In 2022, the Camden Coalition Medical-Legal Partnership began providing civil and criminal legal services to substance use disorder patients at Cooper University Health Care’s Center for Healing. This paper discusses early findings from the program’s first year on the efficacy of the provision of criminal-legal representation, which is uncommon among MLPs and critical for this patient population. The paper concludes with takeaways for other programs providing legal services in an addiction medicine setting.

There are ways that ethical intuitions might be, and the various possibilities have epistemic ramifications. This paper criticizes some extant accounts of what ethical intuitions are and how they justify, and it offers an alternative account. Roughly, an ethical intuition that p is a kind of seeming state constituted by a consideration whether p, attended by positive phenomenological qualities that count as evidence for p, and so a reason to believe that p. They are distinguished from other kinds of seemings, (...) such as those which are content driven (e.g., the sensory experience that a stick in water seems bent) and those which are competence driven (e.g., the intellectual seeming that XYZ is not water, or that one of DeMorgan’s laws is true). One important conclusion is this: when crafting a positive theory of justification ethical intuitionists have fewer resources than intuitionists in other domains, not because of the subject matter of ethical intuitions, but because of the their structure. A second conclusion is that the seemings featured in substantive ethical intuitions deliver relatively weak justification as compared to other seeming states. (shrink)

Recent debates within the autism advocacy community have raised difficult questions about who can credibly act as a representative of a particular population and what responsibilities that...

It has become increasingly difficult for individuals to exercise meaningful control over the personal data they disclose to companies or to understand and track the ways in which that data is exchanged and used. These developments have led to an emerging consensus that existing privacy and data protection laws offer individuals insufficient protections against harms stemming from current data practices. However, an effective and ethically justified way forward remains elusive. To inform policy in this area, we propose the Ethical Data (...) Practices framework. The framework outlines six principles relevant to the collection and use of personal data—minimizing harm, fairly distributing benefits and burdens, respecting autonomy, transparency, accountability, and inclusion—and translates these principles into action-guiding practical imperatives for companies that process personal data. In addition to informing policy, the practical imperatives can be voluntarily adopted by companies to promote ethical data practices. (shrink)

Differences between human beings have long been used to justify a range of degrading, exclusionary, and murderous practices that strip people of their humanity and dignity. While considerable scholarship has been devoted to such dehumanization, Matthew S. Weinert asks how we might conceive its reverse—humanization, or what it means to “make human.” Weinert proposes an account of making human centered on five mechanisms: reflection, recognition, resistance, replication of dominant mores, and responsibility. Examining cases such as the UN Security Council’s (...) engagements with crises and the International Court of Justice’s grappling with Kosovo’s unilateral declaration of independence, he illustrates the distinct and contingent ways these mechanisms have been deployed. Theoretically, the cases evince a complex, evolving relationship between state-centric and human-centric views of society, ultimately revealing the normative potentialities of both. Though the case studies concern specific human relations issues on an international level, Weinert argues in favor of starting from the shared problem of being human and of living in a world in which the humanity of countless groups has been demeaned or denied. Working outward from that point, he proposes, we obtain a more pragmatically grounded understanding of the social construction of the human being. (shrink)

Biomedical research funding bodies across Europe and North America increasingly encourage—and, in some cases, require—investigators to involve members of the public in funded research. Yet there remains a striking lack of clarity about what ‘good’ or ‘successful’ public involvement looks like. In an effort to provide guidance to investigators and research organisations, representatives of several key research funding bodies in the UK recently came together to develop the National Standards for Public Involvement in Research. The Standards have critical implications for (...) the future of biomedical research in the UK and in other countries as researchers and funders abroad look to the Standards as a model for their own policy development. We assess the Standards and find that despite offering useful suggestions for dealing with practical challenges associated with public involvement, the Standards fail to address fundamental questions about when, why and with whom public involvement should be undertaken in the first place. We show that presented without this justificatory context, many of the recommendations in the Standards are, at best, fragments that require substantial elaboration by those looking to apply the Standards in their own work and, at worst, subject to potentially harmful misapplication by well-meaning investigators. As funding bodies increasingly push for public involvement in research, the key lesson of our analysis is that future recommendations about how public involvement should be conducted cannot be coherently formulated without a clear sense of the underlying goals and rationales for public involvement. (shrink)

