The combination of the issue of return of individual genetic results/incidental findings and paediatric biobanks is not much discussed in ethical literature. The traditional arguments pro and con return of such findings focus on principles such as respect for persons, autonomy and solidarity. Two dimensions have been distilled from the discussion on return of individual results in a genetic research context: the respect for a participant’s autonomy and the duty of the researcher. Concepts such as autonomy and solidarity do not (...) fit easily in the discussion when paediatric biobanks are concerned. Although parents may be allowed to enrol children in minimal risk genetic research on stored tissue samples, they should not be given the option to opt out of receiving important health information. Also, children have a right to an open future: parents do not have the right to access any genetic data that a biobank holds on their children. In this respect, the guidelines on genetic testing of minors are applicable. With regard to the duty of the researcher the question of whether researchers have a more stringent duty to return important health information when their research subjects are children is more difficult to answer. A researcher’s primary duty is to perform useful research, a policy to return individual results must not hamper this task. The fact that vulnerable children are concerned, is an additional factor that should be considered when a policy of returning results is laid down for a specific collection or research project. (shrink)

Solidarity could be defined in the broad sense either as a means or as an end. Considered as an end, solidarity is the motive of any virtuous action based on altruistic reasons, such as helping others to rescue someone in order to prevent a harmful situation. E. g. contributing to lift and rescue a heavy person, lying unconscious in the street on the floor, who is being handled by rescuers, but who might be needing an additional person, could express the (...) value of solidarity as an end, since an answer to others request for help is given in the situation of emergency and risk, without having a particular obligation to help. Solidarity as a means (to an end, not an end), could be understood as a property of dependency of a set of parts to a whole (in solidum), as when in a family or a professional group, individual and collective roles and responsibilities are melt together to some extent.This idea of benefiting others could be understood either as a way of sharing together moral sentiments as love, social virtues as friendship and shared commitments and common economic and educational interests, in a limited community circle, that of the family. Even if the division of labour is not simply based on patriarchal authority, mutual consent of family members to rules and to a common circle of interests, those of the family, resemble to a egoism of the group, and not yet to truly social and altruistic values. Solidarity as cohesion of human beings, by the means of "interchangeability of ideas, services, goods, of workforce, virtues and vices", is solidarity limited to the constitution of a process of exchange that is a means that could be used to different ends. (shrink)

Autonomy has risen in esteem, then fallen, only to rise again in recent theorizing about women in society and culture. In this paper, I further bolster the renewed feminist interest in autonomy. I characterize feminist social aspirations in terms of three very abstract goals and then argue that women’s individual autonomy promotes at least two of them in crucial ways. Women’s autonomy will improve the quality of the close personal relationships that pervade women’s traditional moral concems (the first goal) (...) and it will enable women the better to resist traditional, gender-based constraints on their lives (the second goal). My conclusion is tempered, however, by the view that individual autonomy interferes to a significant degree with the solidarity and collective action by women needed to effect feminist social change (the third goal). In passing, I gesture toward a conception of autonomy as a certain kind of narrative of self-development. (shrink)

Accounts of solidarity typically defend it in teleological or loyalty terms, justifying it by invoking its goal of promoting justice or its expression of support for a shared community. Such solidarity seems to be a moral option rather than an obligation. In contrast, A Moral Theory of Solidarity develops a deontological theory grounded in equity. With extended reflection on the Spanish conquest of the Americas and the US Civil Rights movement, Kolers defines solidarity as political action on others' terms. Unlike (...) mere alliances and coalitions, solidarity involves a disposition to defer to others' judgment about the best course of action. Such deference overrides individual conscience. Yet such deference is dangerous; a core challenge is then to determine when deference becomes appropriate.Kolers defends defernce to those who suffer gravest inequity. Such deference constitutes equitable treatment, in three senses: it is Kantian equity, expressing each person's equal status; it is Aristotelian equity, correcting general rules for particular cases; and deference is 'being an equitable person,' sharing others' fate rather than seizing advantages that they are denied. Treating others equitably is a perfect duty; hence solidarity with victims of inequity is a perfect duty. Further, since equity is valuable in itself, irrespective of any other goal it might promote, such solidarity is intrinsically valuable, not merely instrumentally valuable. Solidarity is then not about promoting justice, but about treating people justly. A Moral Theory of Solidarity engages carefully with recent work on equity in the Kantian and Aristotelian traditions, as well as the demandingness of moral duties, collective action, and unjust benefits, and is a major contribution to a field of growing interest. (shrink)

To be autonomous is to be a law to oneself; autonomous agents are self-governing agents. Most of us want to be autonomous because we want to be accountable for what we do, and because it seems that if we are not the ones calling the shots, then we cannot be accountable. More importantly, perhaps, the value of autonomy is tied to the value of self-integration. We don't want to be alien to, or at war with, ourselves; and it seems that (...) when our intentions are not under our own control, we suffer from self-alienation. What conditions must be satisfied in order to ensure that we govern ourselves when we act? Philosophers have offered a wide range of competing answers to this question. (shrink)

