The practice of medicine frequently involves the unconsented restriction of liberty. The reasons for unilateral liberty restrictions are typically that being confined, strapped down, or sedated are necessary to prevent the person from harming themselves or others. In this paper, we target the ethics of chemical restraints, which are medications that are used to intentionally restrict the mental states associated with the unwanted behaviors, and are typically not specifically indicated for the condition for which the patient is being treated. Specifically, (...) we aim to identify the conditions under which chemical restraints are ethically permissible. It is wrong to assume that what is morally true of physical restraints is also true of chemical restraints. Our aim is thus to identify the conditions under which chemical restraints are permissible while distinguishing these conditions from those of the application of physical restraints. (shrink)

As the science and technology of the brain and mind develop, so do the ways in which brains and minds may be surveilled and manipulated. Some cognitive libertarians worry that these developments undermine cognitive liberty, or “freedom of thought.” I argue that protecting an individual’s cognitive liberty undermines others’ ability to use their own cognitive liberty. Given that the threatening devices and processes are not relevantly different from ordinary and frequent intrusions upon one’s brain and mind, strong protections of cognitive (...) liberty may proscribe neurotechnological intrusions, but also ordinary intrusions. Thus, the cognitive libertarian position “hog-ties” others’ use of their own liberties. This problem for the cognitive libertarian is the same problem that ordinary libertarianism faces in protecting individual rights to property and person. But the libertarian strategies for resolving the problem don’t work for the cognitive libertarian. I conclude that the right to mental privacy is weaker than what cognitive libertarians want it to be. (shrink)

Some theorists argue that moral bioenhancement ought to be compulsory. I take this argument one step further, arguing that if moral bioenhancement ought to be compulsory, then its administration ought to be covert rather than overt. This is to say that it is morally preferable for compulsory moral bioenhancement to be administered without the recipients knowing that they are receiving the enhancement. My argument for this is that if moral bioenhancement ought to be compulsory, then its administration is a matter (...) of public health, and for this reason should be governed by public health ethics. I argue that the covert administration of a compulsory moral bioenhancement program better conforms to public health ethics than does an overt compulsory program. In particular, a covert compulsory program promotes values such as liberty, utility, equality, and autonomy better than an overt program does. Thus, a covert compulsory moral bioenhancement program is morally preferable to an overt moral bioenhancement program. (shrink)

Philosophy of language in the 21st century has cultivated a concern for the hateful, the coercive, and the lethal. Amidst this shift of attention toward politically significant speech, ‘non-ideal’ philosophers of language investigate whether common conceptual toolkits from ‘mainstream’ philosophy of language manage to make contact with our non-ideal world in the first place. Drawing on a tradition of Wittgensteinian critical social thought, I contend that philosophers of language risk their (ideology‐)critical bite when they isolate our words from the activities (...) into which they are woven. That is, when philosophers fail to register our ordinary investment in the words we put on display—the interests, stakes, and concerns in light of which we voice them—we make their political import unavailable to philosophy of language. But the non-ideal philosopher’s concept of idealization is itself a normatively non-neutral tool; and, as such, it exemplifies the sort of theoretical resource that may be mobilized with an investment in shaping not only our epistemic resources but also our senses of what matters. (shrink)

There is recent empirical evidence that personal identity is constituted by one’s moral traits. If true, this poses a problem for those who advocate for moral enhancement, or the manipulation of a person’s moral traits through pharmaceutical or other biological means. Specifically, if moral enhancement manipulates a person’s moral traits, and those moral traits constitute personal identity, then it is possible that moral enhancement could alter a person’s identity. I go a step further and argue that under the right conditions, (...) moral enhancement can constitute murder. I then argue that these conditions are not remote. (shrink)

Epistemic burdens – the nature and extent of our ignorance (that and how) with respect to various courses of action – serve to determine our incentive structures. Courses of action that seem to bear impossibly heavy epistemic burdens are typically not counted as options in an actor’s menu, while courses of action that seem to bear comparatively heavy epistemic burdens are systematically discounted in an actor’s menu relative to options that appear less epistemically burdensome. That ignorance serves to determine what (...) counts as an option means that epistemic considerations are logically prior to moral, prudential, and economic considerations: in order to have moral, prudential, or economic obligations, one must have options, and epistemic burdens serve to determine our options. One cannot have obligations without doing some epistemic work. We defend this claim on introspective grounds. We also consider how epistemic burdens distort surrogate decision-making. The unique epistemology of surrogate cases makes the priority of the epistemic readily apparent. We then argue that anyone who accepts a principle similar to ought implies can is committed to the logical priority of the epistemic. We also consider and reject several possible counterarguments. -/- . (shrink)

