On My Own ... On Attaining Autonomy – The Power WithIN

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This sort of disposition or character is something we all highly value, Kant thought. He believes we value it without limitation or qualification. By this, we believe, he means primarily two things. First, unlike anything else, there is no conceivable circumstance in which we regard our own moral goodness as worth forfeiting simply in order to obtain some desirable object.

By contrast, the value of all other desirable qualities, such as courage or cleverness, can be diminished, forgone, or sacrificed under certain circumstances: Courage may be laid aside if it requires injustice, and it is better not to be witty if it requires cruelty. There is no implicit restriction or qualification to the effect that a commitment to give moral considerations decisive weight is worth honoring, but only under such and such circumstances.

Second, possessing and maintaining a steadfast commitment to moral principles is the very condition under which anything else is worth having or pursuing. The value of a good will thus cannot be that it secures certain valuable ends, whether of our own or of others, since their value is entirely conditional on our possessing and maintaining a good will. Indeed, since a good will is good under any condition, its goodness must not depend on any particular conditions obtaining.

Human beings inevitably feel this Law as a constraint on their natural desires, which is why such Laws, as applied to human beings, are imperatives and duties. A human will in which the Moral Law is decisive is motivated by the thought of duty. A holy or divine will, if it exists, though good, would not be good because it is motivated by thoughts of duty because such a will does not have natural inclinations and so necessarily fulfills moral requirements without feeling constrained to do so. Kant confirms this by comparing motivation by duty with other sorts of motives, in particular, with motives of self-interest, self-preservation, sympathy and happiness.

He argues that a dutiful action from any of these motives, however praiseworthy it may be, does not express a good will. Only then would the action have moral worth. Many object that we do not think better of actions done for the sake of duty than actions performed out of emotional concern or sympathy for others, especially those things we do for friends and family. What is crucial in actions that express a good will is that in conforming to duty a perfectly virtuous person always would, and so ideally we should, recognize and be moved by the thought that our conformity is morally obligatory.

The motivational structure of the agent should be arranged so that she always treats considerations of duty as sufficient reasons for conforming to those requirements. In other words, we should have a firm commitment not to perform an action if it is morally forbidden and to perform an action if it is morally required. Having a good will, in this sense, is compatible with having feelings and emotions of various kinds, and even with aiming to cultivate some of them in order to counteract desires and inclinations that tempt us to immorality.

Suppose for the sake of argument we agree with Kant. We now need to know what distinguishes the principle that lays down our duties from these other motivating principles, and so makes motivation by it the source of unqualified value. According to Kant, what is singular about motivation by duty is that it consists of bare respect for the moral law. What naturally comes to mind is this: Duties are rules or laws of some sort combined with some sort of felt constraint or incentive on our choices, whether from external coercion by others or from our own powers of reason.

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For instance, the bylaws of a club lay down duties for its officers and enforce them with sanctions. City and state laws establish the duties of citizens and enforce them with coercive legal power. Thinking we are duty bound is simply respecting, as such, certain laws pertaining to us. Respect for such laws could hardly be thought valuable. For another, our motive in conforming our actions to civic and other laws is rarely unconditional respect. We also have an eye toward doing our part in maintaining civil or social order, toward punishments or loss of standing and reputation in violating such laws, and other outcomes of lawful behavior.

Indeed, we respect these laws to the degree, but only to the degree, that they do not violate values, laws or principles we hold more dear. Yet Kant thinks that, in acting from duty, we are not at all motivated by a prospective outcome or some other extrinsic feature of our conduct except insofar as these are requirements of duty itself. We are motivated by the mere conformity of our will to law as such. Human persons inevitably have respect for the moral law even though we are not always moved by it and even though we do not always comply with the moral standards that we nonetheless recognize as authoritative.

The force of moral requirements as reasons is that we cannot ignore them no matter how circumstances might conspire against any other consideration. Basic moral requirements retain their reason-giving force under any circumstance, they have universal validity. So, whatever else may be said of basic moral requirements, their content is universal.

Only a universal law could be the content of a requirement that has the reason-giving force of morality.

