The globalization changes that are taking place in the modern world, on the one hand, actualize the desire to erase all sorts of borders, and on the other - the passionate desire to preserve at the same time their ethno-cultural and personal identity, which, of course, implies the elucidation of national and cultural identity. people, the peculiarities of his mentality, which is most clearly expressed in philosophical thought. Strengthening the process of political and cultural self-identification of Ukraine, the (...) awareness of our culture as an organic component of world-wide forms of cultural life, makes it urgent to address its origins, in particular, the spiritual culture of Kievan Rus, where for the first time the issues of self-determination of the people and personality in the context of attaching to Christianity were raised. (shrink)

The central argument of this paper is that compatibilist theories that understand human agent causation as self-determination are consistent with, and can accommodate, important insights from evolutionary and developmental psychology. Agent causation is nothing more than the non-mysterious self-determining capability of persons, understood as embodied, emergent ontological entities whose nature is not fixed due to their uniquely evolved and developed capabilities of language use, cultural construction, self-consciousness and self-understanding, and moral concern. Relevant arguments of Dennett (...) and Searle are adapted to fit within the author's own emergentist, developmental theorizing that treats the self-determining capability of persons as arising within relevant biophysical and sociocultural contexts without being reducible to these contexts. Persons are self-determining in ways that require explanation not only in terms of materialistic efficient causal explanations appropriate to our evolved biophysical nature, but also in terms of final purposive explanations appropriate to our emergence as culture- capable, self-reflective agents, and formal explanations consistent with our evolved and developed nature as particular bio-cultural hybrids. (shrink)

At the end of the second Christian millennium, Christians united in the church of different denominations and ceremonies. The most devoted ones are looking for ecumenical paths, "that all be one." However, every person is free in his own way to build ties with the Lord. But, as emphasized by the first Metropolitan Rusich Ilarion in the "Word of Law and Grace," every person and the whole people are responsible before God. This statement is based on the authority of biblical (...) texts. Therefore, Christians must worry not only about their own salvation, but also about the best, most natural and most useful arrangement of the Christian life of their nation. (shrink)

Although Chinese law imposes informed consent for medical treatments, the Chinese understanding of this requirement is very different from the European one, mostly due to the influence of Confucianism. Chinese doctors and relatives are primarily interested in protecting the patient, even from the truth; thus, patients are commonly uninformed of their medical conditions, often at the family’s request. The family plays an important role in health care decisions, even substituting their decisions for the patient’s. Accordingly, instead of personal informed (...) consent, what actually exists is ‘family informed consent’. From a Western perspective, these features of Chinese law and Chinese culture might seem strange, contradicting our understanding of doctor-patient relationship and even the very essence of self-determination and fundamental rights. However, we cannot forget the huge influence of cultural factors in these domains, and that ‘Western’ informed consent is grounded on the individualistic nature of Western culture. This article will underline the differences between the Western and the Chinese perspectives, clarifying how each of them must be understood in its own cultural environment. But, while still respecting Chinese particularities, this paper advocates that China adopt patient individual informed consent because this is the only solution compatible with human dignity and human rights. (shrink)

In the article, the analysis and philosophical explication of a phenomenon of values as synergetic determinants of culture and cultural-historical process, which is culturogenic development of the person and of his subjective being in socio-cultural space and historical time, is presented. The analysis is carried out on the basis of complex methodology having the synergetic approach as its main part. According to it, the semantic interpretation of a phenomenon of values and axiological understanding of culture as the system, (...) which is self-organized on the basis of values, and human history as the cultural-historical process positioning and approving human being in the world, are offered and proved. The human history is considered as a cultural artifact embodying evolutions and changes of conditions of the culturogenic attitude of the person towards reality. It is offered to consider axiology, the philosophical theory of values as the humanitarian doctrine about value development, assimilation of available reality by the person-subject. The modern importance and relevance of an axiology, which during the era of globalization of cultural-historical process becomes area of knowledge connected with definition of reference points and priorities of existence and development of the modern world, is noted. (shrink)

The article analyzes the dignity of a person in secular and Orthodox aspects. The authors argue that every phenomenon of the material and spiritual world is objectively inherent in internal contradictions, so it is not an exception and an idea of human dignity in secular and religious contexts. The research methods are comprehensive and based on the philosophical, anthropological and philosophical and cultural analysis of human dignity in secular and Orthodox dimensions. Discussion. The concepts of «secular» (universal) and «Christian» morality (...) are characterized and distinguished. The authors argue that the latter comes from a supernatural source, from a moral law, the basis of which is the belief in the immortality of the human spirit. Christian morality provides such norms of behavior of people in which the biblical moral commandments are observed.The roots of the universal morality are in a culture that has produced a humanistic outlook, within which a person is recognized as self -sufficient value, capable of asserting his dignity, transforming himself and the world without the intervention of a transcendental super -sensory nature (God). The universal morality is the principles and norms that regulate the behavior of people, the activities of their communities, associations in terms of universally recognized ideas about good and evil, honesty and disobedience, honesty and dishonesty. Finally, the article suggests that, despite the differences, and sometimes contradictions in the understanding of the essential manifestations of human dignity between secular and Christian contexts, quite obvious to both aspects is the understanding that the leading place should be occupied by the personality that manifests itself manifestation and individual aspiration, in the depths of its own consciousness and in its desire for free self -determination and creativity, as a prerequisite for the affirmation of one’s dignity. (shrink)

The values of freedom and equality are at the heart of what it means for liberal states to do justice to their citizens. Yet, when it comes to the question of whether liberal states are capable of realizing the values of freedom and equality while controlling their borders, many philosophers are skeptical that liberalism and existing immigration arrangements can in fact be reconciled. After all, liberal states often deny entrance to prospective immigrants who are fleeing extreme forms of violence. They (...) also often police their borders in ways that are discriminatory and stigmatizing, contributing to a situation where immigrants are treated as morally inferior by society at large. Such practices conflict strongly with any commitment to the values of freedom and equality. -/- Luara Ferracioli here focuses on three key questions regarding the movement of persons across international borders: What gives some residents of a liberal society a right to be considered citizens of that society such that they have a claim to make decisions with regard to its political future? And do citizens of a liberal society have a prima facie right to exclude prospective immigrants despite their commitment to the values of freedom and equality? Finally, if citizens have this prima facie right to exclude prospective immigrants, are there moral requirements regarding how they may exercise it? The book therefore tackles the most pressing philosophical questions that arise from immigration: the questions of who can exercise self-determination, and why they have such a right in the first place. (shrink)

The purpose of this article is to analyze the variability of the "Self-made-man" idea in the context of the Christian Middle Ages in its primarily historical and philosophical presentation. Research is based on the historical and philosophical analysis of the medieval philosophy presented foremost by the works of Aurelius Augustine, P. Abelard, Thomas Aquinas, and also by the modern researches of this epoch. Theoretical basis. Historical, comparative, and hermeneutic methods became fundamental for this research. Originality. The conducted analysis allowed (...) to draw a conclusion that, despite the still existing view of the Middle Ages as a kind of an ideological gap in the formation of the self-determination idea, the Christian philosophy of this period not only does not reject but also gives essentially the universal character of the ancient intention to recognize the individual’s right to self-determination and self-government, makes it not only religiously acceptable but also obligatory. Conclusions. Despite to general theocentrism, providentialism and fatalism of Christian medieval philosophy and culture in general, at its epicenter there is a man of a special type, focused on preserving spiritual autonomy and identity in the social dimensions of their existence, and at the same time, on personal responsibility for their own destiny. Such focus became a logical and somewhat unexpected result of the complex interaction of numerous factors of medieval culture, as well as the ideas and intentions inherited from Antiquity. In particular, the idea that a person who does not act freely cannot be morally responsible for what he does, as well as the intentions of the ancient sage to autonomy, autarky, and apoliticism. In the Middle Ages, this intention became essentially universal, as it became a right, even an obligation of every Christian to be free, at least from the worldly, in determining and realizing his own destiny. The gradual compromise recognition that personal salvation is possible only as a result of synergy, i.e. the co-participation of God’s grace and human freedom, legitimizes and strengthens its focus on active personal efforts and personal responsibility for one’s own salvation, in fact for one’s own destiny. All this in historical perspective was found in its radicalized and purified from all sorts of mystical and religious layers of expression in the idea of "Self-made-man". (shrink)