Currently, humans lack the cognitive and moral capacities to prevent the widespread suffering associated with collective risks, like pandemics, climate change, or even asteroids. In Moral Enhancement and the Public Good, Parker Crutchfield argues for the controversial, and initially counterintuitive claim that everyone should be administered a substance that makes us better people. Furthermore, he argues that it should be administered without our knowledge. That is, moral bioenhancement should be both compulsory and covert. Crutchfield demonstrates how our duty (...) to future generations and our epistemic inability to promote the public good highlight the need for compulsory, covert moral bioenhancement. This not only gives us the best chance of preventing widespread suffering, compared to other interventions (or doing nothing), it also best promotes liberty, autonomy, and equality. In a final chapter, Crutchfield addresses the most salient objections to his argument. (shrink)

Default positions, predetermined starting points that aid in complex decision-making, are common in clinical medicine. In this article, we identify and critically examine common default positions in clinical ethics practice. Whether default positions ought to be held is an important normative question, but here we are primarily interested in the descriptive, rather than normative, properties of default positions. We argue that default positions in clinical ethics function to protect and promote important values in medicine—respect for persons, utility, and justice. Further, (...) default positions in clinical ethics may also guard against harm. Where default positions exist, there are epistemic burdens to overturn them. The person wishing to reject the default position, rather than the person endorsing it, bears this burden. The person who bears the burden of meeting the epistemic requirements must provide evidence proportional to the degree of harm the default position protects against. Default positions that protect against significant harm impose significant epistemic requirements to overturn. This asymmetry not only makes medical decision-making more economical but also serves to promote and protect certain values. The identification and analysis of common and recognizable default positions can help to identify other default positions and the conditions under which their associated epistemic requirements are met. The article concludes with considerations of potential problems with the use of default positions in clinical ethics. (shrink)

"This book is a succinct, pedagogically designed introduction. As classroom text, Sullivan's work is heady with vibrant debate and slim heuristics; her intellectual clarity is stunning." - Choice A Critical Introduction to Queer Theory explores the ways in which sexuality, subjectivity and sociality have been discursively produced in various historical and cultural contexts. The book begins by putting gay and lesbian sexuality and politics in historical context and demonstrates how and why queer theory emerged in the West in the late (...) twentieth century. Sullivan goes on to provide a detailed overview of the complex ways in which queer theory has been employed, covering a diversity of key topics including: race, sadomasochism, straight sex, fetishism, community, popular culture, transgender, and performativity. Each chapter focuses on a distinct issue or topic, provides a critical analysis of the specific ways in which it has been responded to by critics (including Freud, Foucault, Derrida, Judith Butler, Jean-Luc Nancy, Adrienne Rich and Laura Mulvey), introduces key terms, and uses contemporary cinematic texts as examples. (shrink)

Moral bioenhancement is the potential practice of manipulating individuals’ moral behaviors by biological means in order to help resolve pressing moral issues such as climate change and terrorism. This practice has obvious ethical implications, and these implications have been and continue to be discussed in the bioethics literature. What have not been discussed are the epistemological implications of moral bioenhancement. This article details some of these implications of engaging in moral bioenhancement. The argument begins by making the distinction between moral (...) bioenhancement that manipulates the contents of mental states and that which manipulates other, non-representational states. Either way, I argue, the enhanced moral psychology will fail to conform to epistemic norms, and the only way to resolve this failure and allow the moral bioenhancement to be effective in addressing the targeted moral issues is to make the moral bioenhancement covert. (shrink)

Relational Quantum Mechanics is an interpretation of quantum mechanics proposed by Carlo Rovelli. Rovelli argues that, in the same spirit as Einstein’s theory of relativity, physical quantities can only have definite values relative to an observer. Relational Quantum Mechanics is hereby able to offer a principled explanation of the problem of nested measurement, also known as Wigner’s friend. Since quantum states are taken to be relative states that depend on both the system and the observer, there is no inconsistency in (...) the descriptions of the observers. Federico Laudisa has recently argued, however, that Rovelli’s description of Wigner’s friend is ambiguous, because it does not take into account the correlation between the observer and the quantum system. He argues that if this correlation is taken into account, the problem with Wigner’s friend disappears and, therefore, a relativization of quantum states is not necessary. I will show that Laudisa’s criticism is not justified. To the extent that the correlation can be accurately reflected, the problem of Wigner’s friend remains. An interpretation of quantum mechanics that provides a solution to it, like Relational Quantum Mechanics, is therefore a welcome one. (shrink)

Humans are morally deficient in a variety of ways. Some of these deficiencies threaten the continued existence of our species. For example, we appear to be incapable of responding to climate change in ways that are likely to prevent the consequent suffering. Some people are morally better than others, but we could all be better. The price of not becoming morally better is that when those events that threaten us occur, we will suffer from them. If we can prevent this (...) suffering from occurring, then we ought to do so. That we ought to make ourselves morally better in order to prevent very bad things from happening justifies, according to some, the development and administration of moral enhancement. I address in this paper the idea that moral enhancement could give rise to moral transhumans, or moral post-persons. Contrary to recent arguments that we shouldn’t engender moral post-persons, I argue that we should. Roughly, the reasons for this conclusion are that we can expect moral post-persons to resemble the morally best of us, our moral exemplars. Since moral exemplars promote their interests by promoting the interests of others (or they promote others’ interests at the expense of their own) we can expect moral post-persons to pursue our interests. Since we should also pursue our own interests, we should bring about moral post-persons. (shrink)