This brings Kant to a preliminary formulation of the CI: This is the principle which motivates a good will, and which Kant holds to be the fundamental principle of all of morality. Kant holds that the fundamental principle of our moral duties is a categorical imperative. It is an imperative because it is a command addressed to agents who could follow it but might not e. It is categorical in virtue of applying to us unconditionally, or simply because we possesses rational wills, without reference to any ends that we might or might not have.

It does not, in other words, apply to us on the condition that we have antecedently adopted some goal for ourselves. A hypothetical imperative is a command that also applies to us in virtue of our having a rational will, but not simply in virtue of this. It requires us to exercise our wills in a certain way given we have antecedently willed an end. A hypothetical imperative is thus a command in a conditional form. For Kant, willing an end involves more than desiring; it requires actively choosing or committing to the end rather than merely finding oneself with a passive desire for it.

Further, there is nothing irrational in failing to will means to what one desires. The condition under which a hypothetical imperative applies to us, then, is that we will some end. Now, for the most part, the ends we will we might not have willed, and some ends that we do not will we might nevertheless have willed.

But there is at least conceptual room for the idea of a natural or inclination-based end that we must will. The distinction between ends that we might or might not will and those, if any, we necessarily will as the kinds of natural beings we are, is the basis for his distinction between two kinds of hypothetical imperatives. If the end is one that we might or might not will — that is, it is a merely possible end — the imperative is problematic.

Almost all non-moral, rational imperatives are problematic, since there are virtually no ends that we necessarily will as human beings. As it turns out, the only non-moral end that we will, as a matter of natural necessity, is our own happiness. Any imperative that applied to us because we will our own happiness would thus be an assertoric imperative.

Rationality, Kant thinks, can issue no imperative if the end is indeterminate, and happiness is an indeterminate end. Since Kant presents moral and prudential rational requirements as first and foremost demands on our wills rather than on external acts, moral and prudential evaluation is first and foremost an evaluation of the will our actions express. Likewise, while actions, feelings or desires may be the focus of other moral views, for Kant practical irrationality, both moral and prudential, focuses mainly on our willing.

That is, do such imperatives tell us to take the necessary means to our ends or give up our ends wide scope or do they simply tell us that, if we have an end, then take the necessary means to it. Hence, morality and other rational requirements are, for the most part, demands that apply to the maxims that we act on. Since this is a principle stating only what some agent wills, it is subjective.

A principle that governs any rational will is an objective principle of volition, which Kant refers to as a practical law. For anything to count as human willing, it must be based on a maxim to pursue some end through some means. Hence, in employing a maxim, any human willing already embodies the form of means-end reasoning that calls for evaluation in terms of hypothetical imperatives.

To that extent at least, then, anything dignified as human willing is subject to rational requirements. First, formulate a maxim that enshrines your reason for acting as you propose. Second, recast that maxim as a universal law of nature governing all rational agents, and so as holding that all must, by natural law, act as you yourself propose to act in these circumstances.

Third, consider whether your maxim is even conceivable in a world governed by this law of nature.

Autonomy and Independence

If it is, then, fourth, ask yourself whether you would, or could, rationally will to act on your maxim in such a world. If you could, then your action is morally permissible. If your maxim passes all four steps, only then is acting on it morally permissible. Following Hill , we can understand the difference in duties as formal: Hence, one is forbidden to act on the maxim of committing suicide to avoid unhappiness.

By contrast, the maxim of refusing to assist others in pursuit of their projects passes the contradiction in conception test, but fails the contradiction in the will test at the fourth step. Hence, we have a duty to sometimes and to some extent aid and assist others. Kant held that ordinary moral thought recognized moral duties toward ourselves as well as toward others. Hence, together with the distinction between perfect and imperfect duties, Kant recognized four categories of duties: Kant uses four examples in the Groundwork , one of each kind of duty, to demonstrate that every kind of duty can be derived from the CI, and hence to bolster his case that the CI is indeed the fundamental principle of morality.

