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Whether it is fair to usepersonalresponsibility of patients for their own health as a rationing criterion in healthcare is a controversial matter. A host of difficulties are associated with the concept ofpersonalresponsibility in the field of medicine. These include, in particular, theoretical considerations of justice and such practical issues as multiple causal factors in medicine and freedom of health behaviour. In the article,personalresponsibility is evaluated from the perspective of (...) several theories of justice. It is argued that in a healthcare system based on both equality of opportunity and solidarity, responsible health behaviour can—in principle—be justifiably expected. While the practical problems associated withpersonalresponsibility are important, they do not warrant the common knee-jerk refusal to think more deeply aboutresponsibility for health as a means of allocating healthcare resources. In conclusion, the possibility of introducingpersonalresponsibility as a fair rationing criterion is briefly sketched. (shrink)

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Considering entrepreneurial activity from the psychological perspective, primarily it is worth to give an answer to the question of what fundamental, ultimate purpose of entrepreneurship is. In the conceptual and theoretical aspect, two opposite points of view are distinguished: the first recognizes focusing of the entrepreneurship mainly on profit subject to obeying existing laws, the second considers business entities as members of society, who bearpersonalresponsibility to society for their behaviour. However, since laws cannot cover all life (...) events, entrepreneurs are obliged to comply with the requirements of the rules of socially responsible behaviour in order to maintain a society based on order and legality. Scientists identify a number of stages that the company goes through before realizing: corporate socialresponsibility is a tool for creating new value. The first step to the introduction of strategic innovations in companies is to harmonize compliance with the law. Actually, a social company should do this by definition. The second step is when companies begin to realize the need to engage in strategic philanthropy. Thus, corporate funds are established. The third stage is to create mechanisms of self-regulation based on values. The next stage is the direct material benefits from strategic innovations. This is most often the result of increased efficiency. At the last stage, conceptually new products are created, new markets are opened. It is important that strategic innovations through socialresponsibility are mostly aimed at creating new products and services and are a source of income. (shrink)

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What does it take for an individual to be personally responsible for behaviors that lead to increased risk of disease? We examine three approaches toresponsibility that cover the most important aspects of the discussion ofresponsibility and spell out what it takes, according to each of them, to be responsible for behaviors leading to increased risk of disease. We show that only what we call the causal approach can adequately accommodate widely shared intuitions to the effect that (...) certain causal influences—such as genetic make-up or certain social circumstances—diminish, or underminepersonalresponsibility. However, accepting the causal approach most likely makespersonalresponsibility impossible. We therefore need either to reject these widely shared intuitions about what counts asresponsibility-softening or undermining or to accept thatpersonalresponsibility for behaviors leading to increased risk of disease rests on premises so shaky thatpersonalresponsibility is probably impossible. (shrink)

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Rebecca Brown and Julian Savulescu1 focus on individuals’responsibility regarding health-related behaviours. They rightly argue that paying attention to diachronic and dyadic aspects ofresponsibility can further illuminate the highly multifaceted concept ofpersonalresponsibility for health. Their point of departure is a pragmatic one. They note thatpersonalresponsibility ‘is highly intuitive, [that]responsibility practices are a commonplace feature of almost all areas of human life and interpersonal relationship [and that] the pervasiveness (...) of this concept [suggest] the improbability of banishing it entirely’. Indeed, despite—or perhaps even quite independent of—decades of mostly sceptical conceptual analysis of the concept ofpersonalresponsibility by philosophers and others, it endures, if not flourishes. These separate dynamics raise the question of how, in years ahead, the debate onresponsibility can be furthered most effectively, and how nuanced conceptual distinctions can effectively inform policy and practice. The authors’ table 1 matrix illustrates how different levels of control and knowledge people had at different timepoints might be grouped in categories of low, moderate or high demandingness: for policy makers sympathetic to the authors’ proposal that high levels of demandingness should undermineresponsibility attributions, or for advocacy groups seeking to lobby on their behalf, several questions likely arise, including: How should …. (shrink)

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This paper argues against incorporating assessments of individualresponsibility into healthcare policies by expanding an existing argument and offering a rebuttal to an argument in favour of such policies. First, it is argued that what primarily underlies discussions surroundingpersonalresponsibility and healthcare is not causalresponsibility, moralresponsibility or culpability, as one might expect, but biases towards particular highly stigmatised behaviours. A challenge is posed for proponents of takingpersonalresponsibility into account (...) within health policy to either expand the debate to also include socially accepted behaviours or to provide an alternative explanation of the narrowly focused discussion. Second, a critical response is offered to arguments that claim that policies based onpersonalresponsibility would lead to several positive outcomes including healthy behaviour change, better health outcomes and decreases in healthcare spending. It is argued that using individualresponsibility as a basis for resource allocation in healthcare is unlikely to motivate positive behaviour changes, and is likely to increase inequality which may lead to worse health outcomes overall. Finally, the case of West Virginia's Medicaid reform is examined, which raises a worry that policies focused onpersonalresponsibility have the potential to lead to increases in medical spending overall. (shrink)