As an infant, my grandmother chewed my food for me because I was not capable of chewing on my own. As an adult, most African men still want to chew my food for me. So, how do African women consent to research when culturally they must surrender their autonomy? We join in solidarity and create our own collective autonomy. We know the rules of our patriarchal society and outwardly adhere to them. As an ethicist, I have developed a sense (...) of responsibility and solidarity with female research subjects; we collaborate in the full understanding of our lack of autonomy. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Law’s Virtue: Fostering Autonomy and Solidarity in American Society by Cathleen KavenyEric E. SchnitgerLaw’s Virtue: Fostering Autonomy and Solidarity in American Society By Cathleen Kaveny WASHINGTON, DC: GEORGETOWN UNIVERSITY PRESS, 2012. 304 PP. $29.95In Law’s Virtue, Cathleen Kaveny calls those in Western liberal countries to rethink their fundamental framework of ethics and law through the guiding principles of autonomy and solidarity, understood through the Catholic context of Thomistic (...) virtue. The law operates not as the fence of individual isolation as it does in Enlightenment rights theory, whereby liberty is preserved through negative restraint, but as the teacher of a limited form of the virtues of prudence and justice (52). The law teaches this thin form of prudence through autonomy, which Kaveny takes from Joseph Raz as “the capacity to be the ‘part-author’ of one’s own life” (53). Solidarity, pulling from Pope John Paul II, correlates to a learned justice, in that it “attend[s] to the unseen members” of the community (54). It recognizes that the good of the community and the good of individual members are inexorably intertwined.The opening epigram of the preface, which sets the tone for the whole work, is a quotation from Isidore of Seville found in Aquinas: “Law shall be virtuous, just, possible to nature, according to the custom of the country, suitable to place and time, necessary, useful; clearly expressed, lest by its obscurity it lead to misunderstanding; framed for no private benefit, but for the common good” (xi). Kaveny argues that the phrases “possible to nature” and “custom of the country” need more attention in pluralist, democratic societies, because law is morally formed by its constituent community and there are deep disagreements within those communities. This gives a direction for how Catholics, and all citizens, should attempt to influence laws in these democracies. Because the law is a form of consensus over time, it should use severe sanctions such as criminal law only to reinforce the consensus that it represents. Tort and tax law are less severe tools that can encourage the moral direction of society, which, when used well, maintain the consensus of the law but still allow it to be a moral teacher.Kaveny’s practical thinking in this text does have some seeds of radical change. When she moves to the practicalities of life issues in the law—such as abortion, euthanasia, and genetics—she argues that the “entire fabric of the Anglo-American legal system” needs to add the concept of the “vulnerable” person to the “reasonable person” (79). In addition, her reframing of life issues contends that the Catholic view of issues like abortion is too different from [End Page 212] the “custom of the country” to make a change to the virtues and practices of other citizens. Instead, attention to the support necessary for families and social difficulties of economic poverty represents a way of using the law as a moral teacher while recognizing its limits (89, 156, 209). The book concludes with an incisive look at voting, in which Kaveny argues that the idea of issues-based voting is wrongheaded; instead, she urges voters to consider that they are voting for an individual who will take a broad moral stance and make a broad set of decisions (197 ff.).The quality of Kaveny’s clear thinking and moral consistency makes this book a pleasure to read—even for those who may disagree about the nature of the law or the virtues that Christians should bring to political, legislative, and judicial systems. This text, from its depth of legal and theological commitments, sets a high bar for further dialogue.Eric E. SchnitgerFuller Theological SeminaryCopyright © 2015 Society of Christian Ethics... (shrink)

Anne Donchin attended graduate school while raising four children, received her doctorate from the University of Texas in 1970, taught for 18 years in Texas and New York, then joined the philosophy department at Indiana University–Purdue University Indianapolis in 1982. Here she developed a Women’s Studies program, specialized and in numerous ways pioneered in feminist bioethics, and won two prestigious grants. She co-edited two books, published some forty articles, and co-founded and co-ordinated The International Network on Feminist Approaches to Bioethics. (...) Before and after retiring she served on the editorial boards of an encyclopedia, several international bioethics collections and nine prestigious journals. Her publications have influenced many scholars here and abroad. At the time of her death she was at work on a book: Procreation, Power and Personal Autonomy: Feminist Reflections, which is now available on IUPUIScholarWorks. Laura Purdy has generously edited, organized, and, where possible, updated the manuscript. (shrink)

Starting from examples of concrete situations in France, I show that autonomy and solidarity can coexist only if the parameters of autonomy are redefined. I show on the one hand that in situations where autonomy is encouraged, solidarity nevertheless remains at the foundation of their practices. On the other hand, in situations largely infused with family solidarity, the individual autonomy may be put in danger. Yet, based on my ethnographic observations regarding clinical encounters and medical secrecy, I show that while (...) solidarity may endanger individual autonomy, it does not necessarily endanger autonomy itself. The social practices observable in France reflect the reality of an autonomy that goes beyond the individual, a reality that involves a collective subject and includes solidarity. The opposition between these two values can then be resolved if the content of the notion of autonomy is understood to be dependent on its cultural context of application and on its social use. (shrink)

My dissertation traces key aspects of the conceptual influence of Heidegger's work on feminist poststructuralist theories. This archeology enables me to indicate that poststructualism cannot provide the foundation necessary to forming three normative ideals requisite to a viable feminist theory: personal autonomy, heterogeneous community, and solidarity. I argue that certain versions of poststructuralism repeat Heidegger's abstraction from an hermeneutics of suspicion and his totalizing rejection of modernity. Without a theory of willed ignorance, post-Lacanian feminism undercuts women's agency. And, without (...) tying a vision of Sittlichkeit to ideology critique, feminist ethics falls prey to abstraction and antinormativism. ;In Part I, I recover a dialectical theory of autonomy that can account for the deliberate ways that subjects mediate their environment. In Part II, I flesh out Heidegger's and Irigaray's respective visions of heterogeneous community. In Part III, however, I show how neither Heidegger nor US appropriations of Irigaray yield either a sufficiently complex moral theory or a theory of solidarity. After delineating Heidegger's antinormative tendencies, I reveal similar deficiencies in the works of Irigaray and Drucilla Cornell. I demonstrate that the nominalist underpinnings of post-Lacanian feminism threaten to normalize a fragmented view of pluralism rather than tackle the hard problem of developing interactive models of universalism and of solidarity. ;I conclude by developing features of a feminist methodology that can support solidarity and avoid antinormativism. These features include: a hermeneutic of the symbolic order complex enough to address the overlap between race, class and gender; grounding theory in ideology critique; a model of critical social consciousness rooted in the ability to disdain the immiseration of others and to acknowledge one's own interests; and an interactionist basis for moral theory. (shrink)