We will briefly sketch one way of doing so for the perfect duty to others to refrain from lying promises and the imperfect duty to ourselves to develop talents. The maxim of lying whenever it gets you what you want generates a contradiction once you try to combine it with the universalized version that all rational agents must, by a law of nature, lie when doing so gets them what they want.

Here is one way of seeing how this might work: My maxim, however, is to make a deceptive promise in order to get needed money. And it is a necessary means of doing this that a practice of taking the word of others exists, so that someone might take my word and I take advantage of their doing so. It is a world containing my promise and a world in which there can be no promises. Hence, it is inconceivable that I could sincerely act on my maxim in a world in which my maxim is a universal law of nature.

Since it is inconceivable that these two things could exist together, I am forbidden ever to act on the maxim of lying to get money. By contrast with the maxim of the lying promise, we can easily conceive of adopting a maxim of refusing to develop any of our talents in a world in which that maxim is a universal law of nature. It would undoubtedly be a world more primitive than our own, but pursuing such a policy is still conceivable in it. However, it is not, Kant argues, possible to rationally will this maxim in such a world.

Insofar as we are rational, he says, we already necessarily will that all of our talents and abilities be developed. Hence, although I can conceive of a talentless world, I cannot rationally will that it come about, given that I already will, insofar as I am rational, that I develop all of my own. Yet, given limitations on our time, energy and interest, it is difficult to see how full rationality requires us to aim to fully develop literally all of our talents.

Further, all that is required to show that I cannot will a talentless world is that, insofar as I am rational, I necessarily will that some talents in me be developed, not the dubious claim that I rationally will that they all be developed. Moreover, suppose rationality did require me to aim at developing all of my talents.

Then, there seems to be no need to go further in the CI procedure to show that refusing to develop talents is immoral. Given that, insofar as we are rational, we must will to develop capacities, it is by this very fact irrational not to do so. However, mere failure to conform to something we rationally will is not yet immorality. Failure to conform to instrumental principles, for instance, is irrational but not always immoral.

This is a claim he uses not only to distinguish assertoric from problematic imperatives, but also to argue for the imperfect duty of helping others G 4: Each maxim he is testing appears to have happiness as its aim. One explanation for this is that, since each person necessarily wills her own happiness, maxims in pursuit of this goal will be the typical object of moral evaluation.

This, at any rate, is clear in the talents example itself: Second, we must assume, as also seems reasonable, that a necessary means to achieving normal human happiness is not only that we ourselves develop some talent, but also that others develop some capacities of theirs at some time. For instance, I cannot engage in the normal pursuits that make up my own happiness, such as playing piano, writing philosophy or eating delicious meals, unless I have developed some talents myself, and, moreover, someone else has made pianos and written music, taught me writing, harvested foods and developed traditions of their preparation.

Thus, we should assume that, necessarily, rational agents will the necessary and available means to any ends that they will. And once we add this to the assumptions that we must will our own happiness as an end, and that developed talents are necessary means to achieving that end, it follows that we cannot rationally will that a world come about in which it is a law that no one ever develops any of their natural talents.

We cannot do so, because our own happiness is the very end contained in the maxim of giving ourselves over to pleasure rather than self-development. Since we will the necessary and available means to our ends, we are rationally committed to willing that everyone sometime develop his or her talents. So since we cannot will as a universal law of nature that no one ever develop any talents — given that it is inconsistent with what we now see that we rationally will — we are forbidden from adopting the maxim of refusing to develop any of our own.

Related terms:

This formulation states that we should never act in such a way that we treat humanity, whether in ourselves or in others, as a means only but always as an end in itself. Intuitively, there seems something wrong with treating human beings as mere instruments with no value beyond this. But this very intuitiveness can also invite misunderstandings. First, the Humanity Formula does not rule out using people as means to our ends. Clearly this would be an absurd demand, since we apparently do this all the time in morally appropriate ways. Indeed, it is hard to imagine any life that is recognizably human without the use of others in pursuit of our goals.

