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The idea of commercial‐assisted suicide lives a marginal existence in the bioethical literature, despite its significant presence in popular culture. The practice of commercial‐assisted suicide (CAS) is defined as suicide assistance performed for a financial reward through a contractual agreement between a customer and a service‐provider, who does not necessarily need to be a medical professional. While CAS does indeed offer some potential solutions regarding the moral controversies surrounding physician‐assisted suicide (PAS), I defend the idea that adopting it as policy ultimately proves morally indefensible and practically inefficient. This is due to the fact that the commodification of a given good necessarily implies the creation of a market of said good; as such, what I propose in this paper is a moral and practical evaluation of a market of CAS. In order to do so, I first examine the arguments in favor of CAS as put forward by Roland Kipke, who argues that any liberal defense of PAS necessarily implies a defense of CAS. In the first section, I argue against this idea using the liberal values of autonomy and equality of opportunity. In the second section of the paper, I argue that a market of CAS would be gravely dysfunctional due to one particular characteristic of death, namely, that is not compensable ex post. I conclude by arguing that while the practice of CAS may not prove morally problematic, the inevitable market that it will create should it be legalized most certainly will. [ABSTRACT FROM AUTHOR]

The paper contributes to the debate of the Swedish welfare state by re‐examining the view of freedom underlying the design of this welfare model. The point of departure is two interpretations by Bo Rothstein and Henrik Berggren and Lars Trägårdh, which both describe advancement of individual autonomy as the ultimate point of the model. The paper argues that these readings are overly liberal in the sense that they exaggerate the importance of individualism and autonomy. The view of freedom that shaped the Swedish welfare state was not liberal, and individual autonomy was not the overriding goal for the founders of the model. Instead, the view is best described as quasi‐republican and nondomination based. It was mostly a result of semi‐Marxist ideas about capitalist power and exploitation that lingered on in the ideology of the Swedish social democratic party, the SAP, in the 1930s and 1940s. During the first decades of the 1900s, the SAP gradually revised these ideas in a domination‐based direction. It was the outcome of this process that more than anything else gave the impetus to the design of the Swedish welfare state. [ABSTRACT FROM AUTHOR]

The methods and procedures within United States naval aviation to certify an aircraft safe for flight are well established. However, these methods and procedures are based on clearing a system that is operated or monitored by a human. A fully autonomous system will not have a human in or on the loop and will therefore require a new method for certifying it safe for flight. This paper details how to use run time assurance as the framework for a safety of flight certification of autonomous behavior within United States naval aviation. We present an aerial refueling task with run time assurance as use case for the framework for certification. Within the use case we then give more details on the mechanics of using RTA to enable autonomous functionality within naval aviation. [ABSTRACT FROM AUTHOR]

Background: Nurses play a crucial role in enabling older people's autonomy in residential care. However, there is a lack of synthesised knowledge about how nurses can support older people. Objective: The aim of this study was to identify and synthesise nursing support for older people's autonomy in residential care. Methods: An integrative review was carried out by searching the CINAHL, Philosopher's index, PubMed, SocINDEX, Scopus and Web of Science databases, supplemented by manual searches. The searches focused on peer‐reviewed scientific empirical research papers published in English, without date limitations. The constant comparison method was used for the analysis. Results: The review identified 24 papers, and these showed that older people's autonomy was based on dignity. Nurses protected older people's autonomy in eight different ways. They protected their right to make their own decisions, acted as advocates, respected their wishes, provided opportunities for autonomy, fostered independence, gave information to residents and relatives, provided individualised care practices and protected older people's safety. However, there were also barriers that needed to be overcome. Conclusions: Nurses used multiple, individually tailored activities to support older people's autonomy, but they also had different reasons for supporting or hindering it. Work and leadership structures are needed to ensure that older people's autonomy is driven by ethical practices. Implications for practice: The results of this review can help nurses who provide residential care for older people to recognise the different nursing activities that can be used to support older people's autonomy and to develop strategies to apply them in different daily care situations. However, further research is needed to determine how these activities can be realised in daily care and how they cover different aspects of older people's lives in residential care. [ABSTRACT FROM AUTHOR]

In 2011, bioethicists turned their attention to the question of whether prisoners on death row ought to be allowed to be organ donors. The discussion began with a provocative anti‐procurement article by Arthur Caplan and prompted responses from an impressive lineup of commentators. In the 10 years since, the situation for death‐row inmates seeking to donate has hardly changed: U.S. prison authorities consistently refuse to allow death‐row procurement. We believe that it is time to revisit the issue. While Caplan's commentators rebutted his narrow contention that organ procurement would undermine the goals of deterrence and retribution, none of them attempted to make a positive, nonconsequentialist case for organ donation as a right of death‐row inmates. That is the task we take up in this paper. After sketching and briefly defending a theory of punishment, we show how denial of organ donation is inconsistent with punishment's basic logic. [ABSTRACT FROM AUTHOR]

