Could Friends of Relational Autonomy be Relational Sufficientarians Rather than Relational Egalitarians?

2021 ◽  
pp. 57-79
Author(s):  
Kasper Lippert-Rasmussen
Keyword(s):  
2021 ◽  
Vol 58 (4) ◽  
pp. 142-157
Author(s):  
Andrea Lavazza ◽  
Mirko Farina ◽  

The current Covid-19 pandemic is illustrative of both the need of more experts and of the difficulties that can arise in the face of their decisions. This happens, we argue, because experts usually interact with society through a strongly naturalistic framework, which often places experts’ epistemic authority (understood as neutrality and objectivity) at the centre, sometimes at the expenses of other pluralistic values (such as axiological ones) that people (often non-experts) cherish. In this paper, we argue that we need to supplement such a strong naturalistic framework used to promote epistemic authority with a number of virtues -both intellectual and ethical- which include i. intellectual humility, ii. courage, iii. wisdom and cares, as well as iv. relational autonomy. To illustrate this claim, we discuss these ideas in the context of the Covid-19 pandemic and analyse a set of real-life examples where important decisions have been delegated to experts merely based on their epistemic authority. We use the illustrative failures described in the case studies above-mentioned to call for a revision of current understandings of expertise (merely based on epistemic soundness). Specifically, we argue that in social contexts we increasingly need “experts in action”; that is, people with certified specialist knowledge, who can however translate it into practical suggestions, decisions, and/or public policies that are ethically more balanced and that ultimately lead to fairer, more inclusive, and more representative decisions.


2012 ◽  
Vol 23 (4) ◽  
pp. 19-31
Author(s):  
Rada Drezgic

The article explores two questions: what is feminist bioethics, and how different it is from standard bioethics. Development of feminist bioethics, it is argued, began as a response to standard bioethics, challenging its background values, and philosophical perspectives. The most important contribution of feminist bioethics has been its re-examination of the basic conceptual underpinnings of mainstream bioethics, including the concepts of ?universality?, ?autonomy?, and ?trust?. Particularly important for feminists has been the concept of autonomy. They challenge the old liberal notion of autonomy that treats individuals as separate social units and argue that autonomy is established through relations. Relational autonomy assumes that identities and values are developed through relationships with others and that the choices one makes are shaped by specific social and historical contexts. Neither relational autonomy, nor feminist bioethics, however, represents a single, unified perspective. There are, actually, as many feminist bioethics as there are feminisms-liberal, cultural, radical, postmodern etc. Their different ontological, epistemological and political underpinnings shape their respective approaches to bioethical issues at hand. Still what they all have in common is interest in social justice-feminists explore mainstream bioethics and reproductive technologies in order to establish whether they support or impede gender and overall social justice and equality. Feminist bioethics thus brings a significant improvement to standard bioethics.


2021 ◽  
pp. 1-20
Author(s):  
Mervi Issakainen ◽  
Anna Mäki-Petäjä-Leinonen ◽  
Sirkkaliisa Heimonen ◽  
Ann-Charlotte Nedlund ◽  
Arlene Astell ◽  
...  

Abstract Having opportunities to make decisions and choices regarding one's life is crucial when living with dementia. This inter-disciplinary study draws on the concept of relational autonomy to explore how working-age people living dementia seek to influence their lives, and what makes it easier or more difficult for them in their everyday life. The data consist of three focus group discussions conducted with 12 retired adults who developed dementia while still employed. The results illuminate various resources that enable a person to (a) handle their difficulties at work and related consequences with dignity, (b) manage everyday tasks and live a fulfilling life, and (c) fight the stigma associated with (working-age) dementia. Challenges related to these aspects reported by the participants reveal gaps and obstacles that impede the full realisation of the rights of people living with early onset dementia. This research highlights the need for workplace education for different stakeholders, equal and ongoing access to guidance and counselling for younger people who live with dementia, and an effort by society as a whole to eradicate stigma.


