Ashley, Florence. Gatekeeping Hormone Replacement Therapy for Transgender Patients is Dehumanising
2019, The Journal of Medical Ethics. 45: 480-482.
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Added by: Chris Blake-TurnerAbstract:
Although informed consent models for prescribing hormone replacement therapy are becoming increasingly prevalent, many physicians continue to require an assessment and referral letter from a mental health professional prior to prescription. Drawing on personal and communal experience, the author argues that assessment and referral requirements are dehumanising and unethical, foregrounding the ways in which these requirements evidence a mistrust of trans people, suppress the diversity of their experiences and sustain an unjustified double standard in contrast to other forms of clinical care. Physicians should abandon this unethical requirement in favour of an informed consent approach to transgender care.Barclay, Linda. Genetic Engineering and Autonomous Agency2003, Journal of applied philosophy 20(3): 223–236.-
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Added by: Simon Fokt
Abstract: In this paper I argue that the genetic manipulation of sexual orientation at the embryo stage could have a detrimental effect on the subsequent person's later capacity for autonomous agency. By focussing on an example of sexist oppression I show that the norms and expectations expressed with this type of genetic manipulation can threaten the development of autonomous agency and the kind of social environment that makes its exercise likely.Comment: Useful mainly in the context of (the limitations of) reproductive rights and as a further reading on the ethics of genetic engineering and human enhancement.
Begon, Jessica. Paternalism2016, Analysis 76(3): 355-373.-
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Added by: Carl Fox
Summary: Analysis review article of recent work on the topic of paternalism. Discusses different ways in which the term is defined, reviews the debate between 'paternalists' and 'anti-paternalists', and presents soft paternalism.Comment: Could be used as an introductory reading to the topic of paternalism, or a further reading to provide a comprehensive background to recent work in the area.
Bortolotti, Lisa, Daniela Cutas. Reproductive and Parental Autonomy: An Argument for Compulsory Education2009, Reproductive Biomedicine Online, 19 (Ethics Supplement): 5-14.-
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Added by: Rochelle DuFord
Abstract: In this paper we argue that society should make available reliable information about parenting to everybody from an early age. The reason why parental education is important (when offered in a comprehensive and systematic way) is that it can help young people understand better the responsibilities associated with reproduction, and the skills required for parenting. This would allow them to make more informed life-choices about reproduction and parenting, and exercise their autonomy with respect to these choices. We do not believe that parental education would constitute a limitation of individual freedom. Rather, the acquisition of relevant information about reproduction and parenting and the acquisition of self-knowledge with respect to reproductive and parenting choices can help give shape to individual life plans. We make a case for compulsory parental education on the basis of the need to respect and enhance individual reproductive and parental autonomy within a culture that presents contradictory attitudes towards reproduction and where decisions about whether to become a parent are subject to significant pressure and scrutiny.Comment: This text provides a clear overview of debates about reproductive autonomy and compulsory education. It also contains responses to well known criticisms of compulsory parental education. It would be best used in a course dealing with issues of parenthood and procreation, reproduction, or autonomy in a medical context.
Buss, Sarah. Personal autonomy2008, Stanford Encyclopedia of Philosophy.-
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Added by: Clotilde Torregrossa, Contributed by: Simon Fokt
Abstract: To be autonomous is to be a law to oneself; autonomous agents are self-governing agents. Most of us want to be autonomous because we want to be accountable for what we do, and because it seems that if we are not the ones calling the shots, then we cannot be accountable. More importantly, perhaps, the value of autonomy is tied to the value of self-integration. We don't want to be alien to, or at war with, ourselves; and it seems that when our intentions are not under our own control, we suffer from self-alienation. What conditions must be satisfied in order to ensure that we govern ourselves when we act? Philosophers have offered a wide range of competing answers to this question.Comment:
Conly, Sarah. One Child: Do We Have a Right to More?2016, Oxford: Oxford University Press.-
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Added by: Rochelle DuFord
Summary: A compelling argument for the morality of limitations on procreation in lessening the harmful environmental effects of unchecked population. We live in a world where a burgeoning global population has started to have a major and destructive environmental impact. The results, including climate change and the struggle for limited resources, appear to be inevitable aspects of a difficult future. Mandatory population control might be a possible last resort to combat this problem, but is also a potentially immoral and undesirable violation of human rights. Since so many view procreation as an essential component of the right to personal happiness and autonomy, the dominant view remains that the government does not have the right to impose these restrictions on its own citizens, for the sake of future people who have yet to exist. Sarah Conly is first to make the contentious argument that not only is it wrong to have more than one child in the face of such concerns, we do not even retain the right to do so. In One Child, Conly argues that autonomy and personal rights are not unlimited, especially if one's body may cause harm to anyone, and that the government has a moral obligation to protect both current and future citizens. Conly gives readers a thought-provoking and accessible exposure to the problem of population growth and develops a credible view of what our moral obligations really are, to generations present and future.Comment: This book would be an excellent resource for an upper-division course on population ethics, ethcs of reproduction, autonomy, or human rights. It would also serves as a good overview of positions in population ethics or as a supplement to a class on environmental ethics and future generations.