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Does a human right to healthcare imply individual obligations to healthy behavior? Or put another way: Is a self-induced condition a relevant criterion for some sort of restriction of this right—like withholding or modifying treatment in circumstances where choices have to be made? For instance, should a drunk driver bear the costs of medical care that he needs after a car accident he has caused? Should there be a difference in healthcare entitlements between the smoker with a heart attack who (...) is seriously overweight and the 60-year old man who has always taken excellent care of himself and is suddenly stricken by leukemia? And how should we think about the risk-taking behavior of all the persons going on a skiing holiday or an exotic hiking trip? a. (shrink)

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This paper develops the case for establishing curriculum in business school that includes systems-based strategic decision-making. Pepperdine University’s certificate in Social, Environmental and EthicalResponsibility at their Graziadio School of Business is an example of a program that espouses values-based leadership, using the SEER lens as a framework that includes social and environmental values in the process of crafting a sustainable competitive advantage.

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In France a difference has been established between cultural popularization and cultural democracy. The former is aimed at spreading works of art in as large a way as possible; the latter emphasizes the participation of the public. From there, we argue that moving from cultural popularization towards cultural democracy can lead to a shift in responsibilities from professionals towards the general public. With reference to the theoretical background of reception, appropriation and participation, we lead a participant observation on three different (...) fields in order to understand what facilitates and what constrains this shift. This leads us to stress the importance of developing an adequate organizational framework. (shrink)

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American transcendentalists were eager to oppose structural evils such as slavery and poverty. The 1840s were characterized by experiments and debates about whether and how such evils could be opposed. Orestes Brownson, Ralph Waldo Emerson, and Henry David Thoreau, following Thomas Carlyle and William Ellery Channing, set the terms of this debate. In the end, despite their different anthropologies, ecclesiologies, and prescriptions for opposing evil, they agree that spiritual reform is integral to sociopolitical reform. This transcendentalist debate illuminates the role (...) ofpersonalresponsibility and reform in efforts to oppose structural evil in our own time. (shrink)

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While libertarians affirmpersonalresponsibility as a central moral and political value, libertarian theorists write relatively little about the theory and practice of this value. Focusing on the work of F. A. Hayek and David Schmidtz, this article identifies the core of a libertarian approach topersonalresponsibility and demonstrates the ways in which this approach entails a radical revision of the ethics and American politics ofpersonalresponsibility. Then, I highlight several central implications (...) of this analysis in the American political and economic status quo. First, this analysis makes a mockery of so-called libertarian/conservative ‘fusionism’, such that libertarianpersonalresponsibility cannot partner with meritocratic conservative thought to provide a plural grounding for rejecting progressive or redistributive economic policy. Next, preferred libertarian policies threaten the status, esteem and social bases of self-respect of citizens who are worse-off through little or no fault of their own. Finally, these policies undermine the ethics ofpersonalresponsibility that Americans from across the ideological spectrum value and many conservatives and libertarians celebrate. In the American status quo, those who valuepersonalresponsibility must reserve a central place for policies that mitigate opportunity and distributive inequalities. (shrink)

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Luck egalitarianism is aresponsibility-sensitive theory of distributive justice. Its application to health and healthcare is controversial. This article addresses a novel critique of luck egalitarianism, namely, that it wrongfully discriminates against those responsible for their health disadvantage when allocating scarce healthcare resources. The philosophical literature about discrimination offers two primary reasons for what makes discrimination wrong (when it is): harm and disrespect. These two approaches are employed to analyze whether luck egalitarian healthcare prioritization should be considered wrongful discrimination. (...) Regarding harm, it is very plausible to consider the policies harmful but much less reasonable to consider those responsible for their health disadvantages a socially salient group. Drawing on the disrespect literature, where social salience is typically not required for something to be discrimination, the policies are a form of discrimination. They are, however, not disrespectful. The upshot of this first assessment of the discrimination objection to luck egalitarianism in health is, thus, that it fails. (shrink)

