Vulnerability, Autonomy, and Applied Ethics

Christine Straehle

• Publisher: Routledge
• Year: 2016
• Print ISBN: 9781138125551
• eBook ISBN: 9781317297932
• Edition: 1
• Topic: Philosophy
• Subtopic: Philosophy History & Theory

Vulnerability is an important concern of moral philosophy, political philosophy and many discussions in applied ethics. Yet the concept itself—what it is and why it is morally salient—is under-theorized. Vulnerability, Autonomy, and Applied Ethics brings together theorists working on conceptualizing vulnerability as an action-guiding principle in these discussions, as well as bioethicists, medical ethicists and public policy theorists working on instances of vulnerability in specific contexts. This volume offers new and innovative work by Joel Anderson, Carla Bagnoli, Samia Hurst, Catriona Mackenzie and Christine Straehle, who together provide a discussion of the concept of vulnerability from the perspective of individual autonomy. The exchanges among authors will help show the heuristic value of vulnerability that is being developed in the context of liberal political theory and moral philosophy. The book also illustrates how applying the concept of vulnerability to some of the most pressing moral questions in applied ethics can assist us in making moral judgments. This highly innovative and interdisciplinary approach will help those grappling with questions of vulnerability in medical ethics—both theorists and practitioners—by providing principles along which to decide hard cases.

Part I

Vulnerability, Individual Agency and Social Justice

1 Vulnerability and the Incompleteness of Practical Reason

Carla Bagnoli

This chapter concerns vulnerability as a constitutive feature of human agency and argues that the ontological approach to vulnerability provides an important insight about rational agency and practical reasoning. This claim is defended in contrast to two established theoretical approaches to vulnerability. On the one hand, most theories of rationality are primarily concerned with vulnerability as a source of limitations and defects, and they presume to offer normative guidance by adopting an idealized account of rational agency, which brackets the defective features of human agency. On the other hand, theories of bounded or limited rationality and theories of minimal agency reject idealization; and theories of impure agency privilege a circumstantial approach to vulnerability. An often implicit but widely shared assumption in this debate is that vulnerability is morally relevant insofar as it is pathogenic.

By contrast, I argue that vulnerability as an ontological category provides the normative standard for identifying distinctive ways in which we function or fail as agents. The philosophical relevance of vulnerability as an ontological category is not limited to moral theory narrowly understood and defined by what we owe to each other. Rather, vulnerability plays a crucial role in explaining the importance of reasoning by norms and opens the prospect of moral progress and development within practices of mutual respect and recognition. I vindicate these claims from within a non-standard Kantian constructivist account of rational agency and practical reasoning.¹

Constitutive and Circumstantial Vulnerability

That humans are vulnerable is an assessment that we are generally inclined to take at face value, but there is a divisive disagreement about its theoretical and normative implications. This disagreement further depends on a conceptual dispute about the definition of vulnerability and its relation to other concepts such as autonomy, reciprocity and obligation.² Different concepts of vulnerability drive competing philosophical agendas, and these differences become dramatic when we consider their moral impact.

We may distinguish two broad approaches to vulnerability: one ethical and the other one ontological. The concept of vulnerability has gained currency, especially in debates focusing on discrimination and concerned with the protection of vulnerable subjects. In such debates, it seems natural to favor the ethical approach to vulnerability, which aims to identify some categories of agents as especially subjected to harm because of some disfavoring conditions, or else because they are the target of social and political discrimination. The concept of vulnerability seems to serve ethical theory well by providing a useful characterization of subjects that are particularly susceptible to wrongful harms. Paradigmatically, survivors and minorities belong in the category of vulnerable subjects because they are especially susceptible to suffer wrongful harms. In these cases, vulnerability is contingent, due to facts such as natural disasters, the outburst of civil war, the biological features of infancy and body aging or the oppressive and discriminatory practices of a given society. This approach deploys vulnerability as a pivotal concept in representing and defining moral and political problems. In particular, the concept furnishes a shared basis for addressing wrongs directed to specific disadvantaged groups such as women, minorities, children, migrants, and refugees. For instance, by placing refugees in the category of the vulnerable, one is in the position to argue that refugees make legitimate claims on stable societies, thus availing oneself to arguments in favor of special (moral and political) obligations of hospitality and protection. Similarly, one can argue that children, the elderly, and the sick are especially vulnerable subjects insofar as they cannot provide for their own welfare and well-being by themselves and thus they should have their interests and needs protected.

There is, however, a more general sense in which all humans are fundamentally vulnerable and in ways that are inherent to their existential condition, rather than due to the circumstances, although the severity, gravity and moral relevance of such vulnerability may vary according to contingent features and patterns. This concept of vulnerability picks out an ontological feature grounded in our biology, which we share with non-human animals.³ Some philosophers are skeptical that anything morally relevant can be achieved by focusing on the ontological dimension of vulnerability. A particular worry is that focusing on the ontological dimension of vulnerability distracts from a thorough investigation of the circumstances in which some subjects become particularly vulnerable.⁴ To this extent, they argue, the ontological concept of vulnerability is detrimental to ethical theory.