The food we eat, the clothes we wear, the chairs we sit on and the computers we type at are gotten only by way of talents and abilities that have been developed through the exercise of the wills of many people. What the Humanity Formula rules out is engaging in this pervasive use of humanity in such a way that we treat it as a mere means to our ends. Thus, the difference between a horse and a taxi driver is not that we may use one but not the other as a means of transportation.

Thus, supposing that the taxi driver has freely exercised his rational capacities in pursuing his line of work, we make permissible use of these capacities as a means only if we behave in a way that he could, when exercising his rational capacities, consent to — for instance, by paying an agreed on price. Third, the idea of an end has three senses for Kant, two positive senses and a negative sense. An end in the first positive sense is a thing we will to produce or bring about in the world.

For instance, if losing weight is my end, then losing weight is something I aim to bring about. An end in this sense guides my actions in that once I will to produce something, I then deliberate about and aim to pursue means of producing it if I am rational. Once I have adopted an end in this sense, it dictates that I do something: I should act in ways that will bring about the end or instead choose to abandon my goal.

An end in the negative sense lays down a law for me as well, and so guides action, but in a different way. Korsgaard offers self-preservation as an example of an end in a negative sense: We do not try to produce our self-preservation. Rather, the end of self-preservation prevents us from engaging in certain kinds of activities, for instance, picking fights with mobsters, and so on. That is, as an end, it is something I do not act against in pursuing my positive ends, rather than something I produce. Humanity is in the first instance an end in this negative sense: It is something that limits what I may do in pursuit of my other ends, similar to the way that my end of self-preservation limits what I may do in pursuit of other ends.

Insofar as it limits my actions, it is a source of perfect duties. Now many of our ends are subjective in that they are not ends that every rational being must have. Humanity is an objective end, because it is an end that every rational being must have. Hence, my own humanity as well as the humanity of others limit what I am morally permitted to do when I pursue my other, non-mandatory, ends.

The humanity in myself and others is also a positive end, though not in the first positive sense above, as something to be produced by my actions. Rather, it is something to realize, cultivate or further by my actions. Becoming a philosopher, pianist or novelist might be my end in this sense. When my end is becoming a pianist, my actions do not, or at least not simply, produce something, being a pianist, but constitute or realize the activity of being a pianist. Insofar as the humanity in ourselves must be treated as an end in itself in this second positive sense, it must be cultivated, developed or fully actualized.

And insofar as humanity is a positive end in others, I must attempt to further their ends as well. In so doing, I further the humanity in others, by helping further the projects and ends that they have willingly adopted for themselves. Proper regard for something with absolute value or worth requires respect for it.

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But this can invite misunderstandings. I may respect you as a rebounder but not a scorer, or as a researcher but not as a teacher. When I respect you in this way, I am positively appraising you in light of some achievement or virtue you possess relative to some standard of success. If this were the sort of respect Kant is counseling then clearly it may vary from person to person and is surely not what treating something as an end-in-itself requires. For instance, it does not seem to prevent me from regarding rationality as an achievement and respecting one person as a rational agent in this sense, but not another.

And Kant is not telling us to ignore differences, to pretend that we are blind to them on mindless egalitarian grounds. I may respect you because you are a student, a Dean, a doctor or a mother. In such cases of respecting you because of who or what you are, I am giving the proper regard to a certain fact about you, your being a Dean for instance.

This sort of respect, unlike appraisal respect, is not a matter of degree based on your having measured up to some standard of assessment. We are to respect human beings simply because they are persons and this requires a certain sort of regard. We are not called on to respect them insofar as they have met some standard of evaluation appropriate to persons. And, crucially for Kant, persons cannot lose their humanity by their misdeeds — even the most vicious persons, Kant thought, deserve basic respect as persons with humanity.

Although Kant does not state this as an imperative, as he does in the other formulations, it is easy enough to put it in that form: Act so that through your maxims you could be a legislator of universal laws. This sounds very similar to the first formulation. However, in this case we focus on our status as universal law givers rather than universal law followers. This is of course the source of the very dignity of humanity Kant speaks of in the second formulation.

