Liao and Carbonell argue that medical devices are often not merely biased, but rather materialize oppression through the perpetuation of oppression into the present and future (Liao and Carbonell 2...

Zuk et al. (2023) explore personality, mood, and behavioral (PMB) changes in DBS and aDBS, though have not invoked what is known about the similarities and differences for other available brain sti...

Dorfman et al. (2024) survey psychiatrists’ perceptions of patients with “extremely” treatment-refractory symptoms, finding that many psychiatrists would continue recommending treatment despite the...

In “Distinctive but not Exceptional: The Risks of Psychedelic Ethical Exceptionalism,” Cheung et al. (2025) elaborate the ways that psychedelics share individual ethical considerations with those o...

Some contextually sensitive expressions are such that their context independent conventional meanings need to be in some way supplemented in context for the expressions to secure semantic values in those contexts. As we’ll see, it is not clear that there is a paradigm here, but ‘he’ used demonstratively is a clear example of such an expression. Call expressions of this sort supplementives in order to highlight the fact that their context independent meanings need to be supplemented in context for them (...) to have semantic values relative to the context. Many philosophers and linguists think that there is a lot of contextual sensitivity in natural language that goes well beyond the pure indexicals and supplementives like ‘he’. Constructions/expressions that are good candidates for being contextually sensitive include: quantifiers, gradable adjectives including “predicates of personal taste”, modals, conditionals, possessives and relational expressions taking implicit arguments. It would appear that in none of these cases does the expression/construction in question have a context independent meaning that when placed in context suffices to secure a semantic value for the expression/construction in the context. In each case, some sort of supplementation is required to do this. Hence, all these expressions are supplementives in my sense. For a given supplementive, the question arises as to what the mechanism is for supplementing its conventional meanings in context so as to secure a semantic value for it in context. That is, what form does the supplementation take? The question also arises as to whether different supplementives require different kinds of supplementation. Let us call an account of what, in addition to its conventional meaning, secures a semantic value for a supplementive in context a metasemantics for that supplementive. So we can put our two questions thus: what is the proper metasemantics for a given supplementive; and do all supplementives have the same metasemantics? In the present work, I sketch the metasemantics I formulated for demonstratives in earlier work. Next, I briefly consider a number of other supplementives that I think the metasemantics I propose plausibly applies to and explain why I think that. Finally, I consider the prospects for extending the account to all supplementives. In so doing, I take up arguments due to Michael Glanzberg to the effect that supplementives are governed by two different metasemantics and attempt to respond to them. (shrink)

Structural realism has been proposed as an epistemological position interpolating between realism and sceptical anti-realism about scientific theories. The structural realist who accepts a scientific theory thinks that is empirically correct, and furthermore is a realist about the ‘structural content’ of . But what exactly is ‘structural content’? One proposal is that the ‘structural content’ of a scientific theory may be associated with its Ramsey sentence (). However, Demopoulos and Friedman have argued, using ideas drawn from Newman's earlier criticism of (...) Russell's structuralism, that this move fails to achieve an interesting intermediate position between realism and anti-realism. Rather, () adds little content beyond the instrumentalistically acceptable claim that the theory is empirically adequate. Here, I formulate carefully the crucial claim of Demopoulos and Friedman, and show that the Ramsey sentence () is true just in case possesses a full model which is empirically correct and satisfies a certain cardinality condition on its theoretical domain. This suggests that structural realism is not a position significantly different from the anti-realism it attempts to distinguish itself from. Introduction Technical framework Ramsification Empirical adequacy Ramsification empirical adequacy + cardinality constraint Conclusion. (shrink)

ABSTRACTIn this paper I defend a form of epistocracy I call limited epistocracy – rule by institutions housing expertise in non-political areas that become politically relevant. This kind of limited epistocracy, I argue, isn't a far-off fiction. With increasing frequency, governments are outsourcing political power to expert institutions to solve urgent, multidimensional problems because they outperform ordinary democratic decision-making. I consider the objection that limited epistocracy, while more effective than its competitors, lacks a fundamental intrinsic value that its competitors have; (...) namely, political inclusion. After explaining this challenge, I suggest that limited epistocracies can be made compatible with robust political inclusion if specialized institutions are confined to issuing directives that give citizens multiple actionable options. I explain how this safeguards citizens’ inclusion through rational deliberation, choice, and contestation. (shrink)

I examine three ‘anti-object’ metaphysical views: nihilism, generalism, and anti-quantificationalism. After setting aside nihilism, I argue that generalists should be anti-quantificationalists. Along the way, I attempt to articulate what a ‘metaphysically perspicuous’ language might even be.

