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Ahlin Marceta, J. (2019). Authenticity in Bioethics: Bridging the Gap between Theory and Practice. (Doctoral dissertation). Stockholm: KTH Royal Institute of Technology
Open this publication in new window or tab >>Authenticity in Bioethics: Bridging the Gap between Theory and Practice
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this doctoral thesis is to bridge the gap between theoretical ideals of authenticity and practical authenticity-related problems in healthcare. In this context, authenticity means being "genuine," "real," "true to oneself," or similar, and is assumed to be closely connected to the autonomy of persons. The thesis includes an introduction and four articles related to authenticity. The first article collects various theories intended to explain the distinction between authenticity and inauthenticity in a taxonomy that enables oversight and analysis. It is argued that (in-)authenticity is difficult to observe in others. The second article offers a solution to this difficulty in one theory of authenticity. It is proposed that under certain circumstances, it is morally justified to judge that the desires underlying a person's decisions are inauthentic. The third article incorporates this proposition into an already established theory of personal autonomy. It is argued that the resulting conceptualization of autonomy is fruitful for action-guidance in authenticity-related problems in healthcare. The fourth article collects nine cases of possible authenticity-related problems in healthcare. The theory developed in the third article is applied to the problems, when this is allowed by the case-description, to provide guidance with regard to them. It is argued that there is not one universal authenticity-related problem but many different problems, and that there is thus likely not one universal solution to such problems but various particular solutions.

Place, publisher, year, edition, pages
Stockholm: KTH Royal Institute of Technology, 2019. p. 147
Series
Theses in philosophy from the Royal Institute of Technology, ISSN 1650-8831 ; 62
Keywords
Authenticity, autonomy, decision-making, healthcare, paternalism, informed consent, bioethics
National Category
Ethics
Research subject
Philosophy
Identifiers
urn:nbn:se:kth:diva-244301 (URN)978-91-7873-124-4 (ISBN)
Public defence
2019-06-10, Kollegiesalen, Brinellvägen 8, Stockholm, 13:00 (English)
Opponent
Supervisors
Funder
Swedish Research Council, 2014–4024Forte, Swedish Research Council for Health, Working Life and Welfare, 2014–4024
Available from: 2019-03-21 Created: 2019-02-18 Last updated: 2019-03-21Bibliographically approved
Ahlin Marceta, J. (2018). A non-ideal authenticity-based conceptualization of personal autonomy. Medicine, Health care and Philosophy
Open this publication in new window or tab >>A non-ideal authenticity-based conceptualization of personal autonomy
2018 (English)In: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633Article in journal (Refereed) Published
Abstract [en]

Respect for autonomy is a central moral principle in bioethics. The concept of autonomy can be construed in various ways. Under the non-ideal conceptualization proposed by Beauchamp and Childress, everyday choices of generally competent persons are autonomous to the extent that they are intentional and are made with understanding and without controlling influences. It is sometimes suggested that authenticity is important to personal autonomy, so that inauthenticity prevents otherwise autonomous persons from making autonomous decisions. Building from Beauchamp and Childress’s theory, this article develops a non-ideal authenticity-based conceptualization of personal autonomy. Factors that indicate inauthentic decision-making are explicated, and the full concept is defended from three expected objections. The theory is then tested on a paradigm case which has concerned theorists and practitioners for some time, namely the possible inauthenticity of anorexia nervosa patients’ decision-making. It is concluded that the theory seems to be fruitful in analyses of the degree of autonomy of patients’ decision-making, and that it succeeds in providing reliable action-guidance in practical contexts.