A rational will that is merely bound by universal laws could act accordingly from natural and non-moral motives, such as self-interest. But in order to be a legislator of universal laws, such contingent motives, motives that rational agents such as ourselves may or may not have, must be set aside. Hence, we are required, according to this formulation, to conform our behavior to principles that express this autonomy of the rational will — its status as a source of the very universal laws that obligate it.

The Autonomy Formula presumably does this by putting on display the source of our dignity and worth, our status as free rational agents who are the source of the authority behind the very moral laws that bind us. This formulation has gained favor among Kantians in recent years see Rawls, ; Hill, Many see it as introducing more of a social dimension to Kantian morality. The intuitive idea behind this formulation is that our fundamental moral obligation is to act only on principles which could earn acceptance by a community of fully rational agents each of whom have an equal share in legislating these principles for their community.

Kant claimed that all of these CI formulas were equivalent. Unfortunately, he does not say in what sense. Thus, his claim that the formulations are equivalent could be interpreted in a number of ways. There are remaining doubts some commentators have, however, about whether this strategy can capture the full meaning of the Humanity Formula or explain all of the duties that Kant claims to derive from it Wood , ; Cureton Perhaps, then, if the formulas are not equivalent in meaning, they are nevertheless logically interderivable and hence equivalent in this sense. That would have the consequence that the CI is a logical truth, and Kant insists that it is not or at least that it is not analytic.

Kant's Moral Philosophy (Stanford Encyclopedia of Philosophy)

Since the CI formulas are not logical truths, then, it is possible that they could be logically interderivable. However, despite his claim that each contains the others within it, what we find in the Groundwork seems best interpreted as a derivation of each successive formula from the immediately preceding formula.

There are, nonetheless, a few places in which it seems that Kant is trying to work in the opposite direction. One is found in his discussion of the Humanity Formula. If something is absolutely valuable, then we must act only on maxims that can be universal laws. But he postulates humanity is absolutely valuable. Thus , we must act only on maxims that can be universal laws. This we think anomolous discussion may well get at some deep sense in which Kant thought the formulations were equivalent.

Nonetheless, this derivation of the universal law formulation from the Humanity Formulation seems to require a substantive, synthetic claim, namely, that humanity is indeed absolutely valuable. The most straightforward interpretation of the claim that the formulas are equivalent is as the claim that following or applying each formula would generate all and only the same duties Allison This seems to be supported by the fact that Kant used the same examples through the Law of Nature Formula and the Humanity Formula. In other words, respect for humanity as an end in itself could never lead you to act on maxims that would generate a contradiction when universalized, and vice versa.

The subjective differences between formulas are presumably differences that appeal in different ways to various conceptions of what morality demands of us. But this difference in meaning is compatible with there being no practical difference, in the sense that conformity to one formulation cannot lead one to violate another formulation. Most readers interpret Kant as holding that autonomy is a property of rational wills or agents.

It contains first and foremost the idea of laws made and laid down by oneself, and, in virtue of this, laws that have decisive authority over oneself. Consider how political freedom in liberal theories is thought to be related to legitimate political authority: A state is free when its citizens are bound only by laws in some sense of their own making — created and put into effect, say, by vote or by elected representatives. The laws of that state then express the will of the citizens who are bound by them. An autonomous state is thus one in which the authority of its laws is in the will of the people in that state, rather than in the will of a people external to that state, as when one state imposes laws on another during occupation or colonization.

In the latter case, the laws have no legitimate authority over those citizens. In a similar fashion, we may think of a person as free when bound only by her own will and not by the will of another. Her actions then express her own will and not the will of someone or something else. The authority of the principles binding her will is then also not external to her will. It comes from the fact that she willed them. So autonomy, when applied to an individual, ensures that the source of the authority of the principles that bind her is in her own will.

For a contrasting interpretation of autonomy that emphasizes the intrinsic value of freedom of choice and the instrumental role of reason in preserving that value, see Guyer This is, firstly, the concept of a will that does not operate through the influence of factors outside of this responsiveness to apparent reasons. For a will to be free is thus for it to be physically and psychologically unforced in its operation. Hence, behaviors that are performed because of obsessions or thought disorders are not free in this negative sense.