Despite the lack of evidence for their effectiveness, the use of physical restraints for patients is widespread. The best ethical justification for restraining patients is that it prevents them from harming themselves. We argue that even if the empirical evidence supported their effectiveness in achieving this aim, their use would nevertheless be unethical, so long as well known exceptions to informed consent fail to apply. Specifically, we argue that ethically justifiable restraint use demands certain necessary and sufficient conditions. These conditions (...) are that the physician obtain informed consent for their application, that their application be medically appropriate, and that restraints be the least liberty-restricting way of achieving the intended benefit. It is a further question whether their application is ever medically appropriate, given the dearth of evidence for their effectiveness. (shrink)

Slow codes—insincere attempts at resuscitation—are widely regarded in medicine and medical ethics as morally impermissible. My goal here is to enrich this special issue on the slow code with an argument for the permissibility of slow codes that is rooted in moral psychology. Specifically, if we take seriously the results from moral psychology, the slow code is not only permissible, it is often the best option. The context of the decision about whether to perform a slow code is analogous to (...) thoroughly investigated moral dilemmas such as the trolley problem. In particular, when the trolley problem is framed as a trilemma, it becomes clear that the decisional context of the slow code is analogous to the famous moral dilemma. Since in the trolley problem the choice analogous to the slow code is the best choice, the slow code may be the best choice when facing patient or family requests for futile CPR. In establishing this claim, I address a range of objections to the slow code. I conclude with an empirically supported explanation of the conventional wisdom. Resistance to the slow code doesn’t sprout from the act’s moral properties, but from moral judgments influenced by factors such as emotion, physical distance, and personal force. (shrink)

It has recently been argued that a person’s moral judgments (about both their own and others’ actions) are constrained by the nature and extent of their relevant ignorance and, thus, that such judgments are determined in the first instance by the person’s epistemic circumstances. It has been argued, in other words, that the epistemic is logically prior to other normative (e.g., ethical, prudential, pecuniary) considerations in human decision-making, that these other normative considerations figure in decision-making only after (logically and temporally) (...) relevant ignorance has constrained the decision-maker’s menu of options. If this is right, then a person’s moral judgments in some set of circumstances should vary with their knowledge and ignorance of these circumstances. In this study, we test the hypothesis of the logical priority of the epistemic. We describe two experiments in which subjects’ knowledge and ignorance of relevant consequences were manipulated. In the second experiment, we also compared the effect of ignorance on moral judgments with that of personal force, a factor previously shown to influence moral judgments. We found broad empirical support for the armchair arguments that epistemic considerations are logically prior to normative considerations. (shrink)

We aim to establish the following claim: other factors held constant, the relative weights of the epistemic burdens of competing treatment options serve to determine the options that patient surrogates pursue. Simply put, surrogates confront an incentive, ceteris paribus, to pursue treatment options with respect to which their knowledge is most adequate to the requirements of the case. Regardless of what the patient would choose, options that require more knowledge than the surrogate possesses (or is likely to learn) will either (...) be neglected altogether or deeply discounted in the surrogate’s incentive structure. We establish this claim by arguing that the relation between epistemic burdens and incentives in decision-making is a general feature of surrogate decision-making. After establishing the claim, we draw out some of the implications for surrogate decision-making in medicine and offer philosophical and psychological explanations of the phenomenon. (shrink)

High-level theory is the view that high-level properties---the property of being a dog, being a tiger, being an apple, being a pair of lips, etc.---can be represented in perceptual experience. Low-level theory denies this and claims that high-level properties are only represented at the level of perceptual judgment and are products of cognitive interpretation of low-level sensory information (color, shape, illumination). This paper discusses previous attempts to establish high-level theory, their weaknesses, and an argument for high-level theory that does not (...) have these weaknesses. (shrink)

In a recent issue of Bioethics, I argued that compulsory moral bioenhancement should be administered covertly. Alexander Zambrano has criticized this argument on two fronts. First, contrary to my claim, Zambrano claims that the prevention of ultimate harm by covert moral bioenhancement fails to meet conditions for permissible liberty‐restricting public health interventions. Second, contrary to my claim, Zambrano claims that covert moral bioenhancement undermines autonomy to a greater degree than does overt moral bioenhancement. In this paper, I rebut both of (...) these arguments, then finish by noting important avenues of research that Zambrano’s arguments motivate. (shrink)

