The primary objective was to review pediatric ethics consultations at a large academic health center over a nine year period, assessing demographics, ethical issues, and consultant intervention. The secondary objective was to describe the evolution of PECs at our institution. This was a retrospective review of Consultation Summary Sheets compiled for PECs at our Academic Health Center between January 2008 and April 2017. There were 165 PECs reviewed during the study period. Most consult requests came from the inpatient setting, with (...) the Pediatric and Neonatal Intensive Care Units being the highest utilizers. Consultation utilization increased over the study period. The most common patient age was less than one year. Physicians were most likely to request consultation. Patient Best Interest, Withholding/Withdrawing of Life Sustaining Therapy, and Provider Moral Distress were ethical issues most commonly identified by the consultants. Making recommendations was the most common consultant intervention. The ethics consultation process evolved over time from informal provider discussions, to a hospital infant care review committee, to a pediatric only consultation service, to a combined adult/pediatric consultation service, with variable levels of salary support for consultants. Ethics consultation requests are growing at our institution. Similarities in identified ethical issues exist between our findings and existing literature, however meaningful comparisons remains elusive secondary to variability in approaches to investigation and reporting. A combined paid/volunteer/trainee ethics consultation service model appears sustainable and real time ethics consultation is feasible using this approach. (shrink)

The moral enhancement (or bioenhancement) debate seems stuck in a dilemma. On the one hand, the more radical proposals, while certainly novel and interesting, seem unlikely to be feasible in practice, or if technically feasible then most likely imprudent. But on the other hand, the more sensible proposals – sensible in the sense of being both practically achievable and more plausibly ethically justifiable – can be rather hard to distinguish from both traditional forms of moral enhancement, such as non-drug-mediated social (...) or moral education, and non-moral forms of bioenhancement, such as smart-drug style cognitive enhancement. In this essay, I argue that bioethicists have paid insufficient attention to an alternative form of moral bioenhancement – or at least a likely candidate – that falls somewhere between these two extremes, namely the (appropriately qualified) use of certain psychedelic drugs. (shrink)

Volume 20, Issue 8, August 2020, Page 72-75.

Historically, empirical research in bioethics has drawn on methods developed within the social sciences, including qualitative interviews, focus groups, ethnographic studies, and opinion surveys, t...

Our understanding of the neurochemical bases of human love and attachment, as well as of the genetic, epigenetic, hormonal, and experiential factors that conspire to shape an individual's sexual orientation, is increasing exponentially. This research raises the vexing possibility that we may one day be equipped to modify such variables directly, allowing for the creation of “high-tech” conversion therapies or other suspect interventions. In this article, we discuss the ethics surrounding such a possibility, and call for the development of legal (...) and procedural safeguards for protecting vulnerable children from the application of such technology. We also consider the more difficult case of voluntary, adult “conversion” and argue that in rare cases, such attempts might be permissible under strict conditions. (shrink)

If you grade enough papers, you will find some consistent pitfalls, especially in the writing of students who are coming to philosophy for the first time. I wrote up the following tips a couple of years ago when I was a teaching assistant for an introductory philosophy class at Yale led by Daniel Greco called ‘Problems in Philosophy’. The tips were intended, then, for college students, many of them right out of high school, and most of whom had never written (...) a philosophy paper before. So the focus is on clarity and mastering the basics. With that in mind, I hope you will find these tips helpful for teaching or writing in philosophy. (shrink)

When making substituted judgments for incapacitated patients, surrogates often struggle to guess what the patient would want if they had capacity. Surrogates may also agonize over having the (sole) responsibility of making such a determination. To address such concerns, a Patient Preference Predictor (PPP) has been proposed that would use an algorithm to infer the treatment preferences of individual patients from population-level data about the known preferences of people with similar demographic characteristics. However, critics have suggested that even if such (...) a PPP were more accurate, on average, than human surrogates in identifying patient preferences, the proposed algorithm would nevertheless fail to respect the patient’s (former) autonomy since it draws on the ‘wrong’ kind of data: namely, data that are not specific to the individual patient and which therefore may not reflect their actual values, or their reasons for having the preferences they do. Taking such criticisms on board, we here propose a new approach: the Personalized Patient Preference Predictor (P4). The P4 is based on recent advances in machine learning, which allow technologies including large language models to be more cheaply and efficiently ‘fine-tuned’ on person-specific data. The P4, unlike the PPP, would be able to infer an individual patient’s preferences from material (e.g., prior treatment decisions) that is in fact specific to them. Thus, we argue, in addition to being potentially more accurate at the individual level than the previously proposed PPP, the predictions of a P4 would also more directly reflect each patient’s own reasons and values. In this article, we review recent discoveries in artificial intelligence research that suggest a P4 is technically feasible, and argue that, if it is developed and appropriately deployed, it should assuage some of the main autonomy-based concerns of critics of the original PPP. We then consider various objections to our proposal and offer some tentative replies. (shrink)

