AUTONOMY
INTERESTS
THE NON-IDENTITY PROBLEM
MORAL CAUTION
DISABILITY
PRACTICAL EXAMPLE
AUTONOMY
Why is protecting autonomy important?
1. Evidentiary view- supposed people know what is in their best interests
and consequentially no one should interfere with their choices, hence
autonomy is important.
2. Integrity view- autonomy is important regardless whether people
choose well for themselves or not, because respecting it is a sign of
respecting ‘human dignity’
AUTONOMY
Autonomy matters because (1)
people are the best at choosing
for themselves, (2) shows
respect
INTERESTS
1. Experiental – pleasure vs pain, easy to understand. Rudimentary
cognitive capacities are involved in this.
2. Critical interests- beyond expierence, e.g. caring about your childs
well-being even after death. Critical interests have to do with the
integrity of our lives, who we are and what we believe.
THE NON-IDENTITY PROBLEM
Marie is taking a drug that she knows will cause a birth defect. After
some months she will stop taking the drug and it will be possible again
for her to have healthy children.
Is it immoral for Marie to have a child now (Amy)
rather than a child later (Sophie)?
THE NON-IDENTITY PROBLEM
Two partners Sharon & Candy want a deaf child.
They believe they would be able to understand the child's development
more thoroughly and offer better guidance, and say the choice was no
different from opting for a certain gender.
They look for a deaf sperm donor to increase the likelihood of getting
that.
Is it immoral for them to “design” a disabled child?
THE NON-IDENTITY PROBLEM
True Story
THE NON-IDENTITY PROBLEM
1. Is life good and death bad?
2. How can we compare life to non-existence?
CAUTION
Euthanasia in cases of severe illnesses makes sense
1. BUT what if you get better? - it’s irrevocable
2. BUT what if the choice to go through with euthanasia is immoral? –it’s
better to choose the moral choice as opposed to the uncertain one
3. Your judgment may be clouded due to fear/suffering/etc- you cannot
make a rational choice, hence you cannot legitimately choose to die*
* Arguments are typically used when talking about euthanasia, abortion, suicide, various
medical procedures to some extent (e.g. plastic surgery, removal of limbs)
CAUTION
ARGUMENT
RESPONSE
Irrevocability
Applies to every choice
Moral caution
Both choices may be morally dubious
Clouded judgment
If we assume you can choose to do
nothing, you can choose to do
something
Can’t predict future
All choices are a balance of
probabilities
DISABILITY
MODEL
PREFFERED POLICY
Medical model: treats disability is an individual
trait, problem
Disability must be corrected or compensated
Minority group model: disability is subject to
exclusion and discrimination
Eliminate or compensate for exclusionary practices
Human variation model: challenges faced by the
Reconstruction of the physical and social
disabled are not due to deliberate exclusion but rather environment to take into account a wider range of
social environments being built without disability in differences in human structure and function
mind
Feminist: classification of impairment is dependent
on our understanding of illness, e.g. ADD wasn’t
recognized a few decades ago. Impairment is rather
defined via social norms.
IDENTITY & SELF OWNERSHIP
Advance directive- when you have a progressive illness that may
incapacitate you from decision making, you can create a document that
articulates how you wish to be treated once that happens. Similar to a
will.
THW allow euthanasia for all patients suffering from severe
dementia (and therefore legally not allowed to make that
decision) who have signed an advance directive.
IDENTITY & SELF OWNERSHIP
THW allow euthanasia for all patients suffering from severe
dementia (and therefore legally not allowed to make that
decision) who have signed an advance directive.
CRITICAL VS EXPERIENTAL
1.Past critical interests > present
experiential interests
SELF-OWNERSHIP
2.Past self has a pseudo-property right over
their future self
IDENTITY
3.The loss of personhood of the current self
means the person now is reduced to a lesser
moral status, which implies that the past
self deserves a higher level of moral rights
1.Makes no sense to cater to by-gone interests no
matter their nature
2.Ability to express your will is substantial enough to
constitute a sort of pseudo-autonomy, which deserves
respect
3.The identity the person has now is different than
the one before, because it doesn't fit into the
''healthy" persons narrative of self.
Hence the person now is the only one that should be
taken into consideration when making decisions, the
same way respect for my humanity implies that no
one else can make decisions for me.
IDENTITY & SELF OWNERSHIP
THW allow euthanasia for all patients suffering from severe
dementia (and therefore legally not allowed to make that
decision) who have signed an advance directive.
VALUE OF LIFE
4. Value of life is only constituted by it's
contents, as we would agree that 30 years of
torture is worse than 3 years of torture we
can also agree that some lives are not worth
living
4. No reason to say someone can actually foresee
their life and experiences post-disease. Especially
given that healthy people tend to vastly overestimate
how bad it is to be i.e. disabled
CAUTION
5.Irrevocability is BS and we have to
evaluate probabilities.
5. Moral caution arguments
RATIONALITY
6. Even if you draw an arbitrary line
between ''action'' and ''inaction', inaction is
not automatically preferable.
6. Constitutes an irrational, not well informed choice
driven by fear, not calculus. Creates pressure on
those who are considering whether to be a burden for
family when suffering from dementia.