Background The principle of respect for autonomy (PRA) is a central tenet of bioethics. In the quest for a global bioethics, it is pertinent to ask whether this principle can be applied as it is to cultures and societies that are devoid of the Western sociopolitical historical pressures that led to its emergence. Relational autonomists have argued for a more inclusive approach to patient autonomy which takes into account factors such as interdependency and social relations. However, at (...) the outset of any relational approach, it is necessary to identify underlying factors that influence patient autonomy in non-Western cultures. Objective To conduct a review of the literature to uncover the mechanisms through which social, cultural, and religious factors influence and impact the application of the PRA in healthcare decision-making in non-Western cultures and societies. Methods We conducted a systematic review through a comprehensive search of three major electronic databases of biomedical sciences. Returned citations were imported to Covidence, full texts were assessed for eligibility, included articles were thoroughly reviewed and data was synthesized. PRISMA guidelines were followed. Results Our search retrieved 590 non-duplicate results, 50 of which were included after screening and full-text eligibility checks. The included studies were predominantly qualitative in nature, with few quantitative, mixed-methods, and review studies included. Our synthesis of data identified nine key factors that influenced patients’ autonomous decision-making through cultural, social, religious, or intersectional pathways. Conclusion Two main conclusions emerge from this review. Firstly, there is a notable dearth of bioethical research examining the influence of diverse factors on patients’ inclination towards different conceptions of autonomy. Secondly, the analysis of prevalent collectivist cultures and deference of autonomy adds value to the solution-oriented relational autonomy debate. This raises questions regarding how decision-making can be truly autonomous in the presence of such large-scale factors, warranting further attention. (shrink)

Meyers argues that clinical ethicists should sometimes be active participants in the deception of patients and families, whether that involves lies of omission or commission. I shall...

Eichengreen gives an overview of the connections between financial globalization, domestic autonomy, and social justice.

This article provides a donor-focused analysis of how transnational reproductive donation intersects with issues central to bodily autonomy of surrogates and egg donors from the global South. Little is known about the autonomy of surrogates and egg donors, especially among those from the global South. This article addresses this gap by examining two key issues on surrogacy and egg donation—conflict of interest and recruitment market. With these issues, this paper presents contexts of the reproductive body as (...) a space of contestation for autonomy. Analysis reveals that bodily autonomy is not an absolute entitlement available for surrogates and egg donors from the global South. Having bodily autonomy is a privileged disposition rather than a universal liberty for reproductive donors. The discussions in this work encourage further examination to understand the multi-layered experiences of reproductive donors from the global South, towards deeper interrogation of the processes of reproductive industry. (shrink)

Responding to criticism by Gordon Sollars and Frank Englander, this paper highlights a significant tension in recent debates over the ethics of global supply chains. This tension concerns the appropriate focus and normative frame for these debates. My first goal is to make sense of what at first reading seems to be a very odd set of claims: that valuing free, autonomous, and respectful markets entails a “fetish for philosophical purity” that is inconsistent with a moral theory that finds (...) no wrong in harming workers, including the least advantaged among them. Sollars and Englander reach these conclusions, I believe, because their criticism assumes and relies upon the presumption of a global prioritarian frame, one which focuses individual welfare, and which they then apply at the level of individual political and economic actors. Much of Benjamin Powell and Matt Zwolinski’s work, I continue, including their criticism of political and economic activism and Powell’s indictment of organized labor, relies on a similar frame—while expanding the harms to include the freedom and autonomy of would-be sweatshop workers. This prioritarian frame, I argue, is particularly poorly suited to discussion of the ethical responsibilities of individual economic and political actors. We ought to reject it. To make progress on debates over global sweatshops, and the ethics of global supply chains in general, we need a better frame, and better standards of freedom and autonomy, than those invoked by many prominent defenders of sweatshops. (shrink)

