prospectivedonor to make certain that the requirements for a voluntary andautonomous decision are met. The paper focuses on the conceptualquestions underlying this evaluation process. In order to illustrate howdifferent views of autonomy influence the decision if a donor's offer isethically acceptable, three (...) cases are presented – from Germany, theUnited States, and India. Each case features a person with questionabledecision-making capacity who offered to donate a kidney for a siblingwith severe renal insufficiency. Although the normative framework issimilar in the three countries, different or sometimes even contraryarguments for and against accepting the offer were brought forward. Thesubsequent analysis offers two explanations for the differences inargumentation and outcome in spite of the shared reference to autonomyas the guiding principle: (1) Decisions on the acceptability of a livingdonor cannot simply be deducted from the principle of autonomy but needto integrate contextual information; (2) understandings of the wayautonomy should be contextualized have an important influence on theevaluation of individual cases. Conclusion: Analyzing the conceptualassumptions about autonomy and its relationship to contextual factorscan help in working towards more transparent and better justifieddecisions in the assessment of living organ donors. (shrink)

Philosophy of the Social Sciences, Volume 52, Issue 3, Page 150-174, June 2022. This article offers a reassessment of the main import of Peter Winch’s philosophy of the social sciences. Critics argue that Winch presented a flawed methodology for the social sciences, while his supporters deny that Winch’s work is about methodology at all. Contrary to both, the author argues that Winch deals with fundamental questions about methodology, and that there is something substantial to learn from his account. Winch engages (...) methodological questions without being committed to social ontology. Instead, Winch’s work on methodology is best described as a descriptive metaphysics of social inquiry. This alternative reading clarifies the close link between Winch’s argument for the autonomy of the social sciences and R. G. Collingwood’s philosophy of history. (shrink)

The ethics of deceased organ procurement (OP) is supposedly based on individual consent to donate, either explicit (opt-in) or presumed (opt-out). However, in many cases, individuals fail to express any preference regarding donation after death. When this happens, the decision to remove or not to remove their organs depends on the policy’s default option or on family preferences. Several studies show that in most countries the family plays a significant and often decisive role in the process of decision-making for OP. (...) Depending on the country, the family may be allowed to take different kinds of actions in different situations, and this may be granted either by law or by clinical practice only. This adds much complexity to the usual classification of consent policies in two categories: opt-in and opt-out. Here we propose a novel and comprehensive taxonomy of the models of consent for OP according to three variables: (1) the deceased’s wishes, if any, (2) family wishes, if any, and (3) default policies. By analysing these models of consent, we show that they rely on at least three different concepts of autonomy: individual autonomy, relational autonomy, and family autonomy. In light of this analysis, we discuss the ethical debates surrounding two policy approaches: presumed consent and family veto. (shrink)

This article discusses nurses’ and elderly patients’ perceptions of the realization of autonomy, privacy and informed consent in five European countries. Comparisons between the concepts and the countries indicated that both nurses and patients gave the highest ratings to privacy and the lowest to informed consent. There were differences between countries. According to the patient data, autonomy is best realized in Spain, privacy in the UK (Scotland), and informed consent in Finland. For the staff data, the best results (...) tended to concentrate in the UK. The conceptual and methodological limitations of the study are identified and discussed. Implications of the results are divided into three areas: nursing practice, education and research. In practice, the analysis of patients’ values and the ethical sensitivity of nurses are important as part of ethically good care. In nurse education, students should learn to recognize ethical problems, generally and particularly, among vulnerable groups of patients. Multicultural international research is needed in this area. This is the last of a set of five articles published together in this issue of Nursing Ethics in which the results of this comparative research project are presented. (shrink)

Jacques Ellul’s claim that technique became an autonomous phenomenon during the middle of the 20th century, and subsequently a system, means that the influence people have on technique is much less decisive than the influence technique has on people. As a sociohistorical description of the relationship between technique and society, it can be empirically investigated. This article begins by clarifying the concept of an autonomous technique and reviews evidence to support this claim.

An eighty‐six–year‐old woman has had lifelong obsessive‐compulsive disorder. At times, it has been so severe that she has lost touch with reality and been psychotic. She is actively followed by a community mental health nurse. Since she is physically frail, the nurse visits her at home and liaises with the attending psychiatrist, who adjusts medications as needed. Currently, the patient is stable, and there is no evidence of psychosis.The patient's home deteriorates, and several repairs are needed. The nurse questions the (...) patient about this, and the patient agrees to have her nephew arrange for the repairs and pay for them out of her bank account. The nurse asks how the nephew has access to the account. The patient mentions that he has power of attorney, but when asked to supply the document giving him this authority, she becomes confused and supplies a number of bank statements instead. The nurse is surprised to see several withdrawals for over ten thousand dollars each. When she questions the patient about these, the patient simply suggests that her nephew must have “needed the money” for something. The nurse questions her repeatedly about this matter, but she refuses to give further details. The patient becomes quite upset whenever the nurse brings it up and states, “This is my money, and he wouldn't take it unless he needed it to help me.”Should the nurse challenge the patient's right to make her own financial decisions in order to avoid a risk of exploitation by her family members? Does the patient have the right to refuse a capacity assessment, which could determine her decision‐making abilities in this area? (shrink)