The view of business ethics that Christopher McMahon calls the “implicit morality of the market” and Joseph Heath calls the “market failures approach” has received a significant amount of recent attention. The idea of this view is that we can derive an ethics for market participants by thinking about the “point” of market activity, and asking what the world would have to be like for this point to be realized. While this view has been much-discussed, it is still not well-understood. (...) This paper seeks to remedy this problem. I begin by showing, against some recent commentators, that McMahon’s view and Heath’s view are fundamentally the same. Second, I clarify the sense of “efficiency” at work in the market failures approach. Finally, I argue that, in its current form, this view has little relevance to the real world of business. I conclude by sketching two ways of modifying it to fit our world. (shrink)

Famous results by David Lewis show that plausible-sounding constraints on the probabilities of conditionals or evaluative claims lead to unacceptable results, by standard probabilistic reasoning. Existing presentations of these results rely on stronger assumptions than they really need. When we strip these arguments down to a minimal core, we can see both how certain replies miss the mark, and also how to devise parallel arguments for other domains, including epistemic “might,” probability claims, claims about comparative value, and so on. A (...) popular reply to Lewis's results is to claim that conditional claims, or claims about subjective value, lack truth conditions. For this strategy to have a chance of success, it needs to give up basic structural principles about how epistemic states can be updated—in a way that is strikingly parallel to the commitments of the project of dynamic semantics. (shrink)

We consider how an epistemic network might self-assemble from the ritualization of the individual decisions of simple heterogeneous agents. In such evolved social networks, inquirers may be significantly more successful than they could be investigating nature on their own. The evolved network may also dramatically lower the epistemic risk faced by even the most talented inquirers. We consider networks that self-assemble in the context of both perfect and imperfect communication and compare the behaviour of inquirers in each. This provides a (...) step in bringing together two new and developing research programs, the theory of self-assembling games and the theory of network epistemology. (shrink)

That believing truly as a matter of luck does not generally constitute knowing has become epistemic commonplace. Accounts of knowledge incorporating this anti-luck idea frequently rely on one or another of a safety or sensitivity condition. Sensitivity-based accounts of knowledge have a well-known problem with necessary truths, to wit, that any believed necessary truth trivially counts as knowledge on such accounts. In this paper, we argue that safety-based accounts similarly trivialize knowledge of necessary truths and that two ways of responding (...) to this problem for safety, issuing from work by Williamson and Pritchard, are of dubious success. (shrink)

We consider two ways one might use algorithmic randomness to characterize a probabilistic law. The first is a generative chance* law. Such laws involve a nonstandard notion of chance. The second is a probabilistic* constraining law. Such laws impose relative frequency and randomness constraints that every physically possible world must satisfy. While each notion has virtues, we argue that the latter has advantages over the former. It supports a unified governing account of non-Humean laws and provides independently motivated solutions to (...) issues in the Humean best-system account. On both notions, we have a much tighter connection between probabilistic laws and their corresponding sets of possible worlds. Certain histories permitted by traditional probabilistic laws are ruled out as physically impossible. As a result, such laws avoid one variety of empirical underdetermination, but the approach reveals other varieties of underdetermination that are typically overlooked. (shrink)

Linguists often advert to what are sometimes called linguistic intuitions. These intuitions and the uses to which they are put give rise to a variety of philosophically interesting questions: What are linguistic intuitions – for example, what kind of attitude or mental state is involved? Why do they have evidential force and how might this force be underwritten by their causal etiology? What light might their causal etiology shed on questions of cognitive architecture – for example, as a case study (...) of how consciously inaccessible subpersonal processes give rise to conscious states, or as a candidate example of cognitive penetrability? What methodological issues arise concerning how linguistic intuitions are gathered and interpreted – for example, might some subjects' intuitions be more reliable than others? And what bearing might all this have on philosophers' own appeals to intuitions? This paper surveys and critically discusses leading answers to these questions. In particular, we defend a ‘mentalist’ conception of linguistics and the role of linguistic intuitions therein. (shrink)

Business ethics should be taught in business schools as an integrated part of core curricula in MBA programs with a dual focus on both analytical frameworks and their applications to the business disciplines. To overcome the reluctance of many faculty to handle ethical issues, a critical mass of faculty must develop suitable materials, educate their peers in its use, and take the lead by introducing it in their own courses and on senior management programs.