The enhancement debate in neuroscience and biomedical ethics tends to focus on the augmentation of certain capacities or functions: memory, learning, attention, and the like. Typically, the point of contention is whether these augmentative enhancements should be considered permissible for individuals with no particular “medical” disadvantage along any of the dimensions of interest. Less frequently addressed in the literature, however, is the fact that sometimes the _diminishment_ of a capacity or function, under the right set of circumstances, could plausibly contribute (...) to an individual's overall well-being: more is not always better, and sometimes less is more. Such cases may be especially likely, we suggest, when trade-offs in our modern environment have shifted since the environment of evolutionary adaptation. In this article, we introduce the notion of “diminishment as enhancement” and go on to defend a _welfarist_ conception of enhancement. We show how this conception resolves a number of definitional ambiguities in the enhancement literature, and we suggest that it can provide a useful framework for thinking about the use of emerging neurotechnologies to promote human flourishing. (shrink)

Historically, laws and policies to criminalize drug use or possession were rooted in explicit racism, and they continue to wreak havoc on certain racialized communities. We are a group of bioethicists, drug experts, legal scholars, criminal justice researchers, sociologists, psychologists, and other allied professionals who have come together in support of a policy proposal that is evidence-based and ethically recommended. We call for the immediate decriminalization of all so-called recreational drugs and, ultimately, for their timely and appropriate legal regulation. We (...) also call for criminal convictions for nonviolent offenses pertaining to the use or possession of small quantities of such drugs to be expunged, and for those currently serving time for these offenses to be released. In effect, we call for an end to the “war on drugs.”. (shrink)

The ‘born this way’ movement for sexual orientation minority rights is premised on the view that sexual orientation is something that can neither be chosen nor changed. Indeed, current sexual orientation change efforts appear to be both harmful and ineffective. But what if ‘high-tech conversion therapies’ are invented in the future that are effective at changing sexual orientation? The conceptual basis for the movement would collapse. In this chapter, we argue that the threat of HCT should be taken seriously, motivating (...) a change in tactics for proponents of sexual orientation minority rights. We also discuss some of the practical-ethical and public-policy issues surrounding HCT, in case the technology is one day developed. (shrink)

This paper explores an emerging sub-field of both empirical bioethics and experimental philosophy, which has been called “experimental philosophical bioethics” (bioxphi). As an empirical discipline, bioxphi adopts the methods of experimental moral psychology and cognitive science; it does so to make sense of the eliciting factors and underlying cognitive processes that shape people’s moral judgments, particularly about real-world matters of bioethical concern. Yet, as a normative discipline situated within the broader field of bioethics, it also aims to contribute to substantive (...) ethical questions about what should be done in a given context. What are some of the ways in which this aim has been pursued? In this paper, we employ a case study approach to examine and critically evaluate four strategies from the recent literature by which scholars in bioxphi have leveraged empirical data in the service of normative arguments. (shrink)

In her excellent essay, Blumenthal-Barby (2024) argues that it is “time for bioethics to end talk of personhood.” She is concerned, more specifically, with “the philosophical concept of personhood,...

Surprisingly, Lepard finds the most hopeful source for a global ethic is based on the scriptures of the various world religions-the same belief systems that are ...

An inclusive survey from Frederick Douglass to the voices of Black Lives Matter.

There is a long tradition of the value of using film as a pedagogical tool. Such use spans a variety of business disciplines including organizational behavior (Smith 2009), accounting (Bay & Felton 2012), business ethics (Fisher, Grant & Palmer 2015) and cultural competency (Greene, Barden, Richardson & Hall 2014). Presented here is a recently developed course, Business in Film, which engages students in deep reflection on business issues with an emphasis on ethics and values. The course is structured around a (...) weekly film (mix of dramas and documentaries), 15 weeks, 15 films covering approximately 40 years. For each film, students prepare a 2-3 page reflection paper. Student feedback has been consistently positive, with comments along the themes of a greater appreciation of the intersection between business and the human experience, bringing to life ethical considerations, and a greater appreciation of the historical context of business events. (shrink)