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A number of egalitarians have reached the conclusion that inequalities are just provided that they are the outcome of holding people appropriately responsible for their choices, and that only inequalities which can be traced back to the circumstances in which people happen to find themselves are objectionable. But this form of egalitarianism needs to be supplemented with an account of when it is appropriate to hold people responsible for their choices that is properly sensitive to the profound effects of socialisation. (...) Two of the most promising attempts to develop such an account-those of Ronald Dworkin and John Roemer-are found to be problematic in the light of a range of cases where gender socialisation influences values and aspirations. (shrink)

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Taking Kierkegaard Personally: First Person Responses is a one-of-a-kind volume in which scholars from the world over addresspersonal, existential lessons that Kierkegaard has taught them. Papers were selected from the June 2018 International Kierkegaard Conference, sponsored by the Howard V. and Edna H. Hong Kierkegaard Library at St. Olaf College. The Conference's prompt-The Wisdom of Kierkegaard: What Existential Lessons Have You Learned from Him?-compelled scholars to drop their guards and write primarily in first person narrative instead of standard (...) third person scholarly/professorial narrative. Papers range from a preacher in Texas discussing how this white nineteenth-century Dane's thought speaks to black issues, to a university development director wondering what Kierkegaard can teach Silicon Valley executives, to a Danish scholar struggling with human autonomy versus dependence on God, to a Jewish scholar finding hope in this Danish Protestant's works in which existential alienation from the world is the norm, to a Nigerian scholar introducing Kierkegaard's "single individual" into his Ndi Igbo community (a tribe predicated not on the individual but the collective), to a Slovak scholar surviving a bad divorce, to an Hispanic scholar's passion to teach Kierkegaard along the U.S.-Mexico border to Hispanic students, to an American scholar fielding his father's questions about suicide, to other scholars suffering from and coping with deaths of parents, raising children, working in trauma units, finding the need for self-denial in flourishing countries, preaching valuable sermons, dealing with college campus/department politics, and living perfectly quotidian lives. (shrink)

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Introduction -- What ispersonalresponsibility? -- Ordinary language -- Common conceptions -- What do philosophers mean byresponsibility? -- Personally responsible for what? -- What do philosophers think? part I -- Causes -- Capacity -- Control -- Choice versus brute luck -- Second-order attitudes -- Equality of opportunity -- Deservingness -- Reasonableness -- Reciprocity -- Equal shares -- Combining criteria -- What do philosophers think? part II -- Utility -- Self-respect -- Autonomy -- Human flourishing -- (...) Natural duties and special obligations -- A matter of perspectives -- Combining values -- What do politicians think? -- A brief typology -- International comparisons -- Welfare reform -- Healthcare reform -- Rights and responsibilities -- On the responsibilities of politicians -- What do ordinary people think? -- Why ask? -- Attitudes to welfare claimants -- When push comes to shove -- Perceptions and reality -- Further international comparisons -- The trouble with opinion surveys -- Four contemporary issues in focus -- Unemployment -- Health -- Drug abuse --Personal debt and financial rewards -- So how do we decide? -- Getting the public involved -- Citizens juries -- Answering some potential criticisms. (shrink)

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Priority for solid organ transplant generally does not consider the underlying cause of the need for transplantation. This paper argues that a distinctive set of factors justify assigning lower priority to willfully unvaccinated individuals who require transplant as a result of suffering from COVID‐19. These factors include thepersonalresponsibility of the patients for their own condition and the public outrage likely to ensue if willfully unvaccinated patients receive organs at the expense of vaccinated ones. The paper then (...) proposes a three‐prong test for similar deviations from the current allocation standard that incorporates patientresponsibility, foreseeability and avoidability, and the frequency of the occurrence. (shrink)

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In this paper, I develop and discuss an argument intended to demonstrate that the Molinist notion of middle knowledge, and in particular the concept of counterfactuals of freedom, is incompatible with the notion ofpersonalresponsibility (for created creatures). In Sect. 1, I discuss the Molinist concepts of middle knowledge and counterfactuals of freedom. In Sect. 2, I develop an argument (henceforth, the Transfer of NegativeResponsibility Argument, or TNRA) to the effect that, due to their construal (...) of the concepts of middle knowledge and counterfactuals of freedom, Molinists are not entitled to the notion that individuals are personally responsible—even for those actions that they freely perform. I then discuss the only two promising strategies for rejecting the argument in Sects. 3 and 4. Finally, in Sect. 5, I contend that, although TNRA may be unsuccessful as an internal argument against the Molinist, either of the possible strategies for rejecting TNRA poses a difficulty for the Molinist. Both response strategies force the Molinist into adopting a popular compatibilist strategy for rejecting a common negative argument against compatibilism. Thus, if Molinism represents a libertarian—i.e., incompatibilist—account of human freedom (as, e.g., Flint claims in his recent Divine Providence: The Molinist Account , noting that libertarianism is one of the “twin bases of Molinism”), then the discussion of TNRA poses, if not a dilemma , at the very least a serious challenge for the Molinist. (shrink)

