James Taylor

This is the first volume in which an account of personal autonomy is developed that both captures the contours of this concept as it is used in social philosophy and bioethics, and is theoretically grounded in, and a part of, contemporary autonomy theory. James Stacey Taylor’s account is unique as it is explicitly a political one, recognizing that the attribution of autonomy to agents is dependent in part on their relationships with others and not merely upon their own mental states. The volume is distinctive in its examples, which touch on the ethics of using inducements to encourage persons to participate in medical research, the ethical issues associated with the use of antibiotics, and the ethical basis for both patient confidentiality and informed consent

Autonomy has recently become one of the central concepts in contemporary moral philosophy and has generated much debate over its nature and value. This 2005 volume brings together essays that address the theoretical foundations of the concept of autonomy, as well as essays that investigate the relationship between autonomy and moral responsibility, freedom, political philosophy, and medical ethics. Written by some of the most prominent philosophers working in these areas, this book represents research on the nature and value of autonomy that will be essential reading for a broad swathe of philosophers as well as many psychologists.

Jacob Sparks has developed a semiotic critique of markets that is based on the fact that “market exchanges express preferences.” He argues that some market transactions will reveal that the purchaser of a market good inappropriately prefers it to a similar non-market good. This avoids Brennan and Jaworski’s criticism that semiotic objections to markets fail as the meaning of market transactions are contingent social facts. I argue that Sparks’ argument is both incomplete and doomed to fail. It can only show that some preferences are morally problematic, not that the transactions that they lead to are immoral.

In a recent paper Carol Hay has argued for the conclusion that “a woman who has been sexually harassed has a moral obligation to confront her harasser.” I will argue in this paper that Hay’s arguments for her conclusion are unsound, for they rest on both a misconstrual of the nature of personal autonomy, and a misunderstanding of its relationship to moral responsibility. However, even though Hay’s own arguments do not support her conclusion that women have a duty to resist sexual harassment this conclusion can draw support from arguments that are independent of hers. Women, then, do indeed have a moral obligation to confront those who sexually harass them.

For the past three decades philosophical discussions of both personal autonomy and what it is for a person to “identify” with her desires have been dominated by the “hierarchical” analyses of these concepts developed by Gerald Dworkin and Harry Frankfurt. The longevity of these analyses is owed, in part, to the intuitive appeal of their shared claim that the concepts of autonomy and identification are to be analyzed in terms of hierarchies of desires, such that it is a necessary condition for a person to be autonomous with respect to a desire that moves her to act, that she desires that this desire so move her. Despite the intuitive appeal of these analyses, however, Irving Thalberg has argued that they should be rejected. This is because, he argues, a person who is forced to perform an action by being subjected to duress of a certain degree of harshness will desire to be moved by her desire to submit. Thus, he continues, the proponents of hierarchical analyses of autonomy and identification will be forced to hold that such a person acted willingly, and did not suffer from any impairment in her autonomy. This, Thalberg concludes, is so counterintuitive as to justify rejecting hierarchical analyses

Normativism holds that there is a close conceptual link between disease and disvalue. We challenge normativism by advancing an argument against a popular normativist theory, Jerome Wakefield’s harmful dysfunction account. Wakefield maintains that medical disorders are breakdowns in evolved mechanisms that cause significant harm to the organism. We argue that Wakefield’s account is not a promising way to distinguish between disease and health because being harmful is neither necessary nor sufficient for a dysfunction to be a disorder. Counterexamples to the harmful dysfunction account are considered, such as mild infections, perceptual deficits, and beneficial illnesses. Then we consider two ways of amending the harmful dysfunction account to address these cases and argue that the proposed amendments raise even more serious problems for this account. These problems apply generally to any normativist theory and raise doubts about the entire normative approach to the philosophy of health and disease.

The introduction of National Institute for Health and Clinical Excellence (NICE) guidance on Alzheimer's medication in November 2006 will have a significant effect on the treatment of patients, and is opposed by the Royal College of Psychiatrists and many charities dealing with the elderly. The use of the Quality-Adjusted Life Year (QALY) in the guidance formulation is much debated due to questions of ageism. This article seeks to examine the basis of these accusations and whether NICE can be justified using a utilitarian calculation in a principally egalitarian system such as the NHS