Health disparities are primarily driven by structural inequality including systemic racism. Medical educators, led by the AAMC, have tended to minimize these core drivers of health disparities. Ins...

We consider how cue-reading, sensory-manipulation, and signaling games may initially evolve from ritualized decisions and how more complex games may evolve from simpler games by polymerization, template transfer, and modular composition. Modular composition is a process that combines simpler games into more complex games. Template transfer, a process by which a game is appropriated to a context other than the one in which it initially evolved, is one mechanism for modular composition. And polymerization is a particularly salient example of modular (...) composition where simpler games evolve to form more complex chains. We also consider how the evolution of new capacities by modular composition may be more efficient than evolving those capacities from basic decisions. (shrink)

I argue that quantum mechanics is fundamentally a theory about the representation and manipulation of information, not a theory about the mechanics of nonclassical waves or particles. The notion of quantum information is to be understood as a new physical primitive—just as, following Einstein’s special theory of relativity, a field is no longer regarded as the physical manifestation of vibrations in a mechanical medium, but recognized as a new physical primitive in its own right.

The existence of mereological sums can be derived from an abstraction principle in a way analogous to numbers. I draw lessons for the thesis that “composition is innocent” from neo-Fregeanism in the philosophy of mathematics.

It is common for philosophers to offer philosophical accounts or analyses, as they are sometimes called, of knowledge, autonomy, representation, (moral) goodness, reference, and even modesty. These philosophical analyses raise deep questions.What is it that is being analyzed (i.e. what sorts of things are the objects of analysis)? What sort of thing is the analysis itself (a proposition? sentence?)? Under what conditions is an analysis correct? How can a correct analysis be informative? How, if at all, does the production of (...) philosophical analyses differ from what scientists do? The purpose of the present paper is to provide answers to these questions. (shrink)

A central job for propositions is to be the objects of the attitudes. Propositions are the things we doubt, believe and suppose. Some philosophers have thought that propositions are sets of possible worlds. But many have become convinced that such an account individuates propositions too coarsely. This raises the question of how finely propositions should be individuated. An account of how finely propositions should be individuated on which they are individuated very finely is sketched. Objections to the effect that the (...) account individuates propositions too finely are raised and responses to the objections are provided. It is also shown that theories that try to individuate propositions less finely have serious problems. (shrink)

Few notions are more central to Aquinas’s thought than those of matter and form. Although he invokes these notions in a number of different contexts, and puts them to a number of different uses, he always assumes that in their primary or basic sense they are correlative both with each other and with the notion of a “hylomorphic compound”—that is, a compound of matter (hyle) and form (morphe). Thus, matter is an entity that can have form, form is an entity (...) that can be had by matter, and a hylomorphic compound is an entity that exists when the potentiality of some matter to have form is actualized.1 What is more, Aquinas assumes that the matter of a hylomorphic compound explains certain of its general characteristics, whereas its form explains certain of its more specific characteristics. Thus, the matter of a bronze statue explains the fact that it is bronze, whereas its form explains the fact that it is a statue. Again, the matter of a human being explains the fact that it is a material object, whereas its form explains the specific type of material object it is (namely, human). My aim in this chapter is to provide a systematic introduction to Aquinas’s primary or basic notions of matter and form. To accomplish this aim, I focus on the two main theoretical contexts in which he deploys them—namely, his theory of change and his theory of individuation. In both contexts, as we shall see, Aquinas appeals to matter and form to account for relations of sameness and difference holding between distinct individuals. (shrink)

Ryan Tonkens has issued a seemingly impossible challenge, to articulate a comprehensive ethical framework within which artificial moral agents satisfy a Kantian inspired recipe—"rational" and "free"—while also satisfying perceived prerogatives of machine ethicists to facilitate the creation of AMAs that are perfectly and not merely reliably ethical. This series of papers meets this challenge by landscaping traditional moral theory in resolution of a comprehensive account of moral agency. The first paper established the challenge and set out autonomy in Aristotelian terms. (...) The present paper interprets Kantian moral theory on the basis of the preceding introduction, argues contra Tonkens that an engineer does not violate the categorical imperative in creating Kantian AMAs, and proposes that a Kantian AMA is not only a possible goal for Machine ethics research, but a necessary one. (shrink)