Having no recourse to ways of knowing about the natural world, ethical non-naturalists are in need of an epistemology that might apply to a normative breed of facts or properties, and intuitionism seems well suited to fill that bill. Here I argue that the metaphysical inspiration for ethical intuitionism undermines that very epistemology, for this pair of views generates what I call the defeater from cosmic coincidence. Unfortunately, we face not a happy union, but a difficult choice: either ethical intuitionism (...) or ethical non-naturalism, but not both. (shrink)

Psychotherapy and counselling services are now available on-line, and expanding rapidly. Yet there appears almost no ethical analysis of this on-line mode of delivery of such professional services. In this paper I present such an analysis by considering the limitations on-line contact imposes on the nature of the professional–client relationship. The analysis proceeds via the contrast between the face-to-face case and the on-line case. At the core of the problem must be the recognition that on-line interaction imposes a physical barrier (...) largely permitting only those disclosures of self we choose to make available, and greatly restricting the range of involuntary features and behaviours. I show why this is problematic, first, for the development of a close professional–client relationship, with particular emphasis on such failures as diagnosis and monitoring of the patient. Second I describe the importance of the development of professional character, and of how the on-line environment fails to provide a context for such character traits to emerge and develop. (shrink)

Here I discuss the conceptual structure and core semantic commitments of reason-involving thought and discourse needed to underwrite the claim that ethical normativity is not uniquely queer. This deflates a primary source of ethical scepticism and it vindicates so-called partner in crime arguments. When it comes to queerness objections, all reason-implicating normative claims—including those concerning Humean reasons to pursue one's ends, and epistemic reasons to form true beliefs—stand or fall together.

It often seems that what one ought to do depends on what contingent ends one has adopted and the means to pursuing them. Imagine, for example, that you are applying for jobs, and a particularly attractive one comes your way. It offers excellent colleagues in a desirable location, the pay is good, and acquiring a job like this is one of your ends. If practicing your job talk is a means to getting the job, the following seems true: (1) If (...) you want1 to get the job, then you ought to practice your job talk. Let us call conditional ought sentences that purport to express an end in the antecedent and a means to the end in the consequent end-given oughts. Some end-given oughts run into the problem of detachment; i.e., some end-given oughts seem true, and yet we do not think the consequent by itself, detached from the conditional, is true even if the antecedent is true. Consider a case where you want revenge on Bill for some slight offense. You happen to have the opportunity to poison Bill’s drink while he is away, which is the only thing that would lead to his demise. What of: (2) If you want to kill Bill, then you ought to poison his drink. (2) runs up against the problem of detachment because of the following modus ponens argument: • If you want to kill Bill, then you ought to poison his drink. • You want to kill Bill. • Therefore, you ought to poison his drink. In fact, you ought not poison Bill’s drink. You ought to avoid him and seek counseling. (shrink)

This article delineates the core concerns and motivations of the ontological work of Gilles Deleuze, and is intended as a programmatic statement for a general philosophical audience. The article consists of two main parts. In the first, two early writings by Deleuze are analysed in order to clarify his understanding of ontology broadly, and to specify the precise aim of his understanding of being in terms of difference. The second part of the article looks at the work of Heidegger and (...) Derrida in order to distinguish Deleuze's conceptions of ontology and difference from theirs. A final section clarifies Deleuze's efforts to undertake the construction of an ontology divergent from the dominant tradition and in contrast to the emphasis on the closure of metaphysics in the thought of Heidegger and Derrida. (shrink)

For George Woodcock, the key to appreciating Colin Ward was first to understand the importance of Peter Kropotkin’s classic work Mutual Aid (1902). While images of the French Revolution and the Par...

Stories of rare disease advocacy can elicit strong but ambivalent responses. It’s moving to read about the heroic efforts of parents “becoming drug developers to find a cure for their children’s ra...