The main goal of this paper is to prove the thesis that the attempts to transpose the cultural differentiation into the social and economical universalism and globalism must lead to repressive psychosocial totalitarianism on a large scale. Modern human sciences and politics tend to classify the individual in respect to his adaptive efficiency in interactive relation with programmed environment and to qualify him according to given imposed criteria of social functionalism. The correctly socialized individual is expected to be an exchangeable (...) functional unit assessed according to its usefulness in performing a set of particular tasks, despite his cultural background being considered as a second-rate factor, which may affect the social acceptance and correctness of his behavior. However, no community is an exact representation of society because it is held together not by functions but by the values aswell as the forms of their actualization and implementation into the common organization and their way of life. The community is not a contract upon which society is based. The identity of the individual must not be removed from the culture of the community in which he lives and from its constitutive values. It is also rooted in the past and history of striving for self-determination and cultural as well as personal subjectivity. Without these significant cultural and historical components the individual identity is nothing but an operational, programmable algorithm of functional living unit assigned to perform short-term utilitarian tasks. This approach stands in contradiction to the Aristotelian concept of wellbeing and happiness considered as striving for the common good of spiritual values by individuals as well as by human communities. Any extensive and effective civilization neglecting the higher values of moral, symbolic and religious sense of the individual, must face totalitarianism or extinction. (shrink)

Introduction: Expressions of dignity as a clinical phenomenon in nursing homes as expressed by caregivers were investigated. A coherence could be detected between the concepts and phenomena of existence and dignity in relationships and caring culture as a context. A caring culture is interpreted by caregivers as the meaning-making of what is accepted or not in the ward culture. Background: The rationale for the connection between existence and dignity in relationships and caring culture is that suffering (...) is a part of existence, as well as compassion in relieving suffering, and ontological interdependency. Aim: To describe different expressions of dignity in relationships and existence in context of caring cultures from the perspective of the caregivers. Research design: The methodology and method are hermeneutic. The method used was to merge the theoretical preunderstanding as one horizon of understanding with empirical data. Participants and research context: Focus group interviews with caregivers in nursing homes. Ethical considerations: The principles of the Helsinki Declaration have been followed to, for example, preserve self-determination, integrity, dignity, confidentiality and privacy of the research persons. Findings: Data interpretation resulted in four themes: Encountering existential needs that promote dignity in a caring culture; To amplify dignity in relationships by the creative art of caring in a caring culture; Violation of dignity by ignorance or neglect in a non-caring culture and The ethic of words and appropriated ground values in a caring culture. Discussion: Dignity-promoting acts of caring, or dignity-depriving acts of non-caring are adequate to see from the perspective of dignity in relationships and existence and the caring culture. Conclusions: Dignity in relationships seems to touch the innermost existential life, as the existential life is dependent on confirmation from others. (shrink)

The wide diffusion of the concepts of “cultural personality” or “cultural originality” in the social thought of developing Asian and African countries is determined by a number of circumstances. These concepts, though they claim a theoretical understanding of the processes involved in the “entry of these countries into the 20th century,” all boil down to the basic fact that the source, the foundation and the decisive sphere for the processes of self-determination in developing Asian and African countries in (...) the present day world must be their traditional cultures, as opposed to the industrial civilization of the West. (shrink)

In order to be a self-governing agent, a person must govern the process by means of which she acquires the intention to act as she does. But what does governing this process require? The standard compatibilist answers to this question all assume that autonomous actions differ from nonautonomous actions insofar as they are a more perfect expression of the agent’s agency. I challenge this conception of autonomous agents as super agents. The distinguishing feature of autonomous agents is, I argue, (...) the nonagential role they play in the formation of their intentions. I offer an account of the relevant role. (shrink)

_The purpose_ of this study is the reflection on ways of philosophical legitimation for the "Self-made-man" idea in the worldview of the Renaissance and Reformation. _Theoretical basis._ Historical, comparative, and hermeneutic methods became the basis for this. The study is based on the works of Nicholas of Cusa, G. Pico della Mirandola, N. Machiavelli, M. Montaigne, E. Roterodamus, M. Luther, J. Calvin together with modern researchers of this period. _Originality._ The analysis allows us to come to the conclusion that (...) casts doubt on the still widespread belief according to which the emergence of the "Self-made-man" idea is localized by the process of forming the American cultural code and the ideological heritage of Benjamin Franklin. It is highlighted that the formation of this idea is the result of a long process that originated in the ancient world and gains a special impetus in the Renaissance and Reformation. Precisely in the cultural context of the latter, the ancient intention to recognize the individual’s right to self-determination and self-government, which in the depths of Christian theology acquires only a potentially universal character, becomes not only acceptable but also, in the context of Protestantism worldview, the only admissible, in fact, individual’s obligatory life guidelines. _Conclusions._ Humanistic and reformation thoughts quite naturally led to further ideological legitimation of the person’s idea of who is creating oneself. This legitimation was during the complex interaction of numerous factors of culture in the Late Middle Ages, as well as ideas and intentions inherited from Antiquity. Key among them was the gradual formation of a new social order, in essence, indifferent to paternalistic rudiments, together with the ethics of Protestantism corresponding to it. The latter does not only legalize but, de facto, sacralizes the individual’s reorientation from hopes for the synergy of God’s grace and own free will in personal salvation, toward the self-reliance and personal efforts, awareness of personal responsibility for the own fate as key principles of the "Self-made-man" concept. (shrink)

The fundamental changes that took place at the beginning of the 21st century in all spheres of public life actualized the personalized trend of the modern personality, namely its social and professional development, which is associated with the concept of “career”. The purpose of the article is to characterize the pool of factors that determine a career as a socio-cultural phenomenon of modern society. Based on macro- and microsociological approaches, the parameters of career transformation are determined. Economic ones consist in (...) the transition from working professions to expert-type professions that require a high level of education and specialization. Technological - in the development of information technologies, which led to changes in the technical and technological component of social production and the growth of a separate social group of intellectual workers. The transformation of interests and value orientations of a person has led to a shift in the emphasis of personal performance from external signs to individualistic factors. The patterns of new realities in the world of work, which led to the transformation of the concept of career and new trends, are characterized. The first model includes the presence of higher education, intellectual work in the specialty and a fairly low level of income. The second model is based on ideas about the American dream and the unlimited possibilities of the individual, where the main component is a high material status and own business as a symbol of success. The third model is a highly paid professional with a high level of prestigious education and a good profession. A new type of career is defined - “polyvariant”. These days, success in career strategies requires constant professional development and gaining experience. Through the individualization and pluralization of lifestyles and consumption, people are more able to choose their own path to success, including various forms of life and career development. The tendencies of the spread of self-employment and the development of professional qualities in the career strategies of a modern person are determined. Through the individualization and pluralization of lifestyles and consumption, people are more able to choose their own path to success, including various forms of life and career development. (shrink)

Criminal law operates under the assumption that persons have the capacity for free, voluntary choice. However, since the concept of free will and self-determination may be understood in a variety of ways, it must be made the subject of philosophical scrutiny if it is to provide a solid foundation for law. This paper will present two major philosophical concepts of self-determination and evaluate their utility for criminal law. The conclusion delineates the possibilities and limitations of these (...) concepts when applied in particular to the field of criminal law. (shrink)

Respect for autonomy and self-determination is a central principle in nursing ethics. Autonomy and quality of life are strongly connected, and, at the same time, autonomy is an important quality indicator on how older persons' housing functions. In this study, autonomy was conceived as self-determination. The aim of the study was to describe how older people living in sheltered housing experience self-determination and how they are valued as human beings. Eleven persons living in five (...) different housing facilities for older people in southern Sweden were interviewed. The data were analysed by manifest and latent qualitative content analysis. The overall theme expressing the latent content in the interviews emerged as disempowerment, which implied an environment that does not strengthen individual self-determination. The results showed a negative experience of how these older people thought they were valued in the sheltered housing where they lived. In sheltered housing, more attention should be paid to residents' self-determination and sense of value. (shrink)

