This article considers John Harris’ work on autonomy, specifically reproductive autonomy, outlined in The Value of Life and developed throughout his career. Harris often used the concept of reproductive autonomy to make the case for liberal approaches to developments in reproductive and genetic technologies. Harris argued that reproductive autonomy should be highly valued, and therefore we need compelling arguments to justify limiting it in anyway. When discussing reproductive autonomy, Harris focused mainly on restrictions on the potential users of reproductive technologies autonomy, that is, prospective parents. This article extends the discussion of autonomy and the appropriate limits to individuals exercising their autonomy to medical professionals working in this area. Given reproductive technologies have become part of routine medical practice, this article considers whether the current restrictions on both patients and clinicians, as imposed by regulators and professional guidelines, remain ethically justified.

This article explores the accountability experiences and orientations of frontline workers implementing personalised activation services in the Norwegian Labour and Welfare Administration (NAV). The study draws on observations and interviews (2021), with three teams of employment specialists using Supported Employment as an approach to personalised service provision, in a national programme called Extended Follow-up. Adopting the theoretical lens of accountability as behaviours of account giving, three strategies on how to adopt the accountability regime at the frontline are highlighted: (i) reporting, where one team complied with accountability requirements as the perceived best practices for achieving success in work inclusion; (ii) mitigating, where accountability requirements were fulfilled but combined with attention to how to best meet jobseekers’ needs; and (iii) reframing, where accountability requirements were challenged and redefined. The study highlights how accountability requirements may be interpreted variably, promoting personalised service innovation on the one hand or stagnation on the other.

The amount of data available to healthcare practitioners is growing, and the rapid increase in available patient data is becoming a problem for healthcare practitioners, as they are often unable to fully survey and process the data relevant for the treatment or care of a patient. Consequently, there are currently several efforts to develop systems that can aid healthcare practitioners with reading and processing patient data and, in this way, provide them with a better foundation for decision-making about the treatment and care of patients. There are also efforts to develop algorithms that provide suggestions for such decisions. However, the development of these systems and algorithms raises several concerns related to the privacy of patients, the patient–practitioner relationship, and the autonomy of healthcare practitioners. The aim of this article is to provide a foundation for understanding the ethical challenges related to the development of a specific form of data-processing systems, namely clinical algorithms.

This article examines Chinese civil–military relations using a bottom-up analytical approach and hitherto untapped sources, including interviews with military personnel in active service. It argues that traditional approaches to political control, which generally interpret the changing political–military relationship through military professionalism and institutional autonomy, miss out on important aspects and may generate erroneous conclusions. Here, focus is instead on the professional autonomy of the Chinese officer corps. Through an empirical study of the organization of military work at two of China's top military education institutes, the article illustrates how professional autonomy and direct political control vary, both between hierarchical levels and issue areas. This highlights the multidimensionality of both control and professional manoeuvrability and underlines the fruitfulness of including an intra-organizational perspective in order to reach better informed conclusions about political control and civil–military relations in today's China.

Discussions of conscientious objection (CO) in healthcare often concentrate on objections to interventions that relate to reproduction, such as termination of pregnancy or contraception. Nevertheless, questions of conscience can arise in other areas of medicine. For example, the intensive care unit is a locus of ethically complex and contested decisions. Ethical debate about CO usually concentrates on the issue of whether physicians should be permitted to object to particular courses of treatment; whether CO should be accommodated. In this article, I focus on the question of how clinicians ought to act: should they provide or support a course of action that is contrary to their deeply held moral beliefs? I discuss two secular examples of potential CO in intensive care, and propose that clinicians should adopt a norm of conscientious non-objection (CNO). In the face of divergent values and practice, physicians should set aside their personal moral beliefs and not object to treatment that is legally and professionally accepted and provided by their peers. Although there may be reason to permit conscientious objections in healthcare, conscientious non-objection should be encouraged, taught, and supported.

With New Public Management came the idea that public organizations should be led by professional managers, rather than by professionals. This has been referred to as new managerialism. This article explores how new managerialism may affect professional autonomy in a public organization that enjoys a high – and constitutionally protected – degree of organizational autonomy. A framework distinguishing between organizational and occupational professionalism is adopted, in a 10-year case study of the Swedish National Audit Office (SNAO). The study shows how the autonomy of professionals at the SNAO was highly restricted, while management control systems were continuously expanded. At the same time, SNAO performance has been reduced. For example, the SNAO has been criticized for its high overhead costs. The study presented in this article, shows the complex interplay between professionalism, new managerialism, and organizational performance. Based on the findings from this study, the article maintains that it is equally important to consider how autonomy is distributed within agencies, as it is to consider how autonomy is distributed between the political sphere and the administration, when trying to explain organizational performance.