Noncontrol

Although Faden and Beauchamp avoid the word ``voluntariness'' in their argument, instead using ``noncontrol'', it should be noted that other literature surrounding informed consent in the medical and legal fields widely use the former term (such as the Belmont Report (NCPHSBBR, 1978), the Nuremberg Code (U.S. Government, 1949), NHMRC et al. (2007), and WMA (2004)). However, some literature defines ``voluntariness'' mistakenly as synonymous with the concept of autonomy itself, such as the Nuremberg Code, which states that voluntariness requires the person to ``be so situated as to be able to exercise free power of choice, without the intervention of any element of force, fraud, deceit, duress, overreaching, or other ulterior form of constraint or coercion'' [U.S. Government, 1949]. This sort of use could cause problems with the previous definitions of intention (see section 1.2.1) if taken literally, thus Faden and Beauchamp rightly dismiss the use of ``voluntariness'' to describe this. The use of ``noncontrol'' emphasises the measurement of the negative condition which Faden and Beauchamp see as being just as important to informed consent as intention and understanding. They define it as being independence from control, measurable by assessments of influence and resistance and the balance struck between them. A fully noncontrolled act has ``not been the target of an influence attempt'' or ``if [it has] been the target of an attempt to influence, it was either not successful or it did not deprive the actor of any way of willing what he or she wishes to do or believe.'' (p. 258).

A fully externally controlled act, at the other extreme, is ``entirely dominated by the will of another'' and purely serves the aims of the controller. However, there are obviously degrees between these extremes, and this is what Faden and Beauchamp identify in their discussion of manipulation as an influence, and coercion and persuasion the extremes of the continuum of manipulation. They claim that coercion, although thought in most literature to be influencing by degrees, ``always entirely [compromises] autonomy by wholly controlling action'' (p. 259). At the other end of the scale, persuasion is the mechanism by which one willingly chooses to act on a belief, adopting it as one's own belief. Persuasion can be resisted, and it is the rational acceptance of a persuasive argument that allows the actor to act autonomously, without being controlled^1.9. The scale of manipulation also includes such forms as deception (misrepresentation), indoctrination (instituting a strong belief about something that is accepted without criticism), and seduction (using charisma or some other tempting proposition that essentially distracts or misleads), each of which display a variable amount of control ranging from the level of coercion to the noncontrol of persuasion. The fact that noncontrol comes in degrees does not, however, compromise the position Faden and Beauchamp hold in the section on intention, that is, that intention does not come in degrees. This is because the natures of noncontrol and intention are quite distinct and related to the decision-making process in different ways. An action is either intentional or not, but it can be controlled through the various degrees of manipulation.

In information technology, the sorts of degrees of manipulation range the entire scale from coercion through to persuasion. A highly manipulative (close to coercive) situation would be a classic software developer monopoly situation, where, for example, computer users are essentially forced to use a particular piece of software to open a particular file (a document or video, for example). Manipulative situations would range from the deceptive, where a piece of software claims to offer something for free, but then installs advertising software in the background^1.10, to the seductive, where a piece of software offers something for free, and it is the latest must-use software, but also blatantly collects personal information which it sells on to third parties^1.11. A persuasive situation would be the recommendation of a piece of software by a friend or reviewer, or similar^1.12.

This identification of a manipulatory influence continuum allows Faden and Beauchamp to show how degrees of influence can affect the degree of autonomy, thus the goal for a sufficiently autonomous action can be invariably linked to a substantially noncontrolled action threshold. They take pains to assert that the criteria for such a threshold would vary depending on the context, and that it is difficult to accurately distinguish between acts that are substantially noncontrolled and those that are only slightly more controlled. One of the reasons for this is that whether an action is manipulative (and to what degree) is very much a subjective experience, and therefore must be judged based on personal reaction, so degrees of manipulation are context-sensitive.