From the beginnings of philosophical investigation, there has been widespread recognition that reason must be autonomous to think the truth and that philosophy must be the freest of all disciplines. Nonetheless, conceiving how self-determination can be in thought and reality seems to pose insurmountable challenges. The essay shows how these challenges can be met, explaining how the nature of the concept enables reason to be autonomous, how nature can give rise to animal life, providing the enabling conditions for (...) linguistic intelligence, how the psychological and cultural conditions of discourse leave it free, and how conduct can achieve self-determination in the intersubjective exercise of institutionalized rights. (shrink)

_Purpose._ The main purpose of this research is to comprehend the philosophical principles in the spread and legitimation of the Self-made-man idea in the worldview transformations of the 17th century. _Theoretical basis._ Historical and comparative methods became fundamental ones for the research. The research is based on the creative heritage of R. Descartes, T. Hobbes, J. Locke, as well as the works of modern researchers. _Originality._ The analysis shows that the Self-made-man idea, which originated in the ancient world (...) and gradually spreads in the Christian Middle Ages, gained a powerful impetus in the philosophical and moral-legal metamorphoses of the 17th century. These metamorphoses theoretically substantiated and radically accelerated the transition from mystical to rational, from theocentric to the anthropocentric worldview, and, as a result, to the recognition of the intellectual autonomy of the individuals and the freedom of their own will, the emergence of the construct of natural human rights, the requirements of religious tolerance and freedom of conscience, ultimately, to the principle of reliance on one’s own strength and the individual’s personal responsibility for one’s own destiny. Exactly these ideas in interaction with the ideas of Puritanism became the theoretical basis for the formation of B. Franklin’s views and the corresponding cultural code. _Conclusions._ The philosophy of the 17th century, having laid the principles of a new – subject-centric – metaphysics, as well as the philosophical and legal foundations of liberal ideology, provided philosophical and moral-legal legitimation to the sporadic attempts of man to break out of the triple circle of fatalism, paternalism, and conformity to a rationally founded and the ever-growing orientation of the individual towards active self-determination and self-realization, self-reliance and personal responsibility for their own destiny as key principles of the Self-made-man concept. (shrink)

In this paper the author focuses on Australian land management and in particular on the environmental management issues that could have been prompted by the High Court recognition in 1996 (in Wik Peoples v. The State of Queensland) that native title to land and pastoral leaseholdings can co‐exist. Drawing on themes of self‐determination and co‐existence, the paper looks at more specific topics such as aboriginal title to land—what has been called land rights or native title in Australia—and some (...) implications of that for land, sea and resource management. Central to this analysis are competing theories of Aboriginal land management and links between Aboriginal traditional knowledge and conservation of species. These are illustrated through the marine mammal, the dugong. The Australian debates lead to the Canadian debates and then to Scandinavia and the role of the Sami people in protection and management of the Arctic region. Issues of indigenous self determination inevitably provide an overall theme to these discussions. As a matter of global concern, the paper asks, but does not decide, whether indigenous peoples may manage fragile eco‐systems more effectively than outsiders. It maintains that what is important in this context is a broader question. This concerns how culturally inclusive land and resource management can emerge from recognition of indigenous land and human rights and how comparative developments can provide crucial cross‐jurisdictional information for future developments and opportunities in the interests of environmental conservation. (shrink)

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

This work raises the philosophical implications of the contemporary Taiwanese as a Chinese cultural people that socio-philosophically defined herself as a moral or ethical person. The political history of Taiwan has been marked by her struggle for self-determination. Self-determination based and reflected on a self-affirmation and self-identification that is internationally recognized and legitimized. This, no doubt, beyond the generalized bent by all nations towards globalization and multi-culturalism, there has been a more and more openness (...) to the western nations. As she looks towards the West, she ipso facto looks away from the Main Land China. This work is neither an investigation in political science nor a historical critique and reconstruction. It is rather a philosophical critique on the philosophical anthropology of a people that is fundamentally ethical, that is now facing and open to climes of which their philosophical anthropology is not in essence ethical. Put differently, it is an evaluation on the notion of “the Taiwanese person”. An evaluation on how “the Taiwanese person” from the standpoint of philosophical anthropology could still be claimed to be a Confucian. The question is: could the Taiwanese person today be said to be「仁者」, if Confucian philosophical anthropology asserts, 「仁者人也」? Hence, this work will attempt to respond to this question by a philosophical analysis of the notion of 「仁者」as an ethical person based on Karol Wojtyłian notion of the ethical person. To understand the notion of the “ethical” or “moral” person, the concept of “ethics” or “moral” and “person” ought to be exposed. Therefore, in this work Wojtyłian philosophy shall be employed as the epistemological foundation for the definition and explication of the concepts: ethics, moral and person. The writer considers the philosophy of Karol Wojtyłian as a plausible paradigm amongst the western philosophies in the exposition of Confucian ethics and philosophical anthropology. The conception of person as “Person-revealed-in-action” or as it is popularly known, the “Acting Person”, underpins properties of the human person that are very fundamental in the Confucian conception of the person. This “person- revealed-in-action”, is an ethical person, as 「仁者」is 「人」in the Confucian Philosophy. This is as a result of the similarity in the fundamental claims maintained both in the Confucian ethics and philosophical anthropology and in that of Karol Wojtyła. Thus, this work is executed as follows: 1. Exposition of the Problematic. 2. Exposition of Confucian Philosophical Anthropology. 3. Exposition of Karol Wojtyła Ethical Person. 4. A Wojtyłain Reconstruction of 「仁者」and the Notion of Ethical Person. 5. Critique of the Taiwanese Person as「仁者」and Conclusion. (shrink)

Self-determination does and should play an important role in our conceptions of what it is to treat persons and peoples justly. I write at a time when the Middle East is erupting with demands for more appropriate rule by and for the people . Indigenous peoples around the world have been demanding better control over their traditional lands, over the last few decades in particular. And a serious global recession has affected all local economies since 2008, raising pertinent (...) issues about the wisdom of having a global economy as interlinked as ours has become. Would we not do better to "de-link" from the global economy? Would more robust ideals of self-determination and political and economic autonomy provide better guidance than those that seem to dominate the current discussion of models of global justice? (shrink)

Education is viewed as not merely a particular domain of social life. It is more a universal process than a mere learning of sciences and arts; it is richer than an individual's socialization. The educational democratization turns out to be a prerequisite of humanization of the entire social life. The orientation at the supreme humane values as a strategic direction of democratic evolution of education is opposed to the authoritarian tendencies as an “antivalue” of pedagogical relations.Being a significant step towards (...) a genuinely humane society, democratization is unable, however, to resolve the fundamental problem of human formation: that of alienation. The opportunity to resolve it is dependent upon proper conditions for a free self-determination of a personality in culture. (shrink)

OBJECTIVES: The subject of patient self-determination in health care has gained broad interest because of the increasing number of incompetent patients. In an attempt to solve the problems related to doctors' decision making in such circumstances, advance directives have been developed. The purpose of this study was to examine relationships between public attitudes towards patient autonomy and advance directives. SUBJECTS AND MAIN OUTCOME MEASURES: A stratified random sample of 600 adults in northern Sweden was surveyed by a questionnaire (...) with a response rate of 78.2%. The subjects were asked about their wish for control of their health care, their concerns about health care, their treatment preferences in a life-threatening situation (both reversible and irreversible), and their attitudes towards the application of advance directives. RESULTS: Numerous relationships between various aspects of self-determination in health care (desire for control, fears of over-treatment, and choice of treatment level) in general and advance directives, in particular, were found. Those who wanted to have a say in their health care (about 94%) also mainly supported the use of an advance directive. CONCLUSIONS: The fact that almost 30% of the respondents were undecided concerning their personal use of advance directives points to a lack of knowledge and to the necessity of education of the public on these issues. (shrink)

