Welfare,Autonomy, and the Autonomy Fallacy

In this article, I subject the claim that autonomous choice is an intrinsic welfare benefit to critical scrutiny. My argument begins by discussing perhaps the most influential argument in favor of the intrinsic value of autonomy: the argument from deference. In response, I hold that this argument displays what I call the ‘Autonomy Fallacy’: the argument from deference has no power to support the intrinsic value of autonomy in comparison to the important evaluative significance of bare self‐direction (autonomous or not) or what I call ‘self‐direction tout court’. I defend the claim that the Autonomy Fallacy really is a fallacy, and show that my examination of the argument from deference has wider reverberations. Once we clearly distinguish between autonomy and self‐direction tout court, it becomes much less plausible to say that autonomy of itself is an intrinsic welfare benefit.     

Exploitation, autonomy, and the case for organ sales

A recent argument in favor of a free market in human organs claims that such a market enhances personal autonomy. I argue here that such a market would, on the contrary, actually compromise the autonomy of those most likely to sell their organs, namely, the least well off members of society. A Marxian-inspired notion of exploitation is deployed to show how, and in what sense, this is the case.     

Playing the Odds: A New Response to Lucretius's Symmetry Argument

Abstract: Most commentators have assumed that Lucretius's symmetry argument against the fear of death is flawed. There remains, however, dispute as to what the flaw is. After establishing what I understand the target of Lucretius's argument to be (a desire for a longer life as such), I argue for a novel interpretation of what the flaw is, namely, that extending one's life into the time before one was actually born would be an uncertain bet for one who wanted to extend his life, whereas extending one's life beyond the time one actually dies is a sure bet. This account of what the flaw is has the particular merit of relying only on simple concepts used in everyday reasoning and thus can explain why Lucretius's argument gains no traction even in the absence of sophisticated philosophical analysis.     

Is Commercial Surrogacy Baby-selling?

ABSTRACT This essay considers a common objection to commercial surrogacy on the grounds that the child is treated as a commodity for sale by the surrogate and the commissioning couple. I analyse one prevalent argument for the view that commercial surrogacy is a kind of baby-selling, not service-selling. I conclude that this argument rests on an implausible interpretation of what the reproductive services are. I defend an alternative interpretation of typical surrogacy agreements. Furthermore, I argue that this interpretation fails to support the conclusion that the surrogate is primarily or exclusively selling a baby, rather than her reproductive services. My primary concern is to diagnose a conceptual error in an argument against surrogacy. However, the interpretation of surrogacy arrangements that is defended helps to shift the focus from the issue of whether or not the child is degraded to the issue of whether or not the surrogate degrades herself or is degraded by the commissioning couple.     

Autonomy,Vote Buying,and Constraining Options

A common argument used to defend markets in ‘contested commodities’ is based on the value of personal autonomy. (1) Autonomy is of great moral value; (2) removing options from a person's choice set would compromise her ability to exercise her autonomy; (3) hence, there should be a prima facie presumption against removing options from persons’ choice sets; (4) thus, the burden of proof lies with those who wish to prohibit markets in certain goods. Christopher Freiman has developed a version of this argument to defend markets in votes. I argue that Freiman's argument fails, and that its failure illustrates the falsity of the widespread claim that the more options a person has available to her the better able she will be to exercise her autonomy. In Part 1, I outline Freiman's argument from ‘the presumption of voter liberty’ for legalising markets in votes. In Part 2, I argue that the option to sell one's vote in a legal market for them would be a ‘constraining option’ – an option which, if chosen, would be likely to lead to a diminution in a person's future ability to exercise her autonomy. In Part 3, I respond to objections to my arguments.     

Autonomy,constraining options,and organ sales

Although there continues to be a chronic shortage of transplant organs the suggestion that we should try to alleviate it through allowing a current market in them continues to be morally condemned, usually on the grounds that such a market would undermine the autonomy of those who would participate in it as vendors. Against this objection Gerald Dworkin has argued that such markets would enhance the autonomy of the vendors through providing them with more options, thus enabling them to exercise a greater degree of control over their bodies. Paul Hughes and T. L. Zutlevics have recently criticized Dworkin's argument, arguing that the option to sell an organ is unusual in that it is an autonomy–undermining "constraining option" whose presence in a person's choice set is likely to undermine her autonomy rather than enhance it. I argue that although Hughes' and Zutlevics' arguments are both innovative and persuasive they are seriously flawed — and that allowing a market in human organs is more likely to enhance vendor autonomy than diminish it. Thus, given that autonomy is the preeminent value in contemporary medical ethics this provides a strong prima facie case for recognizing the moral legitimacy of such markets.     

How useful is the concept of the ‘harm threshold’ in reproductive ethics and law?