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Emerging parallel to long-standing, academic and policy inquiries onpersonalresponsibility for health is the empirical assessment of lay persons’ views. Yet, previous studies rarely exploredpersonalresponsibility for health among lay persons as dynamic societal values. We sought to explore lay persons’ views onpersonalresponsibility for health using the Fairness Dialogues, a method for lay persons to deliberate equity issues in health and health care through a small group dialogue using a hypothetical (...) scenario. We conducted two 2-h Fairness Dialogues sessions (n = 15 in total) in Nova Scotia, Canada. We analyzed data using thematic analysis. Our analysis showed thatpersonal choice played an important role in participants’ thinking about health. Underlying the concept ofpersonal choice was considerations of freedom and societal debt. In participants’ minds,personal and social responsibilities co-existed and they were unwilling to determine health care priority based onpersonalresponsibility. The Fairness Dialogues is a promising deliberative method to explore lay persons’ views as dynamic values to be developed through group dialogues as opposed to static, already-formed values waiting to be elicited. (shrink)

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Background: Some members of the general public feel that patients who cause their own organ failure through smoking, alcohol use, or drug use should not receive equal priority for scarce transplantable organs. This may reflect a belief that these patients (1) cause their own illness, (2) have poor transplant prognoses or, (3) are simply unworthy. We explore the role that social acceptability,personalresponsibility, and prognosis play in people's judgments about transplant allocation. Methods: By random allocation, we presented (...) 283 prospective jurors in Philadelphia county with one of five questionnaire versions. In all questionnaires, subjects were asked to distribute transplantable hearts between patients with and without a history of three controversial behaviors (eating high fat diets against doctors’ advice, cigarette smoking, or intravenous drug use). Across the five questionnaire versions, we varied the relative prognosis of the transplant candidates and whether their behavior caused their primary organ Results: Subjects were significantly less willing to distribute organs to intravenous drug users than to cigarette smokers or people eating high fat diets (p le; 0.0005), even when intravenous drug users had better transplant outcomes than other patients. Subjects’ allocation decisions were influenced by transplant prognosis, but not by whether the behavior in question was causally responsible for the patients’ organ failure. Conclusion: People's unwillingness to give scarce transplantable organs to patients with controversial behaviors cannot be explained totally on the basis of those behaviors either causing their primary organ failure or making them have worse transplant prognoses. Instead, many people believe that such patients are simply less worthy of scarce transplantable organs. (shrink)

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This paper begins with a simple illustration of the choice between individual and population strategies in population health policy. It describes the traditional approach on which the choice is to be made on the relative merits of the two strategies in each case. It continues by identifying two factors—our knowledge of the consequences of the epidemiological transition and the prevalence ofresponsibility-sensitive theories of distributive justice—that may distort our moral intuitions when we deliberate about the choice of appropriate risk-management (...) strategies in population health. It argues that the confluence of these two factors may lead us to place too much emphasis onpersonalresponsibility in health policy. (shrink)

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Should financial incentives be offered to mothers for breastfeeding? Given the significant socioeconomic and sociodemographic differences in breastfeeding in the USA, researchers and policymakers are exploring the role of financial incentives for breastfeeding promotion with the objective of increasing uptake and reducing disparities. Despite positive outcomes in other health domains, the acceptability of financial incentives is mixed. Financial incentives in the context of infant feeding are particularly controversial given the complex obligations that characterize decisions to breastfeed. After situating the specific (...) ethical tensions related topersonalresponsibility, fairness, and intrusiveness, we argue that exploring carefully designed financial incentives can be ethically justified to support breastfeeding uptake particularly given established medical guidelines that support breastfeeding benefits, wide socioeconomic and racial/ethnic disparities and notable influences in the broader choice architecture of infant feeding in the USA. Additional empirical research is warranted to better understand effectiveness, cost and specific ethical concerns related to free and informed choice. (shrink)

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In this volume, Fr. Fuchs has brought together 12 exceptionally important essays which consider various aspects of the relationship between Christian morality ...