The object of this research is the fragmented everyday life of social life practices. The subject of the research is personal stories realized in storytelling and considered as the result of the creative activity of the subject and a way to overcome the fragmentation of everyday life of modern culture. The authors consider the fragmentation of everyday life as a factor in the desocialization of the subject and the leveling of unified mechanisms of social interaction. Storytelling is defined (...) as a way for a person to consistently present various storylines and broadcast the principles of their personal existence, creating an effect of belonging among recipients and awakening their imagination. The research substantiates that storytelling resources allow a subject to broadcast personal values, creatively express their individuality through virtual self-presentation and respond to current public demands, thereby overcoming the fragmentation of everyday life. As the conclusions of the research, the authors state that public order and social interaction are conditioned by the influence of the narratives of each subject on the foundation of their own being and the formation of a vector of development of all participants in intersubjective relations through the dissemination of the principles of personal existence in the storytelling system. The authors emphasize the creative nature of personal stories, the creation and telling of which is a prerequisite for the formation of unified principles of social existence due to the transmitted ideas about socially acceptable rules and stable patterns of behavior that become a set of rituals. The authors conclude that personal stories allow the subject to overcome fragmented everyday life, move to a qualitatively new level of normative determination, develop a strategy of self-identity and move from a separate way of being to a holistic existence in the context of intersubjective interactions. (shrink)

Definition of the problem. During the last few years obstetricians have become concerned over an increasing rate of cesarean sections, especially an increasing rate of ”section on demand” for non-medical, but personal reasons of pregnant women. For physicians this is a question of risks and benefits for both mother and child. On the other hand, there is the duty to respect women’s autonomy. Arguments. Pregnant women are healthy and the act of giving birth to a child is a physiological (...) one. Thus, the indication has to be proved carefully for surgical intervention instead of vaginal delivery. Cesarean section for non-medical reasons may be helpful for women with an extreme fear of vaginal delivery or previous traumatic experiences. On the other hand the possibility for pregnant women to choose their preferred mode of delivery is combined with the question, whether cesarean section on demand fulfils their demand for a self-determined delivery. Conclusion. With a mode of delivery oriented to the person instead of to the method, self-determination can be realized. Cesarean Section on demand can achieve this in some individual cases. However women’s own ability, activity, and involvement in giving birth to a child may be a stronger manifestation of self-determination. (shrink)

American adults currently enjoy a widely accepted and legally well-settled right to refuse health care, including life sustaining treatment. Joel Feinberg provides a moral foundation for this right in liberal political theory. Feinberg's theory grounds the right to refuse in a broad right to self-determination, and it implements the right through a variable conception of voluntariness. This theory provides a plausible account that comports with the widely accepted right to refuse, commonsense, and ordinary practice. -/- Allen Buchanan and (...) Dan Brock contend, however, that Feinberg's priority for the right to self-determination is inconsistent with his variable scale of voluntariness. Although Feinberg presents his theory as one that grants categorical priority to self-determination over individual well-being, Buchanan and Brock argue that Feinberg's variable scale of voluntariness involves a balancing of self-determination and well-being. This balancing approach, which Buchanan and Brock endorse, seems to undermine the competent patient's right to refuse care because it allows concern for the patient's well-being to override that person's right to self-determination in some circumstances. Taken together, these arguments seem to suggest that we must give up either the competent patient's right to refuse treatment or the intuitively sensible variable scale. -/- In this paper, I argue that one can reconcile a categorical priority for self-determination with legal rules that incorporate a variable scale of competence. This integration requires careful examination of the practical and expressive functions of legal rules as well as of the manner in which these rules embody moral priorities. This analysis pursues specific and general projects. Specifically, it addresses the moral foundations of the legal right to refuse treatment, identifying a substantive difference between the balancing approach and the priority for self-determination that characterizes Feinberg's liberalism. Generally, it examines the types of priorities embodied by legal rules as practical decision guides and as expressions of the conventional morality represented by the law. This general project extends beyond the right to refuse treatment to the analysis of the manner in which legal rules express and apply moral priorities. (shrink)

Topicality is due to the fact that self-identity as the identity of the subject and the result of its self-determination now is explained with the two-sided ascent of human to freedom, when at first the subject realizes the need for self-disclosure of its own essence, the embodiment of human nature, and then it overcomes its dependence from its internal nature and the generation of identity begins as a manifestation of free will and creativity of the person (...) of culture. The purpose of the study is to clarify the essence and the meaning of the personality identity as a result of its self-determination in the educational environment. Objectives of the research: distinguishing of the lines of theoretical interpretation of the personality identity; the characteristic of identity as a form of personal being in the educational environment, which ideally integrates the inner world of a person and its external world into a single psycho-social universe on the subjective level; clarification of the fundamental aspects of the personal identity understanding, its main factors within the framework of the common structure of the educational environment; consideration of the phenomenon of identity from the point of view of the subject in the context of the problem of intersubjectivity. An analysis of recent research and publications that initiated the solution of the problem: the use of articles by the authors Bart R., Weber M., Ilenkov E., Klepko S., Kultaieva M., Oleksenko R.. Scientific novelty is contained in the identification of the high role of interaction in the educational environment on the intercultural level, which is conditioned with the general attitude towards the subject as a representative of one or another group of the educational process subjects, in the distinguishing of the content range of identity. The results of the research : the person is determined to be the center, the subject of the educational environment, whose positive changes can help to talk about the effectiveness of this environment, when it as an essential element of society becomes a self-organized and managed multifunctional open pedagogical system, within which a personality recognizes oneself as a socially developed integrity. Conclusion: identity as a result of self-determination of personality in the circumstances of the educational environment arises as a problem of finding of the meaning of life and of person oneself in the domain of sociocultural and personal values. It is the concept that gives an opportunity to analyze this environment from the point of view of the effectiveness of the growth of self-awareness and subjective activity of its participants. (shrink)

_Purpose._ The authors of this article set the main purpose of understanding the ideological potential of Kant’s philosophical heritage from the viewpoint of its influence on the spread and legitimization of the self-made man idea in the worldview transformations of the modern world. _Theoretical basis._ Historical, analytical, and hermeneutic methods became fundamental for achieving the goal. The study is based on Kant’s works, as well as on the works of modern researchers of his ideological heritage. _Originality._ The analysis shows (...) that the idea of the Self-made-man, which originated in the ancient world and gradually spread in the Western culture of the Middle Ages, early Modernism, and especially the Enlightenment, receives significant additional impulses in the context of Kant’s rethinking of the metaphysical foundations in the theory of knowledge and morality. Perhaps, the systematic theoretical substantiation of people’s abilities to use their own mind, their intellectual, and therefore moral autonomy, and freedom of will as the fundamental principles of personal Self-determination and Self-realization became the most important consequence of this rethinking. This, in turn, became the theoretical and moral-legal basis for further legitimization in the modern and postmodern world of the ideal of a person who creates oneself. _Conclusions._ The importance of Kant’s philosophy in the context of idea generation of the self-made man is hard to overestimate. It is entirely imbued with a leitmotif appeal to the individual to have the courage to use his/her own mind, to be independent and self-sufficient in assessments, choices, and actions, and therefore also responsible for their consequences, in the end, to be primarily an end, not a means. Thanks to this, a person, according to Hegel, finds an unconditionally strong and stable center in oneself. In fact, by strengthening the position of human-centric philosophy, as well as the moral and legal foundations of liberal humanism, Kant’s ideas provided further ideological legitimation in the orientation of an objectively growing individual towards actively placing Self-reliance and Personal responsibility on one’s own destiny as the key principles of the Self-made-man concept. (shrink)

The domestic legal obstacles to affirmative action to address the problem of the color line that have arisen in the United States in the past 30 years have become the occasion for discouragement and even despair in the face of the persistent racial disparities in American life. This is due, in part, to the limits of our domestic vocabulary for speaking about such initiatives. In this paper I argue that Christian ethics, with the help of the resources of the emergent (...) minority rights dialogue in international human rights, can play an important role in securing the cultural transformation needed to broaden our vocabulary and reframe our thinking so that our efforts to secure racial justice are not bound by the limits of the conventional domestic vocabulary. Specifically, I argue that the new international discussion of "the right to self-determination" can be usefully employed within Christian ethics to secure the cultural, moral and legal changes needed to secure racial justice in the United States. (shrink)

One serious harm facing communities in the Anthropocene is epistemic loss. This is increasingly recognized as a harm in international policy discourses around adaptation to climate change. Epistemic loss is typically conceived of as the loss of a corpus of knowledge, or less commonly, as the further loss of epistemic methodologies. In what follows, I argue that epistemic loss also can involve the loss of epistemic self-determination, and that this framework can help to usefully examine adaptation policies.

