Doctoral Degrees (Philosophy)

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Browsing Doctoral Degrees (Philosophy) by Subject "Autonomy (Philosophy)"

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    The autonomy of culture : a cultural-philosophical analysis
    (Stellenbosch : Stellenbosch University, 2013-12) Niemand, Johannes R.; Van Niekerk, Anton A.; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Philosophy.
    ENGLISH ABSTRACT: Multicultural conflicts pervade our world and have sparked considerable debate about their possible resolution. We argue that how culture is conceptualized is crucial to the continued dialogue about multicultural conflicts. Specifically, we argue that approaches that argue for the protection of cultures run into significant problems if they do not employ a conception of cultures as delineated entities. However, we also hold that the notion that cultures cannot be distinct in any way, does very little to contribute to dialogue. From the very beginning, it excludes the notion of a culture that is to be protected and thus stops the dialogue there and then. To be true to the principle of audi ad alteram partem, approaches to multicultural conflicts must conceive of an alternative model, provided that such a model is logically possible. This may provide the dialogue with a much needed point of common understanding from which to proceed. Accordingly, we develop a model of culture whereby it is possible to delineate cultures. In this model, a culture can be delineable in a manner analogous to how we delineate persons. Our model of personal delineation suggests a dual structure whereby a trivial personal boundary contains a unity of conflict within the person. In persons, this unity of conflict lies in the relationship between the “I” and repressed meanings. This relationship must be characterised by self-referential decisions and the capacity to make self-referential decisions is central to our definition of personal autonomy. In cultures, we argue that multicultural conflicts provide the necessary conditions that enable us to conceptualize trivial boundaries in cultures in terms of the communicative relationships between members of a particular culture. Multicultural conflicts prompt self-categorizations by individuals and such self-categorizations are made in terms of group membership. Though all members may not agree as to who belongs to the culture and who does not, the claims made about membership serve to differentiate the communicative relationships inside the culture from those outside it. Furthermore, we show that, inside this trivial boundary, a unity of conflict analogous to the one found in personal autonomy, can be exhibited by cultures. We show how a culture, through its institutions, particularly through an institutionalised exit possibility, 1) may exhibit self-reference and 2) relate to a source of authority in the same way as a person does when making selfreferential decisions. In this regard, we argue that institutionalised exit possibilities embody adherence to the consensus vs. power criterion, according to which the dominant account of a culture is achieved through consensus, as opposed to through the exertion of power. Furthermore, we argue that with a strong analogy between cultures’ and personal delineation, it becomes reasonable to extend concepts we usually apply to persons, such as fairness, attachment and viability, so that they can also apply to cultures. We show that the application of these concepts clarifies certain current multicultural issues. The application of theses concepts also leads to the development of a decision making process to deal with multicultural issues.
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    Identity, personhood and power : a critical analysis of the principle of respect for autonomy and the idea of informed consent, and their implementation in an androgynous and multicultural society
    (Stellenbosch : Stellenbosch University, 2012-03) Rossouw, Theresa Marie; Van Niekerk, Anton A.; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Philosophy.
    ENGLISH ABSTRACT: Autonomy and informed consent are two interrelated concepts given much prominence in contemporary biomedical discourse. The word autonomy, from the Greek autos (self) and nomos (rule), originally referred to the self-governance of independent Hellenic states, but was extended to individuals during the time of the Enlightenment, most notably through the work of Immanuel Kant and John Stuart Mill. In healthcare, the autonomy model is grounded in the idea of the dignity of persons and the claim people have on each other to privacy, self-direction, the establishment of their own values and life plans based on information and reasoning, and the freedom to act on the results of their contemplation. Autonomy thus finds expression in the ethical and legal requirement of informed consent. Feminists and multiculturalists have however argued that since autonomy rests on the Enlightenment ideals of rationality, objectivity and independence, unconstrained by emotional and spiritual qualities, it serves to isolate the individual and thus fails to rectify the dehumanisation and depersonalisation of modern scientific medical practice. It only serves to exacerbate the problematic power-differential between doctor and patient. Medicine is a unique profession since it operates in a space where religion, morality, metaphysics, science and culture come together. It is a privileged space because health care providers assume responsibility for the care of their patients outside the usual moral space defined by equality and autonomy. Patients necessarily relinquish some of their autonomy and power to experts and autonomy thus cannot account for the moral calling that epitomizes and defines medicine. Recognition of the dependence of patients need not be viewed negatively as a lack of autonomy or incompetence, but could rather reinforce the understanding of our shared human vulnerability and that we are all ultimately patients. There is however no need to abandon the concept of autonomy altogether. A world without autonomy is unconceivable. When we recognise how the concept functions in the modern world as a social construct, we can harness its positive properties to create a new form of identity. We can utilise the possibility of self-stylization embedded in autonomy to fashion ourselves into responsible moral agents that are responsive not only to ourselves, but also to others, whether in our own species or in that of another. Responsible agency depends on mature deliberators that are mindful of the necessary diversity of the moral life and the complex nature of the moral subject. I thus argue that the development of modern individualism should not be rejected altogether, since we cannot return to some pre-modern sense of community, or transcend it altogether in some postmodern deconstruction of the self. We also do not need to search for a different word to supplant the concept of autonomy in moral life. What we rather need is a different attitude of being in the world; an attitude that strives for holism, not only of the self, but also of the moral community. We can only be whole if we acknowledge and embrace our interdependence as social and moral beings, as Homo moralis.