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In the effort to address the persistent organ shortage it is sometimes suggested that we should incentivize people to sign up as organ donors. One way of doing so is to give priority in the allocation of organs to those who are themselves registered as donors. Israel introduced such a scheme recently and the preliminary reports indicate increased donation rates. How should we evaluate such initiatives from an ethical perspective? Luck egalitarianism, aresponsibility-sensitive approach to distributive justice, provides one (...) possible justification: Those who decide against being organ donors limit the health care resources available to others. As such, a priority rule can be justified by a luck egalitarian approach to distributive justice. Furthermore, a priority rule inspired by luck egalitarianism is well equipped to avoid prominent criticisms of such a procurement system. Luck egalitarianism provides us with reaons to exempt people who are not responsible for their inability to donate from receiving lower priority, provide sufficient information about donation, and mitigate social and natural circumstances affecting people’s choice to donate. (shrink)

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According to relational egalitarians, equality is not primarily about the distribution of some good but about people relating to one another as equals. However, compared with other theorists in political philosophy – including other egalitarians – relational egalitarians have said relatively little on what rolepersonalresponsibility should play in their theories. For example, is equality compatible withresponsibility? Should economic distributions beresponsibility-sensitive? This article fills this gap. I develop a relational egalitarian framework for (...) class='Hi'>personalresponsibility and show that relational equality commits us toresponsibility. I develop two sets of arguments. First, I draw on relational theories of moralresponsibility – particularly Strawsonian views – to show that valuable egalitarian relationships requireresponsibility. Second, I show why relational equality sometimes requires that economic distributions be sensitive toresponsibility and choice. I also defend a seemingly paradoxical result: being committed toresponsibility, relational egalitarianism not only justifies some distributive inequalities but some relational inequalities too. Overall, relational egalitarianism gives a nuanced and coherent answer as to why and howresponsibility matters from within egalitarianism. That it does should be an important argument in its favour. (shrink)

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Many theorists who argue that individuals have apersonalresponsibility to reduce greenhouse gases (GHGs) tie the amount of GHGs that an individual is obligated to reduce to the amount that an individual releases, or what is often called a carbon footprint. The first section of this article argues that this approach produces standards that are too burdensome in some contexts. Section two argues that this approach produces standards ofresponsibility that are too lenient in other contexts (...) and sketches an alternative account ofpersonalresponsibility that treats it as an obligation to take certain kinds of opportunities to reduce GHGs, regardless of how little or much gas an individual releases through her own actions. Section three argues that this alternative conception ofpersonalresponsibility is well positioned to rebut the Argument from Inconsequentialism, widely considered the most significant challenge to the assumption that individuals are capable of bearing aresponsibility to reduce GHGs. (shrink)

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It is sometimes argued that tort law is, or ought to be understood as, a system ofpersonalresponsibility and corrective justice. Moreover, it is often assumed that these notions are identical, or at least compatible. In fact, however,personalresponsibility and corrective justice are very different concepts and they produce very different pictures of the law. The article demonstrates this by comparing the way in whichpersonalresponsibility and corrective justice deal with three (...) important problems: the presence of non-subjective standards in the law, the place of liability insurance, and the relationship between law and politics. (shrink)

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Die demografische Entwicklung und der medizinische Fortschritt werden die Problematik der Ressourcenknappheit im deutschen Gesundheitswesen in Zukunft weiter verschärfen. Soll nicht nur kurzfristig akuten Sparzwängen ausgewichen werden, steht – wie in verschiedenen Ländern bereits geschehen – auch Deutschland auf Dauer eine Prioritätensetzung im Gesundheitswesen bevor. Diese sollte in möglichst transparenter Weise nach klaren Kriterien erfolgen. Eines der seit einiger Zeit häufig öffentlich zitierten Kriterien der Verteilung von Mitteln in der Gesundheitsversorgung ist die Eigenverantwortung von Patienten. Deren Berücksichtigung in der Allokation (...) von Ressourcen birgt allerdings zahlreiche Probleme. Der vorliegende Beitrag untersucht die gerechtigkeitstheoretischen Grundlagen und die praktischen Probleme bzw. die möglichen Konsequenzen von Eigenverantwortung als Verteilungskriterium im Gesundheitswesen. Auf der Grundlage eines alternativen gerechtigkeitstheoretischen Vorschlags werden drei Möglichkeiten skizziert, Eigenverantwortung von Patienten im deutschen Gesundheitswesen in gerechter Weise stärker zu betonen. (shrink)

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Drawing on accounts of the author'spersonal responses while undertaking a qualitative study on the norms governing the relationship between nurses and mothers, it is argued that such responses, rather than being seen as a source of bias, have the potential to be a source of insight and interpretation in the research. This paper tells the ‘inside’ story of previously published research that was ‘sanitized’ by the omission of any reference to die researcher's subjective responses. The recognition of such (...) researcher responses has implications for how research is supervised and presented. (shrink)

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The exploration ofpersonal identity and theories of narrative in Narrative Identity andPersonalResponsibility is extraordinarily suggestive, resulting in implications for theories of action as well as ethics and psychology. Taking seriously the thought that we mediate our relations with the world by means of self-defining narratives grounded in the natural phenomenon of desire provides new answers to old puzzles of what it means to be human.