On 26 February 2020, the German Constitutional Court rejected a law from 2015 that prohibited any form of ‘business-like’ assisted suicide as unconstitutional. The landmark ruling of the highest federal court emphasised the high priority given to the rights of autonomy and free personal development, both of which constitute the principle of human dignity, the first principle of the German constitution. The ruling echoes particularities of post-war Germany’s end-of-life debate focusing on patient self-determination while rejecting any discussion (...) of active assistance to die through a lethal injection administered by a doctor. This brief report discusses the ruling in the light of the broader sociopolitical and historical context of the German end-of-life debate. (shrink)

A strategic reconstruction of modern German thought from the standpoint of aesthetic theory, The Narrowest Path reveals the characteristically modern, revolutionary project of freedom-as-autonomy to be unresolvably antinomic. Basing himself on four seminal texts by Kleist, Hegel, Marx, and Adorno, Mehrgan develops four basic figures: the literary, the person, the republic, and the artwork. All flourished during the long period between the French Revolution and the aftermath of the Second World War in Europe. The key antagonist is the rule of (...) capital, paradoxically enabling self-determination and thwarting it. Still present in contemporary revolutionary experiments, this daunting conflict, the book argues, shows itself best in the aesthetic - but the resolution lies elsewhere. (shrink)

The determination of death by neurological criteria (brain death) is practiced in at least 80 countries, though it is a matter of continuing controversy. At the same time, the brain is central to human life, thinking, and behavior; however, a growing “neurocentrism” or a brain‐focused image of human identity became established in most Western and in many non‐Western societies and acts as a forceful ideology. This paper seeks a broader theoretical and sociocultural basis to approaching death bioethically by analyzing (...) criticisms aimed at a neurologically focussed vision of human life, and then turning these towards the brain death criteria exposed to the criticism. The overall critique of the “neuro‐self” has scope to offer alternative perspectives to the contested issues in brain‐death criteria. Specifically, the paper examines two major shortcomings of a narrow brain view of life and culture. First, it considers the reduction of the individual to the brain: this is the crux of the neurological way of determining death, and is a way that is seemingly context‐independent and culturally neutral. Second, it considers how dimensions of society and culture for humans are detached from the brain and have little impact on clinical practice and thinking in brain‐death criteria; however, a deeper exploration reveals that they actually have direct relevance and that social and cultural factors have greater contributions to make to the current debates. (shrink)

This book is a comprehensive, empirically-grounded exploration of the relationship between bioethics, culture, and the perspective of being affected. It provides a new outlook on how complex "bioethical" issues become questions of everyday life. The authors focus on two contexts, genetic testing and end-of-life care, to locate and demonstrate emerging themes of responsibility, such as self-responsibility, responsibility for kin, and the responsibility of society. Within these themes, the duty to know versus the right not to know one's genetic (...) fate (in the context of genetic testing), or the sanctity of life versus self-determination (in the context of end of life care) are identified as culturally embedded dilemmas that are very much relevant for lay persons. Furthermore, cultural factors such as religion, history, utopian and dystopian views of biomedical technologies, outlooks on the body and on health/illness, and citizenship are examined. Health issues are increasingly becoming a question of assessing risk and responsibility: How can we better prepare ourselves for the future? We all make such assessments in a way that combines personal inclinations, professional recommendations, and cultural framings. There is still much to be learned about the interplay between these three dimensions. (shrink)

What do we express when we use the first-person pronoun 'I' in phrases such as 'I think' or 'I ought to'? Do we refer to ourselves as biologically unique, socially determined individuals? Or do we express a consciousness of ourselves as the bearers of thoughts we share, or can share, with all other human beings whatever their particular biological, social, or cultural background? Every year the Faculty of Philosophy at the University of Amsterdam invites a prominent philosopher to occupy the (...) Spinoza Chair and give two public lectures on a topic in philosophy. Beatrice Longuenesse, in these lectures, explores the contrast and complementarity between these two aspects of the use of 'I'. Her first lecture considers the first-person pronoun in relation to the exercise of our mental capacities in abstract reasoning, and in relation to our knowledge of objective facts about the world. Her second lecture explores the use of 'I' in relation to what we take to be our moral obligations. In bringing together these two fascinating lectures, this book presents contrasting aspects of the self as radically individual on the one hand, and as the bearer of universally shared capacities on the other. (shrink)

I argue that meaning or significanceper se, along with the capacity to be conscious thereof, and the values, motives and aspirations, etc. central to the constitution of our intrinsic personal identities, arise, as indeed do our extrinsic social identities, and our very self-consciousness as such, from socio-cultural structures and relations to others. However, so far from our identities and behavior therefore being determined, I argue that the capacity for critical reflection and evaluation emerge from these same structural relations, (...) the more complex and quintessentially human aspects of our behavior being explained not in terms of responses to stimuli but as choices reflecting our evaluation of meaningful or significant alternatives. Finally I provide theoretical grounds for accepting the existence of other subjects and give a holistic, as opposed to a dialectical, account of the way individuals may challenge and change the very socio-cultural ways of relating to and interacting with others so central to constituting their capacities and identities. (shrink)

This article examines two distinct ways in which anticolonial thinkers in early twentieth-century Korea reconstructed their nondemocratic tradition in an attempt to justify (rather than take for granted) the claim of self-determination. The exposure to modern education and ideas of democracy prompted these thinkers to critically engage their tradition in the struggle for self-determination. That said, they could not simply abandon the cultural foundation of their nation. Japanese colonial rule drew its legitimacy from not only an (...) assimilation ideology that the Japanese and Koreans shared the same ethnic origin but also a developmentalist conception of the colonized that they were premodern and incapable of self-rule. To reject imperial domination, Korean anticolonial thinkers needed to invent out of their country’s nondemocratic tradition (1) an unassimilable nation/people (2) capable of self-rule. Drawing upon the political writings of two early twentieth-century thinkers in colonial Korea, Yi Kwang-su (1892–1950) and Cho So-ang (1887–1958), I discover from their political thought two nuanced approaches to this project of inventing “the people” in the colonial world. I argue that while Yi succeeded in rebutting the colonial ideology of assimilation, he fell into the trap of developmentalism. I contend that Cho, on the contrary, sidestepped this trap with his revisionist reading of the Confucian past as a history of democratic transformation, thus providing an immediate alternative to imperial sovereignty. (shrink)