The American College of Nurse-Midwives, American Society for Pain Management Nursing, American Academy of Pediatrics, and other largely US-based medical organizations have argued that at least some forms of non-therapeutic child genital cutting, including routine penile circumcision, are ethically permissible even when performed on non-consenting minors. In support of this view, these organizations have at times appealed to potential health benefits that may follow from removing sexually sensitive, non-diseased tissue from the genitals of such minors. We argue that these appeals (...) to “health benefits” as a way of justifying medically unnecessary child genital cutting practices may have unintended consequences. For example, it may create a “loophole” through which certain forms of female genital cutting—or female genital “mutilation” as it is defined by the World Health Organization—could potentially be legitimized. Moreover, by comparing current dominant Western attitudes toward female genital “mutilation” and so-called intersex genital “normalization” surgeries (i.e. surgeries on children with certain differences of sex development), we show that the concept of health invoked in each case is inconsistent and culturally biased. It is time for Western healthcare organizations—including the American College of Nurse-Midwives, American Society for Pain Management Nursing, American Academy of Pediatrics, and World Health Organization—to adopt a more consistent concept of health and a unified ethical stance when it comes to child genital cutting practices. (shrink)

Much of modern ethics is built around the idea that we should respect one another’s autonomy. Here, “we” are typically imagined to be adult human beings of sound mind, where the soundness of our mind is measured against what we take to be the typical mental capacities of a neurodevelopmentally “normal” person—perhaps in their mid-thirties or forties. When deciding about what constitutes ethical sex, for example, our dominant models hold that ethical sex is whatever is consented to, while a lack (...) of consent makes sex wrong.1 Consent, in turn, is analysed in terms of autonomous decision-making: a “yes” or “no” that reflects the free and informed will of our idealised, sound-minded adult. Whether such models provide adequate normative guidance for ethical, much less good, sex between neurotypical human adults is an open question.2 3 When it comes to the ethics of sexual activity between humans and non-humans—robots, say—or between humans who don’t fit the rational stereotype, we hardly know where to begin.4–7 It is therefore heartening to see a number of papers in this issue tackling the difficult question how to respectfully facilitate or respond to the needs, desires, and decisions of people with different kinds or degrees of autonomy.8 For example, Sumytra Menon and colleagues9 explicitly discuss the notion of “borderline capacity” and argue, in the medical domain, for shared and supportive decision-making practices to “foster the autonomy of patients with compromised mental capacity while being mindful of the need to safeguard their well-being.” Touching on a similar theme, Zahra Ladan 10 asks how we should conceive of liberty in the case of persons with certain inborn physical or mental limitations. Might it sometimes be necessary to …. (shrink)

The History of Psychology course occupies an unusual but critical place in the psychology curriculum at most universities. As the field has become ever more specialized, with the various subdisciplines branching off, The History of Psychology is often the one course where the common roots of all of these areas are explored. Asking not only "What is psychology?" but also "What is science?" "Why is psychology a science?" and "How did it become one?" this book examines how the paradigm of (...) Psychology was built. Discussing key figures in history in the context of their time, it takes students on a carefully formulated, chronological journey through the build-up of psychology from ancient times to the present, and seeks to draw students into the way science is done, rather than merely presenting them with historical fact. Students will learn not only the "what," but the "why" of the history of psychology and will acquire the necessary background historical material to fully understand those concepts. Organized around a series of moments and cases--such as a shift from scholasticism to rationalism or empiricism, and a shift from idealism to materialism--the book seeks to portray psychology as an on-going, evolving process, rather than a theory.--page i. (shrink)

If there is a single thread running through this issue of the journal, it may be the complex interplay between the individual and the system of which they are apart, highlighting a need for systems thinking in medical ethics and public health.1 2 Such thinking raises at least three sorts of questions in this context: normative questions about the locus of moral responsibility for change when a system is unjust; practical questions about how to change systems in a way that (...) is morally appropriate without triggering unintended, potentially harmful side-effects; and epistemic questions about how to predict the multidimensional consequences of a proposed change or set of changes to an intricate social system such as healthcare.3 These questions crop up throughout the issue, as I will discuss, but my focus is the target article and linked commentaries on gender bias in the surgical profession. Hutchison conducted in-depth interviews with 46 Australian women surgeons and surgical trainees, taking care to avoid leading questions regarding gender bias or gendered mistreatment. Nevertheless, despite minimal prompting, at least four types of gender-related concerns were described by the surgeons,whether directly or indirectly: 1. structural bias in workplace factors, including insufficient parental leave for women, exclusion from men’s spaces where informal training may occur, and a dearth of senior female role models; 2. epistemic injustices including unfair doubting of women’s surgical competence or knowledge relative to men; 3. stereotyped expectations that women surgeons would or should shoulder the burden of medical carework, for example, by attending to patients’ emotional needs; and 4. objectification, both by colleagues and patients, including sexual innuendo, remarks about clothing, and even outright sexual assault. Each of these concerns is disturbing on its own, and yet they do not operate in isolation. Rather, they interact …. (shrink)