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I do not approach the question of free will as a scientist, like Colin Blakemore, or a lawyer, like David Hodgson, or philosopher, like Daniel Dennett, but as a priest -- someone who feels responsible for my own actions and who is called upon to counsel and absolve such as come to me with their shame and their guilt. Should I say that their sense ofresponsibility is illusory? Or should I encourage them to acceptresponsibility, and then (...) to deal with it in the various ways -- religious, psychological and practical -- that are open to them? (shrink)

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The Hypothesis of Extended Cognition (HEC)—that many cognitive processes are carried out by a hybrid coalition of neural, bodily and environmental factors—entails that the intentional states that are reasons for action might best be ascribed to wider entities of which individual persons are only parts. I look at different kinds of extended cognition and agency, exploring their consequences for concerns about the moral agency andpersonalresponsibility of such extended entities. Can extended entities be moral agents and bear (...)responsibility for actions, in addition to or in place of the individuals typically held responsible? What does it mean to be autonomous when one’s cognition is influenced and supported by a milieu of environmental factors? To answer these questions, I explore strong parallels between HEC’s critique of individualism in cognition, and feminist critiques of individualist accounts of self, agency, and autonomy. This relational and social conception of autonomous agency, as scaffolded and supported (or undermined and impaired) by a milieu of social, relational, and normative factors, has important lessons for HEC. Drawing together these two visions of distributed and decentralized aspects of personhood highlights how cognition, action, andresponsibility are inextricably linked. It also encourages a reconceptualization of all cognition and all concerns aboutresponsibility for actions, not simply as sometimes extended around individuals, but as fundamentally communal, social, and normative, with individual cognition and individual moralresponsibility being derivative special cases, not the paradigm examples. Individuals are merely one of many possible loci of cognition, action, andresponsibility. (shrink)

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This comment responds to Kevin Warwick’s article on predictability andresponsibility with respect to brain-machine interfaces in action. It compares conventionalresponsibility for device use with the potential consequences of phenomenological human-machine integration which obscures the causal chain of an act. It explores two senses of “responsibility”: 1) when it is attributed to a person, suggesting the morally important way in which the person is a causal agent, and 2) when a person is accountable and, on the (...) basis of fairness about rewards and sanctions, has a duty to act responsibly and accept liability. The comment suggests that, in the absence of absolute knowledge and predictability, we continue to engage in practical forms of reasoning about theresponsibility for BMI-use in ways which are inclusive of uncertainties about the liability of persons versus devices and those who create them. (shrink)

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It is often emphasised that persons diagnosed with borderline personality disorder show difficulties in understanding their own psychological states. In this article, I argue that from a phenomenological perspective, BPD can be understood as an existential modality in which the embodied self is profoundly saturated by an alienness regarding the person’s own affects and responses. However, the balance of familiarity and alienness is not static, but can be cultivated through, e.g., psychotherapy. Following this line of thought, I present the idea (...) that narrativising experiences can play an important role in processes of appropriating such embodied self-alienness. Importantly, the notion of narrative used is that of a scalar conception of narrativity as a variable quality of experience that comes in degrees. From this perspective, narrative appropriation is a process of gradually attributing the quality of narrativity to experiences, thereby familiarising the moods, affects, and responses that otherwise govern ‘from behind’. Finally, I propose that the idea of a narrative appropriation of embodied self-alienness is also relevant to the much-debated question ofpersonalresponsibility in BPD, particularly as this question plays out in psychotherapeutic contexts where a narrative self-appropriation may facilitate an increase in sense of autonomy and reduce emotions of guilt and shame. (shrink)

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Setting Up the Problem. Whatpersonal responsibilities do we, people living in rich countries, have for relieving miseries in the less fortunate countries? A great variety of prophets and philosophers urge us without qualification to do everything that we can. I mean, everything. Sartre holds that everybody “carries the weight of the whole world upon his shoulders; he is responsible for the world and for himself in whatever has to do with the character of their being.” Lévinas joins in: (...) “I am responsible for others without expecting any return, should it cost me my life. Any return is [the others’] business.” Peter Unger, following Peter Singer, asks us to do all that we can do to relieve suffering; and insists that the only limit, while the suffering continues, is our capacity to help. Jesus speaks most trenchantly of all: If you are to be saved, “Sell all you have and give it to the poor”, to which may be joined the injunction, powerfully worded in the Moffatt translation of the Bible, “You must be perfect as your heavenly Father is perfect”. (shrink)