Many now countenance the idea that certain groups can have beliefs, or at least belief-like states. If groups can have beliefs like these, the question of whether such beliefs are justified immediately arises. Recently, Goldman Essays in collective epistemology, Oxford University Press, Oxford, 2014) has considered what a reliability-based account of justified group belief might look like. In this paper I consider his account and find it wanting, and so propose a modified reliability-based account of justified group belief. Lackey :341–396, (...) 2016) has also criticized Goldman’s proposal, but for very different reasons than I do. Some of her objections, however, can be lodged against the modified account that I propose here. I also respond to these objections. Finally, I note how some formal and experimental work is relevant to those who are attracted to the kind of reliability-based account of justified group belief I develop here. (shrink)

This chapter follows Lorenzo Magnani's observation that ongoing commercialization of science and academia impoverishes human potential for discovery. The chapter reviews Magnani on affordance, wonders what is accessible when "good" affordances appear absent, and answers self-affordance. Ecologies optimized for discovery should be optimized for self-affordance. The chapter considers the role of oracle as leading vision for discovery, and proposes a naturalized account of self that is essentially propositional, in pursuit of an inner oracle, seeking salvation through routine and religious ritual. (...) This is self-abduction. Variable biological development may motivate religious self-abduction characterized by self-sacrifice for the collective good over the long term. in conclusion, the chapter affirms Magnani's call to optimize cognitive ecologies for discovery, by prioritizing religious self-abduction. (shrink)

Theologians and philosophers of religion are increasingly interested in physics. From the fine-tuning of universal constants to quantum mechanics, relativity, and cosmology, physics is a surprisingly common subject where religion is involved. Bridging the gap between issues in religion and those in physics can be quite difficult, however. Fortunately, the philosophy of science provides a middle ground between the two disciplines. In this book, a philosopher of science provides a critical analysis of the ways in which physics is brought into (...) play in matters of religion. (shrink)

There is good reason to suppose that our best physical theories, quantum mechanics and special relativity, are false if taken together and literally. If they are in fact false, then how should they count as providing knowledge of the physical world? One might imagine that, while strictly false, our best physical theories are nevertheless in some sense probably approximately true. This paper presents a notion of local probable approximate truth in terms of descriptive nesting relations between current and subsequent theories. (...) This notion helps explain how false physical theories might nevertheless provide physical knowledge of a variety that is particularly salient to diachronic empirical inquiry. (shrink)

Creationism is the conjunction of the following theses: (i) fictional individuals (e.g. Sherlock Holmes) actually exist; (ii) fictional names (e.g., 'Holmes') are at least sometimes genuinely referential; (iii) fictional individuals are the creations of the authors who first wrote (or spoke, etc.) about them. CA Creationism is the conjunction of (i) - (iii) and the following thesis: (iv) fictional individuals are contingently existing abstracta; they are non-concrete artifacts of our world and various other possible worlds. TakashiYagisawa has recently provided a (...) number of arguments designed to show that Creationism is unjustified. I here critically examine three of his challenges to CA Creationism. I argue that each fails to undermine this version of Creationism. (shrink)

This chapter follows Lorenzo Magnani's observation that ongoing commercialization of science and academia impoverishes human potential for discovery. The chapter reviews Magnani on affordance, wonders what is accessible when "good" affordances appear absent, and answers self-affordance. Ecologies optimized for discovery should be optimized for self-affordance. The chapter considers the role of oracle as leading vision for discovery, and proposes a naturalized account of self that is essentially propositional, in pursuit of an inner oracle, seeking salvation through routine and religious ritual. (...) This is self-abduction. Variable biological development may motivate religious self-abduction characterized by self-sacrifice for the collective good over the long term. in conclusion, the chapter affirms Magnani's call to optimize cognitive ecologies for discovery, by prioritizing religious self-abduction. (shrink)

Access to a deep pool of talent is essential to the success of every professional services firm. The supply of that talent is contingent upon the available rewards for the exercise of that talent, and both the existence of the potential rewards and the beliefs that individuals hold about the existence of the rewards affect the decision to remain in the field. One structural factor that may affect the judgment about whether to remain in a profession concerns promotions based on (...) the gender of the employee. In this study, we examine the “glass ceiling” within the context of the accounting profession. While advances have been made within the accounting profession to address the glass ceiling, the continued existence—and perceptions about the continued existence—of the issue exert adverse effects upon the available talent pool and may create long-term problems for the profession. In this study, we investigate glass ceiling perceptions among a large sample of female accounting professionals employed in accounting; the sample includes both public accountants, and those employed in industry accounting. Our study yields the finding of beliefs in bias-driven effects, structural effects, and cultural effects among these accounting professionals. Glass ceiling perceptions are also influenced by several demographic factors. Furthermore, accounting professionals employed by industry are more likely to report a glass ceiling within their firms than accounting professionals employed by public accounting firms. The findings are of interest to researchers who explore gender-related issues in professional service firms such as the field of accounting, and to senior members of practice who are tasked with ensuring the integrity and quality of the talent pool and the equitable distribution of rewards to employees. (shrink)