Male circumcision—partial or total removal of the penile prepuce—has been proposed as a public health measure in Sub-Saharan Africa, based on the results of three randomized control trials showing a relative risk reduction of approximately 60 per cent for voluntary, adult male circumcision against female-to-male human immunodeficiency virus transmission in that context. More recently, long-time advocates of infant male circumcision have argued that these findings justify involuntary circumcision of babies and children in dissimilar public health environments, such as the USA, (...) Australasia and Europe. In this article, we take a close look at the necessary ethical and empirical steps that would be needed to bridge the gap between the African RCTs and responsible public health policy in developed countries. In the course of doing so, we discuss some of the main disagreements about the moral permissibility of performing a nontherapeutic surgery on a child to benefit potential future sexual partners of his. In this context, we raise concerns not only about weaknesses in the available evidence concerning such claims of benefit, but also about a child’s moral interest in future autonomy and the preservation of his bodily integrity. We conclude that circumcision of minors in developed countries on public health grounds is much harder to justify than proponents of the surgery suggest. (shrink)

"Neuroreductionism" is the tendency to reduce complex mental phenomena to brain states, confusing correlation for physical causation. In this paper, we illustrate the dangers of this popular neuro-fallacy, by looking at an example drawn from the media: a story about "hypoactive sexual desire disorder" in women. We discuss the role of folk dualism in perpetuating such a confusion, and draw some conclusions about the role of "brain scans" in our understanding of romantic love.

The question of what makes someone the same person through time and change has long been a preoccupation of philosophers. In recent years, the question of what makes ordinary or lay people judge that someone is—or isn’t—the same person has caught the interest of experimental psychologists. These latter, empirically oriented researchers have sought to understand the cognitive processes and eliciting factors that shape ordinary people’s judgments about personal identity and the self. Still more recently, practitioners within an emerging discipline, experimental (...) philosophical bioethics or “bioxphi”—the focus of this chapter—have adopted a similar aim and employed similar methodologies, but with two distinctive features: (a) a special concern for enhanced ecological validity in the examples and populations studied; and (b) an interest in contributing to substantive normative debates within the wider field of bioethics. Our aim in this chapter is to sample illustrative work on personal identity in bioxphi, explore how it relates to studies in psychology covering similar terrain, and draw out the implications of this work for matters of bioethical concern. In pursuing these issues, we highlight recent work in bioxphi that includes the perceived validity of advance directives following neurodegeneration, the right of psychologically altered study participants to withdraw from research, how drug addiction may cause one to be regarded by others as “a completely different person,” the effect of deep-brain stimulation on perceptions of the self, and the potential influence of moral enhancement interventions on intuitive impressions of a person’s character. (shrink)

How shall we decide for others who cannot decide for themselves? And who—or what, in the case of artificial intelligence — should make the decision? The present issue of the journal tackles several interrelated topics, many of them having to do with surrogate decision making. For example, the feature article by Jardas et al 1 explores the potential use of artificial intelligence to predict incapacitated patients’ likely treatment preferences based on their sociodemographic characteristics, raising questions about the means by which (...) we come to decide for others. And a clinical ethics round table led by Wilkinson and Pillay2 examines the case of a premature baby on life support whose primary surrogate is herself incapacitated. Together, these examples force us to think more deeply about the meaning and significance of taken-for-granted concepts: respect for autonomy, substituted judgement, best interests. We’ll consider the baby first and then turn to AI. “Baby T” is a critically ill newborn delivered prematurely by emergency caesarean section. The mother had entered into a surrogacy arrangement with a same-sex male couple, the intended parents, who were to take over the baby’s care after birth—just as soon as a formal parental order could be obtained through the court. Until then, the birth mother, who had used her own eggs to conceive Baby T along with sperm from an unidentified donor, would have legal and ethical responsibility to decide about the baby’s care. Unfortunately, she too was in critical condition, having fallen unconscious prior to delivery due to a sudden brain haemorrhage. She remained unconscious, and thus incapacitated, during a crucial period in which time-sensitive decisions about Baby T’s care needed to be made, including whether to continue life support. Given the mother’s incapacity, who should …. (shrink)