With the discovery of the possibility of neurobiologically and genetically interpreting the actions of a moral agent, the issue of the status of morality returned to applied ethics with renewed vigor. The biotechnological understanding of society as a whole has been a long-running trend in technoscience and can be considered as a transgression of (bio-) technologies into the sphere of ethics. The essence of the conflict between bio-conservative ethics and techno-oriented utilitarians lies in the plane of violation of the fundamental (...) value of autonomy (J. Harris) and the destruction of the principle of solidarity and equality (A. Buchanan). Supporters of techno-determined moral action as conditions for the expansion of technology into the field of morality put forward the predictability of consequences as a condition for the legitimation of technology (N. Agar), the need to prevent maximum harm (J. Savulescu, I. Persson) and the right to an autonomous choice of a biotechnological regulation of morality (V. Rakic). At the center of the discussion is the problem of the good, for the practical solution of which moral outsourcing mechanisms have already been envisaged (e.g. the service of triage officers in disaster medicine, extended informed consent for biobanks). The article compares moral action as a choice, moral action as a coercion and moral action as outsourcing, and determines the place of the neurobiological interpretation of good and moral action within the theoretical understanding of a moral act in applied ethics. In particular, the role of a cognitive act in the context of a moral act is examined, the problem of deferred risks and their regulation when making a moral decision is analyzed. It is concluded that one of the manifestations of the impact of (bio) technology on a person is the complicacy and transformation of moral decision-making models, in connection with which the universal methods that formulate a moral action (moral act as a choice) can be supplemented by new models that constitute good and moral action. (shrink)

Technological advances are bringing new light to privacy issues and changing the reasons for why privacy is important. These advances have changed not only the kind of personal data that is available to be collected, but also how that personal data can be used by those who have access to it. We are particularly concerned with how information about personal attributes inferred from collected data (such as online behaviour), can be used to tailor messages and services to (...) specific individuals or groups. This kind of ‘personalised targeting’ has the potential to influence individuals’ perceptions, attitudes, and choices in unprecedented ways. In this paper, we argue that because it is becoming easier for companies to use collected data for influence, threats to privacy are increasingly also threats to personal autonomy—an individual’s ability to reflect on and decide freely about their values, actions, and behaviour, and to act on those choices.4 While increasing attention is directed to the ethics of how personal data is collected, we make the case that a new ethics of privacy needs to also think more rigorously about how personal data may be used, and its potential impact on personal autonomy. (shrink)

Bioethicists, medical professionals and lawyers who support Posthumous Assisted Reproduction as an ethical procedure in the case of the deceased’s spouse often oppose it in the case of the deceased’s parents. In addition, supporters of PAR usually rely on an individualistic version of liberalism, thus focusing on a personal rather than relational approach to autonomy. This article proposes an alternative and comprehensive theoretical framework for the practice of PAR, based on the concepts of solidarity and relational autonomy. By analyzing (...) empirical data on people’s attitudes towards PAR, we reveal an important distinction between the deceased’s wish and the deceased’s consent. In addition, we show that in the majority of cases individuals report that the well-being of their relatives is paramount once they are dead. This finding, as will be demonstrated in the article, is not fully in line with Tremellen and Savulescu’s position who allow PAR in the case of the deceased’s spouse but not in the case of his parents. We also suggest that a relational autonomy perspective can be used to evaluate the choices and actions of the deceased, and to justify the requests for PAR by his spouse or parents. Furthermore, the discussion leads us to analyze both Sandel’s account of solidarity and the more recent account of Prainsack and Buyx. We conclude that PAR can be considered as a solidarity-based practice, both at the familial and societal level, an aspect that should be given more emphasis in the discourse surrounding PAR. (shrink)

Prominent thinkers such as Jurgen Habermas and Michael Sandel are warning that biomedical enhancements will undermine fundamental political values. Yet whether biomedical enhancements will undermine such values depends on how biomedical enhancements will function, how they will be administered and to whom. Since only few enhancements are obtainable, it is difficult to tell whether these predictions are sound. Nevertheless, such warnings are extremely valuable. As a society we must, at the very least, be aware of developments that could have harmful (...) consequences. Indeed, if important values were to be jeopardized, we should take appropriate measures to protect them. This paper focuses on four central values: solidarity, personal responsibility, equality and autonomy. It delineates the conditions under which biomedical enhancements would undermine these values. It also details the circumstances under which these values would be unaffected by enhancements as well as those under which they would be promoted. Specifying these conditions is valuable; it would enable society to prepare appropriate ethical guidelines and policy responses in advance. (shrink)

This paper critically examines the extent to which health promoting wearable technologies can provide people with greater autonomy over their health. These devices are frequently presented as a means of expanding the possibilities people have for making healthier decisions and living healthier lives. We accept that by collecting, monitoring, analysing and displaying biomedical data, and by helping to underpin motivation, wearable technologies can support autonomy over health. However, we argue that their contribution in this regard is limited and that—even with (...) respect to their ‘autonomy enhancing’ potential—these devices may deliver costs as well as benefits. We proceed by rehearsing the distinction that can be drawn between procedural autonomy and substantive-relational autonomy. While the information provided by wearable technologies may support deliberation and decision-making, in isolation these technologies do little to provide substantive opportunities to act and achieve better health. As a consequence, wearable technologies risk generating burdens of anxiety and stigma for their users and reproducing existing health inequalities. We then reexamine the extent to which wearable technologies actually support autonomous deliberation. We argue that wearable technologies that subject their users to biomedical and consumerist epistemologies, norms and values also risk undermining processes of genuinely autonomous deliberation. (shrink)

Prominent thinkers such as Jurgen Habermas and Michael Sandel are warning that biomedical enhancements will undermine fundamental political values. Yet whether biomedical enhancements will undermine such values depends on how biomedical enhancements will function, how they will be administered and to whom. Since only few enhancements are obtainable, it is difficult to tell whether these predictions are sound. Nevertheless, such warnings are extremely valuable. As a society we must, at the very least, be aware of developments that could have harmful (...) consequences. Indeed, if important values were to be jeopardized, we should take appropriate measures to protect them. This paper focuses on four central values: solidarity, personal responsibility, equality and autonomy. It delineates the conditions under which biomedical enhancements would undermine these values. It also details the circumstances under which these values would be unaffected by enhancements as well as those under which they would be promoted. Specifying these conditions is valuable; it would enable society to prepare appropriate ethical guidelines and policy responses in advance. (shrink)

I once heard a colleague opine that we would be better off if there were a 50-year moratorium on philosophers using the word 'autonomy'. He went on to argue that we could get along just fine without the word, and that a good number of confusions would be dispelled along the way. This collection of new papers goes a long way toward responding to this challenge in ways that both undercut and vindicate aspects of this complaint.