PHOTO ID 121339257© Designer491| Dreamstime.com ABSTRACT When physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be apparent conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters future physicians’ commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. We use an ethical dilemma that was presented to a group of third-year medical students to examine how ethics education might be causing (...) them to give undue deference to autonomy, thereby undermining their commitment to beneficence. INTRODUCTION The right of patients to choose which treatments they prefer is rooted in today’s social mores and taught as a principle of medical ethics as respect for autonomy. Yet, when physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be a conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters a commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. I. An Ethical Dilemma The impetus for this paper arose when students who were completing their third clinical year discussed a real-life ethical dilemma. A middle-aged man developed a pulmonary hemorrhage while on blood thinners for a recently placed coronary stent. The bleeding was felt to be reversible, but the patient needed immediate intubation or he would die. The cardiologist was told that the patient previously expressed to other physicians that he never wanted to be intubated. However, the cardiologist made the decision to intubate the patient anyway, and the patient eventually recovered.[1] Students were asked if they believed that the cardiologist had acted ethically. Their overwhelming response was, “No, the patient should have been allowed to die.” We looked into how students applied ethical reasoning to conclude that this outcome was ethically preferred. To explore how the third-year clinical experience might have formed the students’ judgment, we presented the same case to students who were just beginning their third year. Their responses were essentially uniform in recommending intubation. While there is likely more than one reasonable view in this case, we agree with the physician and the younger medical students that intubation was the ethically appropriate decision and will present an argument for it. But first, we explain the reasoning behind the more advanced medical students’ decision to choose patient autonomy at the expense of beneficence. II. Medical Ethics Education and the Priority of Autonomy Beauchamp and Childress’s Principles of Biomedical Ethics, first published in 1979 and now in its 8th edition, is a significant part of the formal ethics education in medical school.[2] Students learn an ethical decision-making approach based on respect for four ethical principles: autonomy, beneficence, nonmaleficence, and justice. While Beauchamp and Childress officially afford no prima facie superiority to any principle, the importance of respect for patient autonomy has increased through the editions of their book. For example, early editions of their book opposed the legalization of physician-assisted death compared to recent editions that defended it.[3] As another example, Beauchamp and Childress make paternalism harder to justify by adding an autonomy-protecting condition to the list of conditions for acceptable paternalism.[4] Authority, they contend, need not conflict with autonomy—provided the authority is autonomously chosen.[5] “The main requirement,” they write, “is to respect a particular patient’s or subject’s autonomous choices, whatever they may be.[6] In the principlism of Beauchamp and Childress, autonomy now seems to have a kind of default priority.[7] However, the bioethics discourse has strong counternarratives, noting some movement to elevate the role of beneficence and to respect the input of stakeholders, including the family and the healthcare team. Ethics education achieves particular relevance in the third clinical year when students become embedded in the care of patients and learn from what has been called the informal curriculum. They observe how attending physicians approach day-to-day ethical problems at the patient’s bedside. In this context, students observe the importance of informed consent for serious treatments or invasive procedures, a practice that highlights the principle of patient autonomy. In both the formal and informal curriculum, medical students observe how, in the words of Paul Wolpe, “patient autonomy has become the central and most powerful principle in ethical decision-making in American medicine.”[8] In short, students appear to learn a deference for patient autonomy. This curricular shift in favor of autonomy coincides with legal developments that protect patients’ rights and decision-making with respect to their healthcare choices. The priority of autonomy in medicine benefits patients by reflecting their choices and, in some cases, their fundamental liberty. III. The Practice of Medicine and the Commitment to Beneficence There are many critiques of the dominant place that autonomy has in biomedical ethics,[9] especially considering that autonomy seems to be biased toward individualistic, Western, and somewhat American culture-driven values.[10] In addition, many bioethical dilemmas are cast as a conflict between autonomy and beneficence. Our point is that medical students bring to their study of medicine a commitment to beneficence that seems to be suppressed by practical ethics education. We think this commitment is rationally defensible and should be nurtured. It is striking that young medical students have a pre-reflective commitment to beneficence at all. For, as we mentioned, it is not just medicine but Western culture generally that prioritizes autonomy in settling ethical dilemmas. In wanting to act for the good of others (rather than simply agreeing to what others want), physicians are already swimming somewhat against the cultural tide.[11] However, doing so makes sense, given the nature of medicine and the profession of healing. When prospective medical students are asked why they wish to become physicians, the usual answer is some variation on caring for the sick and preventing disease. It is unlikely that a reason to become a physician is to respect a patient’s autonomy. It would be easy to dismiss medical students’ commitment to beneficence as a mere intuition and contrary to a more reasoned and deliberative approach. Beauchamp and Childress seem to minimize the value of physician intuition, stating that justifications for certain procedures are “…supported by good reasons. They need not rest merely in intuition or feeling.”[12] Henry Richardson writes that “situational or perceptive intuition…leaves the reasons for decision unarticulated.”[13] We think this is a crude and rather thin way of understanding intuition. Some bioethicists have defended intuition as essential to the practice of medicine and not something opposed to reason.[14] In the case we describe, we believe the ethical justifications s for the patient’s intubation are fundamentally sound: the patient did not have a “do not intubate” order written in the chart, the emergency intubation had not been foreseen, so the patient did not have the opportunity to consent to or reject intubation; the patient had consented to the treatment for his cardiac disease so his consent for intubation could have been assumed;[15] and the consequences of respecting his autonomy did not justify allowing him to die.[16] While it is possible to have more than one reasonable view on this case, we think the case for beneficence is strong and certainly should not be dismissed out of hand. We do not deny that if a patient makes a clearly documented, well-informed decision to forgo intubation that this decision ought to be respected by the physician (even if the physician disagrees with the patient’s decision). But, in this situation, as in many others in the practice of medicine, the patient’s real wishes and preferences are not well-articulated in advance. There are many cases where a physician acts based on what she believes the patient, or the surrogate, would want, sometimes in situations that do not allow much time for reflection. An example might be resuscitation of a newborn at the borderline of viability. In their ethics education, beneficence would mean acting first to save a life. If the patient or surrogate makes an informed decision to the contrary, a beneficent physician respects that autonomous decision. In the case presented, the patient expressed gratitude to the cardiologist when extubated. But what if he had expressed anger at the physician for violating his autonomy? There are those who could argue that not only was intubation ethically wrong but that the cardiologist put himself in legal jeopardy by his actions (especially if there had been a written refusal applicable to the specific situation). In the example we use, we point out that the cardiologist may not have escaped a lawsuit if the patient had died without intubation. His family, when hearing the circumstances, may have sued for failure to act and dereliction of the cardiologist’s duty to save him. Beyond a potential legal challenge for either action or inaction, there is an overriding ethical question the cardiologist had to address: what course would be most satisfying to his conscience? Would he rather allow a patient to die for fear of recrimination, or act to save his life, regardless of the personal consequences? In the absence of real knowledge about the patient’s considered wishes, it is most reasonable to err on the side of promoting patient well-being. A physician’s commitment to beneficence is not necessarily a way of undermining a patient’s autonomy. In acting for the patient's good, physicians are also acting on what it is reasonable to believe a patient (or most patients, perhaps) would want, which is obviously connected to what a patient does want. Pellegrino and Thomasma argue that beneficence includes respect for a patient’s autonomy since “the best interests of the patient are intimately linked with their preferences.”[17] Instead of conceptualizing ethical dilemmas in medicine as conflicts between autonomy and beneficence, it is possible that medical schools could teach students that truly practicing beneficence is a way of valuing patient autonomy, especially when the patient’s wishes are not specific to the situation and are not clearly expressed. CONCLUSION It is important for students and practicing physicians to understand the principle of respect for patient autonomy in a pluralistic society that demands personal self-determination. However, the role of the physician as a beneficent healer should not be diminished by this respect for autonomy. Respecting a patient’s autonomy is grounded in and manifested by physician beneficence.[18] That is, seeking what is good for the patient can only be good if it respects their personhood and dignity. We propose that a commitment to beneficence, incipient in young medical students, should be developed over time with their other clinical reasoning skills. Such a commitment need not be sacrificed on the altar of patient autonomy. Beneficence needs greater relative moral weight with students as they proceed in their ethics education. - [1] S. Jauhar, “When Doctors Need to Lie,” New York Times, February 22, 2014, https://www.nytimes.com/2014/02/23/opinion/sunday/when-doctors-need-to-lie.html. [2] T. L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019). [3] Louise A. Mitchell, “Major Changes in Principles of Biomedical Ethics,” The National Catholic Bioethics Quarterly 14, no. 3 (2014): 459–75, https://doi.org/10.5840/ncbq20141438. [4] Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019), 238. [5] Beauchamp and Childress, 103. [6] Beauchamp and Childress, p. 108. [7] For other accounts that prioritize autonomy, see e.g. Allen E. Buchanan and Dan W. Brock, Deciding for Others: The Ethics of Surrogate Decision Making (Cambridge University Press, 1989), 38–39; R Gillon, “Ethics Needs Principles—Four Can Encompass the Rest—and Respect for Autonomy Should Be ‘First among Equals,’” Journal of Medical Ethics 29, no. 5 (October 2003): 307–12, https://doi.org/10.1136/jme.29.5.307. For examples of critiques of these accounts, see footnote 9. [8] P. R. Wolpe, “The Triumph of Autonomy in American Bioethics: A Sociological View,” in Bioethics and Society: Constructing the Ethical Enterprise, p. 43. [9] V. A. Entwistle et al., “Supporting Patient Autonomy: The Importance of Clinician-Patient Relationships,” Journal of General Internal Medicine 25, no. 7 (July 2010): 741–45; C. Foster, Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law, 1st ed. (Oxford ; Hart Publishing, 2009); O. O’Neill, Autonomy and Trust in Bioethics, The Gifford Lectures, University of Edinburgh 2001 (Cambridge, UK: Cambridge University Press, 2002). [10] P. Marshall and B. Koenig, “Accounting for Culture in a Globalized Bioethics,” The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics 32, no. 2 (2004): 252–66; R. Fan, “Self-Determination vs. Family-Determination: Two Incommensurable Principles of Autonomy,” Bioethics 11, no. 3–4 (1997): 309–22. [11] Arguments stressing the importance of beneficence, as ours does here, certainly approach paternalistic arguments. We set aside the complex issue of paternalism for purposes of this paper and simply note that the principle of beneficence as such does not say anything specifically about acting against the patient’s will. In the case study that focuses this paper, we do not believe the patient’s will or wishes were clearly indicated. [12] Beauchamp and Childress, Principles of Biomedical Ethics, p. 20, see note 2 above. [13] H. S. Richardson, “Specifying, Balancing, and Interpreting Bioethical Principles,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 25, no. 3 (January 1, 2000): 285–307, p. 287. [14] H. D. Braude, Intuition in Medicine a Philosophical Defense of Clinical Reasoning (Chicago ; University of Chicago Press, 2012). [15] R. Kukla, “Conscientious Autonomy: Displacing Decisions in Health Care,” The Hastings Center Report 35, no. 2 (2005): 34–44. [16] M. Schermer, The Different Faces of Autonomy: Patient Autonomy in Ethical Theory and Hospital Practice, vol. 13, Library of Ethics and Applied Philosophy (Dordrecht: Springer Netherlands, 2002). [17] E. D. Pellegrino and D. C. Thomasma, For the Patient’s Good - the Restoration of Beneficence in Health Care (New York, NY: Oxford University Press, 1988), p. 29. [18] Pellegrino and Thomasma, For the Patient’s Good. 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The paradigm of the interaction of "own" and "foreign", Russia and Europe defined Russian culture during the 18th-20th centuries. The utopian idea of creating a "new kind" of people, which appeared in the circle of Catherine II under the influence of European Enlightenment ideas, accurately characterizes this paradigm. The Enlightenment was a radical rejection of the traditional feudal worldview, a rejection of the old foundations of life. The author emphasizes that Catherine II and her entourage were not determined to (...) radically change the existing social order in the spirit of enlightenment, choosing a more conservative path of "enlightenment absolutism". In addition, the project of creating a "new person" through education in isolated institutions points to the paradoxical nature of this idea and its implementation in the history of Russia. (shrink)