Offering a transdisciplinary study that benefits from the conceptual and theoretical contri­butions of sociology, political science and international relations, this article focuses on three key notions that shed light on the promise and limitations of the prevailing globalization scholarship. The proposed notions are self-determination, autonomy, and agency, which are often seen as merely antagonistic – if not a ‘prey’ or victim – to globalization. They are wor­thy of attention for their common emphasis that rests on the increasingly blurred boundar­ies (...) underlying the nexus between agent and environment, agent and action, and capability and expectations. Besides, they constitute an important source of inspiration for the rise of critical studies on globalization with a special emphasis on glocalization (Robertson) and world society (Meyer). Focusing on the prevailing global context in which claims to agency, autonomy and self-determination emerge, spread and receive diverse reactions, the study aims to discuss the complexity defining the relationship between homogenizing and hetero­genizing, universalizing and parochializing, converging and diverging logics, forces and processes underlying globalization. Overall, the article emphasizes that far from being hostile to global phenomena, self-determination, autonomy, and agency are both the products and key constitutive ingredients of the globalization as we understand it today. (shrink)

Gilabert argues that the humanist conception of duties of global justice and the principle of cosmopolitan justifiability will lead us to accept an egalitarian definition of individual autonomy. Gilabert further argues that realizing conditions of individual autonomy can serve as the cut-off point to duties of global justice. I investigate his idea of autonomy, arguing that in order to make sense of this claim, we need a concept of autonomy. I propose 4 possible definitions (...) of autonomy, none of which seem to necessitate Gilabert’s duties of egalitarian global justice. Instead, I propose that he may have in mind Autonomy 5, which requires that individuals have access to a maximum number of options and not simply a sufficient range of options to choose from. I criticize this premise as too demanding in the global world characterized by fundamental inequality. Second, I argue that if we were to endorse the preconditions for Autonomy 5, we would have to accept that Gilabert’s theory of global justice doesn’t provide for a cut-off point of duties of global justice. (shrink)

This book investigates "cultural instruments," meaning normative forms of analysis and practice that are central to Western culture. It explores their history from antiquity to the early Enlightenment and their use and reworking by different cultures, moving from Europe to Africa and the Americas, especially the Caribbean, in the process giving close readings of a wide range of authors.

The political theorist Michael Walzer has usually been taken as an opponent of global distributive justice, on the basis that it is incompatible with collective autonomy, would endanger cultural diversity, or simply on the basis that principles of global distributive justice cannot be coherently envisaged, given cross-cultural disagreement about the nature and value of the social goods that might be distributed. However in his recent work, Walzer demonstrates a surprising degree of sympathy for the claims of (...) class='Hi'>global distributive justice, even of the egalitarian variety. But the precise contours of his current position on global equality are not yet clearly developed. The paper, therefore, attempts to reconstruct what that position might be, paying particular attention to the conclusions we could draw firstly for our understanding of the opposition between global equality and national self-determination , and secondly for the relationship between global equality and shared understandings.Keywords: global equality; global justice; collective autonomy; shared understandings; Michael Walzer. (shrink)

I defend my pure social account of global autonomy from Steven Weimer's recent criticisms. In particular, I argue that it does not implicitly rely upon the very kind of nonsocial conception of autonomy that it hopes to replace.

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

This chapter contains sections titled: Introduction A. The Formula of Autonomy – Initial Statements B. The Formula of Autonomy, the Formula of Universal Law, and the Formula of Humanity C. The Kingdom of Ends D. Price and Dignity E. Critical Remarks and Worries F. The Formula's Larger Implications References.