The unity with others in collective action to achieve a particular goal, known as political solidarity, transforms the individual. I examine the dual nature of that personal transformation — the motivational transformation and the normative transformation — and offer a study of the relation between political solidarity and empathy. While empathy may be part of the normative transformation, I argue that it is not a necessary element of the motivational transformation. I conclude with a discussion of epistemic empathy.

Although the world has experienced remarkable progress in health care since the last half of the 20th century, global health inequalities still persist. In some poor countries life expectancy is between 37-40 years lower than in rich countries; furthermore, maternal and infant mortality is high and there is lack of access to basic preventive and life-saving medicines, as well a high prevalence of neglected diseases, HIV/AIDS, tuberculosis, and malaria. Moreover, globalization has made the world more connected than before such that (...) health challenges today are no longer limited within national or regional boundaries, making all persons equally vulnerable. Because of this, diseases in the most affluent countries are closely connected with diseases in the poorest countries. In this paper, we argue that, because of global health inequalities, in a situation of equal vulnerability, there is need for global solidarity not only as a means of reducing health inequalities, but also as a way of putting up a united force against global health challenges. We argue for an African approach to solidarity in which the humanity of a person is not determined by his/her being human or rational capacity, but by his/her capacity to live a virtuous life. According to this view of solidarity, because no one is self-sufficient, no individual can survive alone. If we are to collectively flourish in a world where no individual, nation or region has all the health resources or protection needed for survival, we must engage in solidarity where we remain compassionate and available to one another at all times. (shrink)

Background Moral distress is reported to be a critical force contributing to intensifying rates of anxiety, depression and burnout experienced by healthcare workers. In this paper, we examine the moral dilemmas and ensuing distress personally and collectively experienced by healthcare workers while caring for patients during the pandemic. Methods Data are drawn from free-text responses from a cross-sectional national online survey of Australian healthcare workers about the patient care challenges they faced. Results Three themes were derived from qualitative content analysis (...) that illuminated the ways in which moral dilemmas and distress were relationally experienced by healthcare workers: (1) the moral ambiguity of how to care well for patients amid a rapidly changing work environment; (2) the distress of witnessing suffering shared _between_ healthcare workers and patients; and (3) the distress of performing new forms of invisible work in the absence of institutional recognition. These findings reveal that moral distress was a strongly shared experience. Conclusions Findings advance understandings of moral distress as a relational experience, collectively felt, constituted, and experienced by healthcare workers. Considering how to harness collective solidarity in effectively responding to moral distress experienced across the frontline healthcare workforce is critical. (shrink)

Self-tracking devices point to a future in which individuals will be more involved in the management of their health and will generate data that will benefit clinical decision making and research. They have thus attracted enthusiasm from medical and public health professionals as key players in the move toward participatory and personalized healthcare. Critics, however, have begun to articulate a number of broader societal and ethical concerns regarding self-tracking, foregrounding their disciplining, and disempowering effects. This paper has two aims: first, (...) to analyze some of the key promises and concerns that inform this polarized debate. I argue that far from being solely about health outcomes, this debate is very much about fundamental values that are at stake in the move toward personalized healthcare, namely, the values of autonomy, solidarity, and authenticity. The second aim is to provide a framework within which an alternative approach to self-tracking for health can be developed. I suggest that a practice-based approach, which studies how values are enacted in specific practices, can open the way for a new set of theoretical questions. In the last part of the paper, I sketch out how this can work by describing various enactments of autonomy, solidarity, and authenticity among self-trackers in the Quantified Self community. These examples show that shifting attention to practices can render visible alternative and sometimes unexpected enactments of values. Insofar as these may challenge both the promises and concerns in the debate on self-tracking for health, they can lay the groundwork for new conceptual interventions in future research. (shrink)

Several meta-analytic studies suggest that individual and contextual factors determine employees’ workplace quitting intentions. Autonomy motivational orientation as an individual factor has many beneficial outcomes, including a reduction in employee turnover intention. However, the studies in this area suggest that the influence is indirect. Grounded in self-determination theory and career stage theory, we hypothesize that the influence of employees’ autonomy motivational disposition on quitting intention is contingent on the level of employees’ age. Results of data collected from 340 engineers, marketing (...) and service personnel from a large public sector undertaking supported our hypothesized model. Employees with high autonomy motivational disposition show less intention to leave the organization when they grow old than young. We conclude by discussing that employees behave for autonomous reasons and show greater organizational identity and less quitting intention with growing age. (shrink)

‘Shared’ decision-making is heralded as the gold standard of how medical decisions should be reached, yet how does one ‘share’ a decision when any attempt to do so will undermine _autonomous_ decision-making? And what exactly is being shared? While some authors have described parallels in literature, philosophical examination of shared agency remains largely uninvestigated as an explanation in bioethics. In the following, shared decision-making will be explained as occurring when a group, generally comprised of a patient and or their family, (...) and the medical team become a genuine intentional subject which acts as a collective agent. Collective agency can better explain how some medical decisions are reached, contrary to the traditional understanding and operationalization of ‘autonomy’ in bioethics. Paradoxically, this often occurs in the setting of high-stakes moral decision-making, where conventional wisdom would suggest individuals would _most_ want to exercise autonomous action according to their personally held values and beliefs. This explication of shared decision-making suggests a social ontology ought to inform or displace significant aspects of autonomy as construed in bioethics. It will be argued that joint commitments are a fundamental part of human life, informing and explaining much human behavior, and thus suggesting that autonomy - conceived of as discrete, individuated moral reasoning of a singular moral agent - is not an unalloyed ‘good.’. (shrink)

Prominent tuberculosis (TB) actors are invoking solidarity to motivate and justify collective action to address TB, including through intensified development and implementation (D&I) of technologies such as drugs and diagnostics. We characterize the ethical challenges associated with D&I of new TB technologies by drawing on stakeholder perspectives from 23 key informant interviews and we articulate the ethical implications of solidarity for TB technology D&I. The fundamental ethical issue facing TB technological D&I is a failure within and beyond the TB (...) community to stand in solidarity with persons with TB in addressing the complex sociopolitical contexts of technological D&I. The failure in solidarity relates to two further ethical challenges raised by respondents: skewed power dynamics that hinder D&I and uncertainties around weighing risks and benefits associated with new technologies. Respondents identified advocacy and participatory research practices as necessary to address such challenges and to motivate sustained collective action to accelerate toward TB elimination. We present the first empirical examination of bioethical accounts of solidarity in public and global health. Our study suggests that solidarity allows us better to understand and address the ethical challenges that arrest the D&I of new TB technologies. Solidarity lends credence to policies and practices that address the relational nature of illness and health through collective action. (shrink)