In his book Reasons and Persons, Derek Parfit suggests that people are not harmed by being conceived with a disease or disability if they could not have existed without suffering that particular condition. He nevertheless contends that entities can be harmed if the suffering they experience is sufficiently severe. By implication, there is a threshold which divides harmful from non-harmful conceptions. The assumption that such a threshold exists has come to play a part in UK policy making. I argue that Parfit’s distinction between harmful and non-harmful conceptions is untenable. Drawing on Kant’s refutation of the ontological argument for God’s existence, I suggest that the act of creation cannot be identical with the act of harming—nor indeed of benefiting—however great the offspring’s suffering may be. I suggest that Parfit is right that bringing children into existence does not usually harm them, but I argue that this must be applied to all conceptions, since Parfit cannot show how the harm threshold can be operationalised. If we think certain conceptions are unethical or should be illegal, this must be on other grounds than that the child is harmed by them. I show that a Millian approach in this context fails to exemplify the empirical and epistemological advantages which are commonly associated with it, and that harm-based legislation would need to be based on broader harm considerations than those relating to the child who is conceived.     

Truthmaking, Recombination, and Facts Ontology

The idea of truthmakers is important for doing serious metaphysics, since a truthmaker principle can give us important guidance in finding out what we would like to include into our ontology. Recently, David Lewis has argued against Armstrong’s argument that a plausible truthmaker principle requires us to accept facts. I would like to take a close look at the argument. I will argue in detail that the Humean principle of recombination on which Lewis relies is not plausible (independently of the issue of facts). Then I will show that the right truthmaker principle that vindicates facts is superior to the modified truthmaker principle that Lewis has proposed. This will lead into the topic of being and existence. It turns out that truthmaking and facts are plausible, well suited for one another, and very coherent with a plausible conception of being.     

The Human Right to Subsistence

Is there a human right to subsistence? A satisfactory answer to this question will explain what makes human rights distinctive, what is meant by subsistence, and why subsistence is an appropriate content of a human right. This article situates the human right to subsistence within the context of recent philosophical discussions of human rights. The argument for human subsistence rights provides an instructive example of how to understand what human rights are, why we must affirm them, and how they fit together as a coherent group. I begin the article by outlining the meaning, content, and justification of human rights in general. I then identify the strongest arguments for affirming a human right to subsistence and the most powerful objections to such a right. Finally, I address the worry about human rights inflation and question any minimalist understanding of human rights that would either exclude subsistence rights altogether or limit their scope in certain ways.     

A REFUTATION OF CONSEQUENTIALISM

Abstract: This article argues that consequentialism does not work as a comprehensive theory of right action. The argument is that what course of action maximizes the good makes sense only within a particular context, but that it is impossible to supply such a context while adhering to a global consistency requirement. A global consistency requirement merely specifies the demand for maximization: it insists that an individual action, in order to be morally right, must be optimific relative not only to a set of temporally and spatially local alternatives but also to all future possibilities that the action would preclude. I further argue that an appropriate context is impossible to provide because act consequentialism invokes incompatible temporal horizons, that of action and that of a maximizable good. The incompatibility between these two horizons makes it impossible for there to be any morally salient, consistent assignment of consequences to actions, and thus renders act consequentialism empty.     

Raz on the Right to Autonomy

Abstract: In The Morality of Freedom, Joseph Raz argues against a right to autonomy. This argument helps to distinguish his theory from his competitors'. For, many liberal theories ground such a right. Some even defend entirely autonomy‐based accounts of rights. This paper suggests that Raz's argument against a right to autonomy raises an important dilemma for his larger theory. Unless his account of rights is limited in some way, Raz's argument applies against almost all (purported) rights, not just a right to autonomy. But, on the traditional way of limiting accounts like his, Raz's account actually supports the conclusion that people have a right to autonomy. So, unless there is another way of limiting his account that does not have this consequence, Raz's argument against a right to autonomy does not go through.     

In focus. Has patient autonomy gone to far? Geneticists' views in 36 nations

We surveyed genetics professionals, patients, and the public about rights to information, to requested services, and to parenthood, posing difficult cases found in practice. In all, 2906 genetics professionals (63%), 499 primary care physicians (59%), 476 North American genetics patients (67%), 394 French patients (51%), 593 German patients (65%), and 988 members of the American public (99%) returned anonymous questionnaires. Results suggest a trend toward increased respect for patient autonomy since an earlier survey in 1985; in most nations more would perform prenatal diagnosis for a couple with 4 daughters who desire a son. A minority (35% in U.S., 14% elsewhere) would perform PND for a deaf couple who want a deaf child, but most (94% in U.S., 62% elsewhere) would do prenatal paternity testing in the absence of rape or incest. About half (51%) would support a woman with fragile X who wants children. The trend to respect patient autonomy was greatest in the U.S. and was least evident in China and India. In general, responses to these cases illustrate a shift away from population or eugenic concerns to a model of genetics focused on the individual.     