Moral Supervenience says that there can be no moral difference without a descriptive difference. This has been considered one of the least controversial principles in ethics. Explaining it has been a central desideratum. And yet an increasingly popular metaethical view appears to be incompatible with it. According to Moral Contingency, there are metaphysically contingent pure moral principles helping to ground particular moral facts. On such a view, it looks like there can be a difference in pure moral principles without a (...) descriptive difference. This looks like a moral difference without a descriptive difference. Are those who find both Moral Supervenience and Moral Contingency plausible faced with a difficult choice? Many contingentists think so, but I am here to argue that they are mistaken. The two principles are compatible after all, for differences in pure moral principle entail descriptive differences. (shrink)

Survivors of childhood brain tumors face many obstacles to living independently as adults. Causes for lack of independence are multifactorial and generally are investigated in terms of physical, cognitive, and psychosocial treatment–related sequelae. Little is known, however, about the role of expectation for survivors’ function. From a mixed–methods study including qualitative interviews and quantitative measures from 40 caregiver–survivor dyads, we compared the data within and across dyads, identifying four distinct narrative profiles: (A) convergent expectations about an optimistic future, (B) convergent (...) expectations about a less optimistic future, (C) non–convergent expectations about a less optimistic future, and (D) non–convergent expectations about an unclear future. Dyads both do well and/or struggle in systematically different manners in each profile. These profiles may inform the design of interventions to be tested in future research and help clinicians to assist families in defining, (re–)negotiating, and reaching their expectations of function and independence. (shrink)

Historically, the most persuasive argument against external reasons proceeds through a rationalist restriction: For all agents A, and all actions Φ, there is a reason for A to Φ only if Φing is rationally accessible from A's actual motivational states. Here I distinguish conceptions of rationality, show which one the internalist must rely on to argue against external reasons, and argue that a rationalist restriction that features that conception of rationality is extremely implausible. Other conceptions of rationality can render the (...) restriction true, but then the restriction simply fails to rule out external reasons. (shrink)

There are a number of proposals as to exactly how reasons, ends and rationality are related. It is often thought that practical reasons can be analyzed in terms of practical rationality, which, in turn, has something to do with the pursuit of ends. I want to argue against the conceptual priority of rationality and the pursuit of ends, and in favor of the conceptual priority of reasons. This case comes in two parts. I first argue for a new conception of (...) ends by which all ends are had under the guise of reasons. I then articulate a sense of rationality, procedural rationality, that is connected with the pursuit of ends so conceived, where one is rational to the extent that one is motivated to act in accordance with reasons as they appear to be. Unfortunately, these conceptions of ends and procedural rationality are inadequate for building an account of practical reasons, though I try to explain why it is that the rational pursuit of ends generates intuitive but misleading accounts of genuine normative reasons. The crux of the problem is an insensitivity to an is-seems distinction, where procedural rationality concerns reasons as they appear, and what we are after is a substantive sense of rationality that concerns reasons as they are. Based on these distinct senses of rationality, and some disambiguation of what it is to have a reason, I offer a critique of internalist analyses of one’s reasons in terms of the motivational states of one’s ideal, procedurally rational self, and I offer an alternative analysis of one’s practical reasons in terms of practical wisdom that overcomes objections to related reasons externalist views. The resulting theory is roughly Humean about procedural rationality and roughly Aristotelian about reasons, capturing the core truths of both camps. (shrink)

Here I present and defend an etiological theory of objective, doxastic justification, and related theories of defeat and evidence. The theory is intended to solve a problem for reliabilist epistemologies— the problem of identifying relevant environments for assessing a process's reliability. It is also intended to go some way to accommodating, neutralizing, or explaining away many internalist-friendly elements in our epistemic thinking.

Colin Ward is not necessarily a gift for the biographer. As Sophie Scott-Brown’s engaging study reminds us, one of his defining characteristics was a thoroughgoing humility, and one consequence of...

Patient and public involvement (PPI) has gained widespread support in health research and health policy circles, but there is little consensus on the precise meaning or justifications of PPI. We argue that an important step towards clarifying the meaning and justification for PPI is to split apart the familiar acronym and draw a distinction between patient and public involvement. Specifically, we argue that patient involvement should refer to the practice of involving individuals in health research or policy on the basis (...) of their experience with a particular condition, while public involvement should refer to the practice of involving individuals in health policy or research based on their status as members of a relevant population. Analyzing cases from the UK, Australia, and the USA, we show how our proposed distinction can deliver much needed clarity to conversations on PPI, while guiding the development and evaluation of future PPI‐based policies. (shrink)