This article presents a critical analysis of the views of Michael Sandel on human enhancement in his book The Case Against Perfection (2007). Sandel argues that the use of biotechnologies for human enhancement is driven by a will to mastery or hybris, leading to an ‘explosion of responsibility’ and a disappearance of solidarity. I argue that Sandel is using a traditional concept of solidarity which leaves little room for individual differences and which is difficult to reconcile with the modern trend (...) towards individual autonomy and cultural heterogeneity. With reference to the sociology of Giddens, I argue that the ‘explosion of responsibility’ can be considered an expression of the insecurity in modern society and the need for reflexivity in personal and social life. I argue that the need for reflexivity is a driving social and cultural force behind the interest in human enhancement, and that this trend can go together with a commitment to take care of the needs of others. I agree with Sandel that there is a risk that human enhancement may develop into ‘hybris’, particularly when enhancement is driven by scientism and a naturalist reduction of human values to neurological processes. Enhancement based on scientism will threaten solidarity defined by Honneth as an interactive relationship aimed at the mutual recognition of individual identities in relation to a shared value horizon. I will call for a reflective approach in which human enhancement technologies are explored in the context of a ‘system of reference’. Such a reflective approach will help to protect against the hybris of scientism and to maintain solidarity with vulnerable groups. (shrink)

Solidarity has for a long time been referred to as the core value underpinning European health and welfare systems. But there has been debate in recent years about whether solidarity, with its alleged communitarian content, can be reconciled with the emphasis on individual freedom and personal autonomy. One may wonder whether there is still a place for solidarity, and whether the concept of justice should be embraced to analyse the moral issues regarding access to health care. In this article, (...) I will answer this question by analysing the normative foundations of the concept of justice, followed by a deeper examination of the concept of solidarity in continental philosophy. More specifically, I will compare the philosophical traditions rooted in Kant to approaches rooted in Hegel. In addition, I will present the work of Avishai Margalit on the decent society to criticize a predominantly liberal approach to access to health care. The importance of solidarity lies particularly in its emphasis on relational aspects and the role of recognition in care practices, which are usually ignored in liberal approaches to justice. However, the article will argue that solidarity is not an alternative to a rights-based concept of justice, but must be considered as a necessary complement to it. (shrink)

The ‘smart city’ has been driven by advances in information and communication technologies, with the aim of integrating these technologies with urban infrastructures for improved optimisation, automation and control. Smart cities have emerged as a response to the challenges faced by megacities and are likely to manifest the ‘datafying’ society in the public space. However, the pervasive nature of data collection, continuous analysis and inference, and long-term data storage result in a potentially problematic reconfiguration of society that undermines individual and (...) collective autonomy. This article proposes the concept of ‘data autonomy’ as a guiding principle for the development of smart cities, addressing challenges related to the potential misuse of personal data, sphere transgression, and datafied gentrification. Section II. explores concerns related to data protection law, which can be understood as a proxy for the relationship between the individual and society, highlighting power dynamics and the autonomy of individuals and communities. Section III. discusses the concept of sphere transgression, where tech giants expand their influence in society without adequate expertise or accountability. Section IV. examines the potential impact of datafied gentrification on individual and collective autonomy. Building on the challenges identified throughout these sections, this paper proposes ‘data autonomy’ as a guiding principle for smart city development in section V., promoting a value-based approach centred on human dignity. To make it practicable, increased interdisciplinary collaboration in the development of smart cities is needed, with a particular focus on improved design and impact assessment methodologies. (shrink)

Technological advances are bringing new light to privacy issues and changing the reasons for why privacy is important. These advances have changed not only the kind of personal data that is available to be collected, but also how that personal data can be used by those who have access to it. We are particularly concerned with how information about personal attributes inferred from collected data (such as online behaviour), can be used to tailor messages and services to (...) specific individuals or groups. This kind of ‘personalised targeting’ has the potential to influence individuals’ perceptions, attitudes, and choices in unprecedented ways. In this paper, we argue that because it is becoming easier for companies to use collected data for influence, threats to privacy are increasingly also threats to personal autonomy—an individual’s ability to reflect on and decide freely about their values, actions, and behaviour, and to act on those choices.4 While increasing attention is directed to the ethics of how personal data is collected, we make the case that a new ethics of privacy needs to also think more rigorously about how personal data may be used, and its potential impact on personal autonomy. (shrink)

This article traces the way autonomy has become a recognised value in health care in France. In a country that based its social fundamentals on the very idea of solidarity for many years, autonomy has long been considered a foreign ‘Anglo-American principle’. Taking the example of the end-of-life debate, the article shows, however, how the use of the French term ‘accompagnement’ allowed autonomy to be redefined and to be associated with the concept of solidarity. Exploring the arguments used over the (...) past 25 years in professional guidelines, parliamentary reports, ethics committee reports, and legal texts, the authors describe the shift that took place in public and legal discourses on end-of-life care. The analysis demonstrates how the scope of autonomy has been limited by other social values, such as the protection of the dying person, in order to become an accepted social value in its own right. The example of the French end-of-life debate shows that depending on how the concept of autonomy is adapted and applied in a specific context, it can be compatible with the idea of solidarity. Such compatibility has been challenged previously in the international bioethics debate. By demonstrating the possibility of combining autonomy and solidarity, this article makes an important contribution to the international bioethics debate and to the dialogue between countries that are often perceived as significantly different. (shrink)

Moral distress is reported to be a critical force contributing to intensifying rates of anxiety, depression and burnout experienced by healthcare workers. In this paper, we examine the moral dilemmas and ensuing distress personally and collectively experienced by healthcare workers while caring for patients during the pandemic. Data are drawn from free-text responses from a cross-sectional national online survey of Australian healthcare workers about the patient care challenges they faced. Three themes were derived from qualitative content analysis that illuminated the (...) ways in which moral dilemmas and distress were relationally experienced by healthcare workers: (1) the moral ambiguity of how to care well for patients amid a rapidly changing work environment; (2) the distress of witnessing suffering shared between healthcare workers and patients; and (3) the distress of performing new forms of invisible work in the absence of institutional recognition. These findings reveal that moral distress was a strongly shared experience. Findings advance understandings of moral distress as a relational experience, collectively felt, constituted, and experienced by healthcare workers. Considering how to harness collective solidarity in effectively responding to moral distress experienced across the frontline healthcare workforce is critical. (shrink)