Prenatal Testing for Adult-Onset Conditions: the Position of the National Society of Genetic Counselors

Advances in genetic testing and the availability of such testing in pregnancy allows prospective parents to test their future child for adult-onset conditions. This ability raises several complex ethical issues. Prospective parents have reproductive rights to obtain information about their fetus. This information may or may not alter pregnancy management. These rights can be in conflict with the rights of the future individual, who will be denied the right to elect or decline testing. This paper highlights the complexity of these issues, details discussions that went into the National Society of Genetic Counselors (NSGC) Public Policy Task Force’s development of the Prenatal testing for Adult-Onset Conditions position statement adopted in November 2014, and cites relevant literature on this topic through December 2015. Issues addressed include parental rights and autonomy, rights of the future child, the right not to know, possible adverse effects on childhood and the need for genetic counseling. This paper will serve as a reference to genetic counselors and healthcare professionals when faced with this situation in clinical practice.     

Against Limited Foreknowledge

Theological fatalists contend that if God knows everything, then no human action is free, and that since God does know everything, no human action is free. One reply to such arguments that has become popular recently— a way favored by William Hasker and Peter van Inwagen—agrees that if God knows everything, no human action is free. The distinctive response of these philosophers is simply to say that therefore God does not know everything. On this view, what the fatalist arguments in fact bring out is that it was logically impossible for God to have known the truths about what we would freely do in the future. And this is no defect in God’s knowledge, for infallible foreknowledge of such truths is a logical impossibility. It has commonly been assumed that this position constitutes an explanation of where the fatalist argument goes wrong. My first goal is to argue that any such assumption has in fact been a mistake; Hasker and van Inwagen have in effect said only that something does go wrong with the argument, but they have not explained what goes wrong with it. Once we see this result, we’ll see, I think, that they need such an account—and that no such account has in fact been provided. The second goal of this paper is therefore to develop— and to criticize— what seems to be the most promising such account they might offer. As I see it, this account will in fact highlight in an intuitively compelling new way what many regard to be the view’s chief liability, namely, that the truths about the future which God is said not to know will now appear even more clearly (and problematically)‘ungrounded’.     

Aristotle on the Homonymy of Being

A number of philosophers endorse, without argument, the view that there's something it's like consciously to think that p , which is distinct from what it's like consciously to think that q . This thesis, if true, would have important consequences for philosophy of mind and cognitive science. In this paper I offer two arguments for it.
The first argument claims it would be impossible introspectively to distinguish conscious thoughts with respect to their content if there weren't something it's like to think them. This argument is defended against several objections.
The second argument uses what I call "minimal pair" experiences—sentences read without and with understanding—to induce in the reader an experience of the kind I claim exists. Further objections are considered and rebutted.     

Beneficence and procreation

Consider a duty of beneficence towards a particular individual, S, and call a reason that is grounded in that duty a “beneficence reason towards S.” Call a person who will be brought into existence by an act of procreation the “resultant person.” Is there ever a beneficence reason towards the resultant person for an agent to procreate? In this paper, I argue for such a reason by appealing to two main premises. First, we owe a pro tanto duty of beneficence to future persons; and second, some of us can benefit some of those persons by procreating. In support of the first premise I reject the presentist account of time in favor of the view that future persons are just as real as presently existing persons. I then argue that future persons are like us in all the morally relevant ways, and since we owe duties of beneficence to each other, we also owe duties of beneficence to future persons. In support of the second premise I offer an account of benefiting according to which an individual can be benefited by an action even if it makes her no better off than she would have been, had the action not been performed. This account of benefiting solves what I call the “non-identity benefit problem.” Finally, I argue that having a life worth living is a benefit, and some of us can cause some persons that benefit by causing them to exist.     

Prenatal diagnosis, personal identity, and disability

A fascinating criticism of abortion occasioned by prenatal diagnosis of potentially disabling traits is that the complex test-and-abortion sends a morally disparaging message to people living with disabilities. I have argued that available versions of this "expressivist" argument are inadequate on two grounds. The most fundamental is that, considered as a practice, abortions prompted by prenatal testing are not semantically well-behaved enough to send any particular message; they do not function as signs in a rule-governed symbol system. Further, even granting, for the sake of argument, the expressive power of testing and aborting, it would not be possible, contra the argument's proponents, to distinguish between abortions undertaken because of beliefs about the disabling conditions the fetus might face as a child and abortions undertaken for many other possible reasons -- e.g., because of the poverty the fetus would face or the increase in family size that the birth of a new child would occasion. Here, I respond to criticisms of those arguments, and propose and defend another: the expressivist argument cannot, in general, distinguish successfully between abortion and therapy as modalities for responding to disabilities.     