In biomedical ethics, there is widespread acceptance of moral realism, the view that moral claims express a proposition and that at least some of these propositions are true. Biomedical ethics is also in the business of attributing moral obligations, such as “S should do X.” The problem, as we argue, is that against the background of moral realism, most of these attributions are erroneous or inaccurate. The typical obligation attribution issued by a biomedical ethicist fails to truly capture the person's (...) actual obligations. We offer a novel argument for rife error in obligation attribution. The argument starts with the idea of an epistemic burden. Epistemic burdens are all of those epistemic obstacles one must surmount in order to achieve some aim. Epistemic burdens shape decision-making such that given two otherwise equal options, a person will choose the option that has the lesser of epistemic burdens. Epistemic burdens determine one's potential obligations and, conversely, their non-obligations. The problem for biomedical ethics is that ethicists have little to no access to others' epistemic burdens. Given this lack of access and the fact that epistemic burdens determine potential obligations, biomedical ethicists often can only attribute accurate obligations out of luck. This suggests that the practice of attributing obligations in biomedical ethics is rife with error. To resolve this widespread error, we argue that this practice should be abolished from the discourse of biomedical ethics. (shrink)

Previous research has shown that women are disproportionately negatively affected by a variety of socio-economic hardships, many of which COVID-19 is making worse. In particular, because of gender roles, and because women’s jobs tend to be given lower priority than men’s (since they are more likely to be part-time, lower-income, and less secure), women assume the obligations of increased caregiving needs at a much higher rate. This unfairly renders women especially susceptible to short- and long-term economic insecurity and decreases in (...) wellbeing. Single-parent households, the majority of which are headed by single mothers, face even greater risks. These vulnerabilities are further compounded along the dimensions of race, ethnicity, class, and geography. Drawing upon the philosophical literature on political responsibility and structural injustice (specifically, the work of Iris Marion Young), I argue that while the state may not have had either foresight into, or control over, the disproportionate effect the pandemic would have on women, it can nonetheless be held responsible for mitigating these effects. In order to do so, it must first recognize the ways in which women have been affected by the outbreak. Specifically, policies must take into account the unpaid labor of care that falls on women. Moreover, given that this labor is particularly vital during a global health pandemic, the state ought to immediately prioritize the value of this work by providing financial stimuli directly to families, requiring employers to provide both sick leave and parental leave for at least as long as schools and daycares are inoperational, and providing subsidized emergency childcare. (shrink)

We thank all the thoughtful authors for their insightful comments. In this response, we try to address some of themes that emerged from the commentaries. We leave aside some of those comments that...

This chapter discusses some of the most engaging natural phenomena, those in which highly structured collective behavior emerges over time from the interaction of simple subsystems. Emergence is generally understood to be a process that leads to the appearance of structure not directly described by the defining constraints and instantaneous forces which control a system. Over time “something new” appears at scales not directly specified by the equations of motion. An emergent feature also cannot be explicitly represented in the initial (...) and boundary conditions. A feature emerges when the underlying system puts some effort into its creation. These observations form an intuitive definition of emergence. For it to be useful, however, one must specify what the “something” is and in what manner it is “new.” Otherwise, the notion has little or no content, since almost any time-dependent system would exhibit emergent features. (shrink)

Brain-computer interfaces are communication bridges between a human brain and external world, enabling humans to interact with their environment without muscle intervention. Their functionality, therefore, depends on both the BCI system and the cognitive capacities of the user. Motor-imagery BCIs rely on the users’ mental imagination of body movements. However, not all users have the ability to sufficiently modulate their brain activity for control of a MI-BCI; a problem known as BCI illiteracy or inefficiency. The underlying mechanism of this phenomenon (...) and the cause of such difference among users is yet not fully understood. In this study, we investigated the impact of several cognitive and psychological measures on MI-BCI performance. Fifty-five novice BCI-users participated in a left- versus right-hand motor imagery task. In addition to their BCI classification error rate and demographics, psychological measures including personality factors, affinity for technology, and motivation during the experiment, as well as cognitive measures including visuospatial memory and spatial ability and Vividness of Visual Imagery were collected. Factors that were found to have a significant impact on MI-BCI performance were Vividness of Visual Imagery, and the personality factors of orderliness and autonomy. These findings shed light on individual traits that lead to difficulty in BCI operation and hence can help with early prediction of inefficiency among users to optimize training for them. (shrink)