Drawing from an ethics of care, relational approaches to autonomy have recently emerged in bioethics. Unlike individual autonomy with its emphasis on patients’ rights, choice, and self-determination which has been the hallmark of bioethics consistent with the ideology of individualism in neoliberal democracies in Western countries, relational autonomy highlights the relatedness, interdependency, and social embeddedness of patients. By examining the mediating role that male Hospital Liaison Committee members in Germany play in facilitating care that supports Jehovah's Witnesses’ (...) refusal of blood transfusions, this article moves beyond ‘dyadic relations’ and contexts of caregiving. It also contributes to a deeper understanding of care and relational conceptualizations of Witness patients’ autonomy globally. (shrink)

Face aux attitudes passives et violentes de certains jeunes scolarisés, les enseignants expriment de façon permanente la volonté de " rendre les élèves autonomes ". Mais la démarche qui mène à cet objectif est parsemée de pièges. Loin de présupposés non-directifs, cet ouvrage cherche à recenser et à présenter de façon simple l'ensemble des modèles théoriques capables de faire comprendre les processus de modifications d'attitudes de l'élève dans la classe. D'abord vis-à-vis des contenus d'apprentissage, puis vis-à-vis des personnes (le professeur, (...) les autres élèves). Chacun de ces modèles est illustré par des exemples de mises en œuvre en éducation physique. Afin de rendre cohérente l'action du professeur en direction de ces " deux autonomies " (par rapport aux contenus et aux, personnes), la troisième partie de l'ouvrage propose une approche globale qui interprète les conduites observées chez les élèves selon différents niveaux d'intégration des règles dans la situation d'enseignement. (shrink)

The perspectives of the dominant Western ethical theories, have dominated the concepts of autonomy and informed consent for many years. Recently this dominant understanding has been challenged by ethics of care which, although, also emanates from the West presents a more nuanced concept: relational autonomy, which is more faithful to our human experience. By paying particular attention to relational autonomy, particularity and Process approach to ethical deliberations in ethics of care, this paper seeks to construct a concept (...) of informed consent from the perspective of ethics of care which is here called relational autonomy-in-informed consent (RAIC). Thus, providing a broader theoretical basis for informed consent beyond the usual theoretical perspectives that are particularly Western. Care ethics provides such a broader basis because it appeals to a global perspective that encompasses lessons from other cultures, and this will help to enrich the current ideas of bioethics principles of autonomy and informed consent. This objective will be achieved by exploring the ethics of care emphasis on relationships based on a universal experience of caring; and by contrasting its concept of autonomy as relational with the understanding of autonomy in the approaches of the dominant moral theories that reflect rational, individualistic, and rights-oriented autonomy of the American liberalism. (shrink)

Some theorists who accept the existence of global justice duties to alleviate the condition of distant needy strangers hold that these duties are significantly constrained by special ties to fellow countrymen. The patriotic priority thesis holds that morality requires the members of each nation-state to give priority to helping needy fellow compatriots over more needy distant strangers. Three arguments for constraint and patriotic priority are examined in this essay: an argument from fair play, one from coercion, another from coercion (...) and autonomy. Under scrutiny, none of these arguments qualifies as successful. (shrink)

Michael Blake claims that liberal principles ground egalitarian distribution domestically but not globally. This paper raises some worries about these claims. It challenges the argument for domestic distributive equality based on a concern for autonomy, noting that a broader concern for wellbeing is required. And it suggests that a concern for everyone’s autonomy and wellbeing supports the progressive pursuit of global distributive equality rather than only the pursuit of global sufficiency.

This article considers how global ethical matters might be approached differently in the English-speaking literature if values salient in sub-Saharan Africa and East Asia were taken seriously. Specifically, after pointing out how indigenous values in both of these major parts of the world tend to prescribe honouring harmonious relationships, the article brings out what such an approach to morality entails for political power, foreign relations and criminal justice. For each major issue, it suggests that harmony likely has implications that (...) differ from approaches that currently dominate Western thought, namely those of utility, autonomy and capability. Lacking the space to systematically defend harmony as a fundamental value, it nonetheless urges theorists not to neglect it in future work. (shrink)