Privacy as a value and as a right

Conclusions Knowledge of others, then, has value; so does immunity from being known. The ability to extend one's knowledge has value; so does the ability to limit other's knowledge of oneself. I have claimed that no interest can count as a right unless it clearly outweighs opposing interests whose presence is logically entailed. I see no way to establish that my interest in not being known, simply as such, outweighs your desire to know about me. I acknowledge the intuitive attractiveness of such a position; but my earlier discussion concluded that the value of privacy is ease, and the value of knowledge is understanding - and it's not obvious that either outweighs the other. Nor is it obvious that the freedom and autonomy which result from the power to limit what others know is more significant than the freedom and autonomy which result from the power to extend one's knowledge. I believe the intuitive attractiveness of the belief that privacy values outweigh knowledge values lies in the entirely correct belief that a society without any privacy would be unpleasant. But a society without mutual knowledge would be impossible.I conclude therefore that there is no right to privacy nor to control over it. Nevertheless, each of these things is a good, and a good made possible (given the presence of other people) by social structures. A desirable society will provide both privacy and control over privacy to some extent. Nothing in my analysis helps determine what the proper extent is, nor what areas of life particularly deserve protection. Those who would argue that privacy and control over it are entailed by respect for persons should, I think, choose instead some particular areas central to being a person, to counting as a person, and then show how one is less likely to exercise one's capacities there fully without privacy or without control over it. Although Gerstein's attempt fails because he inaccurately defines intimacy as a kind of absorption and incorrectly opposes absorption with publicity, I think it is the kind of attempt which must be made. Furthermore, he has probably chosen the right area of life - if anything has a special claim to privacy it is probably the union between people who care for one another. The value of being together alone may be more significant than the value of being alone, if only because words and actions are public while thoughts are not. But I will not try to develop that argument here.In any case both privacy and control over it are social goods; on egalitarian grounds they should, ceteris paribus, be equally available to everyone. This helps explain the dehumanizing effect of institutions which provide no privacy at all- prisons and some mental institutions. It is not so much that the inmates are totally known; it is rather that those who know them are not so fully known by them; further, that the staff has a great deal of control over what they disclose of themselves, and the inmates very little. The asymmetry of knowledge in those institutions is one aspect of the asymmetry of power; the completely powerless are likely to feel dehumanized.My analysis also helps account for the wrongness of covert observation. It is not simply that the observer violates the wishes of the observed, for the question is whose wishes trump. The observer is violating the justified expectations of the observed: expectations supported by weighty social conventions. These have more moral weight than simple desires do. The peeping torn is violating a convention which structures the distribution of knowledge, a convention from which he benefits. Without it his own activities might well be impossible. He might be more easily caught; or his victim, less trusting, might choose houses without windows. More deeply, the thrill of what he is doing depends on the existence of the convention. Even morally permissible excitement - the suggestiveness of some clothing- would disappear without conventions about nudity. Presumably, too, there are elements of his own personal life for which he values his privacy. He is on grounds of justice obligated to observe the rule which makes his benefits possible.(Some claims to privacy result from personal predilections, rather than from convention. Parent describes a person who is extremely sensitive about being short, for instance, and does not want his exact height to be common knowledge. The grounds for these claims are obviously different from those I've been discussing. The grounds are the moral obligation not to cause needless pain, or, if the information was given in confidence, to keep one's promises.)Although there is no right to privacy or to control over it as such, there is a right to equality of consideration and to a just distribution of benefits and burdens. To put it another way: there is no natural human right to privacy or to control over it; but a good society will provide some of each, and justice requires that the rules of a good society be observed.

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Anger communication in deaf children

In this study, we investigated how deaf children express their anger towards peers and with what intentions. Eleven-year-old deaf children (n=21) and a hearing control group (n=36) were offered four vignettes describing anger-evoking conflict situations with peers. Children were asked how they would respond, how the responsible peer would react, and what would happen to their relationship. Deaf children employed the communicative function of anger expression differently from hearing children. Whereas hearing children used anger expression to reflect on the anguish that another child caused them, deaf children used it rather bluntly and explained less. Moreover, deaf children expected less empathic responses from the peer causing them harm. Both groups did, however, expect equally often that the relationship with the peer would stay intact. These findings are discussed in the light of deaf children's impaired emotion socialization secondary to their limited communication skills.     

The Cartesian Context of Berkeley's Attack on Abstraction

Abstract: I claim that Berkeley's main argument against abstraction comes into focus only when we see Descartes as one of its targets. Berkeley does not deploy Winkler's impossibility argument but instead argues that what is impossible is inconceivable. Since Descartes conceives of extension as a determinable, and since determinables cannot exist as such, he falls within the scope of Berkeley's argument.