By Raanan Gillon

Analyzes the ethical difficulties confronting health and wellbeing care practitioners from a large choice of views, particularly these attached via 4 significant moral principles--respect for autonomy, beneficence, non-maleficence and justice.

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But I should distinguish the problem of normative authority that results from problems of adaptation from the problem of normative authority that results from other sorts of preference failures. Adaptation is not the only feature of a preference that generates a lack of normative authority. Preferences can lack normative 1 See, for instance, Nussbaum (2000, Ch. 2) for a critique of preferences rather than capabilities as the proper index of social choice. I criticize Nussbaum’s position in Dorsey (2012).

So on the view of the objector according to which the non-autonomy of the earlier preference is inherited by later preferences, the preference I express on my 110th birthday for chocolate cake with vanilla icing rather than grasshopper cake with chicken feathers on top is non-autonomous, even if I am dialogically reflective about this preference, as we might expect me to be. Along with the grasshopper cake, the view that none of my preferences as a 110-year old are autonomously retained, and so none of my actions are autonomous, seems too hard to swallow.

There’s another way to see this point. , moral demands, the requirements of respect for others, or some (independent of preference) measure of the objective good. But adaptation seems different: adaptive preferences do not (or do not necessarily) fail to conform to some external measure, but rather with an internal measure. But what is this internal measure? Surely adaptive preferences do not lack normative authority because they do not measure up to what I previously valued; this would render virtually all instances of changed preferences normative failures.

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