I argue in this paper that the development and convergence of information and communication technologies (ICT) is creating a global network of surveillance capabilities which affect the traveler. These surveillance capabilities are reminiscent of 18th century philosopher Jeremy Bentham’s panopticon, and as such the emerging global surveillance network has been referred to as the travel panopticon. I argue that the travel panopticon is corrosive of personal autonomy, and in doing so I describe and analyse various philosophical approaches (...) to personal autonomy. (shrink)

The problem of global climate changes has raised fundamental questions of justice in world politics centered around the vast discrepancies between the causes and the effects of global warming and the uneven levels of consumption/enjoyment of fossil fuels. The overwhelming majority of approaches in environmental ethics have focused on either distributive justice or rights-based frameworks. Climate change justice, however, can be explored through an alternative framework, an approach based on the recognition theory of Axel Honneth that has not (...) been systematically engaged with in this field. A critique of John Rawls’ The Law of Peoples as an exemplar of distributive approaches reveals a number of limitations inherent in Rawlsian models of climate-change justice. Honneth’s theory of recognition is an advance on distributive models toward a notion of climate justice in which the conditions necessary for the “functioning and flourishment” of human freedom includes climatic stability as a basic social condition. The ideal of mutual recognition provides a basis for environmental protections, including but not limited to the global atmosphere as a necessary condition for the realization of self-autonomy for all human kind. (shrink)

Much disease and disability is the result of lifestyle behaviours. For example, the contribution of imprudence in the form of smoking, poor diet, sedentary lifestyle, and drug and alcohol abuse to ill-health is now well established. More importantly, some of the greatest challenges facing humanity as a whole – climate change, terrorism, global poverty, depletion of resources, abuse of children, overpopulation – are the result of human behaviour. In this chapter, we will explore the possibility of using advances in (...) the cognitive sciences to develop strategies to intentionally manipulate human motivation and behaviour. While our arguments apply also to improving prudential motivation and behaviour in relation to health, we will focus on the more controversial instance: the deliberate targeted use of biomedicine to improve moral motivation and behaviour. We do this because the challenge of improving human morality is arguably the most important issue facing humankind (Persson and Savulescu, forthcoming). We will ask whether using the knowledge from the biological and cognitive sciences to influence motivation and behaviour erodes autonomy and, if so, whether this makes it wrong. (shrink)

The article explains the essential features of a theory of global justice that combines justice for individuals with justice for political communities. It holds that arguing within the justificatory framework of cosmopolitanism is compatible with a conditional justification of states that are basically just. The justification rests on an argument I will name ‘the moral path dependency argument’. The article follows its normative consequences into the fields of a justly ordered community of legitimate states and of cosmopolitan principles of (...) distributive justice. Thus, it reconciles the latter with claims to political autonomy of particular communities and with the fact of reasonable disagreement between them. (shrink)

Following decades of maltreatment of women in obstetric care, professional respect for maternal autonomy in obstetric decision making and care have become codified in global and national professional ethical guidelines. Yet, using the example of birth after cesarean, identifiable threats to maternal autonomy in obstetrics continue. This paper focuses on how current scientific knowledge and obstetric practice patterns factor into restricted maternal autonomy as evidenced in three representative maternal accounts obtained prior and subsequent to birth after (...) cesarean. Short- and long-term remedies to improve the current state of restricted maternal autonomy in clinical practice surrounding decision making on birth after cesarean are provided. (shrink)

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

To what degree can the philosophy of Cornelius Castoriadis help analyse and evaluate our current social reality in relation to the project of autonomy? How meaningful is his political proposition for direct democracy in the 21st century? This book presents basic concepts of Castoriadian philosophy, such as the social-historical plane, ontological creativity, and social and individual time, that provide the theoretical tools necessary to evaluate the historical phenomena of our era. By revealing the new significances of social freedom, (...) class='Hi'>global solidarity and movements of direct democracy, this book explores roads towards social autonomy and human freedom today. (shrink)