Increased demand on rail, due to climate initiatives and passenger numbers, places significant pressure on existing railway operations; specifically on capacity, operational flexibility, and network robustness. These pressures are exacerbated by constraints, which prevent the construction of new track and infrastructure. This results in the need to use existing infrastructure and operating processes. One proposed solution is digitalization, which results in autonomous rail, where automated and connected intelligent transport systems facilitate smart traffic management. However, this generates the challenge of integrating autonomous trains and their associated technologies with existing infrastructure and operations. To understand this issue from an enterprise level, this paper has applied Brian Wilson's Soft Systems Methodology (a variation of Checkland's methodology) to the problem situation. This methodology explores and investigates the existing rail system in Great Britain (UK less Northern Ireland) and its stakeholders. The paper aims to propose a solution into how to transform the legacy system into one which incorporates autonomous operations and ultimately becomes fully autonomous. It culminates in a series of models that are relevant to those with a legitimate interest in the system. The models identify the activities required to analyze whether autonomy is worthwhile and if it is, how to successfully integrate it with legacy operations. Additionally, the models provide the basis for which a formal stakeholder analysis can take place. [ABSTRACT FROM AUTHOR]

Advance directives (ADs) have for some time been championed by ethicists and patient associations alike as a tool that people newly diagnosed with dementia, or prior to onset, may use to ensure that their future care and treatment are organized in accordance with their interests. The idea is that autonomous people, not yet neurologically affected by dementia, can design directives for their future care that caregivers are morally obligated to respect because they have been designed by autonomous individuals. In this paper, we first criticize the idea that ADs can retain moral authority in severe dementia by arguing that it is paradoxical. Second, we consider two arguments that initially seem to refute this critique of ADs, but we eventually dismiss them. The first argument states that ADs retain moral authority in severe dementia because autonomously formed interests, for example, ADs, can only be appropriately discarded by autonomous persons. This we term the historical autonomy argument. We dismiss it by demonstrating how we, in analog cases, are not obligated to continue to respect autonomously formed interests even though they have been discarded under nonappropriate conditions. The second argument is that ADs can be justified by what we term external interests. While we agree that people with severe dementia plausible can be said to have external interests, we show that ADs cannot express such interests and hence cannot be justified by them. We conclude that none of the discussed arguments support the use of ADs and because of this, the idea of ADs should be reassigned. [ABSTRACT FROM AUTHOR]

Compared with data that is initially collected for research purposes, the mandatory authorization of a government database for secondary use deserves greater scrutiny because it consists of information that is collected initially for administrative purposes. Using the case of Taiwan's National Health Insurance (NHI) Database as an example, this paper analyzes the ethical issues that emerge when the research participants are "participated" in studies without their consent, according to the current policy. The proponents of secondary use for research purposes maintain that the authorized use of the NHI Database is necessary for public interests, while the opponents argue that the potential lack of democratic accountability and the infringement on people's rights to privacy and information autonomy is unwarranted. Drawing on the solidarity-based approach, this paper proposes a temporal solution as a possible reform direction for better ethical justification of the secondary use of the NHI Database. [ABSTRACT FROM AUTHOR]

Communitarianism has been the dominant disposition of many African scholars towards ubuntu. The nature of the concept somewhat limits how one can theorise about ubuntu. However, I argue that there is still a lot more that can be harnessed from the ubuntu concept, especially as it pertains to the ontology of radical escape. I use radical escape as an ontological character of every human being whereby to exist is to escape. In this paper, I argue that ubuntu does not provide the possibility for radical escape. The nature of escape that ubuntu provides is limited to the confines of its communitarian outlook. In this paper, I bring on board the works of Mogobe Ramose, Thaddeus Metz, Kwame Gyekye, Emmanuel Levinas, and Thomas Lear, among others, to substantiate my position. I hope to demonstrate the need to accommodate the concept of radical escape in theorising about ubuntu. [ABSTRACT FROM AUTHOR]

It has been argued that Thomson's defense of abortion, if successful, implies that abortion is permissible only until the point of viability. After that point, if one wanted to end a pregnancy, one must do so by birthing the fetus through induction or cesarean. In this paper, I argue that Thomson's defense of abortion does, in fact, imply that abortion after the point of viability is sometimes permissible. To show this, I point out that the process of birthing a fetus makes use of the body of the pregnant person in significant ways. Indeed, the body of the pregnant person is as much a part of this process as it is a part of the process of carrying a fetus during pregnancy. Thus, just as it is sometimes morally permissible to choose to have an abortion rather than continue a pregnancy, it is sometimes morally permissible to choose to have an abortion rather than undergo an induction or cesarean. Those who support Thomson's defense of abortion, then, have reason not to support the view that induction or cesarean are the only permissible procedures for ending an unwanted pregnancy with a viable fetus. I then use this discussion to suggest that autonomy rights are more complicated than initially thought. Given the extent to which the body is involved in detaching the fetus, it is not merely that one has a right to detach a fetus, but also a right to actualize one's reasonable preferences over the method of detachment. [ABSTRACT FROM AUTHOR]

This paper contributes to debates on autonomous geographies by foregrounding and analysing democratic praxis in two grassroots agrifood collectives to interrogate the ways in which it constitutes a vehicle for postcapitalist transformation. We focus on the negotiation and (re)distribution of power (Case Study 1) and the politicisation of ambiguous human–more‐than‐human entanglements (Case Study 2) and find that the dynamics and frictions these collectives experience can be understood as diverse processes of becoming‐interdependent. Becoming‐interdependent refers to a collective recognition of existing and emerging relationships and dependencies (amongst human people as well as between humans and more‐than‐human actors) and efforts to continuously navigate these. Based on these insights, we discuss tensions between capitalist–postcapitalist realities and making–unmaking in grassroots collectives. We conclude by conceptualising becoming‐interdependent as a deliberate response to the separations and abstractions inscribed in capitalism and by connecting it to debates on strategies for postcapitalist transformation. [ABSTRACT FROM AUTHOR]

