Personal autonomy is often lauded as a key value in contemporary bioethics. In this thesis, I aim to provide a rationalist account of personal autonomy that avoids the philosophical flaws present in theories of autonomy that are often invoked in bioethics, and that can be usefully applied to contemporary bioethical issues. I claim that we can understand the concept of autonomy to incorporate two dimensions, which I term the 'reflective' and 'practical' dimensions of autonomy. I suggest that the reflective dimension pertains to the critical reflection that agents must carry out on their motivating desires, in order to be autonomous with respect to them. I begin by rejecting prominent desire-based and historical accounts of this dimension of autonomy, before going on to defend an account based upon a Parfitian analysis of rational desires. Following this analysis of the reflective dimension of autonomy, I argue that autonomy can also be understood to incorporate a practical dimension, pertaining to the agent's ability to act effectively in pursuit of their ends. I claim that recognising this dimension of autonomy more comprehensively reflects the way in which we use the concept of autonomy in bioethics, and makes salient the fact that agents carry out their rational deliberations in the light of their beliefs about what they are able to do. I go on to argue that this latter point means that my account of autonomy can offer a deeper explanation of why coercion undermines autonomy than other prominent accounts. Having considered the prudential value of autonomy in the light of this theoretical analysis, in the latter half of the thesis I apply my rationalist account of autonomy to a number of contemporary bioethical issues, including the use of human enhancement technologies, the nature of informed consent, and the doctor-patient relationship.

Autonomy, Rationality, and Contemporary Bioethics

This thesis is primarily a cultural history of abortion in the early medieval West. It is a historical study of perceptions, rather than the practice, of abortion. The span covered ranges from the sixth century, when certain localised ecclesiastical initiatives in the form of councils and sermons addressed abortion, through to the ninth century, when some of these initiatives were integrated into pastoral texts produced in altogether different locales. The thesis uses a range of predominantly ecclesiastical texts – canonical collections, penitentials, sermons, hagiography, scriptural commentaries, but also law-codes – to bring to light the multiple ways in which abortion was construed, experienced and responded to as a moral and social problem.
Although there is a concerted focus upon the ecclesiastical tradition on abortion, a focus which ultimately questions how such a tradition ought to be understood, the thesis also explores the broader cultural significance of abortion. Early medieval churchmen, rulers, and jurists saw multiple things in abortion and there were multiple perspectives upon abortion. The thesis illuminates the manifold and, occasionally, surprising ways in which abortion was perceived in relation to gender, sexuality, politics, theology and the church.
The history of early medieval abortion has been largely underwritten. Moreover, it has been inadequately historicised. Early medieval abortion has been rendered strangely familiar because it has been approached through alien concepts and assumptions, whether pre-medieval, later medieval or modern. Through vigilance against conceptual dangers, a thoroughgoing and sometimes microscopic approach to reading and contextualising early medieval sources, and an interest in bringing the history of abortion into conversation with other areas of early medieval historiography, the thesis seeks to historicise perceptions of and responses to abortion in the early medieval West.

/pdf/alienated-from-the-womb-abortion-in-the-early-medieval-west-49xiozaqj6.pdf

Alienated from the womb : abortion in the early medieval West, c.500-900

Advances in cybernetic and nanotechnological body modifications currently allow for enhancements to human physical and mental function which exceed human species-based norms. This thesis examines body modification and human enhancement from two perspectives—Roman Catholicism and Transhumanism— in order to contribute to bioethical deliberations regarding enhancement technologies. Roman Catholicism has a longstanding tradition of bioethical discourse, informing the healthcare directives of Roman Catholic institutions. Transhumanism is more recent movement that endorses body modifications and human enhancements as a means of individual betterment and social evolution. The thesis first considers definitions of human enhancement and levels of normalcy in connection to cybernetic and nanotechnological bionic implants, and outlines a series of criteria to assess a technology’s potential bioethical acceptability: implantability, permanency, power, and public interaction. The thesis then describes Roman Catholicism’s response to non-enhancing decorative body modifications (cosmetic surgeries, common decorative modifications such as tattoos and piercings, and uncommon modifications such as scarifications and brandings) in order to establish a basis for possible Roman Catholic responses to enhancing cybernetic and nanotechnological modifications. This is followed by an analysis from a Roman Catholic perspective of the major social issues brought forward by enhancement technologies: commodification, eugenics, vulnerability, and distributive justice. Turning to Transhumanism, the thesis describes the origins and philosophy of the movement, and then discusses the bioethical principles it advances with regard to human enhancement. The thesis concludes by locating points of convergence between Transhumanism and Roman Catholicism that could be the basis of more widely accepted ethical guidelines regarding modification technologies.