In this ground-breaking article submitted for publication in mid-1986, Lucinda Vandervort creates a radically new and comprehensive theory of sexual consent as the unequivocal affirmative communication of voluntary agreement. She argues that consent is a social act of communication with normative effects. To consent is to waive a personal legal right to bodily integrity and relieve another person of a correlative legal duty. If the criminal law is to protect the individual’s right of sexual self-determination and physical (...) autonomy, rather than simply to regulate the type and degree of force that may be used to obtain compliance from a victim, the point of reference must be the individual complainant, as a person who makes choices, not social norms or objective tests based on the ordinary person. To determine whether consent is voluntary, attention must be directed to the presence or absence of factors that had a coercive impact on the individual complainant, a specific person with a collection of social, cultural, and psychological experiences, needs, fears, values, and priorities. Individuals have the right to exercise self-determination in accordance with their own values and perceptions, not those of a mythical victim. Accordingly, Vandervort argues that the prosecution may show either refusal, the absence of affirmative voluntary agreement (including passivity or the absence of consent due to unconsciousness), or circumstances that invalidate any apparent consent. Any of these prove the absence of consent for the purposes of establishing the actus reus of sexual assault. -/- The definition of consent as the affirmative communication of voluntary agreement is also shown to have a variety of implications for the interpretation and application of the law of sexual assault and the handling of evidentiary issues at trial in sexual assault cases. Key among these is the pivotal significance of the legal definition of consent as a tool to bar availability of the defence of “mistaken belief in consent.” Vandervort argues that in many cases the defence of “mistaken belief in consent” is based on ignorance of the law of consent, mistake about the legal definition of consent, or a failure to appreciate the legal significance of facts that are well-known, and not on a mistaken belief in an erroneous set of facts. The broad proposition asserted here is that a statutory criminal law is enforceable only if all defences based directly or indirectly on belief in the validity of extra-legal norms that authorize infringement of rights protected by the criminal law are barred. This proposition and the characterization of some mistakes about consent as legal, not factual, are also shown to be useful to exclude rape-myths and stereotypical assumptions---the stuff of which “social” definitions of consent have long been constructed---from the decision-making process at trial. -/- . (shrink)

This article explores the synthesis between the theories and practice of Humanistic Management and Self-Determination Theory of Motivation (SDT). Moving from Economistic to Humanistic Management involves considering human action as uniting internal and external dimensions, having ethics as a guide for a good life, viewing society as a community of people, and being open to beauty and transcendence. The recently elucidated 50-year legacy of SDT describes it as a truly human science of motivation that takes into consideration our (...) attributes as persons, including our capacities for awareness and self-regulation. It also focuses on one’s capacity for autonomy as it applies to individual functioning, interpersonal relationships, and societal interactions. SDT posits a continuum of motivational regulation ranging from amotivation through controlled to autonomous motivation. The current empirical study of Millennials' motivation to support local and global hunger charities based on social media communication employs the complete SDT continuum. Digitalization and globalization have fundamentally changed the nature of human communication. Millennials are central to the humanistic functioning of today’s society. The study findings of the dominance of integrated personal value autonomy demonstrates the necessity of assessing the complete set of SDT motivations in various contexts and situations. Given that SDT and Humanistic Management investigations have mainly involved corporations, one must also be open to investigating the humanistic management of non-profit social and governmental organizations. The non-greenwashed triple sustainability values of corporate, social and environmental good are pertinent targets for Humanistic Management research and Practices. (shrink)

In this paper, I consider the objection that unilateral secession by a national group (e.g., the Scots) from a legitimate, nonusurping state would wrong minority nationalities within the seceding territory. I show first that most proponents of this objection assume that the ground of the right to national self-determination is the protection of the group’s culture. I show that there are alternative justifications available. I then set out a version of this objection that does not rely on (...) this claim; on this objection, a national minority that seceded and created its own state would commit an expressive wrong against minorities within the territory over which it claimed jurisdiction. I show that this objection is undermotivated: only under a specific set of circumstances would the minorities of the secessionist region be subject to an expressive wrong. Finally, I show that the correct way to think about the claims of minorities in secessionist regions is in terms of a claim to secure access to equal civic status such that they are not at risk of becoming justifiably alienated from their new state. If a secessionist group cannot provide this guarantee to the minority residents of their territory, then their seceding would commit wrongful harm, and the presumption in favour of collective autonomy is defeated. I call this defeater the ‘Alienation Defeater.’With this in hand, we are now in a position to explain why nations are normatively special. Responding to the objections broached by Allen Buchanan and others, I show that even if other kinds of groups, such as religious groups, have the features in virtue of which nations have a claim to self-determination, this does not entail that those groups also have the right to secede. This is because an account of self-determination needs a list of ‘defeaters’—features in virtue of which a group’s claim to self-determination is defeated. I argue that religious groups are the strongest candidate for having a claim to collective autonomy in virtue of sharing many features with nations. I then argue that religious groups will run afoul of the Alienation Defeater; religious identity is too narrow to be the basis of the dominant collective identity of a state. This does not apply to nationality. This, I explain, is because of qualitative differences between religious groups, qua religious groups, and nations. (shrink)