Copyright of Ethos (00912131) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Doctors hold a prima facie duty to respect the autonomy of their patients. This manifests as the patient's 'right' not to know when patients wish to remain unaware of medical information regarding their health, and poses ethical challenges for good medical practice. This paper explores how the emergence of digital health technologies might impact upon the patient's 'right' not to know. Method: The capabilities of digital health technologies are surveyed and ethical implications of their effects on the 'right' not to know are explored. Findings: Digital health technologies are increasingly collecting, processing and presenting medical data as clinically useful information, which simultaneously presents large opportunities for improved health outcomes while compounding the existing ethical challenges generated by the patient's 'right' not to know. Conclusion: These digital tools should be designed to include functionality that mitigates these ethical challenges, and allows the preservation of their user's autonomy with regard to the medical information they wish to learn and not learn about. [ABSTRACT FROM AUTHOR]

We comment on Dr. Terman's considerations on the moral justification of ceasing assisted feeding and hydration for people with advanced dementia. The core idea of his paper is that an advance directive can solve future dilemmas regarding assisted feeding. We submit that this static instrument is unfit for the complex and dynamic nature of assessing how to deal with refusals to eat, in particular for people with dementia. It overvalues the past in relation to the present situation and leaves no room for the possibility of changing wishes. Moreover, the perspectives of professional caregivers and families are not addressed because the focus is entirely on individual autonomy in early dementia. Multiple perspectives should be considered in interpreting directives and the actual situation in light of the patient's view of life in order to realistically account for what is morally justifiable in care in advanced dementia. [ABSTRACT FROM AUTHOR]

This paper challenges the role individual autonomy has played in debates on moral neuroenhancement (MN). It shows how John Hyman's analysis of agency as consisting of functionally integrated dimensions allows us to reassess the impact of MN on practical agency. I discuss how MN affects what Hyman terms the four dimensions of agency: psychological, ethical, intellectual, and physical. Once we separate the different dimensions of agency, it becomes clear that many authors in the debate conflate the different dimensions in the concept they call 'autonomous agents'. They contend that, for example, reason‐giving and previous autonomous acts are relevant to agency as such, when in fact they capture only one aspect of functionally integrated agency. This paper reconsiders MN in light of the functional integration of reason and emotions in practical agency. To illustrate the impact of MN on different aspects of agency, I consider examples from legal practice, which show that autonomy cannot be our sole focus when evaluating the moral implications of MN. [ABSTRACT FROM AUTHOR]

If you are interested in people as a subject, even if you are interested in them only as an aspect of the effective managing of organisations, you are likely to be more aware of the impact of your actions and reactions on others, and therefore more likely to be civil. But perhaps we still need to keep the issue of civility in our minds as we write our papers and our emails, review others' work and aim to develop a new generation of researchers. Key points: We know that civility matters, but it has to be tempered with our ability to continue to engage critically with fellow scholars.Criticism has two meanings: one involving attacks on the motivation or character of the individual concerned and the other involving analytical deconstruction of individual's work.Given how much of ourselves we put into academic work, we need to be extra careful to disentangle the two forms of criticism.Human resource management scholars are. [ABSTRACT FROM AUTHOR]

'Big Data' digital technologies are beginning to make inroads into peasant agriculture in the Global South. Of particular importance is the subset of technologies that appropriate agricultural decision‐making, here theorized as surveillance agriculture. These technological regimes aspire to not only remove decision‐making from the farmer, but eventually to replace the farmer with, for instance, 'autonomous' tractors. This paper looks ahead to ask what a technological trajectory that aspires to autonomy for the tractor may portend for autonomy for the peasant farmer. It compares surveillance agriculture to other forms of surveillance capitalism, noting that it shares a will to not only sell products and services but to manipulate behaviour but differs in that the behaviour being manipulated is professional productive behaviour. The paper surveys the vested interests of the entities behind surveillance agriculture and asks how informational relations of production may be changed between farmers and these entities. It then examines the informational relations of production among peasant farmers that may be interdicted by surveillance agriculture, especially the group‐level decision‐making dynamics that make 'individual autonomy' a misnomer. But surveillance agriculture is resolutely individualized, which raises concerns for peasant decision‐making autonomy. [ABSTRACT FROM AUTHOR]

This paper discusses autonomy as a set of practices that result in the production and reproduction of resources that allow for self‐organization. We define autonomy as a social construct that refers to the self‐organizing capacity of people, communities, and movements. Such capacity assumes both resources and agency. In that vein, our conceptualisation implies that autonomy is a relational concept: It can only emerge when and where struggles that aim at going beyond dependency (i.e., nonautonomy) concretely exist. Autonomy is three‐pronged, involving a set of goal‐oriented activities, a distantiation from capital, and the agency of social actors. Intertwined with these levels are peasant movements that have the capacity to develop and implement a political agenda that is not overshadowed and/or dictated by external influences. The paper illustrates this intertwining with the case of the Circuito (O Circuito), a Brazilian peasant movement that has constructed and operates an extended farmers' market and which simultaneously transforms farming practices. The Circuit is the outcome of collective action and shows the potential of multilevel performance of several actors engaged in concerted actions. In the conclusion, we suggest that the Circuit represents autonomy based on commonly pooled resources as well representing a countermovement to the destructive dynamics of food empires. [ABSTRACT FROM AUTHOR]