This paper proposes a novel relational view of autonomy designed to overcome the inadequacies of procedural and substantive views of autonomy as they relate to physician-assisted suicide (PAS) requests for individuals with diminished cognitive functioning. Traditional and other relational views of autonomy regard a patient as an “isolated monad,” ignore patients with limited personal autonomy, and overlook the contexts in which decisions like PAS are made. However, these weaknesses become the strengths of a synthesized relational view of autonomy, which (...) enhances the personal autonomy of those with limited personal autonomy so that their PAS requests can be granted. (shrink)

BackgroundPregnant people have been overlooked or excluded from clinical research, resulting in a lack of scientific knowledge on medication safety and efficacy during pregnancy. Thus far, both the opportunities to generate evidence-based knowledge beyond clinical trials and the role of pregnant people in changing their status quo have not been discussed. Some scholars have argued that for rare disease patients, for whom, just like pregnant people, a poor evidence base exists regarding treatments, solidarity has played an important role in addressing (...) the evidence gap. This paper explores whether and how the enactment of solidarity among pregnant people can be stimulated to help address the poor evidence base on medications used during pregnancy.MethodWe use the concept of solidarity formulated by Prainsack and Buyx and enrich their concept by providing an account for stimulating the enactment of solidarity. Then we apply this account to the case of pregnant people who use medication.ResultsSolidarity means enacted commitment on the part of an individual to assisting others with whom the person recognizes a similarity in a relevant respect. Although solidarity cannot be imposed, we argue that the empowerment of people is a crucial concept in understanding how solidarity can be stimulated. Empowerment in the context of pregnant people means creating awareness about their status quo, explaining how scientific research can help close the knowledge gap, and how pregnant people can themselves contribute. In particular, how pregnant people can contribute to the collection of health data to strengthen the evidence base for medications used during pregnancy.ConclusionsWe conclude that acting in solidarity can help change the status quo for pregnant people. Furthermore, we argue that the empowerment of pregnant people and other relevant stakeholders is a way to stimulate the enactment of solidarity. The process of empowerment starts by raising awareness about the lack of evidence on medications used during prengnacy and by explaining to pregnant people how they can contribute to changing the way knowledge is being generated by, for example, sharing data on the health effects of medications. (shrink)

This monograph contrasts two prominent models of education, Competence-Based Education (CBE), more recent and currently dominant in most school systems around the world, and Bildung-Oriented Education (BOE), once the basis of the school systems of Northern Europe. CBE is assessment-oriented and interprets learning as the acquisition of clearly definable and allegedly measurable competences, and is supported by supranational organisations, such as the OECD, which approach education from the perspective of human capital theory. BOE is instead teaching-oriented and characterises learning holistically (...) as aimed at the progressive articulation of a meaningful ‘big picture’ in the student’s mind. Emerged in Northern Europe under the influence of the ideals of the Enlightenment and Neo-Humanism of individual and collective autonomy and responsibility, BOE was subsequently enriched with a hermeneutical approach to teaching and socio-political objectives of emancipation and solidarity originating within Critical Theory. The book first analyses CBE and argues that, in spite of its celebrated ‘scientificity’, it is internally incoherent and unreliable, contributes to structural forms of oppression and injustice, can foster social pathologies, and fails to provide students with the kind of intellectual autonomy they need as both human beings and citizens of our complex post-industrial societies. Then, it introduces BOE and articulates and defends an updated version of it from objections raised by critical theorists, poststructuralists and postcolonial thinkers. It argues that BOE is a coherent and flexible model of education that endows students with autonomy and responsibility, can reduce structural forms of oppression and injustice, and can heal social pathologies. (shrink)

I read Rorty’s Contingency, Irony, and Solidarity as an attempt to reconcile two, seemingly conflicting, sources of authority and obligation. Some believe that persons are obligated by reason or God to promote just institutions. While others locate authority and obligation solely in the self. Rorty tells us that we need not choose between these sources of normativity, but can see each as applicable to two, non-conflicting parts of our lives. I contend that Rorty’s solution rests on a misunderstanding of the (...) upshots of contingency and of the conditions of personhood. I argue that Hegel provides a more compelling resolution of the tension between public obligation and private autonomy. (shrink)

Given the lack of knowledge about safety and efficacy of many treatments for children, pediatric clinical trials are important, but recruitment for pediatric research is difficult. Little is known about children's perspective on participating in trials. The purpose of this study was to understand the experiences and motivations of young people who took part in clinical trials. This is a qualitative interview study of 25 young people aged 10–23 who were invited to take part in clinical trials. Interviews were audio (...) or video recorded and analyzed using framework analysis. Young peoples' motivations were both personal benefit and helping others. Both incentives appeared to be more complex than expected. We introduce the terms “network of exchange” and “intergenerational solidarity” to describe these motivations. To improve recruitment, professionals should be more open about research opportunities, provide better information, and give young people feedback after the trial has ended. (shrink)

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

This paper is concerned with a recent, clever, and novel argument for the need for genuine collectives in our ontology of agents to accommodate the kinds of normative judgments we make about them. The argument appears in a new paper by David Copp, "On the Agency of Certain Collective Entities: An Argument from 'Normative Autonomy'" (Midwest Studies in Philosophy: Shared Intentions and Collective Responsibility, XXX, 2006, pp. 194-221; henceforth ‘ACE’), and is developed in Copp’s paper for this special (...) journal issue, “The Collective Moral Autonomy Thesis” (henceforth ‘CAT’). The argument goes as follows. -/- (1) We correctly assign blame (or obligations) to collectives in circumstances in which it would be a mistake to assign any (relevantly related) blame (or obligations) to their members. (2) If (1), then collectives are genuine agents over and above their members. (3) Therefore, collectives are genuine agents over and above their members. -/- Following Copp, I call (1) the Collective Moral Autonomy Thesis (CMA). Copp argues for CMA primarily by appeal to cases, but also offers two general arguments for it. In the cases that Copp describes, we are to judge that a collective act is blameworthy, though each member of the group that acts is blameless because he is merely following procedures appropriate for his participation, or because there are excusing factors, or because of overriding personal duties. -/- I argue that the case for CMA has not been made. In particular, I argue that, in each case in which we feel inclined to hold a group responsible for something but not its members, it is because -/- 1. we have accepted a false dilemma, that when no one agent is fully responsible for the action of a group of which he is a member, the only entity that could be responsible is the group as such, or 2. we have directed our attention to the wrong individual or individuals, or 3. we have become confused about the commitments of the individuals, or 4. we have mistaken ameliorating for excusing factors, or 5. we have mistaken moral blameworthiness and all-in rational blameworthiness, or 6. a combination of these things. (shrink)