There is an ongoing public debate about sex, gender and identity that is often quite heated. This is an edited transcript of an informal lecture I recorded in 2019 to serve as a friendly guide to these complex issues. It represents my best attempt, not to score political points for any particular side, but to give an introductory map of the territory so that you can think for yourself, investigate further, and reach your own conclusions about such controversial questions as (...) ‘What does mean to be a man or a woman?’. (shrink)

“Female Genital Mutilation” or FGM—the terminology is extremely contentious1—is sometimes held up as a counterexample to moral relativism.2 Those who advance this line of thought suggest that such mutilation is so harmful in terms of its physical and emotional consequences, as well as so problematic in terms of its sexist or oppressive implications, that it provides sufficient, rational grounds for the assertion of a universal moral claim—namely, that all forms of FGM are wrong, regardless of the cultural context. Prominent philosophers (...) who have argued for this position, or one reasonably close to it, include Martha... (shrink)

Ethical dilemmas arise when one must decide between conflicting ethical imperatives. One potential ethical dilemma is a manager’s decision of whether to engage in corporate social responsibility activities. This decision could pit the ethical imperative of honoring unwritten obligations to society against the ethical imperative of honoring contractual obligations to the firm. However, CSR activities might only be a minor ethical dilemma or none at all if they simultaneously benefit the firm and society. To examine this I test the association (...) between future-period employee productivity and current-period use of one type of CSR activity: employee volunteer programs. I use a unique sample of 1428 firm-years, hand-collected from sustainability reports of 373 firms. I find evidence that the current-period use of an employee volunteer program has a positive association with future-period employee productivity. I find this result in future periods up to 6 years after a firm uses an employee volunteer program. I also find a positive association between incentives that focus CEOs’ attention on long-term firm outcomes and more extensive employee volunteer programs. (shrink)

When used clinically, psychedelics may appear unusual or even unique when compared to more familiar or long-standing medical interventions, prompting some to suggest that the ethical issues raised may likewise be exceptional. If that is correct, then perhaps psychedelics should be treated differently from other medical substances: for example, by being subjected to different ethical or evidentiary standards. Alternatively, it may be that psychedelics have more in common with various existing medical interventions than first meets the eye. We argue in (...) favor of the latter position, drawing on parallels from earlier debates around genetic exceptionalism in bioethics. We suggest there are risks to adopting a stance of “psychedelic ethical exceptionalism,” and propose that consistent ethical rules and evidentiary standards should be applied across all relevant areas of clinical medicine. Importantly, this does not preclude the possibility that changes to existing standards should be made; but if so, this should not be justified by appealing to the alleged uniqueness of psychedelics. (shrink)

The current study investigated the relationship of the Dark Triad with peer reporting, which occurs when an employee informs management that another coworker has engaged in counterproductive work behavior (CWB). We hypothesized that low organizational commitment would strengthen the negative relationships between each Dark Triad trait and peer reporting. Data from 281 employees suggested that low organizational commitment indeed strengthened the negative relationships between (a) narcissism and the base rate of peer reporting CWBs and (b) psychopathy and the base rate (...) of peer reporting CWBs. Our findings thus extended Dark Triad research to the topic of peer reporting. (shrink)

This paper presents two notes relating to Jason’s prayer to Apollo before the launch of the Argo in Apollonius’ Argonautica. In both cases, I examine what may be termed the “subtextual” facets of the passage: textual data that are significant—productive of meaningful interpretation—and yet hardly apparent on a surface-level reading of the poem. The first note concerns the changing total number of crewmembers aboard the Argo, an evolving figure which Apollonius encourages the reader to track as the narrative progresses. The (...) second proposes a new acrostic that “completes” the ΑΚΤΙΑ acrostic that Selina Stewart recently discovered in Jason’s prayer. In each case, I draw different conclusions from these subliminal data, which have ramifications for questions of gender and inclusivity in Jason’s crew and the role of the gods in the poem. Both readings, however, are a testament to the careful design and unity of purpose that runs through the epic. (shrink)

Chow's endorsement of a limited role for null hypothesis significance testing is a needed corrective of research malpractice, but his decision to place this procedure in a hypothetico-deductive framework of Popperian cast is unwise. Various failures of this version of the hypothetico-deductive method have negative implications for Chow's treatment of significance testing, meta-analysis, and theory evaluation.