Copyright of Higher Education Quarterly is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In the debates regarding the ethics of human enhancement, proponents have found it difficult to refute the concern, voiced by certain bioconservatives, that cognitive enhancement violates the autonomy of the enhanced. However, G. Owen Schaefer, Guy Kahane and Julian Savulescu have attempted not only to avoid autonomy‐based bioconservative objections, but to argue that cognition‐enhancing biomedical interventions can actually enhance autonomy. In response, this paper has two aims: firstly, to explore the limits of their argument; secondly, and more importantly, to develop a more complete understanding of autonomy and its relation to cognitive enhancement. By drawing a distinction between the capacity for autonomy and the exercise and achievement of autonomy, and by exploring the possible effects of cognitive enhancement on both competence and authenticity conditions for autonomy, the paper identifies and explains which dimensions of autonomy can and cannot, in principle, be enhanced via direct cognitive interventions. This allows us to draw conclusions regarding the limits of cognitive enhancement as a means for enhancing autonomy. [ABSTRACT FROM AUTHOR]

Advance directives are intended to extend patient autonomy by enabling patients to prospectively direct the care of their future incapacitated selves. There has been much discussion about issues such as whether the future incompetent self is identical to the agent who issues the advance directive or whether advance directives can legitimately secure patient autonomy. However, there is another important question to ask: to what extent and in what conditions is it ethically appropriate for one to limit the liberty or agency of one's future incompetent self by issuing an advance directive? In this paper, I use a virtue‐ethical approach to explore this question, focusing on the case of an advance directive for the future self with moderate dementia. First, I examine virtuous attitudes with regard to autonomy and argue that one can manifest vices or ethically undesirable character traits in trying to intervene in the future self's life. In particular, I argue that this case can manifest vices such as disdainfulness, intellectual arrogance, and self‐dictatorship, which is the vice of trying to control one's life to an excessive degree, and that a self‐dictator fails to give due moral consideration to the future self's liberty or agency. I then introduce the Daoist idea of wu‐wei, which recommends embracement of what happens in one's life, as one of the possible remedies for the overemphasis on the value of autonomy and control. [ABSTRACT FROM AUTHOR]

Introduction Objectives Conclusions Efforts to develop reversible male contraceptives analogous to female oral contraceptives are underway and may be introduced in the next decade. The advent of novel male contraceptives provides an opportunity for an ethical reformulation of the contraceptive paradigm given the relational, rather than individual, nature of sexual relationships, and family planning. For individuals in any sexual relationship that could result in pregnancy, issues of reproductive autonomy, freedom, equality in reproductive decision‐making and risks—both of side effects and of unintended pregnancies—are significant. Historically, however, women have been attributed the greatest responsibilities simultaneously with the most restrictions on their freedom of choice and access to reproductive care.In this paper, we extend our prior “shared risk” model of male contraception to one of “shared risk and responsibility” to ethically inform this discourse.This updated framework more fully captures the complexity of this novel technology and may be of use to regulatory and legal agencies grappling with an intervention that poses medical risks to the member of the relationship who does not face risks of becoming pregnant. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) based clinical decision support systems (CDSS) are becoming ever more widespread in healthcare and could play an important role in diagnostic and treatment processes. For this reason, AI‐based CDSS has an impact on the doctor–patient relationship, shaping their decisions with its suggestions. We may be on the verge of a paradigm shift, where the doctor–patient relationship is no longer a dual relationship, but a triad. This paper analyses the role of AI‐based CDSS for shared decision‐making to better comprehend its promises and associated ethical issues. Moreover, it investigates how certain AI implementations may instead foster the inappropriate paradigm of paternalism. Understanding how AI relates to doctors and influences doctor–patient communication is essential to promote more ethical medical practice. Both doctors' and patients' autonomy need to be considered in the light of AI. [ABSTRACT FROM AUTHOR]

Five countries now permit organ donation after euthanasia, on the basis of respecting donor autonomy. Some now openly consider performing euthanasia itself via organ extraction to better preserve organ viability, albeit in violation of the dead donor rule. Proponents argue that respect for patient autonomy requires this option; the dead donor rule is inapplicable since it fulfills donors' wishes. Other ethical arguments, not addressed herein, explore issues including dying at home, impact on clinicians, and societal faith in donation enterprise, but these concerns are not insurmountable. This paper instead solely critiques proponents' oversimplified understanding of autonomy with an autonomy‐based argument against any linkage of organ donation and euthanasia, regardless of its timing. Respect for patient autonomy does not unilaterally require fulfilling patients' every wish. Moreover, the very possibility of organ donation with euthanasia limits donor autonomy qualitatively and quantitatively substantially more than by offering it. In fact, organ donation after euthanasia violates the purpose of the dead donor rule, even if not its technicalities. [ABSTRACT FROM AUTHOR]