Most current dental ethics curricula use a deontological approach to biomedical and dental ethics that emphasizes adherence to duties and principles as properties that determine whether an act is ethical. But the actual ethical orientation of students is typically unknown. The purpose of the current study was to determine the ethical orientation of dental students in resolving clinical ethical dilemmas. First-year students from one school were invited to participate in an electronic survey that included eight vignettes featuring ethical conflicts common (...) to the health care setting. The Multidimensional Ethics Scale was used to evaluate the students’ ethical judgments of these conflicts. Students rated each vignette along 13 ethically relevant items using a 7-point scale. Nine of the thirteen items were analyzed because they represent the dominant ethical theories, including deontology. One hundred sixteen dental students successfully completed the survey. Of the analyzed items, those associated with deontology had comparatively weak associations with whether students judged the action to be ethical and whether students judged themselves likely to perform the action. Whether an action was judged to be caring had the strongest association with whether the action was judged to be ethical and whether students judged themselves likely to perform the action. These results suggest that adherence to duties or principles has weaker association with students’ ethical judgments and behavior compared to caring, which was found to be more influential in their ethical judgments and behavior. Current dental school curricula with a primary focus on deontology may no. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:632 Feminist Studies 42, no. 3. © 2016 by Feminist Studies, Inc. Nikki Lane Bringing Flesh to Theory: Ethnography, Black Queer Theory, and Studying Black Sexualities As Dorothy Hodgson tells us, the most common features of an ethnographic project involve “talking to, participating with, and observing the people who produce... texts, exploring the contexts of their ideas and actions, and often studying how their situations, ideas, and actions (...) change over time.”1 Practically, this often involves spending months, and more often years, in a particular field site, where one develops relationships with members of the group, community, or institution being studied. Ethnographers are positioned in a place to observe, but also place their bodies on the line—participating, when possible, in the quotidian practices of the group. This observation and participation is captured in the form of “field notes” that may relay in the form of “thick description,” what the ethnographer sees as she observes and participates in various cultural and social practices.2 As such, ethnography requires reflexivity because the ethnographer must constantly consider how her body is affecting and is effected by the communities and institutions in which she is embedded. The benefit of this reflexive ethnographic approach is that, as Faye Ginsburg notes, it “has the capacity to reveal the fault lines in 1. Dorothy Louise Hodgson, “Of Modernity/Modernities, Gender, and Ethnography,” in Gendered Modernities: Ethnographic Perspectives, ed. Dorothy Louise Hodgson (New York: Palgrave, 2001), 17. 2. Clifford Geertz, The Interpretation of Cultures: Selected Essays (New York: Basic Books, 1973). Nikki Lane 633 communities, social movements, and institutions, which frequently run along class, race, and generational lines, and that might easily be missed by more deductive and quantitative methodologies.”3 MarlonM.Bailey’s ButchQueensUpinPumps, Jafari S. Allen’s ¡Venceremos?, Mignon Moore’s Invisible Families, and Mireille Miller-Young’s A Taste for Brown Sugar represent an exciting trend within an interdisciplinary body of research that I am referring to as Black sexuality studies. What links these projects is their use of ethnographic methodologies to understand how Blackness informs racialized gender and sexuality in the everyday experiences of their interlocutors. In relying on ethnography, to varying degrees, they are in conversation with and expand upon methodological trends within Black feminist studies and Black queer studies. Further, the Black sexuality studies projects reviewed here question the (hetero)normative bent within the field of African American studies, the normatively white subject position that exists within queer theory, and the lack of attention to issues of sexual pleasure within Black feminist theory. They also challenge theorists of race and sexuality to move 3. Faye Ginsburg, “Ethnography and American Studies,” Cultural Anthropology 21, no. 3 (2006), 492. Books Discussed in This Essay¡Venceremos? The Erotics of Black Self-making in Cuba. By Jafari S. Allen. Durham, NC: Duke University Press, 2011. Butch Queens Up in Pumps: Gender, Performance, and Ballroom Culture in Detroit. By Marlon M. Bailey. Ann Arbor: University of Michigan Press, 2013. Invisible Families: Gay Identities, Relationships, and Motherhood among Black Women. By Mignon Moore. Oakland: University of California Press, 2011. A Taste for Brown Sugar: Black Women in Pornography. By Mireille Miller-Young. Durham, NC: Duke University Press, 2014. 634 Nikki Lane in the direction of interrogating the flesh, because they go to the site— the place where the body acts, feels, and engages the world—asking the simple question articulated best by E. Patrick Johnson: “What is the utility of queer [or feminist] theory on the front lines, in the trenches, on the street, or anyplace where the racialized and sexualized body is beaten, starved, fired, cursed—indeed, where the body is the site of trauma?”4 In my discussion of these texts, I will focus on how each utilizes ethnographic methodologies in distinct ways. I will argue that regardless of how they employ ethnography’s methods, they make two very important contributions to fields of Black feminist theory and Black queer theory. First, they add information about the lived experiences of Black sexual subjectivity to the ethnographic record. By adding these experiences to the record, they become part of the limited but growing body of available knowledge about the everyday experiences of Black people within the African... (shrink)