This article explores the social and historical conditions under which “people changing technology” overshadows that of “technology changing people” through its influence on human life, society, and the biosphere. Social construction and determinism are thus two sides of the same coin. However, both ignore the inseparability of thoughts and action from lives, lives from communities, and communities from their historical journeys. This hides from view the possibility of technology becoming a secular myth, in the sense of cultural anthropology. The current (...) discipline-based intellectual and professional division of labor treats the living world as if it were structured the way technology is. As a result, human life has become “digitized,” since the process of industrialization transformed human life and society to make the computer and information revolution both possible and necessary. It has also misdirected our sense of responsibility for technology. (shrink)

This paper juxtaposes two conflicting positions on the justifiability of authority: Robert Wolff's philosophical anarchist argument and a response to Wolff consisting in Joseph Raz's service conception of authority. Following an introduction, I provide a brief exposition of Wolff's claim that authority is incompatible with moral autonomy (Section 2). After presenting the Razian response (Section 3), I consider what implications follow from Raz's service conception of authority assuming it is correct (Section 4). I argue that, even if the service (...) conception successfully meets the anarchist challenge, it does so not by entirely dissolving the tension between authority and autonomy, but through a balancing act whereby one aspect of our autonomy gives way to another aspect of our autonomy. Finally, I consider the service conception of authority itself and point out certain vulnerabilities thereof (Section 5). (shrink)

All people have human rights and there is a close connection between human rights, needs, and autonomy. Accounting for this connection is difficult on many of the traditional rights theories. On many traditional theories, human rights protect individuals’ important interests. These theories are well suited to account for the fact that human rights protect individuals from dire need. Even the non-autonomous have some needs, which constitute some of their important interests. But because these theories sometimes say autonomy is (...) not constitutive of the interests human rights protect they can fail to capture the close relationship between human rights and autonomy. On other traditional human rights theories, human rights only protect individuals’ autonomy. These theories avoid the problem sketched above. But, purely autonomy-based theories cannot explain the universality of rights -- some people lack autonomy. Furthermore, if human rights only protect individuals’ autonomy, human rights can be fulfilled and yet some can be left in dire need. So, some of the best known attempts to justify human rights either cannot appropriately connect human rights and autonomy or cannot account for the human right of all to meet their basic needs. This paper suggests that a theory on which human rights protect individuals’ ability to live minimally good lives should be taken seriously because it can avoid this dilemma. For, it argues, people need whatever will enable them to live such lives and autonomy is partly constitutive of such a life. (shrink)

As patient autonomy expands, a highly controversial issue has emerged. Should the advance directives of refusing life-saving treatments or requesting euthanasia of persons with dementia who express changed minds or are often in a happy state be fulfilled? There are two autonomy-related positions. The mainstream position in philosophical discussions supports the priority of ADs based on precedent autonomy. Buchanan and Brock, and Dworkin represent this view. The other position supports the priority of PWDs’ current wishes based on (...) minimal autonomy represented by Jaworska. By rethinking the theoretical and practical challenges of the two positions and their arguments respectively, the paper concludes that in such a scenario, the priority of ADs is morally indefensible, and it is also challenging to establish minimal autonomy defend the moral priority of PWDs’ current wishes. For PWDs whose past values, beliefs, and preferences fade away but who retain apparent intrinsic sentience of well-being, a modified defined quality-of-life approach serves as another reasonable basis in their medical decision-making, and the ADs and the QoL should be further merged to reduce the uncertainty of the grey zone. (shrink)

Pauline Kleingeld has argued persuasively that Kant’s Principle of Autonomy draws an analogy between two relationships: 1) that between an individual agent and their maxim, and 2) that between a legislator and their legislation. She also suggests that Kant’s evolving views on the normative significance of popular elections made his analogy inapt, which explains its disappearance from his later writings. This comment concurs with Sorin Baiasu that the merits of Kant’s analogy were untouched by his evolving political views. The (...) analogy presupposes that when lawmakers legislate, they do so as representatives of the people, but even Kant’s mature writings posit that unelected lawmakers are representatives of the people in the necessary sense. Facts about whether a lawmaker acquired legislative authority by election, heredity, or conquest do have normative implications in the larger context of Kant’s political theory, but such facts are necessarily temporally upstream of the relation between legislator and legislation, just as facts about how an agent became rational are upstream of the relation between individual agent and maxim. Because the analogy focuses exclusively on these two relationships, it cannot be damaged by such upstream facts. Moreover, we should consider the possibility that Kant’s Principle of Autonomy compares a human will to the united general will of the people itself rather than to the will of a fallible public official or institution. On this alternative reading, it is even more clear that Kant’s evolving views on the significance of elections could have no possible relevance to the Principle of Autonomy. (shrink)

In Scepticism, Freedom and Autonomy, Araujo argues against this interpretation, asserting that we retain control over our opinions only through selective ...