Objective: Farmers are prone to poor well‐being and are at higher risks of suicide than the general population. The aim of this study was to understand whether the negative impact of daily stressors on Australian farmers' well‐being could be buffered through a strong internal locus of control – a strong sense of control over what happens in life. Methods: Australian farmers self‐reported their well‐being, daily stress, and locus of control. Design: Cross‐sectional via pen‐and‐paper survey. Setting: Participants completed the surveys at the beginning of agricultural management training courses. Participants: Australian farmers (N = 129, M age = 39 ± 12 years, 54.7% male). Main Outcome Measures Internal and external locus of control, daily stress, and subjective well‐being. Results: More daily stressors were associated to poorer well‐being, regardless of external locus of control; however, farmers with a stronger internal locus of control were buffered from the negative impacts of daily stressors. That is, daily stressors were not significantly associated with well‐being for farmers with a strong internal locus of control. Conclusions: Internal locus of control may be a significant factor in supporting good well‐being for farmers. Further research should investigate how to enhance internal locus of control amongst this population. It may be that interventions to enhance internal locus of control in farmers could improve their well‐being and productivity, good outcomes for the individual farmers, and global society overall. [ABSTRACT FROM AUTHOR]

The dead donor rule (DDR) regulates current practice for vital organ donation, which means that organs may only be retrieved from people who are already dead (or brain dead). However, several authors criticize the DDR and argue that we should instead adopt a rule that allows us to retrieve vital organs before people are dead. They call this proposal organ donation euthanasia (ODE). While I am sympathetic to this proposal I do not think it goes far enough. In this paper, I show that the key reasons put forward in favor of permitting ODE actually justify a more far‐reaching suggestion for regulation, permitting people to become living vital organ donors even when they are not about to die for other reasons. Further, I argue that only accepting imminently dying people as eligible donors for living vital organ donation would be objectionably paternalistic. [ABSTRACT FROM AUTHOR]

A cyber‐physical system‐of‐systems (CPSoS) can be defined as a system‐of‐systems (SoS), composed of several operable and autonomous constituent systems (CSs) that are themselves cyber‐physical systems (CPSs). A main challenge in integrating CPSoS to function as a single integrated system is the autonomy of its components, which may result in undesirable, unsecure, or even unsafe situations. In this paper, we advocate that in order to facilitate the integration of CPSs within the overall context of their CPSoS, we may need to adjust their level of autonomy in a way that enables them to perform their activities and avoid undesirable, unsecure , and unsafe situations. Reducing such situations surely contributes to the dependability of the CPSoS. In particular, we propose a novel model‐based approach for modeling and analyzing the autonomy levels of CPSs based on their awareness concerning their operational environment as well as their capability to react in a timely, secure, and safe manner while performing their activities. The model is further described in a UML profile and applied to represent activities for autonomous driving scenarios. Using a driving simulator, we implement such models on a target vehicle, and we show the resulting safety improvement, especially in terms of reduced collisions. [ABSTRACT FROM AUTHOR]

This paper offers a theoretical analysis of Self‐Determination Theory (SDT) and its claims regarding human autonomy. Self‐determination theorists have advanced a form of self‐regulated, engaged behavior (i.e., autonomy), founded upon on a consilient account of human motivation that assumes multiple, hierarchical levels of organization and causation (e.g., biological, psychological, and social). Autonomy, from this perspective, is taken to emerge from underlying biological mechanisms, but also able to exert its own causal effects in the world as a unique psychological phenomenon. We contend that in theorizing this way, self‐determination theorists have invoked a mixed discourse of mechanism and autonomy that leaves important questions unanswered, perhaps most importantly those concerning how autonomy as a kind of volition can fit coherently in the mechanistic account of world that they advocate. We then offer an alternative perspective based upon the work of various hermeneutic‐phenomenological thinkers in philosophy and psychology. This alternative perspective conceptualizes human phenomena such as autonomy and motivation in agentic terms, emphasizing meaningful participation in possibility‐laden contexts of everyday practices. [ABSTRACT FROM AUTHOR]

The debate on agencification in the public sector has traditionally overlooked the influence of space on how autonomy unfolds in practice. Starting with the contention that organizing and space are interweaved, the study analyzes the early stages of the agencification process of three Italian museums and reveals that space is a constraint to, and an enabler of, de facto autonomy for newly created entities. Space is a constraint when spatial changes are temporally misaligned with the agencification process, including directorship cycles. On the other hand, space enables de facto autonomy, as it is purposely modified to accommodate new demands and needs by newly appointed managers. The paper maintains that policy makers and site managers should seriously consider space when dealing with agencification reforms, paying attention to the revenue and cost implications of spatial solutions, and the areas of responsibility concerning buildings and objects. [ABSTRACT FROM AUTHOR]

Voluntary childlessness constitutes a social and generational rupture from tradition and culture, with significant effects on the reproduction of the so‐called life and family cycle. This study aims at understanding the reasons why people decide to remain childless and the social pressures that this decision generates. A qualitative phenomenological study was conducted on the emerging decision of non‐motherhood and non‐fatherhood based on semi‐structured interviews with 56 people who autonomously made the decision to opt out of parenthood. This paper underscores the multiple biographical situations involved in the decision, in addition to the concerns about personal development and future. The current social crisis context serves as a means of justification to lessen social and family pressure. We conclude that people who have made this decision promote a different meaning from that of reproduction as a mechanism of the social order. [ABSTRACT FROM AUTHOR]