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

Colburn’s ambition in this book is to defend a ‘political morality of autonomy-minded liberalism’. Colburn defines autonomy as the ability to live in accordance with what one has deemed valuable, and to bear responsibility for this decision. There is a traditional debate that forces liberalism either to identify itself as anti-perfectionist and thus as neutral on the question of autonomy’s value , or as pro-autonomy and perfectionist. Colburn alleges that this debate is premised on a logical (...) error. In Chapter 1, Colburn proposes a content-neutral account of autonomy in the tradition of liberal individualism espoused by Wilhelm von Humboldt and John Stuart Mill, and more recently by Joseph Raz and Steven Wall. In Chapter 2, Colburn offers an account of autonomy as a global phenomenon ; lives, rather than episodes of individual choice and action, are at issue. Colburn’s account is an amalgam of ideas defended by Gerald Dworkin, Harry Frankfurt, Mill, and philosophers who defend some form of a social-historical relational account of autonomy. The autonomous agent has values she would hypothetically endorse under conditions of independence, free of factors such as hypnosis or coercion that might derail her critical faculties. Colburn helpfully develops the independence condition by specifying that one’s general commitments to a way of life must be ‘content-sensitive’; they must not ‘depend on something other than the nature of that thing’ deemed valuable. Moreover, the agent must perceive the reasons for her endorsement of a value. The final condition of autonomy might be labelled the relational one of actually ‘living life in accordance with values’ and ‘putting one’s decisions into effect’ . The heart of the book lies in Colburn’s argument for his ‘Equivalence Claim’ in Chapter 3, and in his discussion of the relationship …. (shrink)

Interactions with global markets offer development opportunities for Indigenous communities. They also place pressure on the natural resources that communities depend upon for their livelihood and, in many cases, their political and cultural autonomy. These markets often interact with family-based enterprises embedded within commons, with important implications for the social relationships and shared territorial resources that characterise such regimes. In this paper, we analyse the relationships that exist between commons, global markets, and small-scale family enterprises, using the (...) case of mezcal production—an alcoholic beverage made from agave—in an Indigenous community in Oaxaca, Mexico. Most mezcal production is organized at the family level; yet the raw materials and inputs necessary for making mezcal are held communally and regulated by locally-crafted institutions. Empirical data show that as family enterprises engage with an emergent global market for mezcal, the commons become essential for not only protecting territorial resources but also maintaining a degree of autonomy from powerful global markets and value chains. However, this requires substantial investment in monitoring and enforcement, and for community members to value sustainable commons management over short-term economic self-interest. To seek autonomy while participating in global markets, producer families also join together to develop cooperative strategies to access markets on better terms. (shrink)

Autonomy, an individual's right to make personal decisions regarding his/her own health, represents one of the major ethical principles of medicine. While there are many examples citing the benefits this right provides for the individual, the impact that personal healthcare decisions have on others is often neglected. Here, evidence from end-stage renal disease is reviewed to hypothesise the creation of a universal kidney donation programme that although provides unparalleled benefits to its citizens, relies on the participation of a large (...) proportion of the society. Given that this essay also addresses the public's major concerns regarding kidney donation, one of the only remaining implementation barriers is the individuals' right not to participate. Therefore, irrespective of the humane and complex emotionally laden reasons for not enrolling in such programmes, this essay provides some estimates of the significant resource and quality of life costs associated with autonomy. Assuming humans are competent to make informed personal healthcare choices, similar to recent efforts to increase awareness about the negative impact of certain lifestyle choices on global warming, citizens should also be better informed about the medical costs their autonomy has on society. (shrink)

