This short paper offers a skeptical solution to Åqvist's paradox of epistemic obligation. The solution is based on the contention that in SDL/KDT logics the externalist features of knowledge, about which we cannot have obligations, are obscured.

In an earlier paper by the author, Åqvist , I presented an approach to the logic of historical necessity, or inevitability, in the sense of a “two-dimensional” combination of tense and modal logic for worlds, or histories, with the same time order, known as T × W logic. Distinctive features of that approach were, apart from its two-dimensionality, its being based on discrete and finite time, and its use of so-called systematic frame constants in order to enable us to indicate (...) longitudes and latitudes of any points in the co-ordinate systems under consideration. This led us to study and axiomatize an infinite hierarchy HTWxy of two-dimensional modal tense logics with the characteristic operators for historical necessity and possibility added to the original basic vocabulary. The main purpose of the present paper is then twofold: to extend the logics HTWxy to the interesting branch of philosophical logic constituted by deontic logic as combined with tense logic; and to deal with a curious puzzle known as the so-called epistemic obligation paradox – a well known stumbling-block in this area of research in philosophical logic. We argue for a solution to both these problems, which appeals to a new infinite hierarchy DHTWxym of extensions of the HTWxy in the sense of logics combining dyadic deontic modalities with temporal ones such as those for historical necessity and other two-dimensional modalities. (shrink)

Many medieval philosophers and logicians regarded modal logic as a model for epistemic, normative and optative concepts on the basis of their apparent similarities to modal concepts. These interpretations of modal logic led to critical studies of the applicability of modal principles to deontic concepts. Some philosophers presented apparent counterexamples to the deontic interpretation of the Consequence Principle, according to which the consequences of what is obligatory (or permitted) are also obligatory (permitted). These examples are variants of Lennart Åqvist's (...) paradox of the Good Samaritan. In this article it is argued that the examples involve a confusion between the compounded and the divided senses of deontic propositions, and are not genuine counterexamples to the Consequence Principle. If the concept of knowledge is analysed as epistemically satisfactory belief, the paradox of epistemic obligation can be solved in a similar way. (shrink)

Thomas Kroedel argues that the lottery paradox can be solved by identifying epistemic justification with epistemic permissibility rather than epistemic obligation. According to his permissibility solution, we are permitted to believe of each lottery ticket that it will lose, but since permissions do not agglomerate, it does not follow that we are permitted to have all of these beliefs together, and therefore it also does not follow that we are permitted to believe that all tickets (...) will lose. I present two objections to this solution. First, even if justification itself amounts to no more than epistemic permissibility, the lottery paradox recurs at the level of doxastic obligations unless one adopts an extremely permissive view about suspension of belief that is in tension with our practice of doxastic criticism. Second, even if there are no obligations to believe lottery propositions, the permissibility solution fails because epistemic permissions typically agglomerate, and the lottery case provides no exception to this rule. (shrink)

Intellectually disabled students face particular barriers to epistemic participation within schooling contexts. While negative forms of bias against intellectually disabled people play an important role in creating these barriers, this paper suggests that it is often because of the best intentions of educators and peers that intellectually disabled students are vulnerable to forms of epistemic injustice. The author outlines a form of epistemic injustice that operates through an educational practice widely regarded as serving the interests of intellectually (...) disabled students. ‘Epistemic ability profiling’ involves the identification of the epistemic consequences of disability in the service of promoting students’ best interests, or to create opportunities for their participation in epistemic communities. Epistemic ability profiling is a double-edged sword: it is important that educators understand and attend to the ways in which differences in ability shape students’ epistemic agency, and yet epistemic ability profiling operates against the background of a conceptually ableist conceptual terrain. As a result, epistemic ability profiling runs the risk of legitimating structural forms of injustice against intellectually disabled people. (shrink)

This paper generalizes the preface paradox beyond the conjunctive aggregation of beliefs and constructs an analogous paradox for deontic reasoning. The analysis of the deontic case suggests a systematic restriction of intuitive rules for reasoning with obligations. This proposal can be transferred to the epistemic case: it avoids the preface and the lottery paradox and saves one of the two directions of the Lockean Thesis (i.e., high credence is sufficient, but not necessary for rational belief). The (...) resulting account compares favorably to competing proposals; in particular, we can formulate the rules of correct doxastic reasoning without reference to probabilistic features of the involved propositions. (shrink)