But also, for Kant, a will that operates by being determined through the operation of natural laws, such as those of biology or psychology, cannot be thought of as operating by responding to reasons. Hence, determination by natural laws is conceptually incompatible with being free in a negative sense.

Indeed, Kant goes out of his way in his most famous work, the Critique of Pure Reason , to argue that we have no rational basis for believing our wills to be free. Of such things, he insists, we can have no knowledge. For much the same reason, Kant is not claiming that a rational will cannot operate without feeling free. Although there is, according to Kant, no rational basis for the belief that the natural world is or is not arranged according to some purpose by a Designer, the actual practices of science often require looking for the purpose of this or that chemical, organ, creature, environment, and so on.

Thus, one engages in these natural sciences by searching for purposes in nature. Yet when an evolutionary biologist, for instance, looks for the purpose of some organ in some creature, she does not after all thereby believe that the creature was designed that way, for instance, by a Deity. Practicing biology involves searching for the purposes of the parts of living organisms.

Kant says that a will that cannot exercise itself except under the Idea of its freedom is free from a practical point of view im practischer Absicht. In saying such wills are free from a practical point of view, he is saying that in engaging in practical endeavors — trying to decide what to do, what to hold oneself and others responsible for, and so on — one is justified in holding oneself to all of the principles to which one would be justified in holding wills that are autonomous free wills.

Thus, once we have established the set of prescriptions, rules, laws and directives that would bind an autonomous free will, we then hold ourselves to this very same of set prescriptions, rules, laws and directives. And one is justified in this because rational agency can only operate by seeking to be the first cause of its actions, and these are the prescriptions, and so on, of being a first cause of action.

Therefore, rational agents are free in a negative sense insofar as any practical matter is at issue. Crucially, rational wills that are negatively free must be autonomous, or so Kant argues. This is because the will is a kind of cause—willing causes action.

Kant took from Hume the idea that causation implies universal regularities: These laws, which Kant thought were universal too, govern the movements of my body, the workings of my brain and nervous system and the operation of my environment and its effects on me as a material being. But they cannot be the laws governing the operation of my will; that, Kant already argued, is inconsistent with the freedom of my will in a negative sense.

So, the will operates according to a universal law, though not one authored by nature, but one of which I am the origin or author. Thus, Kant argues, a rational will, insofar as it is rational, is a will conforming itself to those laws valid for any rational will. Addressed to imperfectly rational wills, such as our own, this becomes an imperative: Kant appeared not to recognize the gap between the law of an autonomous rational will and the CI, but he was apparently unsatisfied with the argument establishing the CI in Groundwork III for another reason, namely, the fact that it does not prove that we really are free.

Hence, while in the Groundwork Kant relies on a dubious argument for our autonomy to establish that we are bound by the moral law, in the second Critique , he argues from the bold assertion of our being bound by the moral law to our autonomy. In many cases, the individual defines the self not by his or her own personal accomplishment but by the degree of contribution to group goals and overall ability to fit in seamlessly with a group. The valence of self-evaluations is also culturally nuanced.

Self-evaluations include assessments of how self-esteem is developed, how people view themselves in comparison with others, and what factors individuals consider when describing an ideal member of a particular culture. North Americans are typically found to demonstrate an elevated sense of self-appraisal bias, consistently feeling better about themselves in comparison with Asians Heine et al. Visions of personal success in individualist cultures embrace the perceived universality of human uniqueness, with practically everyone thought to have a particular talent or ability and everyone capable of making a meaningful and diverse contribution to societal prosperity Gardner, With regard to emotions, individual exuberance is tempered in collectivist cultures, with conscious effort focused on deliberately avoiding attention to the self or standing out in comparison with others.


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Emotion is hallmarked by the suppression of inner feelings in collectivist cultures, where the lack of exhibited expression is valued even in the face of strong emotions, including anger, fear, or nervousness. For instance, Kitayama, Mesquita, and Karasawa sought to determine if priming emotions during similar social situations resulted in multi-cultural differences. Comparison between Americans and Japanese individuals revealed that individuals from the United States were more likely to display socially disengaging emotions e.