In the spirit of Slavoj Žižek’s book, Hegel in a Wired Brain, this article asks how the questions central to Hans-Georg Gadamer’s philosophical hermeneutics are changed and complicated by the possibility of brain-to-brain communication and the datafication of thought made potential through brain-computer interfaces. By taking a phenomenological approach to understanding the nature of communication through a technology that does not require language for the transmission of ideas, this article explores how BCI communication confronts the ontological character of interpretation as (...) presented by Gadamer while also juxtaposing how the insights of Gadamer and Heidegger concerning temporality problematize materialist foundations of BCI communication. In the final analysis, it is argued that thought only becomes meaningful in accord with the temporality of Dasein and that hermeneutics remains central in BCI communication because the material replication of thought does not overcome the particular temporalities of historically effected consciousnesses. (shrink)

In a recent article, Jecker and Ko propose that a capabilities approach can be useful as an ethical framework for evaluating the use of BCI applications. Jecker and Ko defend this application, in part, because a capabilities list is not necessarily unchanging, but can account for rapid enhancements in human abilities. In this commentary, I argue that, though the capabilities approach is provisional, its primary relevance for BCI emerges from the ways in which capabilities remain constant amidst changing human abilities.

Given the rise of genetic etiological beliefs regarding psychiatric disorders, a growing body of research has focused on trying to elucidate the effects that such explanatory frameworks might be having on how mental disorders are perceived by patients, clinicians, and the general public. Genetic and other biomedical explanations of mental disorders have long been seen as a potential tool in the efforts to destigmatize mental disorders, given the harshness of the widespread negative attitudes about them and the important negative clinical (...) and social impacts of this stigma. The conventional wisdom has appeared to be that because the effects of genes are seen as falling outside individual control, conceiving of mental disorders as caused by genes casts patients as blameless, thereby reducing stigmatization. Indeed, the results of experimental and correlational research have now robustly linked genetic and other biomedical explanations for mental disorders with reductions in the extent to which people are blamed for their psychiatric symptoms. However, research examining the impact of genetic and other biomedical explanations of mental disorders has also suggested that they can have significant downsides. The most consistently observed negative effect of these kinds of explanations is that they can apparently lead to the assumption that mental disorders are unlikely to improve or abate. Genetic and other biomedical explanations of mental disorders can also increase people’s confidence in the effectiveness of biomedical treatments (such as pharmacotherapy) but decrease their confidence in the effectiveness of “nonbiomedical” treatments (such as psychotherapy). (shrink)

ABSTRACT After the tragedies of the twentieth century, the utopian impulse was subject to searching criticism by a host of liberal intellectuals including Karl Popper, Hannah Arendt, Isaiah Berlin, and Jacob Talmon. Looking to history and political philosophy, these thinkers impugned utopianism for so frequently destroying the freedoms it appeared to pursue. Defined by its theoretical contradictions, the utopian project, rooted in the politics of the Enlightenment, bore some responsibility for the totalitarianism and genocide that had shaped their lives. As (...) this critique became liberal orthodoxy, a heretic group of anarchist thinkers challenged these conclusions. While travelling some distance with the liberal critics, for Paul Goodman, Marie Louise Berneri, and Herbert Read, the twentieth century, rather than invalidating the utopian urge made its boldness and experimentalism all the more vital. Their act of heresy was defending utopianism as a central component of their anarchist critique of the present. (shrink)

Normative cognition seems rather important, even ineliminable. Communities that lack normative concepts like SHOULD, IS A REASON TO, JUSTIFIES, etc. seem cognitively handicapped and communicatively muzzled. And yet a popular metaethic, normative naturalism, has a hard time accommodating this felt ineliminability. Here, I press the argument against normative naturalism, consider some replies on behalf of normative naturalists, and suggest that a version of sophisticated subjectivism does the best job preserving the importance and ineliminability of the special, normative way of thinking.

This commentary on Daniel Stader's recent article, “Algorithms Don't Have a Future: On the Relation of Judgement and Calculation” develops and complicates his argument by suggesting that algorithms ossify multiple kinds of prejudices, namely, the structural prejudices of the programmer and the exemplary prejudices of the dataset. This typology at once suggests that the goal of transparency may be impossible, but this impossibility enriches the possibilities for developing Stader's concept of reflected prejudiced use.