The article suggests a reading of the term ‘epistemic account of truth’ which runs contrary to a widespread consensus with regard to what epistemic accounts are meant to provide, namely a definition of truth in epistemic terms. Section 1. introduces a variety of possible epistemic accounts that differ with regard to the strength of the epistemic constraints they impose on truth. Section 2. introduces the paradox of knowability and presents a slightly reconstructed version of (...) a related argument brought forward by Wolfgang Künne. I accept the paradox and Künnes argument as sound objections to all the different epistemic accounts which are committed to one of the various constraints on truth introduced in section 1. Section 3. offers a modified epistemic constraint which, or so I argue, is immune to the paradox of knowability and plausible on independent grounds. (shrink)

The book's key questions concern whether we have a right to believe whatever we choose and whether we have significant control over our beliefs. After exploring four case studies in which the question of a right to believe arises and querying what epistemic obligations are, we consider how epistemic obligations might be grounded, whether in prudence, morality, or human virtues. Some argue that epistemic excellence is less concerned with our obligations to believe the truth and avoid falsehood (...) than with seeing that the beliefs we hold are justified. We argue that our epistemic responsibility is best fulfilled somewhere in between the strict objectivist and strict subjectivist views. We proceed to defend the thesis that we have not only indirect but direct control over our beliefs. We then examine the nature of belief, contending for belief as both disposition and an action. In the final chapter we discuss the relation between epistemic obligations and moral accountability. (shrink)

This essay corrects an error in the presentation of the Paradox of the Knowledge-Plus Knower, which is the variant of Kaplan and Montague’s Knower Paradox presented in C. Cross 2001: ‘The Paradox of the Knower without Epistemic Closure,’ MIND, 110, pp. 319–33. The correction adds a universally quantified transitivity principle for derivability as an additional assumption leading to paradox. This correction does not affect the status of the Knowledge-Plus paradox as a rebuttal to an (...) argument against epistemic closure, since the quantified transitivity principle is true in the standard model of arithmetic and therefore innocuous. (shrink)

This article provides a brief overview of several formal frameworks concerning the relation between knowledge on the one hand, and obligation on the other. We discuss the paradox of the knower, knowledge based obligation, knowingly doing, deontic dynamic epistemology, descriptive obligations, and responsibilities as dynamic epistemology.