“Sustainability” is widely used by diverse organizations as the normative direction to coordinate common actions. But what should we sustain or maintain? Through philosophical reasoning and a literature review in environmental ethics, this paper explores this question and develops a working definition of “sustainability” that intends to be compatible with the global diversity of worldviews. I argue that sustainability is the maintenance of the conditions of possibility of continuation of (1) self-determining flourishing human existences. It entails (2) maintaining the (...) natural processes of the global environment autonomous to limit the possible harmful consequences of the conflicts of distribution and domination, and (3) cultivating meaningful, diverse, and adaptable nurturing milieus. This definition encompasses the three intricate ideas of self-determination, autonomy of the global environment, and diversity. Self-determination as well as the preservation of the autonomy of global environmental processes are crucial elements to prevent the unescapable domination of some powerful groups and worldviews over others. Diversity is also a key piece of the sustainability puzzle as it provides ranges of options that make self-determination possible. This paper proposes an inclusive and flexible working definition of sustainability that is mindful of the global diversity of worldviews. (shrink)

The practice of medicine—and especially the patient-doctor relationship—has seen exceptional shifts in ethical standards of care over the past few years, which by and large originate in occidental countries and are then extrapolated worldwide. However, this phenomenon is blind to the fact that an ethical practice of medicine remains hugely dependent on prevailing cultural and societal expectations of the community in which it serves. One model aiming to conceptualise the dichotomous efforts for global standardisation of medical care against differing (...) sociocultural expectations is the individualism-collectivism model, with the ‘West’ being seen as individualistic and the ‘East’ being seen as collectivistic. This has been used by many academics to explain differences in approach towards ethical practice on key concepts such as informed consent and patient autonomy. However, I argue that this characterisation is incomplete and lacks nuance into the complexities surrounding cross-cultural ethics in practice, and I propose an alternative model based on the ethics of clinical care in Hong Kong, China. Core ethical principles need not be culture-bound—indeed, their very existence mandates for them to be universal and non-derogable—but instead cultural alignment occurs in the particular implementation of these principles, insofar as they respect the general spirit of contemporary ethical standards. (shrink)

Liberals are concerned with the equal moral status of all human beings. This article discusses what flows from this premise for moral cosmopolitans when analysing temporary foreign worker programs for low-skilled workers. Some have hailed these programs as a tool to achieve redistributive global goals. However, I argue that in the example of Live-In-Caregivers in Canada, the morally most problematic aspect is that it provokes vulnerability of individual workers. Once in a situation of vulnerability, important conditions of individual (...) class='Hi'>autonomy are jeopardized. Even if these programs provide for redistribution of opportunities on a global scale, the challenge such programs pose to the conditions of autonomy can not outweigh these gains. Instead, they need to be re-assessed and changed to fundamentally express equal moral status of all human beings. (shrink)

ABSTRACT:This article considers the economic case for so-called sweatshop wages and working conditions. My goal is not to defend or reject the economic case for sweatshops. Instead, proceeding from a broadly pluralist understanding of value, I make and defend a number of claims concerning the ethical relevance of economic analysis for values that different agents utilize to evaluate sweatshops. My arguments give special attention to a series of recent articles by Benjamin Powell and Matt Zwolinski, which represent the latest and (...) best defense of the economic case for sweatshops. In the process, I challenge Zwolinski’s “non-worseness claim”, and the idea that opposition to sweatshop wages and working conditions fails to respect that the autonomy of would-be sweatshop workers. Ultimately, I conclude that even if the economic case for sweatshops rests on a solid empirical foundation, agents possess good reason to advocate for better wages and working conditions for sweatshop workers, and to prefer less exploitative or coercive relationships. Sweatshop labor undermines a compelling vision of free markets, according to both Kantian and republican conceptions of freedom, and the relationships formed by those who participate in such markets. (shrink)

Abstract: In this essay a set of principles is defended that yields a determinate allocation of sovereign competences across a global system of territorially nested jurisdictions. All local sovereign competences are constrained by a universal, justiciable human rights regime that also incorporates a conception of cross-border distributive justice and regulates the competence to control immigration for a given territory. Subject to human rights constraints, sovereign competences are allocated according to a conception of global democracy. The proposed allocation scheme (...) can accommodate substantial local autonomy while at the same time ensuring that everyone has a voice in the political decisions that affect his or her interests. The relevant class of affected interests is fully specified. Relevant affects are of two kinds: those that impose norms of governance on individuals, and those that impose external costs on them. The favored sense of "an external cost" is developed and defended. (shrink)

