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Authenticity in Bioethics: Bridging the Gap between Theory and Practice
Filosofi och historia, KTH, Skolan för arkitektur och samhällsbyggnad (ABE), Filosofi och teknikhistoria, Filosofi.ORCID-id: 0000-0003-1456-4352
2019 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
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.

Ort, förlag, år, upplaga, sidor
Stockholm: KTH Royal Institute of Technology, 2019. , s. 147
Serie
Theses in philosophy from the Royal Institute of Technology, ISSN 1650-8831 ; 62
Nyckelord [en]
Authenticity, autonomy, decision-making, healthcare, paternalism, informed consent, bioethics
Nationell ämneskategori
Etik
Forskningsämne
Filosofi
Identifikatorer
URN: urn:nbn:se:kth:diva-244301ISBN: 978-91-7873-124-4 (tryckt)OAI: oai:DiVA.org:kth-244301DiVA, id: diva2:1289625
Disputation
2019-06-10, Kollegiesalen, Brinellvägen 8, Stockholm, 13:00 (Engelska)
Opponent
Handledare
Forskningsfinansiär
Vetenskapsrådet, 2014–4024Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2014–4024Tillgänglig från: 2019-03-21 Skapad: 2019-02-18 Senast uppdaterad: 2019-03-21Bibliografiskt granskad
Delarbeten
1. The impossibility of reliably determining the authenticity of desires: implications for informed consent
Öppna denna publikation i ny flik eller fönster >>The impossibility of reliably determining the authenticity of desires: implications for informed consent
2017 (Engelska)Ingår i: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

It is sometimes argued that autonomous decision-making requires that the decision-maker’s desires are authentic, i.e., “genuine,” “truly her own,” “not out of character,” or similar. In this article, it is argued that a method to reliably determine the authenticity (or inauthenticity) of a desire cannot be developed. A taxonomy of characteristics displayed by different theories of authenticity is introduced and applied to evaluate such theories categorically, in contrast to the prior approach of treating them individually. The conclusion is drawn that, in practice, the authenticity of desires cannot be reliably determined. It is suggested that authenticity should therefore not be employed in informed consent practices in healthcare.

Ort, förlag, år, upplaga, sidor
Springer, 2017
Nyckelord
Authenticity, Autonomy, Informed consent, Decision-making, Healthcare
Nationell ämneskategori
Etik
Forskningsämne
Filosofi
Identifikatorer
urn:nbn:se:kth:diva-208635 (URN)10.1007/s11019-017-9783-0 (DOI)000425299900006 ()2-s2.0-85020429439 (Scopus ID)
Forskningsfinansiär
Vetenskapsrådet, 2014–4024
Anmärkning

QC 20170612

Tillgänglig från: 2017-06-09 Skapad: 2017-06-09 Senast uppdaterad: 2019-02-18Bibliografiskt granskad
2. What Justifies Judgments of Inauthenticity?
Öppna denna publikation i ny flik eller fönster >>What Justifies Judgments of Inauthenticity?
2018 (Engelska)Ingår i: HEC Forum, ISSN 0956-2737, E-ISSN 1572-8498Artikel i tidskrift (Refereegranskat) 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.

Ort, förlag, år, upplaga, sidor
Springer, 2018
Nyckelord
Authenticity, Autonomy, Decision-making, Paternalism, Bioethics
Nationell ämneskategori
Etik
Forskningsämne
Filosofi
Identifikatorer
urn:nbn:se:kth:diva-233506 (URN)10.1007/s10730-018-9356-5 (DOI)000452209200004 ()2-s2.0-85049565770 (Scopus ID)
Anmärkning

QC 20180822

Tillgänglig från: 2018-08-21 Skapad: 2018-08-21 Senast uppdaterad: 2019-07-15Bibliografiskt granskad
3. A non-ideal authenticity-based conceptualization of personal autonomy
Öppna denna publikation i ny flik eller fönster >>A non-ideal authenticity-based conceptualization of personal autonomy
2018 (Engelska)Ingår i: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633Artikel i tidskrift (Refereegranskat) 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.

Nyckelord
Autonomy, Authenticity, Anorexia nervosa, Healthcare, Bioethics
Nationell ämneskategori
Etik
Forskningsämne
Filosofi
Identifikatorer
urn:nbn:se:kth:diva-244298 (URN)10.1007/s11019-018-9879-1 (DOI)000482898400006 ()
Forskningsfinansiär
Vetenskapsrådet, 2014–4024Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2014–4024
Anmärkning

QC 20190218

Tillgänglig från: 2019-02-18 Skapad: 2019-02-18 Senast uppdaterad: 2019-09-17Bibliografiskt granskad
4. Nine Cases of Possible Inauthenticity in Biomedical Contexts and What They Require from Bioethicists
Öppna denna publikation i ny flik eller fönster >>Nine Cases of Possible Inauthenticity in Biomedical Contexts and What They Require from Bioethicists
(Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
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.

Nyckelord
Authenticity, autonomy, healthcare, bioethics
Nationell ämneskategori
Etik
Forskningsämne
Filosofi
Identifikatorer
urn:nbn:se:kth:diva-244299 (URN)
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2014–4024Vetenskapsrådet, 2014–4024
Anmärkning

QC 20180218

Tillgänglig från: 2019-02-18 Skapad: 2019-02-18 Senast uppdaterad: 2019-02-18Bibliografiskt granskad

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