Keywords
Autonomy, Authenticity, Anorexia nervosa, Healthcare, Bioethics
National Category
Ethics
Research subject
Philosophy
Identifiers
urn:nbn:se:kth:diva-244298 (URN)10.1007/s11019-018-9879-1 (DOI)
Funder
Swedish Research Council, 2014–4024Forte, Swedish Research Council for Health, Working Life and Welfare, 2014–4024
Note

QC 20190218

Available from: 2019-02-18 Created: 2019-02-18 Last updated: 2019-02-18Bibliographically approved
Ahlin, J. (2018). What Justifies Judgments of Inauthenticity?. HEC Forum
Open this publication in new window or tab >>What Justifies Judgments of Inauthenticity?
2018 (English)In: HEC Forum, ISSN 0956-2737, E-ISSN 1572-8498Article in journal (Refereed) Published
Abstract [en]

The notion of authenticity, i.e., being “genuine,” “real,” or “true to oneself,” is sometimes held as critical to a person’s autonomy, so that inauthenticity prevents the person from making autonomous decisions or leading an autonomous life. It has been pointed out that authenticity is difficult to observe in others. Therefore, judgments of inauthenticity have been found inadequate to underpin paternalistic interventions, among other things. This article delineates what justifies judgments of inauthenticity. It is argued that for persons who wish to live according to the prevailing social and moral standards and desires that are seriously undesirable according to those standards, it is justified to judge that a desire is inauthentic to the extent that it is due to causal factors that are alien to the person and to the extent that it deviates from the person’s practical identity. The article contributes to a tradition of thinking about authenticity which is known mainly from Frankfurt and Dworkin, and bridges the gap between theoretical ideals of authenticity and real authenticity-related problems in practical biomedical settings.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Authenticity, Autonomy, Decision-making, Paternalism, Bioethics
National Category
Ethics
Research subject
Philosophy
Identifiers
urn:nbn:se:kth:diva-233506 (URN)10.1007/s10730-018-9356-5 (DOI)000452209200004 ()2-s2.0-85049565770 (Scopus ID)
Note

QC 20180822

Available from: 2018-08-21 Created: 2018-08-21 Last updated: 2019-07-15Bibliographically approved
Ahlin, J. (2017). Personal Autonomy and Informed Consent: Conceptual and Normative Analyses. (Licentiate dissertation). Kungliga Tekniska högskolan
Open this publication in new window or tab >>Personal Autonomy and Informed Consent: Conceptual and Normative Analyses
2017 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

This licentiate thesis is comprised of a “kappa” and two articles. The kappa includes an account of personal autonomy and informed consent, an explanation of how the concepts and articles relate to each other, and a summary in Swedish.

Article 1 treats one problem with the argument that a patient’s consent to treatment is valid only if it is authentic, i.e., if it is “genuine,” “truly her own,” “not out of character,” or similar. As interventions with a patient’s life and liberties must be justified, the argument presupposes that the authenticity of desires can be reliably determined. If the status of a desire in terms of authenticity cannot be reliably determined, discarding the desire-holder’s treatment decision on the basis that it is inauthentic is morally unjustified. In the article, I argue that no theory of authenticity that is present in the relevant literature can render reliably observable consequences. Therefore, the concept of authenticity, as it is understood in those theories, should not be part of informed consent practices.

Article 2 discusses the problem of what it is to consent or refuse voluntarily. In it, I argue that voluntariness should be more narrowly understood than what is common. My main point is that a conceptualization of voluntariness should be agent-centered, i.e., take into account the agent’s view of her actions. Among other things, I argue that an action is non-voluntary only if the agent thinks of it as such when being coerced. This notion, which at first look may seem uncontroversial, entails the counterintuitive conclusion that an action can be voluntary although the agent has been manipulated or coerced into doing it. In defense of the notion, I argue that if the agent’s point of view is not considered accordingly, describing her actions as non-voluntary can be alien to how she leads her life. There are other moral concepts available to describe what is wrong with manipulation and coercion, i.e., to make sense of the counterintuitive conclusion. Voluntariness should be reserved to fewer cases than what is commonly assumed.