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

ABSTRACT: Debates about global distributive justice focus on the gulf between the wealthy North and the impoverished South, rather than on issues arising between liberal democracies. A review of John Rawls’s approach to international justice discloses a step Rawls skipped in his extension of his original-position procedure. The skipped step is where a need for the distributional autonomy of sovereign liberal states reveals itself. Neoliberalism denies the possibility and the desirability of distributional autonomy. A complete Rawlsian account (...) of global justice shows the necessity and possibility of a charter between liberal states, assuring each a proper minimum degree of distributional autonomy. (shrink)

In this book, the authors set forth a new model of globalization that lays claims to supersede existing models, and then use this model to assess the way the processes of globalization have operated in different historic periods in respect to political organization, military globalization, trade, finance, corporate productivity, migration, culture, and the environment. Each of these topics is covered in a chapter which contrasts the contemporary nature of globalization with that of earlier epochs. In mapping the shape and political (...) consequences of globalization, the authors concentrate on six states in advanced capitalist societies (SIACS): the United States, the United Kingdom, Sweden, France, Germany, and Japan. For comparative purposes, other states—particularly those with developing economics—are referred to and discussed where relevant. The book concludes by systematically describing and assessing contemporary globalization, and appraising the implications of globalization for the sovereignty and autonomy of SIACS. It also confronts directly the political fatalism that surrounds much discussion of globalization with a normative agenda that elaborates the possibilities for democratizing and civilizing the unfolding global transformation. (shrink)

This paper is a critique of the present mode of capitalist democracy from the ethico-moral viewpoint. The crisis of values is identified as the great bane of free market-led globalization. This trend has aggravated worldwide inequality, promoted terrorism and violence, created psychological anomie and triggered eco logical disasters. Only a few business interests in the wealthier economies are gaining at the expense of humankind. The moral dimension of the government's role has been undermined by such profit-making free market gospel. The (...) author contends that more than beingjust secular, democracy is a pre-social moral force and, as such, is perceived more proximately in the religious temper of a non-industrial society than in a mass industrial society. In the latter democracy is almost a farce with the periodic ritual of public voting as its main act. The paper castigates the global economy and global media which cleverly mastermind our lives, and pleads for a change of values which will make humans self-conscious and will restore their autonomy. (shrink)

One of the major concerns of advocates of common morality is that respect for cultural diversity may result in moral relativism. On their part, proponents of culturally responsive bioethics are concerned that common morality may result in moral imperialism because of the asymmetry of power in the world. It is in this context that critics argue that global bioethics is impossible because of the difficulties to address these two theoretical concerns. In this paper, I argue that global bioethics (...) is possible if we adopt a culturally responsive and self-critical attitude towards our moral values and those of others. I use the example of women’s reproductive autonomy in indigenous African culture to show that the difference between the leading Euro-American and indigenous African construal of autonomy is that the former ascribes greater weight on individual self-determination while the latter emphasizes responsibilities towards the community. One develops dignity in virtue of their capacity for communing with others. Hence, women have rights, but as members of the community, they also have obligations including the duty to procreate. The involvement of the family in reproductive decisions does not contravene women’s dignity and human rights. In applying the principle of autonomy in this communitarian context, one has to be sensitive to these ontological and moral specificities. The aim of global bioethics should not be to reach common grounds at all costs; any common norms should be the result of a negotiated democratic dialogue between cultures and not the result of imposition by the preponderant culture(s). (shrink)