This paper is an empirical study of what solidarity in a Western European healthcare system means today. Drawing upon empirical research on the 2015 refugee cohort's health needs and their health-seeking behaviour, it unites claims from the literature on solidarity in the fields of migration and healthcare. I argue that the Austrian healthcare system not only is an example of ‘civic solidarity’ in the form of institutionalised obligations to citizens but that it also enacts political forms of solidarity and produces (...) political inclusion for marginalised groups such as refugees. My findings show that being entitled to and accessing services in the healthcare system holds meaning beyond the provision of care: It enables to act autonomously, to build familiar relationships with Austrian institutions, inclusion via the personal electronic health card and to support others in the same solidaristic system. These insights can be used to raise awareness about the inclusional function of healthcare services among practitioners. They also show how solidarity-based healthcare systems can be a motor for shaping positive relationships between immigrants and the host country, and point to additional modes of solidarity in the context of forced migration next to civil society and nonstate support structures. This paper builds upon ethnographic data that were collected between 2018 and 2020 in Vienna, Austria (observational notes before, during and after medical consultations with refugees; interviews with them; interviews with healthcare practitioners and other care providers). (shrink)

We analyse solidarity as a mixture of social justice on the onehand and a set of cultural values and ascriptions on the otherhand. The latter defines the relevant sense of belonging togetherin a society. From a short analysis of the early stages of theDutch welfare state, we conclude that social responsibility wasoriginally based in religious and political associations. In theheyday of the welfare state, institutions such as sick funds,hospitals or nursing homes became financed collectively entirelyand became accessible to people of (...) all denominations. Solidaritywas transformed in a more general category, related to the statusof Dutch citizenship. Responsibility was transformed tocollective responsibility.Financial pressures on the Welfare State have resulted in adebate on choices in health care and in a number of systemreforms, so far relatively small. In the surrounding discourse,justice was linked to private responsibility. Both fromgovernment officials and from participants in the societaldebate, moralistic overtones could be heard concerning the threatof overburdening of the health care system by citizens.In this paper, we develop a concept of reflexive solidarity thatlinks elements of social justice to conceptualisations ofresponsibility that address policy makers and health careinstitutions as well as citizens, in their role of carereceivers. A short analysis of the phenomenon of personal budgetsin care services should prove that our concept of reflexivesolidarity is not empty. Linked to, but beyond the concept ofjustice, issues of social responsibility can be addressed withoutmoralistic overtones. (shrink)

Solidarity has for a long time been referred to as the core value underpinning European health and welfare systems. But there has been debate in recent years about whether solidarity, with its alleged communitarian content, can be reconciled with the emphasis on individual freedom and personal autonomy. One may wonder whether there is still a place for solidarity, and whether the concept of justice should be embraced to analyse the moral issues regarding access to health care. In this article, (...) I will answer this question by analysing the normative foundations of the concept of justice, followed by a deeper examination of the concept of solidarity in continental philosophy. More specifically, I will compare the philosophical traditions rooted in Kant to approaches rooted in Hegel. In addition, I will present the work of Avishai Margalit on the decent society to criticize a predominantly liberal approach to access to health care. The importance of solidarity lies particularly in its emphasis on relational aspects and the role of recognition in care practices, which are usually ignored in liberal approaches to justice. However, the article will argue that solidarity is not an alternative to a rights-based concept of justice, but must be considered as a necessary complement to it. (shrink)

This essay discusses and weaves together three interrelated topics: loneliness as a neglected bioethics problem, solidarity as one potential solution to loneliness, and the Israeli‐Palestinian Conflict as a neglected bioethics problem in which loneliness is stark. I first present and define various kinds of loneliness, focusing on ethical loneliness, defined as suffering injustice without a proper repair process. I next discuss current health conditions in Gaza, focusing on healthcare providers who, according to the UN, are being intentionally targeted by Israel. (...) I explain how the various kinds of loneliness are reflected among people in Gaza. I lastly relate together the notions of solidarity, responsibility and personal autonomy, arguing that bioethicists and healthcare providers have a duty to support the people in Gaza, stemming from solidarity and an extended responsibility perspective. (shrink)

The Hypothesis of Extended Cognition (HEC)—that many cognitive processes are carried out by a hybrid coalition of neural, bodily and environmental factors—entails that the intentional states that are reasons for action might best be ascribed to wider entities of which individual persons are only parts. I look at different kinds of extended cognition and agency, exploring their consequences for concerns about the moral agency and personal responsibility of such extended entities. Can extended entities be moral agents and bear responsibility (...) for actions, in addition to or in place of the individuals typically held responsible? What does it mean to be autonomous when one’s cognition is influenced and supported by a milieu of environmental factors? To answer these questions, I explore strong parallels between HEC’s critique of individualism in cognition, and feminist critiques of individualist accounts of self, agency, and autonomy. This relational and social conception of autonomous agency, as scaffolded and supported (or undermined and impaired) by a milieu of social, relational, and normative factors, has important lessons for HEC. Drawing together these two visions of distributed and decentralized aspects of personhood highlights how cognition, action, and responsibility are inextricably linked. It also encourages a reconceptualization of all cognition and all concerns about responsibility for actions, not simply as sometimes extended around individuals, but as fundamentally communal, social, and normative, with individual cognition and individual moral responsibility being derivative special cases, not the paradigm examples. Individuals are merely one of many possible loci of cognition, action, and responsibility. (shrink)