The strength of emotions was also related to cultural orientation, as the intensity of socially engaging emotions was greater for Japanese individuals, while Americans showed more passion when displaying socially disengaging emotion. Cultural differences in emotion are also substantiated by neurological evidence. Several studies have indicated moderated brain activity in individuals from collectivist cultures during episodes of suggested emotional suppression, when understanding the perspectives of others, and when a social situation suggested the need for emotional empathy.

Consider a routine situation found in many classrooms and corporate training arenas: The first step in group work is usually to elect a team leader or spokesperson. Individualistic cultures encourage volunteering and the desire to assume a leadership role. Conversely, the emphasis on social hierarchy in the collectivist culture would suggest leader appointment to be a group process, with the leadership role assumed by the individual with the highest perceived social stature. Typical project participation in the individualist culture would involve brainstorming, with team participants readily volunteering ideas; in the collectivist culture, norms dictate that participants take direction from the leader and volunteer suggestions only when asked.

If you have the impression that you can accurately predict behavior based upon cross-cultural assessments of individualism and collectivism, temper your confidence. First, stereotypical behavior is not a basis for evaluation or assessment. Second, not all individuals from Western populations embrace individualism and egocentric behaviors to the same extent, nor do all Asians display collectivist tendencies. Fourth, many studies related to assessment of cultural orientation are correlational.

These variables, individually or collectively, may have an equally compelling influence on overall cultural assessments, thus moderating any statistically significant within-group differences. Families vary considerably in how they interact with their children. Under optimal conditions, family members feel supported through warm and responsive interactions that also indicate respect for independence and autonomy. Family life would not be typical if there were not conflict of some sort, however.

All families experience disagreements, whether it is over bringing home a new puppy or choice of peer group; these squabbles are part of family life. However, it is how disagreements are resolved, not necessarily the actual outcome, that portends good or poor functioning. Longitudinal evidence suggests that sustained and unresolved conflict in the home can compromise children's health through increased stress reactivity, disruptions in health management, and increased behavior problems. Over time, conflictive family interactions reduce opportunities for effective problem solving, and spiraling negativity may threaten the integrity of the family as a whole.

For the busy pediatrician, it is important to recognize that persistent patterns of negativity and conflict in the family may reduce the likelihood that treatment regimens will be followed. There is a cause for optimism, however: The results from family-based intervention programs suggest that problem solving, communication, and positive parenting can ameliorate risks and lead to more optimal outcomes for children.

We return to this point in our discussion of family-based interventions. Thus far, we have considered variations in family process along the dimensions of family practices and beliefs as reflected in the construction of routines and representation of relationships expressed through family narratives. We have examined these variations in the context of environmental risks and family response to chronic illnesses. Another important source of variation in family process is the effects of culture on daily practices and regulation of beliefs. We now consider some of the general ways in which culture may intersect with family process and influence child health and development.

Productive aging is defined as the capacity of an individual or population to serve in the paid workforce and in volunteer activities, to assist in the family, and to maintain, to varying degrees, autonomy and independence for as long as possible. The concept was created primarily in response to stereotyped depictions of older persons as dependent and a burden to society.

It served to draw attention to the fact that productivity does not stop when a person grows older, and that the older population is being underused by society. It reflected both the need for older persons to work longer in an older society, and the persistence and universality of prejudice against them in the workplace. The extent to which an older person can remain productive is determined by a variety of personal factors, including physical and emotional well-being, motivation, attitude, education, and experience, and by changing technologies and societal attitudes and structures.

The interplay between personal issues and societal norms has an important influence on both paid and unpaid productive activities. Confirming the landmark study by the National Institute of Mental Health of healthy community-resident aged men conducted in the s and s, The MacArthur Study of Successful Aging in America found that engagement in meaningful activities contributes to good health, satisfaction with life, and longevity, along with providing a potentially effective means of reducing costs of physical and emotional illness in later life.