THE PAPER DEFINES AND DEFENDS A PRINCIPLE OF COLLECTIVE SELF-DETERMINATION AS ONE OF THE PRINCIPLES OF THE ORDERING OF A JUST SOCIETY. THAT PRINCIPLE SPECIFIES THAT INDIVIDUALS PARTICIPATE EQUALLY IN THE MAKING OF DECISIONS WHICH WILL GOVERN THEIR ACTIONS WITHIN INSTITUTIONS OF SPECIAL COOPERATION. THE PAPER ADOPTS THE STRATEGY OF ARGUING TO PRINCIPLES OF JUSTICE BY ASKING WHAT PRINCIPLES WOULD BE CHOSEN IN RAWLS' ORIGINAL POSITION. IT ARGUES THAT, CONTRARY TO THE THRUST IMPLICIT IN RAWLS AND OTHER LIBERAL (...) THINKERS, PERSONS IN THE ORIGINAL POSITION WOULD HAVE NO BASIS FOR DISTINGUISHING BETWEEN POLITICAL AND NON-POLITICAL INSTITUTIONS OF SOCIAL COOPERATION, AND THUS WOULD CHOOSE THE PRINCIPLE OF SELF-DETERMINATION DIRECTLY AS APPLYING TO ALL INSTITUTIONS AND ACTIVITIES OF SOCIAL COOPERATION. (shrink)

In this dissertation I argue that Hegel‘s analysis of freedom based on the concept of self-determination provides us with an opportunity to radically rethink personal freedom and restore it to its necessary domain: the political. I reconstruct Hegel‘s exposition of the dynamic of self-determination in the Logic by focusing on a central premise: that the exposure and overcoming of the conceptual indifference [Gleichgültigkeit] between categories – between, for example, something and other, identity and difference, or (...) universality and particularity – is the driving force of the argument leading to the Concept, i.e., the concept of self-determination. I show that Hegel‘s critiques of abstract universal free will as well as of particular arbitrary freedom use the same strategy, that of exposing the claims of indifference that sustain the legitimacy of these conceptions of freedom. I argue that the critique of indifference, explicit in the analysis and exposition of self-determination in the Logic and implicit in Hegel‘s discussion of the free will in the Philosophy of Right, offers a new perspective for thinking personal freedom. (shrink)

This article attacks the view that global justice should be understood in terms of a global principle of equality. The principle mainly discussed is global equality of opportunity – the idea that people of similar talent and motivation should have equivalent opportunity sets no matter to which society they belong. I argue first that in a culturally plural world we have no neutral way of measuring opportunity sets. I then suggest that the most commonly offered defences of global egalitarianism – (...) the cosmopolitan claim that human lives have equal value, the argument that a persons nationality is a morally arbitrary characteristic, and the more empirical claim that relationships among fellow-nationals are no longer special in a way that matters for justice – are all defective. If we fall back on the idea of equality as a default principle, then we have to recognize that pursuing global equality of opportunity systematically would leave no space for national self-determination. Finally, I ask whether global inequality might be objectionable for reasons independent of justice, and argue that the main reason for concern is the inequalities of power that are likely to emerge in a radically unequal world. (shrink)

The 1970s and 1980s meant an ethnic politicization of the indigenous movement in Ecuador, until this moment defined largely as a class-based movement of indigenous peasants. The indigenous organizations started to conceptualize indigenous peoples as nationalities with their own economic, social, cultural and legal structures and therefore with the right to autonomy and self-determination. Based on this conceptualization, the movement developed demands for a pluralist reform of state and society in order to install a plurinational state with wide (...) degrees of autonomy and participation for indigenous nationalities. A part of those demands was the double strategy to fight for legal pluralism while already installing it at the local level. Even if some degrees of legal pluralism have been recognized in Ecuador since the mid-1990s, in practice, the local de facto practice prevails until today. Another central part of the demand for plurinationality is the representation of indigenous peoples in the legislative organs of the state, developing since their first appearance in the 1940s in a complex way. This article will analyze the development of right-based demands within the discourse of the indigenous movement in Ecuador, the visions of the implied state-reform and the organizational and political background and implication they have. Based on an analysis of the central texts of the indigenous organizations, conceptualizations of rights and laws and their appropriation within an autonomist discourse and a local practice will be highlighted. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.1 (2003) 17-21 [Access article in PDF] Self-Injury:Symbolic Sacrifice/Self-Assertion Renders Clinicians Helpless Christa Krüger Keywords feminism, iconic communication, moral conflict, oppression, psychiatrist/psychologist roles, societal norms. POTTER'S PAPER CONSIDERS self-injury in women diagnosed with borderline person ality disorder (BPD) to be a form of body modification where the body is used to communicate meaning. She touches on symbolism as a possible explanatory theory (...) for this sort of self-injury. She also refers to the culture of body commodification as underlying self-injury. She then argues that clinicians have a duty to give uptake to the patient's own interpretations about the meaning of the self-injury. Giving uptake is a virtuous approach for ethical interactions with people diagnosed with BPD who self-injure, and it aims to preserve the communicator's integrity, along with other benefits. Potter offers five maxims for giving uptake properly. However, I shall argue that giving uptake can be very difficult for clinicians, and that an appreciation of this difficulty depends on an expansion and linkage of some of the theories that she touched on. Self-injury is revisited experimentally as a double-edged sword of symbolic sacrifice and iconic-symbolic self-assertion. This revisiting aims to illustrate how clinicians might be caught in a double bind, where giving uptake properly might be very difficult if not more or less doomed to fail.Potter's paper starts by situating self-injury in a broader discourse of body modifications. In this discourse the body is being used as a text, a tool to communicate meaning. The meaning that is communicated might be difficult or impossible to articulate otherwise (by using words, for example). The meaning of the communication is embedded in a context of social, cultural, religious, political, and other norms. Potter explores possible interpretations of the meaning of self-injury in women with BPD, including an interpretation of self-injury as symbolic sacrifice. She suggests that a cultural understanding/nonunderstanding of the meaning of a particular instance of self-injury is an important determinant of whether such self-injury is considered pathological/nonpathological. She then shifts the focus to the present-day culture in which women's bodies are commodified and objectified, and where women become alienated from their bodies. Self-injury might then be interpreted as an attempt to re-own one's body as a part of oneself. This re-owning is a socially transgressive act that violates repressive norms for the bodies of women. [End Page 17]Notwithstanding these possible significations of self-injury, Potter then argues that clinicians have a duty to give uptake to the patient's own interpretations, instead of jumping to conclusions (my oversimplification) about the meaning of the self-injury. Giving uptake, then, constitutes a framework for ethical interactions with people diagnosed with BPD who self-injure, and it aims to preserve the communicator's integrity. Potter offers five maxims for giving uptake properly.At the risk of losing their essence, I translate the five maxims for practicing psychiatrists as involving the following: critical self-reflection about one's own conceptual framework and cultural context; being receptive to the patient's conceptual framework and cultural context; giving the patient the benefit of the doubt; being open to the emergence of new meanings of self-injury; and keeping a range of possible interpretative options open, rather than insisting on having the final word. We should try to understand what the world looks like from the patient's position. All of this requires some moral effort.Potter describes a number of benefits that result from giving uptake. Giving uptake is a crucial corrective to the human tendencies of becoming overly committed to prevailing societal norms and conceptual schemes (stuck in our ways), of imposing our views on others, and of silencing or distorting the communications of our patients. Giving uptake allows clinicians to be dialogically responsive and to treat patients with respect and dignity. Giving uptake fosters trust in a therapeutic relationship where clinicians do not exploit their patients' vulnerabilities. Giving... (shrink)