Although the standard objections to Harry Frankfurt's early hierarchical analysis of identification and its variants are well known, more recent work on identification has yet to be subjected to the same degree of scrutiny. To remedy this I develop in this paper objections to Frankfurt's most recent analysis of identification as satisfaction that he first outlined in his paper ?The Faintest Passion?. With such objections in place I show that they demonstrate that Frankfurt's analysis fails because it is based on the attitudes that the person whose identification with his desires is in question adopts towards them. I then develop a new (objective and cognitive) analysis that avoids the difficulties that Frankfurt's subjective approach is prey to. I conclude by considering and rebutting some preliminary objections to this new analysis

How can healthcare systems gain self-sufficiency in their procurement and distribution of blood and blood products efficiently while maintaining a degree of relatively equitable access for patients? This is a question that, at first look, the World Health Organization has answered in detail by advocating for self-sufficiency through non-remunerated blood donation. This essay serves two purposes. First, it illustrates key differences between the WHO’s policy recommendations and the realities of healthcare. For example, it can be readily demonstrated that the WHO has no empirical foundation for their claim that blood and blood products from unpaid donors is safer or more efficient than other, more commercial, avenues of procurement. Indeed, the WHO appears to take an ideological stand against compensation for blood products, which the empirical data does not support. Whether donation for blood and blood products should be compensated is a pressing ethical issue of practical import, especially if it can be shown that more market-oriented procedures leads to greater self-sufficiency, as well as safer and easier access to blood products than other alternatives. Such policy decisions should be based on the best available empirical data and ethical argumentation, rather than on political ideological grounds. Second, this essay serves as an Introduction to a special thematic issue of HEC Forum, which aims critically to explore ethical arguments in light of the best available empirical data so as to orient the blood industry towards more efficient and effective, and morally honest, procurement procedures

One of the most widespread objections to legalizing a market in human organs is that such legalization would stimulate the black market in human organs. Unfortunately, the proponents of this argument fail to explain how such stimulation will occur. To remedy thus, two accounts of how legalizing markets in human organs could stimulate the black market in them are developed in this paper. Yet although these accounts remedy the lacuna in the anti-market argument from the black market neither of them provide reason to believe that legalizing an organ markets would stimulate the black market in organs. Despite its prevalence, then, the argument from the black market should be rejected.

In recent years, there has been a considerable increase in the degree of philosophical attention devoted to the question of the morality of offering financial compensation in an attempt to increase the medical supply of human body parts and products, such as plasma. This paper will argue not only that donor compensation is ethically acceptable, but that plasma donors should not be prohibited from being offered compensation if they are to give their informed consent to donate. Regulatory regimes that prohibit donor compensation thus unethically prevent the typical donor from being able to give her informed consent to donate.

In recent years there has been much philosophical discussion over the question of whether the prohibitions on markets in such items as human body parts and gene sequences, and services such as human reproductive labor and sex, should be lifted. Yet despite the attention paid to this issue there are been surprisingly little discussion of the question of whether markets in certain items that are currently freely traded should be restricted or eliminated. In particular, there has been little discussion of the question of whether markets in items that could be readily used to deceive people should be restricted. I argue in this paper that one of the central moral values of the contemporary West – respect for personal autonomy – requires that such markets be restricted.

A common criticism of plurality voting is that it fails to reflect the degree of intensity with which voters prefer the candidate or policy that they vote for. To rectify this, many critics of plurality voting have argued that vote buying should be allowed. Persons with more intense preferences for a candidate could buy votes from persons with less intense preferences for the opposing candidate and then cast them for the candidate that they intensely support. This paper argues that instead of better reflecting voters’ weighted preferences, vote buying will lead to electoral outcomes that reflect them less accurately.

In ‘Three Arguments Against Prescription Requirements’, Jessica Flanigan argues that ‘prescription drug laws violate patients' rights to self-medication’ and that patients ‘have rights to self-medication for the same reasons they have rights to refuse medical treatment according to the doctrine of informed consent , claiming that the strongest of these reasons is grounded on the value of autonomy. However, close examination of the moral value of autonomy shows that rather than being the strongest justification for the DIC, respect for the value of autonomy is actually the weakest, and it is dependent upon the first two well-being-based justifications for the DIC. Recognising this has important implications for Flanigan's argument against prescription requirements

Petersen and Lippert-Rasmussen argue that persons who decide to be organ donors should receive a tax break, and then defend their view against eight possible objections. However, they misunderstand the Titmuss-style concerns that might be raised against their proposal. This does not mean that it should be rejected, but, instead, that when it is reconfigured to meet the Titmuss-style charges against it, they should support legalizing markets in human organs rather than merely offering tax breaks to encourage their donation