In recent decades, researchers have attempted to prospectively identify individuals at high risk of developing psychosis in the hope of delaying or preventing psychosis onset. These psychosis risk individuals are identified as being in an 'At‐Risk Mental State' (ARMS) through a standardised psychometric interview. However, disclosure of ARMS status has attracted criticism due to concerns about the risk–benefit ratio of disclosure to patients. Only approximately one quarter of ARMS patients develop psychosis after three years, raising concerns about the unnecessary harm associated with such 'false‐positive' results. These harms are especially pertinent when identifying psychosis risk individuals due to potential stigma and discrimination in a young clinical population. A dearth of high‐quality evidence supporting interventions for ARMS patients raises further doubts about the benefit accompanying an ARMS disclosure. Despite ongoing discussion in the bioethical literature, these concerns over the ethical justification of disclosure to ARMS patients are not directly addressed in clinical guidelines. In this paper, we aim to provide a unified disclosure strategy grounded in principle‐based analysis for ARMS clinicians. After considering the ethical values at stake in ARMS disclosure, and their normative significance, we argue that full disclosure of the ARMS label is favoured in the vast majority of clinical situations due to the strong normative significance of enhancing patients' understanding. We then compare our framework with other approaches to ARMS disclosure and outline its limitations. [ABSTRACT FROM AUTHOR]

Nearly everyone recognizes the fact of deep pluralism: it is hard to deny that contemporary America is characterized by widespread diversity of beliefs, practices, and values. We disagree, not on this reality, but on the way we should respond to the pluralism around us. In this paper, Emily G. Wenneborg discusses one of the most common responses to pluralism in contemporary philosophy of education: autonomy‐based liberalism. She praises liberalism for its attempt to navigate certain tensions that accompany its approach to pluralism. At the same time, she raises several critiques of liberalism as a response to pluralism, particularly with regard to religious communities and belief systems. She suggests that trust provides a better framework than autonomy for educating in and for deep pluralism. [ABSTRACT FROM AUTHOR]

Many philosophers, psychologists, and lay folk associate volition with autonomy (actions are independent of an individual's environment) and free will (individuals originate their actions). Most behaviorists hold these views to be incompatible with behavior analyses. The present paper describes volition as interpreted by B. F. Skinner, Howard Rachlin, and Allen Neuringer. Skinner relates volition to positively reinforced operant behavior. That works because, like operants, voluntary actions are free, in the sense of not physically constrained; they affect their environments, often resulting in positive outcomes, and are sometimes unpredictable. Rachlin, while incorporating Skinnerian methods, interprets volition within his own Teleological Behaviorism framework. For Rachlin, reinforcement of an individual response is often incompatible with voluntary control, thereby disagreeing with Skinner. Responses are voluntary only when they are members of extended response patterns. Neuringer also begins with Skinner's operants, but argues that, under the control of reinforcing consequences, both voluntary actions and operant responses are sometimes predictable and other times "truly" unpredictable. Neuringer does not assume that environments determine voluntary actions, thereby disagreeing with Skinner and Rachlin. Taken together, the agreements and disagreements among these three behaviorists may help to shed light on the relationship between operants and volition. [ABSTRACT FROM AUTHOR]

This paper offers a critical perspective on the debate surrounding autonomy at work for a specific category of non‐standard workers: independent professionals. The increasing numbers now working this way as well as their spread into all sectors, industries and occupations, mean that their work arrangements can no longer be dismissed as non‐standard or atypical. Defining them by what they are not is quite simply no longer an option. Our paper examines the various components intertwined behind the taken‐for‐granted concept of autonomy. Drawing on debates from the legal through to the sociological and HR literatures, we identify three underlying dimensions to autonomy. When combined, they provide the basis for an analytical matrix that may assist policy makers, practitioners and individual workers to understand the challenges and opportunities linked to new ways of working. [ABSTRACT FROM AUTHOR]

This paper critically analyses 'the paradox of autonomy and consent in maternity care'. It argues that maternity care has certain features that increase the need for explicit attention to, and respect for, both autonomy and rigorous informed consent processes. And, moreover, that the resulting need is considerably greater than in almost all other areas of medicine. These features are as follows: (1) maternity care involves particularly socially sensitive body parts that are regularly implicated in consent‐centred procedures, as well as in unconsented interventions, in ordinary, non‐medical life; and (2) much of maternity care (especially intervening in childbirth) is medically unique, in that it harms one patient (the mother) not primarily for the promotion of her own health but for the benefit of another (the baby). The apt comparison, within medicine, is therefore with non‐therapeutic research and transplantation medicine—both of which have elevated consent requirements characterized by very rigorous consent processes. At the same time—and this delivers the titular paradox—the importance of autonomy and consent in maternity care is at particular risk of being denied or disregarded. Jointly, these considerations make a very strong case for change: attention to and respect for autonomy and consent should be (1) core values; (2) key points of practical attention in the years ahead; and (3) central quality indicators in maternity care. [ABSTRACT FROM AUTHOR]

Evidence suggests that one reason doctors provide certain interventions in assisted reproductive technologies (ART) is because of patient demand. This is particularly the case when it comes to unproven interventions such as 'add‐ons' to in vitro fertilisation (IVF) cycles, or providing IVF cycles that are highly unlikely to succeed. Doctors tend to accede to demands for such interventions because patients are willing to do and pay 'whatever it takes' to have a baby. However, there is uncertainty as to what moral weight should be placed on patient‐led demands in ART, including whether it is acceptable for such demands to be invoked as a justification for intervention. We address this issue in this paper. We start by elucidating what we mean by 'patient‐led demand' and synthesise some of the evidence for this phenomenon. We then argue that a doctor's professional role morality (PRM) yields special responsibilities, particularly in commercialised healthcare settings such as ART, because of the nature of professions as social institutions that are distinct from markets. We argue on this basis that, while there may be reasons (consistent with PRM) for doctors to accede to patient demand, this is not always the case. There is often a gap in justification between acceding to patient‐led demands and providing contested interventions, particularly in commercial settings. As a result, acceding to demand in such settings needs a strong justification to be consistent with PRM. [ABSTRACT FROM AUTHOR]