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    Moral bioenhancement: an ethical and philosophical investigation
    (Stellenbosch : Stellenbosch University, 2018-03) Palk, Andrea Christy; Van Niekerk, Anton A.; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Philosophy.
    ENGLISH SUMMARY: It has been argued, in the bioethics literature, that traditional forms of moral instruction and development are no longer adequate in equipping humanity to address the urgent nature of the ethical problems facing contemporary societies. Rather than continuing to rely upon these supposedly ineffective methods, we should explore the possibility of biologically enhancing our morality. This would entail both decreasing the likelihood that we would wish to cause harm to others as well as increasing our motivation to do good. The proponents of moral bioenhancement argue that the best way of achieving this would be to isolate which affective dispositions, that are associated with moral traits, are susceptible to biological modification and to biologically enhance these dispositions. However, despite the presence of strong consequentialist arguments in favour of moral bioenhancement, it has elicited a variety of ethical concerns as well as conceptual and practical problems that would have to be addressed for it to become a coherent possibility. An ethical concern that has been raised in the literature is the concern that moral bioenhancement is wrong, in principle, and regardless of any benefits it could produce, because it risks negatively impacting phenomena that are regarded as intrinsically valuable. In particular, the concern is that moral bioenhancement could impact our moral autonomy, and thus, threaten human morality as such. This concern is based upon the view that the conditions for the exercise of autonomous moral behaviour, and thus morality itself, lie in the deliberation and choice that must be freely made in the face of competing demands. In other words, if it became possible to biologically increase our motivation to do good, thereby increasing the likelihood that we act in a way that is regarded as morally desirable, could our resultant behaviour still be regarded as morally autonomous; or, is morality solely a product of our given, unaltered biological predispositions, working in conjunction with traditional mechanisms of moral education? Will morality as we know it disappear if moral bioenhancement becomes a possibility? This dissertation contributes towards the literature through a comprehensive review in which particular conceptual, philosophical and empirical problems are addressed, as well as by providing a structured discussion of the practical and theoretical ethical concerns regarding moral bioenhancement. The dissertation includes a substantive definition of moral bioenhancement and makes further independent contributions through the analysis and application of a coherence theory of autonomy to ascertain the status for moral autonomy of various outcomes of moral bioenhancement interventions. From this analysis, a checklist of interventions that could be potentially inimical to autonomy, in terms of their outcomes, is constructed. The conclusion is that in certain cases, moral bioenhancement could produce an increase, rather than a decrease, in the level of autonomy experienced by individuals.
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    Patient autonomy and evidence-based choice – philosophical and ethical perspectives
    (Stellenbosch : University of Stellenbosch, 2010-03) Moore, Willem; Van Niekerk, Anton A.; Louw, J. A.; University of Stellenbosch. Faculty of Arts and Social Sciences. Dept. of Philosophy.
    ENGLISH ABSTRACT: This study involves a critically evaluation of evidence-based patient choice as partnership model in clinical decision making. It pays attention to the emergence of the concept of autonomy in modern moral philosophy and in particular to the pivotal contributions of Immanuel Kant and John Stuart Mill in this regard. Against this background, it elaborates on the ethical principle of respect for autonomy, informed consent as paradigm for patient autonomy in clinical decision making, the conflicts that arise between the ethical concepts of autonomy and beneficence, the dominance of paternalism in clinical decision making, the challenges posed to the dominance of paternalism, the resulting emergence of the concept of partnership in clinical decision making and evidence-based patient choice as partnership model in clinical decision making. Moreover, it provides an exposition of the context, nature and practice of evidence-based patient choice and of the four key decision making skills required from health care professionals to involve patients in clinical decision making, namely shared decision making, risk communication, decision analysis, and the use of decision aids. Against this background, it critically evaluates the effectiveness of evidence-based patient choice as partnership model in clinical decision making by judging it in terms of the ethical concept of patient autonomy as reflected in the informed consent elements of competence, disclosure, understanding and voluntariness and indicates that none of the key skills of evidence-based patient choice can be regarded as completely adequate in honouring the principle of respect for autonomy in clinical decision making and that consequently each of these four key skills leave evidence-based patient choice with a challenge that needs to be addressed from another angle in order to establish and maintain the ethical principle of respect for autonomy. In response to these challenges, the study makes three recommendations for the transformation of evidence-based patient choice to a therapeutic alliance health care, namely to review and further develop the philosophical foundations of evidence-based patient choice, to consider the continental philosophical perspectives of Edmund Husserl, Jean-Paul Sartre, Maurice Merleau-Ponty and Jürgen Habermas on the evidence-based patient choice challenges of the separate worlds of doctor and patient, the constitution of meaning in illness and the dangers of abstractions and informational manipulation in health care and to transform the practice of evidence-based patient choice to a therapeutic alliance in health care by individualising the provision of information by embedding it in the human processes of sense making, knowledge creation and decision making through which information is transformed into insight, knowledge and action.