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The basics -- The family as an institution for the development of values -- The role of community and culture in shaping land use policy -- The mending wall : religion and ethics at the dawn of a century -- Character education : a dialogue -- Restoring trust in government : the role of integrity and responsiveness -- Is there a crisis of citizenship? -- Organizational ethics andresponsibility -- Media ethics -- Reflections on values, ethics, andpersonal (...)responsibility. (shrink)

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Despite worldwide attention given to food access, very little progress has been made under the current model. Recognizing that individual engagement is likely based on individual experiences and perceptions, this research study investigated whether or not a correlation exists between one’s socioeconomic status (SES) and perceivedpersonalresponsibility for food access. Discussion of results and implications provide fresh insight into the ongoing global debate surrounding food access. Outcomes also provide insight into willing and able participants and point to (...) least-cost solutions which may be better suited to implement and initiate change. Results indicate that the issue of food access is more complex than simply lobbying for better decision-making among individuals and populations, highlighting the importance of unit of analysis considerations. (shrink)

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The book treats the compelling question of war andpersonalresponsibility in contemporary America. Cheyney Ryan examines how Americans often support modern warfare but have zero interest in fighting themselves . Ryan seeks to show how we must come to terms with our understanding and valuing of war when we ourselves are not committed to fighting in it.

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Offering an alternative to the theories of Skinner and other behaviorists, Rychlak draws upon recent research to support his belief that people can alter the grounds for their behavior and assume greaterresponsibility for it.

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This paper argues that assessingpersonalresponsibility in healthcare settings for the allocation of medical resources would be too privacy-invasive to be morally justifiable. In addition to being an inappropriate and moralizing intrusion into the private lives of patients, it would put patients’ sensitive data at risk, making data subjects vulnerable to a variety of privacy-related harms. Even though we allow privacy-invasive investigations to take place in legal trials, the justice and healthcare systems are not analogous. The duty (...) of doctors and healthcare professionals is to help patients as best they can—not to judge them. Patients should not be forced into giving up any morepersonal information than what is strictly necessary to receive an adequate treatment, and their medical data should only be used for appropriate purposes. Medical ethics codes should reflect these data rights. When a doctor askspersonal questions that are irrelevant to diagnose or treat a patient, the appropriate response from the patient is: ‘none of your business’. (shrink)

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A number of egalitarians have reached the conclusion that inequalities are just provided that they are the outcome of holding people appropriately responsible for their choices, and that only inequalities which can be traced back to the circumstances in which people happen to find themselves are objectionable. But this form of egalitarianism needs to be supplemented with an account of when it is appropriate to hold people responsible for their choices that is properly sensitive to the profound effects of socialisation. (...) Two of the most promising attempts to develop such an account-those of Ronald Dworkin and John Roemer-are found to be problematic in the light of a range of cases where gender socialisation influences values and aspirations. (shrink)

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Over the course of the past few decades 4E approaches that theorize cognition and agency as embodied, embedded, extended, and/or enactive have garnered growing support from figures working in philosophy of mind and cognitive science. Correspondingly, there has been a rising interest in the wider conceptual and practical implications of 4E views. Several proposals have for instance been made regarding 4E’s bearing on ethical theory, 505–526, 2009; Cash, Phenomenology and the Cognitive Sciences, 9, 645–671 2010). In this paper I contribute (...) to this trend by critically examining the enactive contribution made by Colombetti and Torrance, Phenomenology and the Cognitive Sciences, 8, 505–526 and by laying the foundations for an alternative enactive approach. Building off recent enactive approaches to social interaction, Colombetti and Torrance, Phenomenology and the Cognitive Sciences, 8, maintain that many of our actions and intentions “and in particular the ethical significance of what we do and mean” are “emergent from the interactions in which we participate”. Taking this seriously, they argue, entails a radical shift away from moral theory’s traditional emphasis on individual orpersonalresponsibility. I challenge their suggestion that accepting a broadly enactive 4E approach to cognition and agency entails the kind of wholesale shift they propose. To make my case I start by revisiting some of the general theoretical commitments characteristic of enactivism, including some relevant insights that can be gathered from Vasudevi Reddy’s broadly enactive approach to developmental psychology. After that I examine both the arguments internal to Colombetti and Torrance’s proposal and, in an effort to sketch the beginnings of an alternative view, I draw some connections between enactivism, the ethics of care and P.F. Strawson’s work onpersonalresponsibility. I believe that a consideration of the commonalities but also the differences between these views helps advance the important conversation concerning the link between enactivism and questions ofpersonalresponsibility in ethical theory that Colombetti and Torrance have undeniably helped jumpstart. (shrink)