Cordova, Viola. Ethics: The We and the I2004, In: American Indian Thought: Philosophical Essays. Anne Waters (ed.), Blackwell (Oxford).-
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Added by: Sonja Dobroski and Quentin PharrAbstract:
This book brings together a diverse group of American Indian thinkers to discuss traditional and contemporary philosophies and philosophical issues. The essays presented here address philosophical questions pertaining to knowledge, time, place, history, science, law, religion, nationhood, ethics, and art, as understood from a variety of Native American standpoints. Unique in its approach, this volume represents several different tribes and nations and amplifies the voice of contemporary American Indian culture struggling for respect and autonomy. Taken together, the essays collected here exemplify the way in which American Indian perspectives enrich contemporary philosophy.Comment:
available in this Blueprint
Corrigan, Oonagh. Empty Ethics: The Problem with Informed Consent2003, Sociology of Health & Illness, 25 (3): 768-792.-
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Added by: Rochelle DuFord
Abstract: Informed consent is increasingly heralded as an ethical panacea, a tool to counter autocratic and paternalistic medical practices. Debate about the implementation of informed consent is constricted and polarised, centring on the right of individuals to be fully informed and to freely choose versus an autocratic, paternalistic practice that negates individual choice. A bioethical framework, based on a principle-led form of reductive/deductive reasoning, dominates the current model of informed consent. Such a model tends to abstract the process of consent from its clinical and social setting. By fleshing out the social process involved when patients and healthy volunteer subjects consent to take part in clinical drug trials, this paper attempts to address the problem arising from the current 'empty ethics' model. My arguments are substantiated by qualitative interview data drawn from a study I conducted on the process of consent as experienced by participants in clinical drug trials.Comment: This text is a clear critique of the use of informed consent as a medical-ethical panacea (it could be taught alongside O'neill's "Paternalism and Partial Autonomy" for a more accessible and applied look at the problem of informed consent). It would be useful as a contrast at the end of a unit on informed consent for medical treatment or a unit on clinical research ethics. It is especially good for use in a biomedical ethics or research ethics course aimed at students interested in the health professions.
Etieyibo, Edwin. The Case of Competancy and Informed Consent2013, Journal of Clinical Research and Bioethics, 4 (2): 1-4.-
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Added by: Rochelle DuFord
Abstract: Patient competence is an essential element of every doctor-patient relationship. In this paper I provide a case report involving an older Korean man in a Hawaiian hospital who refused treatment on the basis of mistaken facts or beliefs about his doctors and treatment. I discuss the case as it relates to competency and extends it to informed consent, autonomy and paternalism. I suggest and argue firstly, that the older Korean man is not fully competent, and secondly, that if he is not fully competent, then soft and weak paternalism may be justified in his case and in cases similar to his.Comment: This text presents an introduction to the relationship between competance, informed consent, and autonomy in medical contexts through the use of a case study. As such, it would be a good text for an introductory course in health care ethics or biomedical ethics within a unit on autonomy or culturally-specific applications of medical ethical principles.
Friedman, Marilyn. Autonomy, Social Disruption, and Women2000, in Mackenzie, C. and Stoljar, N. (Eds.) Relational Autonomy: Feminst Perspectives on Autonomy, Agency, and the Social Self. Oxford: Oxford University Press. 35-51.-
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Added by: Carl Fox
Abstract: This chapter develops a point made in preceding chapters that autonomy, although socially grounded, has an individualizing dimension — a dimension that is defend against the worries of critics. The main thesis is that: at the same time that we embrace relational accounts of autonomy, we should also be cautious about them. Autonomy increases the risk of disruption in interpersonal relationships. While this is an empirical and not a conceptual claim about autonomy, nevertheless, the risk is significant and its bearing on the value of autonomy is therefore empirically significant. It makes a difference in particular to whether the ideal of autonomy is genuinely hospitable to women.Comment: This chapter presents an account of autonomy that sits between highly relational and highly individual accounts of autonomy.
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Comment (from this Blueprint): Ashley draws on their own experiences as a trans person, as well as that of the trans community more broadly, to argue against assessment and referral requirements for hormone-replacement therapy (HRT). Ashley argues instead for an informed consent model, on which providers of HRT are not gatekeepers of transness, but facilitators of thoughtful decision-making.