As the federal government distributed remdesivir to some of the states COVID-19 hit hardest, policymakers scrambled to develop criteria to allocate the drug to their hospitals. Our state, Michigan, was among those states to receive an initial quantity of the drug from the U.S. government. The disparities in burden of disease in Michigan are striking. Detroit has a death rate more than three times the state average. Our recommendation to the state was that it should prioritize the communities that bear (...) a disproportionate burden of suffering in the allocation of the new potential treatment. This recommendation is justified not only for new drugs with uncertain effects, but also for drugs of certain benefit or vaccines. For states with significant health disparities, such as Michigan, this allocation priority may help to repair them. In fact, any other allocation strategy may make them worse. (shrink)

Berger (forthcoming) states that moral intimacy is important in applying the best interests standard. But what he calls moral intimacy requires that someone has overcome epistemic burdens needed to represent the patient. We argue elsewhere that good surrogate decision-making is first and foremost a matter of overcoming epistemic burdens, or those obstacles that stand in the way of a surrogate decision-maker knowing what a patient wants and how to satisfy those preferences. Berger’s notion of moral intimacy depends on epistemic intimacy: (...) the fact that a surrogate's epistemic burdens with respect to the best interests of the incapacitated patient have been adequately surmounted, plus some other feature. Thus, where a particular patient-surrogate relationship fails to be morally intimate, what is lacking is either epistemic intimacy or this second feature. Furthermore, Berger uses the notion of moral intimacy as an explanans for the application of the best interests standard. We argue that the notions of epistemic intimacy and epistemic burdens not only help to explain the notion of moral intimacy, but also better explain the application of the best interests standard. Given the role of epistemic burdens and the epistemic intimacy that overcoming them enables, bioethicists and physicians should consider a surrogate’s epistemic standing relative to the patient’s best interests before pronouncing on the former’s ethical probity. (shrink)

In 1977 John Money published the first modern case histories of what he called ‘apotemnophilia’, literally meaning ‘amputation love’ [Money et al., The Journal of Sex Research, 13(2):115–12523, 1977], thus from its inception as a clinically authorized phenomenon, the desire for the amputation of a healthy limb or limbs was constituted as a sexual perversion conceptually related to other so-called paraphilias. This paper engages with sex-based accounts of amputation-related desires and practices, not in order to substantiate the paraphilic model, but (...) rather, because the conception of these (no doubt) heterogeneous desires and practices as symptoms of a paraphilic condition (or conditions) highlights some interesting cultural assumptions about ‘disability’ and ‘normalcy’, their seemingly inherent (un)desirability, and their relation to sexuality. In critically interrogating the socio-political conditions that structure particular desires and practices such that they are lived as improper, distressing and/or disabling, the paper constitutes an exercise in what Margrit Shildrick [Beyond the body of bioethics: Challenging the conventions. In M. Shildrick and R. Mykitiuk (Eds.), Ethics of the body: Postconventional challenges (pp. 1–26). New York: MIT Press, 2005] refers to as “postconventional ethics”. (shrink)

Brummett and Salter propose a useful and timely taxonomy of clinical ethics expertise (2019). As the field becomes further “professionalized” this taxonomy is important, and the core of it is right. It needs some refinement around the edges, however. In their conclusion, Brummett and Salter rightly point out that there is a significant difference between the ethicist whose recommendations are procedure- and process-heavy, consensus-driven, and dialogical and the authoritarian ethicist whose recommendations flow from “private moral views” (Brummett and Salter, 2019). (...) This admission doesn’t go far enough. Brummett and Salter’s taxonomy fails to capture the notion that offering recommendations whose normative force is moral is different in kind from recommendations whose normative force is non-moral, such as those recommendations that are free of moral content or justified by convention. The difference is in kind, not scale. I argue further that clinical ethics expertise, if possible, consists at least in offering recommendations whose normative force is moral. These two claims imply that the taxonomy fails to cut clinical ethics expertise at the joints: the ethicist who offers justified non-moral normative recommendations is a different kind of ethicist from the one who offers justified moral normative recommendations, yet both are categorized as clinical ethics experts. I finish by offering a refinement of the taxonomy that more precisely categorizes clinical ethicists. (shrink)

Dynamics is not enough for cognition, nor it is a substitute for information-processing aspects of brain behavior. Moreover, dynamics and computation are not at odds, but are quite compatible. They can be synthesized so that any dynamical system can be analyzed in terms of its intrinsic computational components.