In his monograph, Robust Ethics: The Metaphysics and Epistemology of Godless Normative Realism, Erik Wielenberg offers arguably one of the most sophisticated defenses of the autonomy thesis to date. Wielenberg argues that the divine command theory is problematic because it cannot account for the moral obligations of reasonable unbelievers; Godless normative robust realism can be formulated in a way that avoids the standard objections to the autonomy thesis; and GRNR provides a better account of intrinsic value. In this (...) paper, I will argue Wielenberg’s defenses of the autonomy thesis fails. I will argue that his objection to divine command theories fails, that he fails to address two standard challenges to the autonomy thesis adequately, and, finally, that Wielenberg fails to show that GRNR better accounts for the intuition that certain things are intrinsically good than various forms of theistic alternatives. (shrink)

Background: Personal genomic testing (PGT) offers individuals genetic information about relationships, wellness, sporting ability, and health. PGT is increasingly accessible online, including in emerging markets such as Australia. Little is known about what consumers expect from these tests and whether their reflections on testing resonate with bioethics concepts such as autonomy. Methods: We report findings from focus groups and semi-structured interviews that explored attitudes to and experiences of PGT. Focus group participants had little experience with PGT, while interview participants (...) had undergone testing. Recordings were transcribed and analyzed using thematic analysis. Findings were critically interpreted with reference to bioethics scholarship on autonomy. Results: Fifty-six members of the public participated in seven focus groups, and 40 individuals were interviewed separately. Both groups valued the choice of PGT, and believed that it could motivate relevant actions. Focus group themes centered on the perceived value of choices, knowledge enabling action and knowledge about the self. Interview themes suggest that participants reflexively engage with their PGT information to make meaning, and that some appreciate its shortcomings. Critical interpretation of findings shows that while consumers of PGT are able to exercise a degree of autonomy in choosing, they may not be able to achieve a substantive conceptualization of autonomy, one that promotes alignment with higher-order desires. Conclusions: PGT consumers can critically reason about testing. However, they may uncritically accept test results, may not appreciate drawbacks of increased choice, or may overestimate the potential for information to motivate behavioral change. While consumers appear to be capable of substantive autonomy, they do so without ongoing support from companies. PGT companies promote a problematic (“default”) account of autonomy, reliant on empowerment rhetoric. This leaves consumers vulnerable to making decisions inconsistent with their higher-order desires. As PGT expands, claims about its power and value need to be carefully drawn. (shrink)

In a recent article in this journal, Parker Crutchfield argues that if moral bioenhancement ought to be compulsory, as some authors claim, then it ought to be covert, i.e., performed without the knowledge of the population that is being morally enhanced. Crutchfield argues that since the aim of compulsory moral bioenhancement is to prevent ultimate harm to the population, compulsory moral bioenhancement is best categorized as a public health issue, and should therefore be governed by the norms and values that (...) apply in public health settings. In this article, I argue for two related claims. First, I question the extent to which compulsory moral enhancement should be considered a public health issue that ought to be governed by the norms and values that apply in public health settings. Second, I argue that Crutchfield's argument that covert moral bioenhancement would better respect people's autonomy than an overt program overlooks two important autonomy‐based reasons that, in fact, favor an overt moral enhancement program over a covert one. (shrink)

Gerald Dworkin has argued that it is inconsistent with the proper ends of medicine for a physician to participate in an execution by lethal injection. He does this by proposing a principle by which we are to judge whether an action is consistent with the proper ends of medicine. I argue: (a) that this principle, if valid, does not show that it is inconsistent with the proper ends of medicine for a physician to participate in an execution by lethal injection; (...) and (b) that this principle is not valid, and this is because it mistakenly views the promotion of patient autonomy as one of the proper ends of medicine. Rather, I propose, we should view respect for a patient's autonomy as a constraint on the pursuit of the proper ends of medicine, rather than as one of the proper ends itself. With this revised understanding of the proper ends of medicine, we can conclude that it is inconsistent with the proper ends of medicine for a physician to participate in an execution by lethal injection. (shrink)

Can a collective be an agent in its own right? Can it be the bearer of moral and other properties that we have traditionally reserved for individual agents? The answer, as one might expect, is ‘In some ways yes, in other ways no.’ The way in which the answer is ‘Yes’ has been described recently by Copp; I intend to discuss his position and defend it against objections. This describes a fairly weak form of autonomy that I will claim (...) does not require the abandonment of methodological individualism or our commonplace intuitions about individual responsibility. I will also discuss, and reject, a stronger conception of autonomy suggested especially by the work of Pettit that would result in methodological individualism. (shrink)