Suppose that beliefs come in degrees. How should we then measure the accuracy of these degrees of belief? Scoring rules are usually thought to be the mathematical tool appropriate for this job. But there are many scoring rules, which lead to different ordinal accuracy rankings. Recently, Fallis and Lewis [2016] have given an argument that, if sound, rules out many popular scoring rules, including the Brier score, as genuine measures of accuracy. I respond to this argument, in part by noting (...) that the argument fails to account for verisimilitude—that certain false hypotheses might be closer to the truth than other false hypotheses are. Oddie [forthcoming], however, has argued that no member of a very wide class of scoring rules (the so-called proper scores) can appropriately handle verisimilitude. I explain how to respond to Oddie's argument, and I recommend a class of weighted scoring rules that, I argue, genuinely measure accuracy while escaping the arguments of Fallis and Lewis as well as Oddie. (shrink)

The proposal that the criminal justice system should focus on rehabilitation – rather than retribution, deterrence, or expressive denunciation – is among the least popular ideas in legal philosophy. Foremost among rehabilitation’s alleged weaknesses is that it views criminals as blameless patients to be treated, rather than culpable moral agents to be held accountable. This article offers a new interpretation of the rehabilitative approach that is immune to this objection and that furnishes the moral foundation that this approach has lacked. (...) The view rests on the principle that moral agents owe it to one another to maintain the dependability of their moral capacities. Agents who culpably commit criminal wrongs, however, betray an unacceptable degree of moral unreliability. Punishment, on this theory, consists in the enforcement of the duties that offenders have to reduce their own likelihood of recidivism. (shrink)

Given Hugh Everett III's understanding of the proper cognitive status of physical theories, his relative-state formulation of pure wave mechanics arguably qualifies as an empirically acceptable physical theory. The argument turns on the precise nature of the relationship that Everett requires between the empirical substructure of an empirically faithful physical theory and experience. On this view, Everett provides a weak resolution to both the determinate record and the probability problems encountered by pure wave mechanics, and does so in a way (...) that avoids unnecessary metaphysical complications. Taking Everett's goal to be showing the empirical faithfulness of the relative-state formulation agrees well with his characterization of his project as one of seeking a model for observation in the correlation structure described by pure wave mechanics and seeking a measure of typicality over this empirical substructure that covaries with our empirically warranted expectations. 1 Pure Wave Mechanics and Relative States2 Everett and Frank3 Everett on the Nature of Physical Theories4 Conditions for Empirical Faithfulness5 The Empirical Faithfulness of Pure Wave Mechanics6 Conclusion. (shrink)

No profession has undergone as much scrutiny in the past several decades as that of medicine. Indeed, one might well argue that no profession has ever undergone so much change in so short a time. An essential part of this change has been the growing insistence that competent, adult patients have the right to decide about the course of their own medical treatment. However, the familiar and widely accepted principle of patient self-determination entails a corollary that has received little attention (...) in the growing literature on the ethics of physician-patient relations: if patients are to direct the course of their own medical treatment, then physicians are at least sometimes to be guided in their actions on behalf of patients by values that are not, and may even be incompatible with, their own values. Unless it is supposed that it would be best if physicians were simply to accommodate any and all patient requests, a possibility I consider and reject in this paper, there are bound to be numerous instances of legitimate moral conflict between the preferences of physicians and patients. In this paper, I examine the implications of this sort of moral conflict from the standpoint of the integrity of the physician. -/- Critical to a proper appreciation of the significance of this conflict is a distinction that the literature on biomedical ethics has largely failed to draw: that between medical paternalism and physician integrity. (shrink)

This Element has two aims. The first is to discuss arguments philosophers have made about the difference God's existence might make to questions of general interest in metaethics. The second is to argue that it is a mistake to think we can get very far in answering these questions by assuming a thin conception of God, and to suggest that exploring the implications of thick theisms for metaethics would be more fruitful.