This paper examines the ways in which two methods of horse training generally considered divergent approach the concepts of partnership and conflict in human-horse relations. It focuses on finding similarities between the methods, both of which, it is argued, demonstrate the significance of communication in improving human-horse relations. Using interview material, the paper analyzes the practices and beliefs of individuals involved in natural horsemanship. In doing so the paper shows that communication between human and horse works to promote relations between (...) them that are free of conflict. This analysis is offered as a potential “solution” to welfare problems that exist both within competitive dressage practice and within individual human-horse relations. The paper also examines how the fundamental similarities between dressage and natural horsemanship could point to universalized theories of horse training focused on improving human-horse relations. (shrink)

Advances in genomic medicine have lead to debate about the potential inclusion of genetic tests for susceptibility to common complex disorders in newborn screening programmes. Empirical evidence concerning psychosocial reactions to genetic testing is a crucial component of both ethical debate and policy development, but while there has been much speculation concerning the possible psychosocial impact of screening newborns for genetic susceptibilities, there remains a paucity of data. The aim of the study reported here is to provide some of this (...) missing empirical evidence, using type 1 diabetes as an example of a common disorder with multiple significant genetic contributors to its aetiology. Semi-structured interviews were conducted with 11 parents of babies who had received increased risk results in a study that involved newborn screening for genetic susceptibility to type 1 diabetes. Interpretative phenomenological analysis was used to evaluate the data. The interview data suggest that the probabilistic nature of results of genetic susceptibility tests impacts upon all aspects of parents' psychosocial reactions, resulting in a complex and dynamic process quite different to that described in relation to current newborn screening programmes. While parents generally reported fairly minor levels of concern in response to news of their child's increased genetic risk, these worries frequently recurred, and perception of risk also varied and fluctuated over time. Both individual and contextual factors appeared to interact with the inherent uncertainty of the test result to contribute to the dynamic nature of parental reactions, and their behavioural responses. The implications of these findings for future research and for the debate concerning potential expansion of newborn screening are discussed. (shrink)

The collapse of society is inevitable, even if it is in the distant future. When it collapses, it is likely to do so within the lifetimes of some people. These people will have matured in pre-collapse society, experience collapse, and then live the remainder of their lives in the post-collapse world. I argue that this group of people—the transitional generation—will be the worst off from societal collapse, far worse than subsequent generations. As the transitional generation, they will suffer disparately. This (...) intergenerational disparity in suffering is inequitable. Given that other disparities in suffering are worthy of remediation, this intergenerational disparity in suffering is worthy of remediation. However, the only way to do so is to target the mental states of the members of the transitional generation. (shrink)

It has recently been argued that a person’s moral judgments (about both their own and others’ actions) are constrained by the nature and extent of their relevant ignorance and, thus, that such judgments are determined in the first instance by the person’s epistemic circumstances. It has been argued, in other words, that the epistemic is logically prior to other normative (e.g., ethical, prudential, pecuniary) considerations in human decision-making, that these other normative considerations figure in decision-making only after (logically and temporally) (...) relevant ignorance has constrained the decision-maker’s menu of options. If this is right, then a person’s moral judgments in some set of circumstances should vary with their knowledge and ignorance of these circumstances. In this study, we test the hypothesis of the logical priority of the epistemic. We describe two experiments in which subjects’ knowledge and ignorance of relevant consequences were manipulated. In the second experiment, we also compared the effect of ignorance on moral judgments with that of personal force, a factor previously shown to influence moral judgments. We found broad empirical support for the armchair arguments that epistemic considerations are logically prior to normative considerations. (shrink)

It is plausible that current generations owe something to future generations. One possibility is that we have a duty to not harm them. Another possibility is that we have a duty to protect them. In either case, however, to satisfy the duties to future generations from environmental or political degradation, we need to engage in widespread collective action. But, as we are, we have a limited ability to do so, in part because we lack the self-discipline necessary for successful collective (...) action. Given that having an obligation hinges on being able to satisfy it, the apparent duty to future generations is at odds with our apparent inability to satisfy it. Thus, we either need to rethink our duties to future generations or rethink the nature of our abilities. I argue in this chapter that we should rethink the nature of our abilities. Specifically, we should enhance our self-discipline, which is distinct from enhancements of motivation, judgment, or emotion. Even the most intelligent, motivated, and empathetic actor is likely to slip up, which encourages others to withdraw their cooperation. Without the necessary self-discipline to sustain our public cooperative behavior, collective action is likely to fail, leaving us with one alternative: to abandon our duties to future generations. (shrink)

Conducting research on animals is supposed to be valuable because it provides information on how human mechanisms work. But for the use of animal models to be ethically justified, it must be epistemically justified. The inference from an observation about an animal model to a conclusion about humans must be warranted for the use of animals to be moral. When researchers infer from animals to humans, it’s an extrapolation. Often non-human primates are used as animal models in laboratory behavioral research. (...) The target populations are humans and other non-human primates. I argue that the epistemology of extrapolation renders the use of non-human primates in laboratory behavioral research unreliable. If the model is relevantly similar to the target, then the experimental conditions introduce confounding variables. If the model is not relevantly similar to the target, then the observations of the model cannot be extrapolated to the target. Since using non-human primates in as animal models in laboratory behavioral research is not epistemically justified, using them as animal models in laboratory behavioral research is not ethically justified. (shrink)

