Personal autonomy is often lauded as a key value in contemporary Western bioethics. Though the claim that there is an important relationship between autonomy and rationality is often treated as uncontroversial in this sphere, there is also considerable disagreement about how we should cash out the relationship. In particular, it is unclear whether a rationalist view of autonomy can be compatible with legal judgments that enshrine a patient's right to refuse medical treatment, regardless of whether the reasons underpinning the choice are known and rational, or indeed whether they even exist. Jonathan Pugh brings recent philosophical work on the nature of rationality to bear on the question of how we should understand personal autonomy in contemporary bioethics. In doing so, he develops a new framework for thinking about the concept of autonomy, one that is grounded in an understanding of the different roles that rational beliefs and rational desires have to play in it. Pugh's account allows for a deeper understanding of d the relationship between our freedom to act and our capacity to decide autonomously. His rationalist perspective is contrasted with other prominent accounts of autonomy in bioethics, and the revisionary implications it has for practical questions in biomedicine are also outlined.
Law
Partiality for Humanity and Enhancement
Pugh J, Kahane G, Savulescu J
October 2016
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Chapter
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The Ethics of Human Enhancement
Neurointerventions as criminal rehabilitation: An ethical review
Pugh J, Douglas T
July 2016
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Chapter
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The Routledge Handbook of Criminal Justice Ethics
This chapter analyzes the problem of remedies for state wrongs in criminal justice institutions. The problem of remedies is analytically distinct from questions of what the substantive rules should be in the first instance. Jurisdictions differ in how much authority they assign to police, prosecutors, and other key actors in the criminal justice system. The chapter discusses why criminal justice institutions should include remedies for serious malfeasance and neglect in the first instance and why do these rights violations even provide a cause for remedial design expenditures. It explores two pivotal institutional design choices that a democratic principal must make: should policy responses or remedies be ex ante or ex post; and should they be public or privatized. The chapter explains the strengths and weaknesses of each approach. The political, sociological, and historical circumstances of criminal justice diverge widely from jurisdiction to jurisdiction. The ensuing variance precludes across-the-board responses.