This paper offers a historical analysis of organizational identity development at a particular Dutch university, the Vrije Universiteit (VU) Amsterdam. Our analysis contributes to the discussion on what factors contribute to organizational identity maintenance and evolution. Whereas the literature suggests a rather straightforward development, with national and institutional governance arrangements offering more institutional autonomy and providing significant scope for identity development and profiling, this case study shows that these relationships between identity, governance, and autonomy are not that obvious. In this particular case, the opposite happened. Despite more autonomy, VU Amsterdam was not able to maintain its historically distinctive identity, nor was it able to replace this with a new, unambiguous identity. External factors (demographics) and internal dynamics (leadership strategies) explain the anomalies. [ABSTRACT FROM AUTHOR]

Nudges are small changes in the presentation of options that make a predictable impact on people's decisions. Proponents of nudges often claim that they are justified as paternalistic interventions that respect autonomy: they lead people to make better choices, while still letting them choose for themselves. However, existing work on nudges ignores the possibility of "hard choices": cases where a person prefers one option in some respects, and another in other respects, but has no all‐things‐considered preference between the two. In this paper, I argue that many significant medical decisions are hard choices that provide patients with an opportunity to exercise a distinctive sort of "formative autonomy" by settling their preferences and committing themselves to weigh their values in a particular way. Since nudges risk infringing formative autonomy by depriving patients of this opportunity, their use in medical contexts should be sensitive to this risk. [ABSTRACT FROM AUTHOR]

Medical students commonly learn how to administer pelvic exams by practicing on unconscious patients, often without first obtaining explicit consent from patients to do so. While 21 states currently have laws that require teaching hospitals to obtain consent from patients to participate in this educational experience, opposition from the medical community has stymied legislative progress. In this paper, I respond to the two most common reasons offered to oppose the legislation, which appeal to (1) the educational benefits of these exams or (2) protecting institutional autonomy. Kantian ideas about autonomy help to illuminate the problematic ways in which these arguments supplant the importance of women's choices over how their bodies are used while seeking medical treatment. Ultimately, neither argument offers sufficient reason to oppose laws that require explicit consent before administering training pelvic exams. [ABSTRACT FROM AUTHOR]

Marine operations required to transfer technicians and equipment represent a significant proportion of the total cost of offshore wind. The profile of sites being considered for floating offshore wind farms (FOWFs), e.g., further from the shore and in harsher environments, indicates that these costs need to be assessed by taking into account the maintenance requirements and restricted weather windows. There is an immediate need to investigate the potential use of robotic systems in the wind farm's operations and maintenance (O&M) activities, to reduce the need for costly manned visits. The use of robotic systems can be critical, not only to replace repetitive activities and bring down the levelised cost of energy but also to reduce the health and safety risks by supporting human operators in performing the desired inspections. This paper provides a review of the state of the art in the applications of robotics for O&M of FOWFs. Emerging technology trends and associated challenges and opportunities are highlighted, followed by an outline of the agenda for future research in this domain. [ABSTRACT FROM AUTHOR]

Community engagement is increasingly defended as an ethical requirement for biomedical research. Some forms of community engagement involve asking the consent of community leaders prior to seeking informed consent from community members. Although community consent does not replace individual consent, it could problematically restrict the autonomy of community members by precluding them from research when community leaders withhold their permission. Community consent is therefore at odds with one of the central principles of bioethics: respecting autonomy. This raises the question as to how community consent can be justified or even required. This paper aims to provide an answer to this question by arguing, based on the work of Taylor and Kymlicka, that community practices are important for the identity and autonomy of community members. When these practices are incompatible with a solitary focus on individual informed consent, they need to be protected by making these decision‐making practices (including asking permission to community authorities) part of the consent process. Since these decision‐making practices are important for the autonomy of community members, community consent with the goal of protecting these practices is not necessarily in conflict with autonomy. [ABSTRACT FROM AUTHOR]

This paper clarifies and reflects on the four values that Serene Khader argues feminism can do without in Decolonizing Universalism: independence individualism, personhood individualism, Enlightenment freedom, and gender‐role eliminativism. Persuaded by her condemnation of the view Khader calls "headship complementarianism" and her defense of a different form of gender complementarianism, the paper leaves the question of gender role eliminativism aside. It starts by presenting some concerns about her treatment of Enlightenment freedom, independence individualism, and personhood individualism. It agrees that Enlightenment freedom and independence individualism have no place in feminism. Contrary to Khader, however, it maintains that personhood individualism is necessarily a feminist value. It then shows why the value of women's autonomy is more central to non‐imperialist feminism than Khader acknowledges. Ultimately, it agrees with Khader that feminism can be both universalist and non‐imperialist provided that these qualifications are adopted. [ABSTRACT FROM AUTHOR]