ABSTRACT I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments. INTRODUCTION In contrast to the classic model of randomized-control trials, often with a large number of (...) subjects enrolled, precision medicine attempts to optimize therapeutic outcomes by focusing on the individual.[i] A recent publication highlights the strengths and weakness of both traditional evidence-based medicine and precision medicine.[ii] Plus, it outlines a tension in the shift from evidence-based medicine’s inductive reasoning style (the collection of data to postulate general theories) to precision medicine’s abductive reasoning style (the generation of an idea from the limited data available).[iii] The paper’s main example is the application of precision medicine for the treatment of cancer.[iv] I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. As the name suggests, brain-computer interfaces are a significant advancement in neurotechnology that directly connects someone’s brain to external or implanted devices.[v] Among the various kinds of brain-computer interfaces, adaptive deep brain stimulation devices require numerous personalized adjustments to their settings during the implantation and computation stages in order to provide adequate relief to patients with treatment-resistant disorders. What makes these devices unique is how adaptive deep brain stimulation integrates a sensory component to initiate the stimulation. While not commonly at the level of sophistication as self-supervising or generative large language models,[vi] they currently allow for a semi-autonomous form of neuromodulation. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments.[vii] ANALYSIS I. The State of Precision Medicine in Oncology and the Epistemological Shift While a thorough overview of precision medicine for the treatment of cancer is beyond the scope of this article, its practice can be roughly summarized as identifying clinically significant characteristics a patient possesses (e.g., genetic traits) to land on a specialized treatment option that, theoretically, should benefit the patient the most.[viii] However, in such a practice of stratification patients fall into smaller and smaller populations and the quality of evidence that can be applied to anyone outside these decreases in turn.[ix] As inductive logic helps to articulate, the greater the number of patients that respond to a particular therapy the higher the probability of its efficacy. By straying from this logical framework, precision medicine opens the treatment of cancer to more uncertainty about the validity of these approaches to the resulting disease subcategories.[x] Thus, while contemporary medical practices explicitly describe some treatments as “personalized”, they ought not be viewed as inherently better founded than other therapies.[xi] A relevant contemporary case of precision medicine out of Norway focuses on the care of a patient with cancer between the ventricles of the heart and esophagus, which had failed to respond to the standard regimen of therapies over four years.[xii] In a last-ditch effort, the patient elected to pay out-of-pocket for an experimental immunotherapy (nivolumab) at a private hospital. He experienced marked improvements and a reduction in the size of the tumor. Understandably, the patient tried to pursue further rounds of nivolumab at a public hospital. However, the hospital initially declined to pay for it given the “lack of evidence from randomised clinical trials for this drug relating to this [patient’s] condition.”[xiii] In rebuttal to this claim, the patient countered that he was actually similar to a subpopulation of patients who responded in “open‐label, single arm, phase 2 studies on another immune therapy drug” (pembrolizumab).[xiv] Given this interpretation of the prior studies and the patient’s response, further rounds of nivolumab were approved. Had the patient not had improvements in the tumor’s size following a round of nivolumab, then pembrolizumab’s prior empirical evidence in isolation would have been insufficient, inductively speaking, to justify his continued use of nivolumab.[xv] The case demonstrates a shift in reasoning from the traditional induction to abduction. The phenomenon of ‘cancer improvement’ is considered causally linked to nivolumab and its underlying physiological mechanisms.[xvi] However, “the weakness of abductions is that there may always be some other better, unknown explanation for an effect. The patient may for example belong to a special subgroup that spontaneously improves, or the change may be a placebo effect. This does not mean, however, that abductive inferences cannot be strong or reasonable, in the sense that they can make a conclusion probable.”[xvii] To demonstrate the limitations of relying on the abductive standard in isolation, commentators have pointed out that side effects in precision medicine are hard to rule out as being related to the initial intervention itself unless trends from a group of patients are taken into consideration.[xviii] As artificial intelligence (AI) assists the development of precision medicine for oncology, this uncertainty ought to be taken into consideration. The implementation of AI has been crucial to the development of precision medicine by providing a way to combine large patient datasets or a single patient with a large number of unique variables with machine learning to recommend matches based on statistics and probability of success upon which practitioners can base medical recommendations.