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In her excellent and comprehensive article, Friesen argues that utilisingpersonalresponsibility in healthcare is problematic in several ways: it is difficult to ascriberesponsibility to behaviour; there is a risk of prejudice and bias in deciding which behaviours a person should be held responsible for; it may be ineffective at reducing health costs. In this short commentary, I will elaborate the critique ofpersonalresponsibility in health but suggest one way in which it could (...) be used ethically. In doing so, I will introduce the concepts of reasonable risk and golden opportunity. I previously argued that it is both difficult to disentangleresponsibility and that we risk prejudice and bias in singling out behaviours that are socially disapproved of.1 So I am sympathetic to Friesen’s concerns. I also discussed another way in which ascribingpersonalresponsibility for health is problematic which Friesen does not discuss and which, in my view, is the most concerning and further supports her arguments. It represents a back door assault on liberalism and neutrality towards concepts of the good life. Even if one were to accurately and in an unbiased way divine thepersonal contribution to disease, the greatest problem would remain: those who voluntarily take on risk would be penalised. That is, such a system would be risk-averse. Those lives which avoided risk would be prioritised, while those who chose to take on risky activities in their conception of the good life would be penalised. Yet risk is necessary, both for the good life, and social progress. Columbus, Edmund Hilary, Florence Nightingale, Ernest Hemingway and countless monumental figures in human history took risks in order to achieve something great. Should we aim for a society of trembling, teetotalling health nuts? Surely that prospect is horrific. It is horrific because it elevates health …. (shrink)

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Epigenetic markers could potentially be used for risk assessment in risk-stratified population-based cancer screening programmes. Whereas current screening programmes generally aim to detect existing cancer, epigenetic markers could be used to provide risk estimates for not-yet-existing cancers. Epigenetic risk-predictive tests may thus allow for new opportunities for risk assessment for developing cancer in the future. Since epigenetic changes are presumed to be modifiable, preventive measures, such as lifestyle modification, could be used to reduce the risk of cancer. Moreover, epigenetic markers (...) might be used to monitor the response to risk-reducing interventions. In this article, we address ethical concerns related topersonalresponsibility raised by epigenetic risk-predictive tests in cancer population screening. Will individuals increasingly be held responsible for their health, that is, will they be held accountable for bad health outcomes? Will they be blamed or subject to moral sanctions? We will illustrate these ethical concerns by means of a Europe-wide research programme that develops an epigenetic risk-predictive test for female cancers. Subsequently, we investigate when we can hold someone responsible for her actions. We argue that the standard conception ofpersonalresponsibility does not provide an appropriate framework to address these concerns. A different, prospective account ofresponsibility meets part of our concerns, that is, concerns about inequality of opportunities, but does not meet all our concerns aboutpersonalresponsibility. We argue that even if someone is responsible on grounds of a negative and/or prospective account ofresponsibility, there may be moral and practical reasons to abstain from moral sanctions. (shrink)

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The debate onresponsibility for health takes place within political philosophy and in policy setting. It is increasingly relevant in the context of rationing scarce resources as a substantial, and growing, proportion of diseases in high-income countries is attributable to lifestyle. Until now, empirical studies of medical professionals' attitudes towardspersonalresponsibility for health as a component of prioritisation have been lacking. This paper explores to what extent Norwegian physicians findpersonalresponsibility for health relevant (...) in prioritisation and what type of risk behaviour they consider relevant in such decisions. The proportion who agree that it should count varies from 17.1% to 26.9%. Higher age and being male is positively correlated with acceptance. The doctors are more willing to consider substance use in priority setting decisions than choices on food and exercise. The findings reveal that a sizeable proportion have beliefs that conflict with the norms stated in the Norwegian Patient Act. It may be possible that the implementation of legal regulations can be hindered by the opposing attitudes among doctors. A further debate on the rolepersonalresponsibility should play in priority setting seems warranted. However, given the deep controversies about the concept of healthresponsibility and its application, it would be wise to proceed with caution.Design Nationally representative cross-sectional study. Setting Panel-data. Participants 1072 respondents, response rate 65%. (shrink)

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