AUTONOMY

INTERESTS

THE NON-IDENTITY PROBLEM

MORAL CAUTION

PRACTICAL EXAMPLE

DISABILITY

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

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.

INTERESTS

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?

THE NON-IDENTITY PROBLEM

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*

CAUTION

* 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 disabled are not due to deliberate exclusion but rather social environments being built without disability in mind

Reconstruction of the physical and social environment to take into account a wider range of differences in human structure and function

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

1.Makes no sense to cater to by-gone interests no matter their nature

SELF-OWNERSHIP2.Past self has a pseudo-property right over their future self

2.Ability to express your will is substantial enough to constitute a sort of pseudo-autonomy, which deserves respect

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

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 LIFE4. 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

CAUTION5.Irrevocability is BS and we have to evaluate probabilities.

5. Moral caution arguments

RATIONALITY6. 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.