While these worries are not altogether misplaced, I want to press the case that the ontological approach to vulnerability has ethical implications that have not been fully appreciated. My claim is that limiting the significance of the concept of vulnerability to the ethics of discrimination, reparation and redress is, ultimately, not a good strategy for comprehending the ethical, epistemic, and political impact of vulnerability. I will not argue that the ontological conception of vulnerability is all we need for ethical purposes. My aim is to establish that the ontological conception of vulnerability plays a large role in a general account of normativity and that this role is crucial for understanding how we function and fail as rational agents.

To carry on this investigation, I propose that we deploy an alternative contrastive pair of concepts: constitutive and circumstantial vulnerability.⁵ Constitutive vulnerability, understood as a feature constitutive of human being and agency, indicates a generic capacity to be affected and understood in a very broad sense and marked by positive and negative valence. It depends on a complex network of dispositions and capacities, e.g., suffering and enjoyment, frailty and resilience, reliance and dependency. By contrast, circumstantial vulnerability, instead, indicates a contingent vulnerability to specific kinds of wrongs and inflicted harms due to discrimination, such as loss of status, lack of recognition, oppression and deprivation.

These two ways to be vulnerable are not mutually exclusive: circumstantial vulnerability presupposes ontological vulnerability. The fact that we are vulnerable to viruses depends on the fact that we are embodied and thus susceptible to being affected by external agents such as viruses. Yet this is not to say that being sick with a virus is a normal condition for embodied agents. It is a pathological condition, but it is a condition that affects us insofar as we have bodies that can be affected. For the same reason, we are capable of enhancement and development. Pathogenic and circumstantial forms of vulnerability presuppose some ontological definition of vulnerability, but these notions drive different philosophical agendas.⁶

The distinction between constitutive and circumstantial vulnerability allows us to reset the debate as follows. Moral philosophers have privileged the circumstantial approach to vulnerability because it is more readily applicable to moral and political projects of addressing injustice and redressing discrimination and inequality. Such philosophers are concerned with identifying categories of subjects that are particularly susceptible to having their interests threatened, their needs undercut, their life projects jeopardized, their opportunities for action denied or severely limited, and their normative status undermined. The availability of this category facilitates the identification of adverse social or political circumstances that produce pathogenic vulnerability and provide justification of special obligations to protect or compensate the vulnerable. However, the characterization of circumstantial vulnerability has direct normative implications.⁷ Its definition determines the scope and moral impact of vulnerability, the scope of moral obligations and the correctives or reparatory strategies to be implemented. In addition, it is not pacific that the category of vulnerable subjects is the best way to identify the specific moral and political responsibilities associated with the condition of vulnerability. One concern is that the qualification of special vulnerable subjects is often associated with victimhood, inferiority, incapacity to provide for oneself, pathological dependence and failures to meet the condition for attribution of the status as moral and epistemic peers. As a consequence, this sort of characterization misrepresents the challenges associated with vulnerability by exaggerating the tension with the concept of autonomy or implicitly condoning paternalistic attitudes.⁸

By contrast, focusing on constitutive vulnerability allows us to identify the general constraints and predicaments that agents face insofar as they are embodied, but also to appreciate the practical resources that are distinctively associated with the status of constitutive vulnerability. Three generic features of human biology seem especially relevant in the present context of investigation. First, as are all living things, humans are affected by time: they act in time, they are finite, and sensitive to various sorts of temporal bias. Second, insofar as they are social animals, humans are mutually dependent in profound ways. They depend on each other, not only occasionally but systematically, and not only strategically for mutual benefit but also, and in a fundamental way, for the ordinary exercise of their cognitive and practical agency. Third, emotional vulnerability allows humans to develop a complex network of dispositions, skills and capacities by which to respond to the predicaments of a situated life. On the basis of these truisms about constitutive vulnerability, we can argue for more substantial claims. Some of these dependencies are not merely biological necessities or adaptive traits but also, and perhaps more importantly, morally valuable features of human life and indeed contributive to leading a life that is worth living. This claim can be advanced from a moral and an epistemic perspective. Civic and personal friendships, as well as loving relations, are shared activities grounded both on reciprocity and on mutual dependency. Likewise, we depend on others in acquiring knowledge, forming beliefs and learning about our surroundings.

The Relevance of Vulnerability as a Constitutive Feature

When understood as a constitutive feature of human agency, vulnerability is primarily characterized as an aspect of embodiment—a dimension that humans share with other non-human animals.⁹ This characterization of human vulnerability highlights different clusters of problematic aspects of human agency. First, it pairs vulnerability to situatedness, hence revealing how human agency is exposed in contextual contingencies. Human agency is constrained and susceptible to some significant forms of luck (Williams 1981).