For centuries philosophers have wrestled with the dichotomy between individual freedom on the one hand and collective solidarity on the other. Yet today there is a growing realization that this template is fundamentally flawed. In this book, Mark Young embraces and advocates a more holistic concept of freedom; one which is not merely defined negatively but which positively provides the preconditions for individuals to actively exercise their autonomy and to flourish as human beings in the process. Young posits the (...) idea of 'freedom in community' and traces its origin back to Aristotle. Taking as his premise that humans are deeply social beings who live their lives intricately interwoven with each other, he examines what type of political community is relevant for us in this post-Classical, post-Enlightenment and, indeed, post-Existential world. Identifying the failure of traditional 'statist' models of politics, Young instead argues for a civil society: a globally interlinked and free set of liberal communities as the best context for nourishing human flourishing. In this way we can achieve a proper setting for Eudaimonia in a modern sense. (shrink)

Solidarity has for a long time been referred to as the core value underpinning European health and welfare systems. But there has been debate in recent years about whether solidarity, with its alleged communitarian content, can be reconciled with the emphasis on individual freedom and personal autonomy. One may wonder whether there is still a place for solidarity, and whether the concept of justice should be embraced to analyse the moral issues regarding access to health care. In this article, (...) I will answer this question by analysing the normative foundations of the concept of justice, followed by a deeper examination of the concept of solidarity in continental philosophy. More specifically, I will compare the philosophical traditions rooted in Kant (with emphasis on autonomy and individual rights) to approaches rooted in Hegel (with emphasis on individual relations of recognition). In addition, I will present the work of Avishai Margalit on the decent society to criticize a predominantly liberal approach to access to health care. The importance of solidarity lies particularly in its emphasis on relational aspects and the role of recognition in care practices, which are usually ignored in liberal approaches to justice. However, the article will argue that solidarity is not an alternative to a rights-based concept of justice, but must be considered as a necessary complement to it. (shrink)

Background Factors that could potentially act as facilitators and barriers to successful recruitment strategies in perinatal clinical trials are not well documented. The objective was to assess lay persons’ understanding of the informed consent for randomized clinical trial in emergency obstetric and newborn care. Methods This was a qualitative study conducted among survivors of severe obstetric complications who were attending the post-natal clinic of Kawempe National Referral Hospital, Uganda, 6–8 weeks after surviving severe obstetric complications during pregnancy or childbirth. The (...) study that involved 18 in-depth interviews was conducted from June 1, 2019 to July 6, 2019. The issues explored included perceptions of the purpose and necessity to conduct such research how research-related information would be disclosed, and what could be the potential benefits and risks of participation. The data was analyzed by thematic analysis. Results Respondents felt that research was necessary to investigate the cause, prevention or complications of an illness, especially as much was known about some pregnancy and newborn complications. Most believed that the emergency contexts affects whether and what prospective participants may understand if information about research was disclosed. Whereas they did not see the value of procedures like randomization, they felt that if these and any other procedures necessary should be done transparently and fairly. The decisions to participate would significantly be influenced by possibility of risk to the unborn baby or the newborn. Solidarity was an important influence on decision-making. Conclusions Respondents valued participation in RCTs in emergency obstetric and newborn care. However, they expressed concerns and valued openness, transparency and accountability with regard to how clinical trials information is disclosed and the decision-making process for clinical trial participation. While autonomy and solidarity are contradictory values, they complement each other during decision-making for informed consent. (shrink)

In this Article, I contest on both theoretical and empirical grounds the progressive agenda, as represented by Hanoch Dagan, that seeks to advance the unionization movement in the name of individual autonomy and property. Theoretically, the Article shows that the common-law account of autonomy, which stresses freedom of action from external constraints involving the use or threat of force, provides the best analytical framework, one that undermines the modern progressive case for collective bargaining by workers. The negative account of (...) autonomy applies to all persons; its correlative duties are simple. It applies regardless of the overall level or distribution of wealth. It is scalable from small to large societies. And it forces employers to respect the full range of material and psychological needs in order to recruit and retain their workers. In contrast, the modern progressive alternative imposes no clear correlative duties on employers. It has no obvious way to constrain the dominance of union forces. And its commands are sufficiently complex that they are often not understood by the workers whom they are intended to protect. Empirically, this Article shows that the institutional rigidity of union structures in dynamic markets fails; and it rejects the claim that individual workers are wedded to their current employer, given competitive forces that allow for rapid entry and exit. Given the long-term systematic advantages of the classical liberal model, it is no surprise that unions are generally in decline in major industrial societies. (shrink)

Solidarity is a significant but poorly understood feature of political life. It is typically conceived, in “associative and teleological” terms, as working together for common political aims. But this conception misses the fact that solidarity requires individuals to will collective ends despite incompletely shared interests. Careful consideration of these elements reveals four “dynamics of solidarity”: its characteristic duties, the durability of commitments made in solidarity, the deference it involves, and its effects over time on agents’ habits and capacities. In (...) this article I describe these dynamics, first contrasting solidarity-given duties with duties of beneficence, justice, and loyalty. These contrasts lay bare the distinctive durability of solidarity, which differs from both the liberal’s commitment to justice and the loyalist’s commitment to the group. I then discuss deference, a feature of solidarity that has implications for individual engagement in political life more generally. Finally, I discuss the effects of solidarity on agents’ intellectual and physical capacities. I conclude by drawing out implications of these dynamics, challenging Tommie Shelby’s influential conception and justification of black solidarity and buttressing Philip Soper’s rejection of the Principle of Autonomy. (shrink)

Much debate concerning ‘precedent autonomy’ – that is, the authority of former, competent selves to govern the welfare of later, non-competent selves – has assumed a radical discontinuity between selves, and has overlooked the ‘bridging’ role of intimate proxy decision-makers. I consider a recent proposal by Lynn et al. (1999) that presents a provocative alternative, foregrounding an imagined dialogue between the formerly competent patient and her/his trusted others. I consider what standards must be met for such dialogues to have moral (...) force, appealing to narrative and feminist ethics. I then critique the dualistic construction of selves implicit in much of the advance directive literature, noting the continuities of dependence, character, and body, as well as the social dimension of the construction of selves. (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)