After summarizing Kathleen Wallace's cumulative network model of the self, this paper explores Wallace's account of the whole self's capacity for self‐reflection in some detail. Supposing that constituents of the self are capable of interpreting and communicating with one another, how is it possible for the whole self to interpret and communicate with itself and to act on the basis of its self‐understandings? The paper suggests that Wallace needs an account of the self's ability to synthesize the information that interpretative communication furnishes and manage it to reach all‐things‐considered judgments and decide what to do. The paper sketches such an account and concludes by considering some implications for selfhood of different types of traumatic experience. [ABSTRACT FROM AUTHOR]

Abstract: While monolithic satellite missions still pose significant advantages in terms of accuracy and operations, novel distributed architectures are promising improved flexibility, responsiveness, and adaptability to structural and functional changes. Large satellite swarms, opportunistic satellite networks or heterogeneous constellations hybridizing small‐spacecraft nodes with high‐performance satellites are becoming feasible and advantageous alternatives requiring the adoption of new operation paradigms that enhance their autonomy. While autonomy is a notion that is gaining acceptance in monolithic satellite missions, it can also be deemed an integral characteristic in Distributed Satellite Systems (DSS). In this context, this paper focuses on the motivations for system‐level autonomy in DSS and justifies its need as an enabler of system qualities. Autonomy is also presented as a necessary feature to bring new distributed Earth observation functions (which require coordination and collaboration mechanisms) and to allow for novel structural functions (e.g., opportunistic coalitions, exchange of resources, or in‐orbit data services). Mission Planning and Scheduling (MPS) frameworks are then presented as a key component to implement autonomous operations in satellite missions. An exhaustive knowledge classification explores the design aspects of MPS for DSS, and conceptually groups them into: components and organizational paradigms; problem modeling and representation; optimization techniques and metaheuristics; execution and runtime characteristics and the notions of tasks, resources, and constraints. This paper concludes by proposing future strands of work devoted to study the trade‐offs of autonomy in large‐scale, highly dynamic and heterogeneous networks through frameworks that consider some of the limitations of small spacecraft technologies. [ABSTRACT FROM AUTHOR]

In the debates regarding the ethics of human organoid biobanking, the locus of donor autonomy has been identified in processes of consent. The problem is that, by focusing on consent, biobanking processes preclude adequate engagement with donor autonomy because they are unable to adequately recognize or respond to factors that determine authentic choice. This is particularly problematic in biobanking contexts associated with organoid research or the clinical application of organoids because, given the probability of unforeseen and varying purposes for which a donor's organoids could be employed and given the different ways in which a donor can relate to her biospecimens, a donor can value her organoids differently in different contexts, and her reasons for autonomously permitting use of her cells and tissues in one case may not support an autonomous decision in another. In response, this paper has three aims: first, to make the case for why organoid biobanks ought to respect donor autonomy conceived as authentic choice; second, to explore the autonomy‐respecting limits of established and widely prevalent models of biobank consent; and third, to propose certain conditions that organoid biobanks ought to support or facilitate in order to respect donor autonomy. [ABSTRACT FROM AUTHOR]

In this paper, we aim to stimulate ethical debate about the morally relevant connection between ectogenesis and the foetus as a potential beneficiary of treatment. Ectogenesis could facilitate foetal interventions by treating the foetus independently of the pregnant woman and provide easier access to the foetus if interventions are required. The moral relevance hereof derives from the observation that, together with other developments in genetic technology and prenatal treatment, this may catalyse the allocation of a patient status to the foetus. The topic of foetal medicine is of growing interest to clinicians, and it also deserves due attention from an ethical perspective. To the extent that these developments contribute to the allocation of a patient status to the foetus (and to its respective interests for medical treatment), normative questions arise about how moral responsibilities towards foetal interests should be balanced against the interests of the pregnant woman. We conclude that, even if ectogenesis could facilitate foetal therapy, it is important to remain sensitive to the fact that it would not circumvent the key ethical concerns that come with in utero foetal treatment and that it may even exacerbate potential conflicts between directive treatment recommendations and the pregnant woman's autonomous decision to the contrary. [ABSTRACT FROM AUTHOR]

Anti‐dualistic social ontologies, those highlighting the intrinsic interdependency of agency and structure as two sides of the same coin, are sometimes criticized for failing to provide a satisfactory account of autonomous – capable and free – agency, or even denying the reality of such agency. This paper contests these claims, arguing that anti‐dualistic ontologies only conflict with autonomous agency when the latter is understood in a highly voluntaristic sense, whose ideational roots go to what philosophers of free will call "incompatibilist" intuitions of freedom. Those intuitions suggest that actions (intentions, decisions) ultimately determined by extrinsic causes lack the kind of freedom presupposed by moral responsibility, so when agentive autonomy is presumed to involve such freedom, it does indeed cohere poorly with the anti‐dualistic picture of intrinsically structured agency. Herein, however, an alternative, "compatibilist" notion of autonomy is advanced, such that does not conflict with extrinsic determination and is therefore congruent with anti‐dualistic social ontologies. [ABSTRACT FROM AUTHOR]

This article examines the question of when and why states should comply with international institutions. It argues that while individuals may have moral reasons to comply, states often prioritize their self-interest and sovereignty. The paper proposes an autonomy-based conception of legitimacy, which suggests that states have a right to personal pursuits but are also restricted by other-regarding reasons. The article concludes that all states have reasons to join and comply with multilateral arrangements that ensure the autonomy of their citizens and other states' peoples. It also discusses the authority of the state, the role of international institutions, and the importance of state consent in determining legitimacy. [Extracted from the article]

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