Over the past few years, we and our colleagues have been exploring the ethical implications of what we call “love drugs” and “anti-love drugs.” We use these terms informally to refer to “current, near-future, and more speculative distant-future technologies that would enhance or diminish, respectively, the romantic bond between couples engaged in a relationship”. In a recent “qualified defense” of our work, Andrew Andrew McGee suggests that, if we would only stop using the word “love” so expansively, our ethical proposals (...) might gain more traction. Specifically, he argues that “many of the putative instances of love” that we discuss in our papers “are not in fact... (shrink)

In this paper I scrutinize the so-called China Brain thought experiment famously articulated by Ned Block to see whether it refutes functionalism as a theory of consciousness. I argue that it does not. Block’s case rests on a single premise, P, in the following argument: a creature with a China Brain would lack qualitative experience, despite its being a functional replica of you or me, and working under the assumption that we have rich mental life complete with qualia. Yet if (...) a China Brain-creature were truly and completely R, and yet P were true as the thought experiment purports to show, functionalism would have to be false. Since I want to reject that conclusion, I must do one of the following: deny that Mr. Li is truly R in the first place; grant that Mr. Li is truly R and grant that P, but deny that we have M; or grant that Mr. Li is truly R and grant that we have M, but deny that P. I opt for the third option. First, I paint a picture according to which Mr. Li's having M would not seem as implausible as it does at first. That is, I try to make the premise P seem less intuitive. But in case I am unpersuasive in this first approach, I employ a second tactic as well. This one is to suggest that we cannot know, even in principle whether P, so it is an irrelevant intuition upon which to base the China Brain attack. In any case, the China Brain fails to provide a true counterexample to functionalism. (shrink)

In his lengthy survey of the cosmic devastation wrought by Phaethon's disastrous chariot ride, Ovid includes two catalogues detailing the scorching of the world's mountains and rivers. Ovid enlivens these lists through his usual play with sound patterns and revels in the opportunity to adapt so many Greek names to Latin prosody; for instance the opening line of the catalogue of mountains masterfully illustrates both of these features. The lists are also brimming with playful erudition. To take but a few (...) examples: a dried-up Ida belies its standard epithet πολυπῖδαξ, ‘many-fountained’ ; the sun's heat doubles the flames of volcanic Etna ; burning Xanthus is destined to burn again ; and the famous gold-bearing sands of the Tagus are melting. These features not only ‘relieve monotony’; they warrant the catalogues’ inclusion in the category of Ovid's most entertaining. (shrink)

Insight problem solving is hindered by automated verbal–conceptual processes. Because mindfulness meditation training aims at “nonconceptual awareness” which involves a reduced influence of habitual verbal–conceptual processes on the interpretation of ongoing experience, mindfulness may facilitate insight problem solving. This hypothesis was examined across two studies . Participants in both studies completed a measure of trait mindfulness and a series of insight and noninsight problems. Further, participants in Study 2 completed measures of positive affect and a mindfulness or control training. The (...) results indicated that trait mindfulness predicts better insight but not noninsight problem solving , this relation is maintained when controlling for positive affect , mindfulness training improves insight but not noninsight problem solving and this improvement is partially mediated by state mindfulness . These findings are the first to document a direct relation between mindfulness and creativity. (shrink)

Background: Recent literature on addiction and judgments about the characteristics of agents has focused on the implications of adopting a ‘brain disease’ versus ‘moral weakness’ model of addiction. Typically, such judgments have to do with what capacities an agent has (e.g., the ability to abstain from substance use). Much less work, however, has been conducted on the relationship between addiction and judgments about an agent’s identity, including whether or to what extent an individual is seen as the same person after (...) becoming addicted. Methods: We conducted a series of vignette-based experiments (total N = 3,620) to assess lay attitudes concerning addiction and identity persistence, systematically manipulating key characteristics of agents and their drug of addiction. Conclusions: In Study 1, we found that US participants judged an agent who became addicted to drugs as being closer to ‘a completely different person’ than ‘completely the same person’ as the agent who existed prior to the addiction. In Studies 2-6, we investigated the intuitive basis for this result, finding that lay judgments of altered identity as a consequence of drug use and addiction are driven primarily by perceived negative changes in the moral character of drug users, who are seen as having deviated from their good true selves. (shrink)