Scholars have failed to adequately distinguish Kant’s grades of evil: frailty (weakness of will), impurity, and depravity. I argue that the only way to distinguish them is, f irstly, to recognize that frailty is explicitly, practically irrational and not caused by any sort of self-deception. Instead, it is caused by the radical evil that Kant finds within the character of all persons. Secondly, impurity can only be understood to be self-deception either about the nature of the act itself, which results (...) in an epistemic error, or about one’s motivations for following a properly reasoned, moral conclusion, which results in a motivational error. Thirdly, depravity is self-deception about morality itself, by which the agent believes that it is morally right to follow self-love. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Unmastering Speech:Irony in Plato's PhaedrusMatthew S. Linck"So, my shall suffer what it deserves."—Phaedrus 242a1It is tempting, after one has reflected closely on the words and deeds of the Phaedrus, to read the dialogue as if Socrates had the whole conversation worked out from the first words. The art of Plato is such that the intricate cohesion of word and action reveals itself through many layers. Plato writes; and as (...) a writer he has the time and the means (written letters) to compose. But what is Socrates doing? He does not have the leisure to compose "over a long period of time" (228a). He is responding to particular individuals, in particular circumstances, in the moment. He is thinking on his feet. One might claim that this is actually the first deficiency of the dialogues, that they are artificial and unrealistic in this way. If the written text reveals itself as finely crafted in the subtlety of its inner connections, how seriously can we take the apparent spontaneity of the spoken discourse? My suggestion would be that we take this not as a fault of the dialogues, but rather as the first instance of Plato's irony. This may be Plato's supreme irony—the evocation of truth through artificiality.But that is already going too fast. I want to begin by looking at the words and deeds of Socrates and Phaedrus, without considering yet what Plato might be doing as the author of the dialogue. My first interpretive principle will be to take the drama at face value, as naturalistic, temporal, and even commonplace—two friends go for a walk in the countryside to listen to speeches.Immediately, however, the commonness is disrupted. The city, the commonwealth, is left behind. This is certainly uncommon for Socrates, who never leaves the city walls.2 Furthermore, the language of the text indicates a thematization of, out-of-placeness, strangeness. Rather than being accused of already violating my one hermeneutical principle, it should be noted that this indication of strangeness comes through the words [End Page 264] and deeds of the characters, not through a retrospective recovery of the dialogue as a whole. From the beginning the reader encounters a tension between the commonplace and the unusual.3Nevertheless, the impetus to move outside of the city is commonplace enough. Phaedrus has a speech that Socrates wants to hear. Before Socrates is told what this speech is about, he indicates that nothing would please him more than "hearing how you [Phaedrus] and Lysias passed the time" (227b). After Phaedrus, in his excitement, gives away the topic of the speech—"an attempted seduction of a handsome boy—but not by a lover!" (227c)—Socrates seems even more eager to hear the speech. Does Socrates already see what is to come? Is he merely excited to hear a speech, or is he excited about challenging the beautiful Phaedrus' excitement about a speech that defends an unworthy principle—"that one should gratify the one who does not love rather than the one who does" (227c)?After leaving the city and finding a comfortable place for their speech, for, Phaedrus reads his copy of Lysias' speech for Socrates. The gist of Lysias' speech, as Phaedrus has already announced, is that a young lover should associate himself with, and gratify, a non-lover rather than one who is in love. One central theme of the speech, which will be important for thinking about irony, is that of self-mastery. The recurring motif in Lysias' speech is that the lover is not in control of himself, while the non-lover is. Therefore (the non-lover argues) associating with a lover is unpredictable, and will most likely result in harm to the beloved. The non-lover claims that his self-control will prevent and preclude unforeseen harm. This slippage, from self-mastery to mastery of the situation, is decisive. We would be wrong to interpret Socrates' two speeches as wholesale rejections of everything in Lysias' speech. Socrates cannot reject self-control outright. His consistent concern with rules out simply espousing lack of control. Yet the measuredness of Socratic practice does not entail the... (shrink)

Non-naturalists face a dilemma. They either leave their normative views hostage to a non-natural realm, which is immoral, or they do not, which is irrational. David Enoch has argued that the problem rests on cases of junk knowledge — conditionals that cannot be used to expand knowledge via modus ponens. Camil Golub has suggested that the dilemma rests on questionable assumptions about how we might come to know about the non-natural. Here I reply to these worries, sharpen the dilemma, and (...) situate it in the literature on doxastic wrongs. (shrink)