Older persons who have goals and structure are more likely to live longer than people who lack motivation and purpose. Paid work includes remunerative self-employment and work for others. For older employees, the central issue regarding participation in paid work is retirement. Normal adolescence is a taxing time for all concerned, and is complicated if there is a comorbidity such as asthma. This big subject has been reviewed in detail recently []. The tasks of normal adolescence include establishing increasing independence and autonomy, and, in the context of asthma, taking more responsibility for treatment or lack of it.

Asthma may remit, return or worsen in adolescence, or present for the first time; epidemiological data are conflicting. Diagnosis of a new presenting asthma may be difficult, with atypical presentations such as chest pain being not uncommon. Management may be very difficult.

Risk-taking behaviors by adolescents may be considered almost normal, but smoking and substance abuse do not help asthma control. Compliance is almost always an issue; adolescents often do not want to be different from their peers, and will not take medications for this reason. They may worry about adverse effects of therapy; or probably most usually, be too idle and disorganised to be bothered. Control is frequently poor. Management is very difficult, with many theoretically good ideas being trial, which are often very time-consuming, and with very little objective evidence of benefit.

Specialist adolescent clinics are advocated, in which teenagers are seen on their own, at least initially without their parents, in an age-appropriate environment. It is believed that a non-directive, non-threatening approach is optimal, with negotiation over what treatment is reasonable.

Others like this author merely hope to weather the storm until adulthood is reached, whereupon the young person is referred to the calm waters of the adult clinic! The vulnerable child may present with a number of different types of problems divided by Green and Solnit into the following major categories. An example of this is a parent's reluctance to leave the child in the care of a babysitter.

The parent's sense of the child's being vulnerable and the resulting abnormality in interactions with the child lead to a decrease in the child's sense of autonomy and independence. Parents may complain of the child's sleep problems, although this may in part be because the child is sleeping in the parents' bed or the parents are regularly checking on the sleeping child to make sure that the child is still alive. In some cases, the parents are unable to set appropriate disciplinary limits for the child and are overindulgent and excessively protective of the child.

The child may become disobedient and argumentative and may refuse to eat. Often the child's episodes of negative behavior disintegrate into physical fighting, with hitting and biting, and the parent is unable to handle the behavior appropriately. Most description of children's behavior in the vulnerable child syndrome come from clinical reports, although there has been some research that has examined child behavior.

Kant's Moral Philosophy

In a follow-up study of premature infants, Allen and colleagues assessed children when they were 1 year old and demonstrated that increased parental perceptions of vulnerability were associated with an increase in abnormal adaptive behaviors even in those children who had no medical sequelae of prematurity, such as cerebral palsy or growth delay. Importantly, however, there was no association between parental perceptions of vulnerability and either motor development or mental development as measured by the Bayley scale, except in those cases in which there was true medical vulnerability.

A parent who perceives his or her child to be vulnerable is often a frequent visitor to the clinician for what the clinician considers to be only minor medical problems. There is often excessive focus on such things as the regularity of the child's bowel movements and complaints that the child has a sickly appearance or has circles under the eyes. The child may have psychosomatic problems, such as recurrent abdominal pain or headaches, and may have frequent absences from school.

Sometimes Munchausen by proxy syndrome must be considered. Even though school underachievement was initially described by Green and Solnit, it is usually not the major presenting problem in the vulnerable child syndrome. The child's school performance may suffer because of distractible, hyperactive behavior in the classroom.

The parents' earlier reluctance to separate from the child and the unspoken fear that the child is unsafe out of the parents' presence may be transferred to the child, and the resulting preoccupation and anxiety can interfere with the child's abilities to concentrate and to learn. Almost as many theories have been proposed as the number of people who have researched the condition, with individual, family or societal factors prominent in most explanations.

Review of the premorbid personality characteristics of anorexics shows them to be conformist, conscientious, compliant and high achieving. Issues over autonomy and independence are core issues for anorexics, with control over food intake the only available means to preserve self-identity and independence. Similar conflicts over autonomy and independence have been observed among families with an anorectic member, but whether this is cause or effect is unclear. We use cookies to help provide and enhance our service and tailor content and ads.

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