Many people find the manipulation of the human germline—editing the DNA of sperm or egg cells such that these genetic changes are passed to the resulting offspring—to be morally impermissible. In this paper, I argue for the claim that editing the human germline is morally permissible. My argument starts with the claim that outcome uncertainty regarding the effects of germline editing shows that the duty to not harm cannot ground the prohibition of germline editing. Instead, if germline editing is wrong, (...) it is wrong because it violates a duty to protect. However, we also have an epistemic duty to gather evidence regarding the effects of editing the human germline which overrides any moral duty to protect future generations. Thus, we have a duty to gather evidence regarding the effects of editing the human germline, which is to say that we have a duty to edit the human germline. (shrink)

Among psychiatric conditions, delusions have received significant attention in the philosophical literature. This is partly due to the fact that many delusions are bizarre, and their contents interesting in and of themselves. But the disproportionate attention is also due to the notion that by studying what happens when perception, cognition, and belief go wrong, we can better understand what happens when these go right. In this paper, I attend to delusions for the second reason—by evaluating the epistemology of delusions, we (...) can better understand the epistemology of ordinary belief. More specifically, given recent advancements in our understanding of how delusions are formed, the epistemology of delusions motivates a proper functionalist account of the justification of belief. Proper functionalist accounts of the justification of belief hold that whether a belief is justified is partly determined by whether the system that produces the belief is functioning properly. Whatever pathology is responsible for delusion formation, restoring it to its proper function resolves the epistemic condition, an effect which motivates proper functionalism. (shrink)

PURPOSE: The conventional wisdom in dental and medical education is that dental and medical students experience "ethical erosion" over the duration of dental and medical school. There is some evidence for this claim, but in the case of dental education this evidence consists entirely of survey research, which doesn't measure behavior. The purpose of this study was to measure the altruistic behavior of dental students, in order to fill the significant gap in knowledge of how students are disposed to behave, (...) rather than how they are disposed to think. -/- METHODS: To test the altruistic behavior of dental students, we conducted a field experiment using the Ultimatum Game, which is a game commonly used in economics to observe social behavior. Students from each of the four years of dental school played the game in standardized conditions with real money. -/- RESULTS: Students exhibited greater levels of altruism than the general population typically does. Students' altruism peaked in year four. Students' altruism was associated with the socioeconomic status of responder. -/- CONCLUSION: The results suggest that that dental students are more altruistic than the population average and that altruism increases during their education. Thus, if a decreasing ability to behave altruistically is observed during dental school, it is not likely due to a general disposition of students, but rather some factor specific to the educational environment in which the decrease is observed. (shrink)

There has been considerable debate on how to teach ethics within the marketing curriculum to accommodate the AACSB requirements requiring emphasis on ethical issues within the business curricula. Since introducing a separate course on marketing ethics has limited reach, we propose incorporating the ethical dimension through guest speeches and reflective learning in a mandatory Marketing course for all business majors. Through phenomenographic analysis of 121 student reflections, we report evidence supporting the effectiveness of this approach in significantly raising awareness of (...) ethics in the marketing domain and in initiating the nurturing of ethical reasoning abilities in undergraduate business students early in their college careers. Students absorbed substantial amounts of knowledge at different levels and demonstrated significant cognitive processing within the revised Bloom’s taxonomy. Using this method to teach marketing ethics promotes awareness and application of ethical reasoning without compromising disciplinespecific instruction. (shrink)

Objective: Evidence suggests people experience an oral size illusion and commonly perceive oral size inaccurately; however, the nature of the illusion remains unclear. The objectives of the present study were to confirm the presence of an oral size illusion, determine the magnitude (amount) and direction (underestimation or overestimation) of the illusion, and determine whether immediately prior crossmodal perceptual experiences affected the magnitude and direction. Design: Participants (N = 27) orally assessed 9 sizes of stainless steel spheres (1/16 in to 1/2 (...) in) categorized as small, medium, or big, and matched them with digital and visual reference sets. Each participant completed 20 matching tasks in 3 assessments. For control assessments, 6 oral spheres were matched with reference sets of same-sized spheres. For primer-control assessments, similar to control, 6 matching tasks were preceded by cross-modal experiences of the same-sized sphere. For experimental assessments, 8 matching tasks were preceded by a cross-modal experience of a differently sized sphere. Results: For control assessments, small and medium spheres were consistently underestimated, and big spheres were consistently overestimated. For experimental assessments, magnitude and direction of the oral size illusion varied according to the size of the sphere used in the cross-modal experience. Conclusion: Results seemed to confirm an oral size illusion, but direction of the illusion depended on the size of the object. Immediately prior cross-modal experiences influenced magnitude and direction of the illusion, suggesting that aspects of oral perceptual experience are dependent upon factors outside of oral perceptual anatomy and the properties of the oral stimulus. (shrink)