2015 ◽  
Vol 32 (2) ◽  
pp. 91 ◽  
Author(s):  
Eniola Salami ◽  
Bonnie Lashewicz

In Canadian law, the concept of autonomy is individualistic in nature, manifest as the capacity, or legal ability of an individual to actively understand the purpose and consequences of their actions according to whether they have faculties to comprehend and weigh risks and benefits.  Feminist scholars critique such conceptualizations of autonomy and, instead, argue the importance of “relational autonomy” which is predicated on the view that actions result from one’s own volition in combination with the influence of one’s social and relational connections. In this paper, we examine the dynamics and implications of relational autonomy in decision-making by adults with developmental disabilities by studying adults with developmental disabilities in interaction with their caregiving family members.  Our purpose is to contribute understandings of how and in what ways family caregiving relational contexts both support and hinder decision-making by adults with developmental disabilities.  We begin with an overview of conceptualizations and applications of autonomy, then illustrate relational autonomy dynamics through comparative analysis of data from two women with developmental disabilities who were interviewed together with their family caregivers about successes and struggles in giving and receiving care and making decisions. These two women, and their family caregivers (N=9) are selected from a larger sample of adults with developmental disabilities and their family caregivers (N = 26) because the contrasts, as well as the similarities, between their family care situations are striking, and taken together, illustrate a range of ways in which decision-making is supported and hindered.  We conclude by upholding the importance of relational autonomy for legal understandings of decision-making, yet we caution that critical examination of relationship dynamics is vital. En droit canadien, le concept de l’autonomie est un concept individualiste de par sa nature et est perçu comme l’aptitude, physique ou juridique, d’une personne à comprendre activement l’objet et les conséquences de ses actes en fonction de la question de savoir si elle possède les facultés voulues pour apprécier et soupeser les risques et les avantages en jeu. Des universitaires féministes critiquent ces conceptualisations de l’autonomie et mettent plutôt l’accent sur l’importance de l’« autonomie relationnelle », qui repose sur l’interaction entre la volonté de la personne et l’influence de ses contacts sociaux et relationnels. Dans le présent document, nous nous penchons sur la dynamique et sur les incidences de l’autonomie relationnelle dans les décisions que prennent les adultes handicapés en étudiant l’interaction d’adultes handicapés avec leurs aidants familiaux. Notre but est de favoriser une meilleure compréhension de la mesure dans laquelle les contextes relationnels dans lesquels se trouvent les aidants familiaux peuvent à la fois appuyer et entraver le processus de prise de décisions chez les adultes handicapés. Après avoir présenté un bref aperçu des conceptualisations et des applications de l’autonomie, nous illustrons la dynamique de l’autonomie relationnelle au moyen d’une analyse comparative de données provenant de deux femmes handicapées qui ont été interrogées ainsi que leurs aidants familiaux au sujet des défis et des réussites liés à la prestation et à la réception de soins et à la prise de décisions. Ces deux femmes et leurs aidants familiaux (N=9) ont été choisis à partir d’un plus grand échantillon d’adultes handicapés et de leurs aidants familiaux (N=26), parce que les contrastes, tout comme les similitudes, entre leurs situations sont frappants et que, examinées ensemble, ces données illustrent différentes façons dont la prise de décisions est appuyée et entravée. Nous concluons en insistant sur l’importance de l’autonomie relationnelle pour la compréhension des aspects juridiques de la prise de décisions, tout en soulignant qu’un examen critique de la dynamique des relations est vital.


Geriatrics ◽  
2018 ◽  
Vol 3 (3) ◽  
pp. 43 ◽  
Author(s):  
Cheng-Pei Lin ◽  
Shao-Yi Cheng ◽  
Ping-Jen Chen

With dramatically increasing proportions of older people, global ageing has remarkably influenced healthcare services and policy making worldwide. Older people represent the majority of patients with cancer, leading to the increasing demand of healthcare due to more comorbidities and inherent frailty. The preference of older people with cancer are often ignored, and they are considered incapable of making choices for themselves, particularly medical decisions. This might impede the provision of their preferred care and lead to poor healthcare outcomes. Advance care planning (ACP) is considered an effective intervention to assist older people to think ahead and make a choice in accordance with their wishes when they possess capacity to do so. The implementation of ACP can potentially lead to positive impact for patients and families. However, the assessment of mental capacity among older adults with cancer might be a crucial concern when implementing ACP, as loss of mental capacity occurs frequently during disease deterioration and functional decline. This article aims to answer the following questions by exploring the existing evidence. How does ACP develop for older people with cancer? How can we measure mental capacity and what kind of principles for assessment we should apply? What are the facilitators and barriers when implementing an ACP in this population? Furthermore, a discussion about cultural adaptation and relevant legislation in Asia is elucidated for better understanding about its cultural appropriateness and the implications. Finally, recommendations in relation to early intervention with routine monitoring and examination of capacity assessment in clinical practice when delivering ACP, reconciling patient autonomy and family values by applying the concept of relational autonomy, and a corresponding legislation and public education should be in place in Asia. More research on ACP and capacity assessment in different cultural contexts and policy frameworks is highlighted as crucial factors for successful implementation of ACP.


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