Abstract
Deep brain stimulation has been of considerable interest to bioethicists, in large part because of the effects that the intervention can occasionally have on central features of the recipient's personality. These effects raise questions regarding the philosophical concept of authenticity. In this article, we expand on our earlier work on the concept of authenticity in the context of deep brain stimulation by developing a diachronic, value-based account of authenticity. Our account draws on both existentialist and essentialist approaches to authenticity, and Laura Waddell Ekstrom's coherentist approach to personal autonomy. In developing our account, we respond to Sven Nyholm and Elizabeth O'Neill's synchronic approach to authenticity, and explain how the diachronic approach we defend can have practical utility, contrary to Alexandre Erler and Tony Hope's criticism of autonomy-based approaches to authenticity. Having drawn a distinction between the authenticity of an individual's traits and the authenticity of that person's values, we consider how our conception of authenticity applies to the context of anorexia nervosa in comparison to other prominent accounts of authenticity. We conclude with some reflections on the prudential value of authenticity, and by highlighting how the language of authenticity can be invoked to justify covert forms of paternalism that run contrary to the value of individuality that seems to be at the heart of authenticity.
Highlights
Deep brain stimulation has been of considerable interest to bioethicists, in large part because of the effects that the intervention can occasionally have on central features of the recipient’s personality
Comparatively rare, such cases have been of considerable interest to bioethicists, in large part because of the questions that they raise regarding the philosophical concept of authenticity[5], as well as questions related to inter alia, personal identity,[6] and moral responsibility.[7]
In light of the close relationship between authenticity and autonomy according to many approaches, the identification of authentic desires as those that are congruous with widely shared values raises the prospect that this strategy might in practice amount to dressing up considerations of beneficence in the language of autonomy; this in turn, is a good recipe for paternalism, albeit via the back door
Summary
As an initial starting point, we can say that to be authentic is to live in accordance with one’s “true self.” If such language of a “true self” is to be of any practical significance, it seems that one must accept that there can be elements of a person’s self more generally that are not part of the “true” self, but instead merely peripheral. It might be claimed that the coherence approach seems to be an account of authenticity that contrasts the concept with the notion of narrative identity, in so far as we claim that one can disvalue significant elements of one’s personal history This understanding of authenticity departs from Nyholm and O’Neill’s synchronic understanding, in so far as an agent’s values are most plausibly understood in a diachronic sense. It is important to note that the expectation that elements of the true self will be continuous and long-lasting is quite consistent with the possibility of one retaining authenticity despite undergoing a radical change in character (as Nyholm and O’Neill’s feature 5 suggests) Such change can be authentic if it is intelligible to the agent in the light of that agent’s preexisting values and commitments. Our values and essential elements of our characters may be understood in a symbiotic fashion; it is through the lens of our evaluations, themselves developed in the light of our personal history and our stable, long-lasting characteristics and traits, that we are able to understand which of our features we want to be incorporated into our understanding of who we really are
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Schedule a callMore From: Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees
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