Second, when tied to embodiment, vulnerability makes the temporal structure of human agency apparent. Humans are finite, and the importance of temporal constraints reverberates at different levels, which concern the nature of agency, the resources available to embodied rational agents and the external conditions of choice. As Makropulos’s case powerfully illustrates, agency acquires meaning and significance only within the framework of mortality.¹⁰ This is a paradoxical condition because the pressure of time also importantly challenges the agent’s moral integrity and metaphysical integrity over time. Practical and cognitive resources are finite. Humans act in time and under the pressure of time; they produce finite actions, even though the long-lasting effects of an action may survive the action itself as well as the agent who produced the action. Humans represent their own agency within the horizon of death; they conceive of their own agency as a perishable good. Consequently, they are subjected to various forms of temporal bias.¹¹ Furthermore, the reflective perspective on agency as finite is in itself a temporal achievement—that is, something that humans acquire in time and through experience, and in particular through the experience of the body as changing and declining. Partly, this is the subjective experience of measuring how internal resources run out and opportunities fade accordingly, but there are deeper normative dimensions of this temporal acquisition, which requires a hermeneutics sensitive to temporal change.¹²

Third, when focusing on the corporal dimension of agency, vulnerability is associated with interests, needs, desires and other conative states. Being the repository of needs and interests, the body makes us susceptible to suffer from deprivation of resources in ways that deplete both the opportunity and the capacity for action. This particular aspect of vulnerability is a traditional theme in moral philosophy, because desires, interests and needs stand in a problematic relation with morality. On the one hand, they are sources of resistance to morality, as the vice of frailty and weakness of the will exemplify. On the other hand, needs are exactly the sorts of things that morality must protect: it is a primary moral obligation to provide for shelter, food and basic means of survival, and the grounds of such a moral obligation have to do with the protection of humanity, rather than with benevolence.

Finally, embodiment stands in an interesting relation to the social nature of human animals. In this connection, vulnerability indicates emotional mutual dependency as well as the susceptibility to be harmed or helped, obstructed or facilitated, undercut or enhanced, directed or manipulated by other agents. Fundamentally, vulnerability is the root of shared agency.

Vulnerability, Normative Failures and Defective Practical Rationality

The notion of vulnerability figures prominently in the explanation of defective forms of rationality. Indeed, vulnerability is perhaps the major source of normative failures. Or, rather, all normative failures can be ultimately traced back to constitutive vulnerability. However, to identify vulnerability as the source of normative failures is not a trivial move. It commits us to engage in a debate about the normative standards that are appropriate for rational and vulnerable subjects.

In the present context, I consider “normative failure” as a broad category that includes several kinds of failures to be guided by the norm, including failures to recognize correct principles of action, failures to act in conformity to the rule and failures to be responsive to the norm. On the one hand, each of these kinds of normative failures may be ultimately grounded on constitutive vulnerability. On the other hand, if we were not vulnerable, we would not need laws, principles and norms. We would know and do things aright. This is to say that while constitutive vulnerability is the root of all sorts of normative failures, it is also the deepest reason why we need norms. In short, the category of “vulnerability” should appear not only in the explication of irrationality and defective rationality but also, and importantly, in the explanation of the emergence of norms and of normative authority.

I am advancing the view that vulnerability plays a crucial explanatory role, not only in detecting the ways in which we go astray in understanding, applying or acting against the norms but also, and more importantly, in the account of why norms are needed. In short, I propose that it is a requirement of descriptive plausibility for a theory of practical reasoning to bring constitutive vulnerability in close relation to the emergence of norms and the basic issue of normative authority. Remarkably, this is a requirement that many theories of normativity and normative authority fail to meet.

Most theories of practical rationality presume to offer normative guidance by adopting an idealized account of rational agency. They propose standards that vulnerable agents can only approximate, and thus they also need to adopt corrective systems of enforcement. These theories face serious problems of feasibility, which I highlight by pressing the following questions. Given that vulnerability is the main source of failures to respond adequately to normative claims, how shall we conceive of the ideal standards of rational agency? Such standards are prescriptive, but how can they be put into practice? Are they regulative, or merely inspirational? In each of these cases, how shall we assess failures to abide by the norm? Is it unfair or unduly punitive to judge normal people by idealized standards that they cannot meet in reality?

There are two major approaches to these questions. On the one hand, the idealized approach treats the standards as regulative, but supplies norms of reasoning that g...

Table of contents

• Cover
• Title
• Copyright
• Contents
• Introduction: Vulnerability, Autonomy and Applied Ethics
• Part I Vulnerability, Individual Agency and Social Justice
• Part II Vulnerability in Applied Ethics
• Contributors
• Index