To what degree can the philosophy of Cornelius Castoriadis help analyze and evaluate our current social reality in relation to the project of autonomy? How meaningful is his political proposition for direct democracy in the 21st century? What significance do the concepts of social time and social space have in the determination of political freedom? -/- Castoriadis and Autonomy in the 21st Century presents basic concepts of Castoriadian philosophy, including the social-historical plane, ontological creativity, and social and individual (...) time that provide the theoretical tools to evaluate the historical phenomena of our era. Drawing from Greece's own turbulent past and the current global crisis to reveal new significances of social freedom, global solidarity and movements of direct democracy, this book explores social autonomy and human freedom today through critical dialogue with Castoriadis' ideas. (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 chapter contains sections titled: Introduction Doubts About Libertarianism Obligations Conclusions References Further reading.

The debate about the direction, coherence and possible imperialism of universal norms in global bioethics has been going on for years. Proponents of universal norms have fiercely stated their cases focusing on human rights, autonomy and/or further principles in bioethics. Equally forceful has been the opposition to such universal principles arguing mainly on grounds of cultural diversity. The alternative is commonly presented as one between moral relativism and moral imperialism; solutions that are equally unattractive. This paper suggests a (...) way forward for global bioethics by focusing on techniques of moral deliberation as well as on the specific social context from which moral dilemma arises. Such focus will show that the alternative between moral relativism and imperialism only arises when an unreflected notion of medical ethics is applied. The way forward for global bioethics is to acknowledge the way medical ethics is connected to a specific medical practice and to examine its cultural and conceptual foundation rather than insisting on context independent principles.If it is already doubtful whether bioethics exists, it is even more dubious for global bioethics. For almost two decades, discussion over such issue has been going on with hardly any progress. Some uphold the famous four principles as the universal standard; others would like to modify them while still hoping for universality; still others challenge the very notion of universality in the field of medical ethics. The discussion is trapped in a variety of antagonisms: between universalism and particularism, between liberalism and communitarism, between principalism and case-based-bioethics. This paper suggests a way forward beyond these antagonisms by asking about the very nature of medical ethics. First, however, we need to take a closer look on the issue at stake: the quest for a global bioethics and the debate over the identity of medical ethics. (shrink)

Given the increase in research in less developed countries and the necessary reliance on informed consent guidelines, we should pay close attention to the extent to which these guidelines address important cross-cultural differences. I argue that the current underlying conception of autonomy that is reflected in informed consent guidelines fails to adequately address important cultural differences—namely differences in conceptions of the person. Since this conception directly influences one’s conception of autonomy, the narrowness of the current guidelines demands attention. (...) In examining a conception of the person that is popular in Africa—a less developed country in which much research is currently being conducted—I argue that the current foundation for informed consent should rest on strong relational autonomy in order to be more globally applicable. This revision, in turn, calls for changes to the policies for informed consent. (shrink)

This chapter contains section titled: A Cosmopolitan Law? Global Responsibilities Global Politics Morality in International Relations.

Maternal mortality is still very high in Africa, despite progress in control efforts at the global level. One elemental link is the question of autonomy in maternal health, especially at the household level where intrinsic human rights are undermined. A rights-based consideration in bioethics is an approach that holds the centrality of the human person, with a compelling reference to the fundamental human rights of every person. A philosophical and sociological engagement of gender and the notion of (...) class='Hi'>autonomy within the household reveals some fundamental rights-based perplexities for bioethical considerations in maternal health. The right to self-determination is undermined, and therefore women’s dignity, freedom and autonomy, capacities, and choices are easily defiled. This study applies a rights-based approach to maternal health and demonstrates how rights concerns are associated with negative outcomes in maternal health in Africa. The discussion is situated at the household level, which is the starting point in health care. The paper submits that beyond legal and political rights within the context of the state, rights-based issues manifest at the household level. Many of those rights issues, especially relating to women’s autonomy, are detrimental to maternal health in Africa. Therefore, a rights-based approach in the social construction of maternal health realities will contribute to alleviating the burden of maternal mortality in Africa. (shrink)