Doctoral Degrees (Philosophy)

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Browsing Doctoral Degrees (Philosophy) by Subject "Bioethics"

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    Harm and enhancement : philosophical and ethical perspectives
    (Stellenbosch : Stellenbosch University, 2012-12) Hall, Susan; Van Niekerk, Anton A.; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Philosophy.
    ENGLISH ABSTRACT: The distinction between treatment and enhancement is often considered to be a morally significant boundary, which, at the very least, marks the limits of our moral obligations. This conviction holds despite the fact that treatment and enhancement are situated along a continuum of interventions that are directed towards the improvement of human functioning. The distinction between these two sorts of interventions is based upon a notion of normative normality, which suggests that we are morally obligated to provide interventions which are directed toward the achievement of normal functioning, but that no obligation exists to improve functioning beyond this point. This dissertation will subject this position to critique by examining the constitution of normal functioning, and by suggesting that this kind of functioning cannot operate as a normative standard which determines the limits of our moral obligations. The moral desirability which we attribute to the achievement of normal functioning is based upon the independent ethical imperative to promote the possibilities for well-being of moral agents. This motivation, however, equally suggests that we will be obligated to provide certain kinds of enhancement interventions which will be likely to promote the welfare interests of moral agents, when these become available. This argument also implies that the development of enhancement technologies will require us to rethink our ethical conception of harmful non-benefits. We currently think of the non-provision of medical treatment and some environmental enhancements, such as education, as harmful to the extent that state intervention is justified to rectify this. We recognise that such non-provision, and the resultant failure to promote the welfare interests of moral agents, where such promotion is possible, harms persons by putting them in a worse position than they could have been in, with regards to their chances of leading a good life. The new technological possibilities offered by the prospect of genetic enhancement mean that we might soon have a better alternative, in terms of our chances of leading a good life, to the level of functioning that we have thus far been able to achieve. This implies that the non-provision of these enhancements would be harmful to the extent that intervention to bring about this provision would be justified.
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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.