[xix] The AI is usually not establishing a causal relationship[xx] – it is predicting. So, as AI bleeds into medical devices, like brain-computer interfaces, the same cautions about using abductive reasoning alone should be carried over. II. Responsive Neurostimulation, AI, and Personalized Medicine Like precision medicine in cancer treatment, computer-brain interface technology similarly focuses on the individual patient through personalized settings. In order to properly expose the intersection of AI, precision medicine, abductive reasoning, and implantable neurotechnologies, the descriptions of adaptive deep brain stimulation systems need to deepen.[xxi] As a broad summary of adaptive deep brain stimulation, to provide a patient with the therapeutic stimulation, a neural signal, typically referred to as a local field potential,[xxii] must first be detected and then interpreted by the device. The main adaptive deep brain stimulation device with premarket approval, the NeuroPace Responsive Neurostimulation system, is used to treat epilepsy by detecting and storing “programmer-defined phenomena.”[xxiii] Providers can optimize the detection settings of the device to align with the patient’s unique electrographic seizures as well as personalize the reacting stimulation’s parameters.[xxiv] The provider adjusts the technology based on trial and error. One day machine learning algorithms will be able to regularly aid this process in myriad ways, such as by identifying the specific stimulation settings a patient may respond to ahead of time based on their electrophysiological signatures.[xxv] Either way, with AI or programmers, adaptive neurostimulation technologies are individualized and therefore operate in line with precision medicine rather than standard treatments based on large clinical trials. Contemporary neurostimulation devices are not usually sophisticated enough to be prominent in AI discussions where the topics of neural networks, deep learning, generative models, and self-attention dominate the conversation. However, implantable high-density electrocorticography arrays (a much more sensitive version than adaptive deep brain stimulation systems use) have been used in combination with neural networks to help patients with neurologic deficits from a prior stroke “speak” through a virtual avatar.[xxvi] In some experimental situations, algorithms are optimizing stimulation parameters with increasing levels of independence.[xxvii] An example of neurostimulation that is analogous to the use of nivolumab in Norway surrounds a patient in the United States who was experiencing both treatment-resistant OCD and temporal lobe epilepsy.[xxviii]Given the refractory nature of her epilepsy, implantation of an adaptive deep brain stimulation system was indicated. As a form of experimental therapy, her treatment-resistant OCD was also indicated for the off-label use of an adaptive deep brain stimulation set-up. Another deep brain stimulation lead, other than the one implanted for epilepsy, was placed in the patient’s right nucleus accumbens and ventral pallidum region given the correlation these nuclei had with OCD symptoms in prior research. Following this, the patient underwent “1) ambulatory, patient-initiated magnet-swipe storage of data during moments of obsessive thoughts; (2) lab-based, naturalistic provocation of OCD-related distress (naturalistic provocation task); and (3) lab-based, VR [virtual reality] provocation of OCD-related distress (VR provocation task).”[xxix] Such signals were used to identify when to deliver the therapeutic stimulation in order to counter the OCD symptoms. Thankfully, following the procedure and calibration the patient exhibited marked improvements in their OCD symptoms and recently shared her results publicly.[xxx] In both cases, there is a similar level of abductive justification for the efficacy of the delivered therapy. In the case study in which the patient was treated with adaptive deep brain stimulation, they at least had their neural activity tested in various settings to determine the optimum parameters for treatment to avoid them being based on guesswork. Additionally, the adaptive deep brain stimulation lead was already placed before the calibration trials were conducted, meaning that the patient had already taken on the bulk of the procedural risk before the efficacy could be determined. Such an efficacy test could have been replicated in the first patient’s cancer treatment, had it been biopsied and tested against the remaining immunotherapies in vitro. Yet, in the case of cancer with few options, one previous dose of a drug that appeared to work on the patient may justify further doses. However, as the Norwegian case presents, corroboration with known responses to a similar drug (from a clinical trial) could be helpful to validate the treatment strategy. (It should be noted that both patients were resigned to these last resort options regardless of the efficacy of treatment.) There are some elements of inductive logic seen with adaptive deep brain stimulation research in general. For example, abductively the focus could be that patient X’s stimulation parameters are different from patient Y’s and patient Z’s. In contrast, when grouped as subjects who obtained personalized