/pdf/traditional-and-new-enhancing-human-cybernetic-and-4iad94pv8b.pdf

Traditional and New Enhancing Human Cybernetic and Nanotechnological Body Modification Technologies: A Comparative Study of Roman Catholic and Transhumanist Ethical Approaches

The primacy of the virtuous

This paper discusses the philosophical argument and the application of the Triple Font Theory (TFT) for moral evaluation of human acts and attempts to integrate the conceptual components of major moral theories into a systematic internally consistent decision-making model that is theoretically driven. The paper incorporates concepts such as formal and material cooperation and the Principle of Double Effect (PDE) into the theoretical framework. It also advances the thesis that virtue theory ought to be included in any adequate justification of morality and the need to integrate or coordinate notions of virtue into various act-oriented or principles-based ethics. The TFT offers a comprehensive and practical approach to ethical decision-making and is a useful alternative embedded in traditional wisdom. This paper provides a more general framework of the TFT than traditionally presented. Practical judgment is shown to play a constitute role in providing a guide for right action and is the “glue” that integrates the various components of the TFT.

https://www.jstor.org/stable/info/25075346

Ethical Decision-Making: A Case for the Triple Font Theory

Rather than end the debate over artificial means of contraception once and for all, the encyclical letter "Humanae Vitae" only energized the debate when it appeared in 1968, and that debate continues to this day Janet E Smith presents a comprehensive review of this issue from a philosophical and theological perspective Tracing the emergence of the debate from the mid-1960s and reviewing the documents from the Special Papal Commission established to advise Pope Paul V1, Smith also examines the Catholic Church's position on marriage, which provides the context for its condemnation of contraception Smith analyzes the various moral principles that are crucial to an understanding of "Humanae Vitae" She offers new renderings of several traditional arguments based on natural law, among which is an argument based on personalist values Throughout the book, Smith's observations and perceptions contribute to a thought-provoking study

Humanae vitae, a generation later

Upon reading case books on medical ethics or simply news reports in the media, one cannot escape noticing that the medical professions are currently involved in practices that some few decades ago would have been unthinkable, not only because of the level of technology involved, but because of the then prevailing moral evaluation of the practices. One reads of Dr. Kevorkian and his death machine; of a sixty-one-year-old woman having a baby conceived with another woman’s ovum in a petri dish; of embryos created solely for experimental purposes; of vital organs taken from living anencephalic infants; of millions of abortions yearly. Clearly a revolution of some kind, beyond the merely technological, has taken place.

The Pre-eminence of Autonomy in Bioethics

The Morality of Condom Use by HIV-Infected Spouses

Veritatis Splendor n'a pas ete ecrit pour reiterer la condamnation ecclesiale de la contraception, mais pour etablir que certains points de vue de l'ecole de theologie morale connue sous le nom de proportionalisme sont en conflit avec l'enseignement moral du magistere catholique. La pretention proportionaliste que la contraception n'est pas une action intrinsequement mauvaise, semble avoir ete l'impulsion pour defier le concept des actions intrinsequement mauvaises dans leur ensemble. Cet article explore la discussion terminologique sur la comprehension du terme mal intrinseque. Il tente de degager le debat de ce theme ou il s'est enlise pour le diriger vers la nature meme des biens que sont la procreation et l'union du mariage ainsi que leur relation.

Veritatis Splendor, Proportionalism, and Contraception

Aquinas’s Theory of Natural Law: An Analytic Reconstruction

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