Place, publisher, year, edition, pages
Kungliga Tekniska högskolan, 2017. p. 65
Series
Theses in philosophy from the Royal Institute of Technology, ISSN 1650-8831
National Category
Ethics
Research subject
Philosophy
Identifiers
urn:nbn:se:kth:diva-212300 (URN)978-91-7729-495-5 (ISBN)
Presentation
2017-10-20, 16:04 (English)
Opponent
Supervisors
Funder
Swedish Research Council, 2014-4024Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-4024
Note

QC 20170821

Available from: 2017-08-21 Created: 2017-08-17 Last updated: 2017-08-21Bibliographically approved
Ahlin, J. (2015). The Ethics of Immigration [Review]. Theoria, 81(4), 380-384
Open this publication in new window or tab >>The Ethics of Immigration
2015 (English)In: Theoria, ISSN 0040-5825, E-ISSN 1755-2567, Vol. 81, no 4, p. 380-384Article, book review (Other academic) Published
Place, publisher, year, edition, pages
Wiley-Blackwell, 2015
National Category
Philosophy
Identifiers
urn:nbn:se:kth:diva-177407 (URN)10.1111/theo.12081 (DOI)000363872300008 ()
Note

QC 20151127. QC 20160222

Available from: 2015-11-27 Created: 2015-11-20 Last updated: 2017-12-01Bibliographically approved
Ahlin Marceta, J.Nine Cases of Possible Inauthenticity in Biomedical Contexts and What They Require from Bioethicists.
Open this publication in new window or tab >>Nine Cases of Possible Inauthenticity in Biomedical Contexts and What They Require from Bioethicists
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Respect for autonomy is a main moral principle in bioethics. It is sometimes argued that authenticity, i.e., being "real," "genuine," "true to oneself," or similar, is crucial to a person's autonomy. This article collects nine cases in which the notion of authenticity has been or could be invoked in biomedical contexts. One recently developed theory aiming to provide normative guidance with regard to authenticity-related problems is applied when it is possible, while it is explained in detail why the theory is inept or impractical in the remaining cases. The article thus provides an overview of authenticity-related problems which may be helpful for autonomy theorists. Furthermore, it is argued that there is no universal problem of authenticity, but many problems, and that they may require various particular solutions rather than one universal solution. Among other things, it is suggested that bioethicists should explore non-ideal methodological approaches to authenticity-related problems to provide action-guidance with regard to them.

Keywords
Authenticity, autonomy, healthcare, bioethics
National Category
Ethics
Research subject
Philosophy
Identifiers
urn:nbn:se:kth:diva-244299 (URN)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2014–4024Swedish Research Council, 2014–4024
Note

QC 20180218

Available from: 2019-02-18 Created: 2019-02-18 Last updated: 2019-02-18Bibliographically approved
Ahlin, J.Reflective Equilibrium Defended.
Open this publication in new window or tab >>Reflective Equilibrium Defended
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Reflective equilibrium is a method of justification in ethics. In this essay, I account for an argument against reflective equilibrium put forth by Theo van Willigenburg from a position of (weak) foundationalism. I attempt to demonstrate why it is flawed and how reflective equilibrium as a method of justification can withstand the foundationalist critique.

Keywords
reflective equilibrium, justification
National Category
Philosophy
Identifiers
urn:nbn:se:kth:diva-188131 (URN)
Note

Unsubmitted manuscript. QCR 20160615

Available from: 2016-06-06 Created: 2016-06-06 Last updated: 2016-06-15Bibliographically approved
Ahlin, J.Toward an Agent-Centered Theory of Voluntariness.
Open this publication in new window or tab >>Toward an Agent-Centered Theory of Voluntariness
(English)Manuscript (preprint) (Other academic)
Abstract [en]

The concept of voluntariness is central to informed consent and personal autonomy, yet it has been underexplored by bioethicists. There are various theories intended to explain voluntary choice and action. None is fully agent-centered, in the sense that the conceptualization of voluntariness takes into account the agent’s views of her decisions and actions. An agent-centered theory of voluntariness would promote analytical precision, and foster autonomy in healthcare and research practices. According to the most influential bioethical theory of voluntariness, here called the Voluntariness as Control theory, an action is non-voluntary if the agent is controlled by external influences. The theory is critically discussed from an agent-centered perspective, and a new conceptualization of voluntariness is proposed.

Keywords
voluntariness, autonomy, informed consent, agent-centered, bioethics
National Category
Ethics
Research subject
Philosophy
Identifiers
urn:nbn:se:kth:diva-212299 (URN)
Funder
Swedish Research Council, 2014-4024Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-4024
Note

QC 20170821

Available from: 2017-08-17 Created: 2017-08-17 Last updated: 2017-08-21Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-1456-4352

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