stimulation, patients X, Y, and Z demonstrate an inductive aspect to this approach’s safety and/or efficacy. The OCD case holds plenty of abductive characteristics in line with precision medicine’s approach to treating cancer and as more individuals try the method, there will be additional data. With the gradual integration of AI into brain-computer interfaces in the name of efficacy, this reliance on abduction will continue, if not grow, over time. Moving forward, if a responsive deep brain stimulation treatment is novel and individualized (like the dose of nivolumab) and there is some other suggestion of efficacy (like clinical similarities to other patients in the literature), then it may justify insurance coverage for the investigative intervention, absent other unrelated reasons to deny it. III. Ethical Implications and Next Steps While AI’s use in oncology and neurology is not yet as prominent as its use in other fields (e.g., radiology), it appears to be on the horizon for both.[xxxi] AI can be found in both the functioning of the neurotechnologies as well as the implementation of precision medicine. The increasing use of AI may serve to further individualize both oncologic and neurological therapies. Given these implications and the handful of publications cited in this article, it is important to have a nuanced evaluation of how these treatments, which heavily rely on abductive justification, ought to be managed. The just use an abductive approach may be difficult as AI infused precision medicine is further pursued. At baseline, such technology relies on a level of advanced technology literacy among the general public and could exclude populations who lack access to basic technological infrastructure or know-how from participation.[xxxii] Even among nations with adequate infrastructure, as more patients seek out implantable neurotechnologies, which require robust healthcare resources, the market will favor patient populations that can afford this complex care.[xxxiii] If patients already have the means to pay for an initial dose/use of a precision medicine product out of pocket, should insurance providers be required to cover subsequent treatments?[xxxiv] That is, if a first dose of a cancer drug or a deep brain stimulator over its initial battery life is successful, patients may feel justified in having the costs of further treatments covered. The Norwegian patient’s experience implies there is a precedent for the idea that some public insurance companies ought to cover successful cancer therapies, however, insurance companies may not all see themselves as obligated to cover neurotechnologies that rely on personalized settings or that are based on precision/abductive research more than on clinical trials. CONCLUSION The fact that the cases outlined above rely on abductive style of reasoning implies that there may not be as strong a justification for coverage by insurance, as they are both experimental and individualized, when compared to the more traditional large clinical trials in which groups have the same or a standardized protocol (settings/doses). If a study is examining the efficacy of a treatment with a large cohort of patients or with different experimental groups/phases, insurance companies may conclude that the resulting symptom improvements are more likely to be coming from the devices themselves. A preference for inductive justification may take priority when ruling in favor of funding someone’s continued use of an implantable neurostimulator. There are further nuances to this discussion surrounding the classifications of these interventions as research versus clinical care that warrant future exploration, since such a distinction is more of a scale[xxxv] than binary and could have significant impacts on the “right-to-try” approach to experimental therapies in the United States.[xxxvi] Namely, given the inherent limitations of conducting large cohort trials for deep brain stimulation interventions on patients with neuropsychiatric disorders, surgically innovative frameworks that blend abductive and inductive methodologies, like with sham stimulation phases, have traditionally been used.[xxxvii] Similarly, for adaptive brain-computer interface systems, if there are no large clinical trials and instead only publications that demonstrate that something similar worked for someone else, then, in addition to the evidence that the first treatment/dose worked for the patient in question, the balance of reasoning would be valid and arguably justify insurance coverage. As precision approaches to neurotechnology become more common, frameworks for evaluating efficacy will be crucial both for insurance coverage and for clinical decision making. ACKNOWLEDGEMENT This article was originally written as an assignment for Dr. Francis Shen’s “Bioethics & AI” course at Harvard’s Center for Bioethics. I would like to thank Dr. Shen for his comments as well as my colleagues in the Lázaro-Muñoz Lab for their feedback. - [i] Jonathan Kimmelman and Ian Tannock, “The Paradox of Precision Medicine,” Nature Reviews. Clinical Oncology 15, no. 6 (June 2018): 341–42, https://doi.org/10.1038/s41571-018-0016-0. [ii] Henrik Vogt and Bjørn Hofmann, “How Precision Medicine Changes Medical Epistemology: A Formative Case from Norway,” Journal of Evaluation in Clinical Practice 28, no. 6 (December 2022): 1205–12, https://doi.org/10.1111/jep.13649. [iii] David