Scientific knowledge is not merely a matter of reconciling theories and laws with data and observations. Science presupposes a number of metatheoretic shaping principles in order to judge good methods and theories from bad. Some of these principles are metaphysical (e.g., the uniformity of nature) and some are methodological (e.g., the need for repeatable experiments). While many shaping principles have endured since the scientific revolution, others have changed in response to conceptual pressures both from within science and without. Many of (...) them have theistic roots. For example, the notion that nature conforms to mathematical laws flows directly from the early modern presupposition that there is a divine Lawgiver. This interplay between theism and shaping principles is often unappreciated in discussions about the relation between science and religion. Today, of course, naturalists reject the influence of theism and prefer to do science on their terms. But as Robert Koons and Alvin Plantinga have argued, this is more difficult than is typically assumed. In particular, they argue, metaphysical naturalism is in conflict with several metatheoretic shaping principles, especially explanatory virtues such as simplicity and with scientific realism more broadly. These arguments will be discussed as well as possible responses. In the end, theism is able to provide justification for the philosophical foundations of science that naturalism cannot. (shrink)

_Post-Postmodernism_ begins with a simple premise: we no longer live in the world of "postmodernism," famously dubbed "the cultural logic of late capitalism" by Fredric Jameson in 1984. Far from charting any simple move "beyond" postmodernism since the 1980s, though, this book argues that we've experienced an _intensification_ of postmodern capitalism over the past decades, an increasing saturation of the economic sphere into formerly independent segments of everyday cultural life. If "fragmentation" was the preferred watchword of postmodern America, "intensification" is (...) the dominant cultural logic of our contemporary era. _Post-Postmodernism_ surveys a wide variety of cultural texts in pursuing its analyses—everything from the classic rock of Black Sabbath to the post-Marxism of Antonio Negri, from considerations of the corporate university to the fare at the cineplex, from reading experimental literature to gambling in Las Vegas, from Badiou to the undergraduate classroom. Insofar as cultural realms of all kinds have increasingly been overcoded by the languages and practices of economics, Nealon aims to construct a genealogy of the American present, and to build a vocabulary for understanding the relations between economic production and cultural production today—when American-style capitalism, despite its recent battering, seems nowhere near the point of obsolescence. Post-postmodern capitalism is seldom late but always just in time. As such, it requires an updated conceptual vocabulary for diagnosing and responding to our changed situation. (shrink)

Volume 20, Issue 7, July 2020, Page 112-114.

Entrepreneurship is a critical need in society, and an entrepreneur's life can be a life wonderfully lived. However, most of the literature examining entrepreneurship takes an overly narrow financial viewpoint when examining entrepreneurship and entrepreneurial success. Our paper surveys the current entrepreneurial literature on what constitutes successful entrepreneurship. We then engage key conceptual ideas within the Catholic social tradition to analyze what we see as an undeveloped notion of success. We then move to construct a richer notion of success through (...) the framework of virtue. (shrink)

Sociologists of education often emphasize goods that result from a practice (external goods) rather than goods intrinsic to a practice (internal goods). The authors draw from John Dewey and Alasdair MacIntyre to describe how the same practice can be understood as producing “skills” that center external goods or as producing habits (Dewey) or virtues (MacIntyre), both of which center internal goods. The authors situate these concepts within sociology of education’s stratification paradigm and a renewed interest in the concept of alienation, (...) contrasting the concepts of skills, habits, and virtues to capital, credentials, and habitus. They close by connecting the argument to broader critiques of procedural liberalism and the ideology of meritocracy, then giving suggestions for an expanded sociology of education beyond the stratification paradigm. (shrink)

Philosophically, the most interesting objection to the reliance on advance directives to guide treatment decisions for formerly competent patients is the argument from the loss of personal identity. Starting with a psychological continuity theory of personal identity, the argument concludes that the very conditions that bring an advance directive into play may destroy the conditions necessary for personal identity, and so undercut the authority of the directive. In this article, I concede that if the purpose of a theory of personal (...) identity is to provide an answer to the question What is it for a person to persist over time?, then reflection on personal identity poses a potentially serious threat to the moral authority of advance directives. However, as Marya Schechtman observes, questions about how a single person persists through change are not what most of us are interested in when we think about who a person is. Rather, we are interested in what it means to say that a particular set of actions, experiences, and characteristics is that of a given person rather than someone else. (shrink)