Barrett and Ahtisham Younas, “Induction, Deduction and Abduction,” Evidence-Based Nursing 27, no. 1 (January 1, 2024): 6–7, https://doi.org/10.1136/ebnurs-2023-103873. [iv] Vogt and Hofmann, “How Precision Medicine Changes Medical Epistemology,” 1208. [v] Wireko Andrew Awuah et al., “Bridging Minds and Machines: The Recent Advances of Brain-Computer Interfaces in Neurological and Neurosurgical Applications,” World Neurosurgery, May 22, 2024, S1878-8750(24)00867-2, https://doi.org/10.1016/j.wneu.2024.05.104. [vi] Mark Riedl, “A Very Gentle Introduction to Large Language Models without the Hype,” Medium (blog), May 25, 2023, https://mark-riedl.medium.com/a-very-gentle-introduction-to-large-language-models-without-the-hype-5 f67941fa59e. [vii] David E. Burdette and Barbara E. Swartz, “Chapter 4 - Responsive Neurostimulation,” in Neurostimulation for Epilepsy, ed. Vikram R. Rao (Academic Press, 2023), 97–132, https://doi.org/10.1016/B978-0-323-91702-5.00002-5. [viii] Kimmelman and Tannock, 2018. [ix] Kimmelman and Tannock, 2018. [x] Simon Lohse, “Mapping Uncertainty in Precision Medicine: A Systematic Scoping Review,” Journal of Evaluation in Clinical Practice 29, no. 3 (April 2023): 554–64, https://doi.org/10.1111/jep.13789. [xi] Kimmelman and Tannock, “The Paradox of Precision Medicine.” [xii] Vogt and Hofmann, 1206. [xiii] Vogt and Hofmann, 1206. [xiv] Vogt and Hofmann, 1206. [xv] Vogt and Hofmann, 1207. [xvi] Vogt and Hofmann, 1207. [xvii] Vogt and Hofmann, 1207. [xviii] Vogt and Hofmann, 1210. [xix] Mehar Sahu et al., “Chapter Three - Artificial Intelligence and Machine Learning in Precision Medicine: A Paradigm Shift in Big Data Analysis,” in Progress in Molecular Biology and Translational Science, ed. David B. Teplow, vol. 190, 1 vols., Precision Medicine (Academic Press, 2022), 57–100, https://doi.org/10.1016/bs.pmbts.2022.03.002. [xx] Stefan Feuerriegel et al., “Causal Machine Learning for Predicting Treatment Outcomes,” Nature Medicine 30, no. 4 (April 2024): 958–68, https://doi.org/10.1038/s41591-024-02902-1. [xxi] Sunderland Baker et al., “Ethical Considerations in Closed Loop Deep Brain Stimulation,” Deep Brain Stimulation 3 (October 1, 2023): 8–15, https://doi.org/10.1016/j.jdbs.2023.11.001. [xxii] David Haslacher et al., “AI for Brain-Computer Interfaces,” 2024, 7, https://doi.org/10.1016/bs.dnb.2024.02.003. [xxiii] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 103–4; “Premarket Approval (PMA),” https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P100026. [xxiv] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 104. [xxv] Burdette and Swartz, 126. [xxvi] Sean L. Metzger et al., “A High-Performance Neuroprosthesis for Speech Decoding and Avatar Control,” Nature 620, no. 7976 (August 2023): 1037–46, https://doi.org/10.1038/s41586-023-06443-4. [xxvii] Hao Fang and Yuxiao Yang, “Predictive Neuromodulation of Cingulo-Frontal Neural Dynamics in Major Depressive Disorder Using a Brain-Computer Interface System: A Simulation Study,” Frontiers in Computational Neuroscience 17 (March 6, 2023), https://doi.org/10.3389/fncom.2023.1119685; Mahsa Malekmohammadi et al., “Kinematic Adaptive Deep Brain Stimulation for Resting Tremor in Parkinson’s Disease,” Movement Disorders 31, no. 3 (2016): 426–28, https://doi.org/10.1002/mds.26482. [xxviii] Young-Hoon Nho et al., “Responsive Deep Brain Stimulation Guided by Ventral Striatal Electrophysiology of Obsession Durably Ameliorates Compulsion,” Neuron 0, no. 0 (October 20, 2023), https://doi.org/10.1016/j.neuron.2023.09.034. [xxix] Nho et al. [xxx] Nho et al.; Erik Robinson, “Brain Implant at OHSU Successfully Controls Both Seizures and OCD,” OHSU News, accessed March 3, 2024, https://news.ohsu.edu/2023/10/25/brain-implant-at-ohsu-successfully-controls-both-seizures-and-ocd. [xxxi] Awuah et al., “Bridging Minds and Machines”; Haslacher et al., “AI for Brain-Computer Interfaces.” [xxxii] Awuah et al., “Bridging Minds and Machines.” [xxxiii] Sara Green, Barbara Prainsack, and Maya Sabatello, “The Roots of (in)Equity in Precision Medicine: Gaps in the Discourse,” Personalized Medicine 21, no. 1 (January 2024): 5–9, https://doi.org/10.2217/pme-2023-0097. [xxxiv] Green, Prainsack, and Sabatello, 7. [xxxv] Robyn Bluhm and Kirstin Borgerson, “An Epistemic Argument for Research-Practice Integration in Medicine,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 43, no. 4 (July 9, 2018): 469–84, https://doi.org/10.1093/jmp/jhy009. [xxxvi] Vijay Mahant, “‘Right-to-Try’ Experimental Drugs: An Overview,” Journal of Translational Medicine 18 (June 23, 2020): 253, https://doi.org/10.1186/s12967-020-02427-4. [xxxvii] Michael S. Okun et al., “Deep Brain Stimulation in the Internal Capsule and Nucleus Accumbens Region: Responses Observed during Active and Sham Programming,” Journal of Neurology, Neurosurgery & Psychiatry 78, no. 3 (March 1, 2007): 310–14, https://doi.org/10.1136/jnnp.2006.095315. (shrink)

Since the early 20th century, advocates of public relations professionalism have mandated that practitioners serve the public interest making it an ethical standard for evaluating the morality of public relations practice. However, the field has devoted little research to determining just what it means for practitioners to serve the public interest. Most research suggests practice-oriented solutions. This article focuses what practitioners must do to serve the public interest. It reviews theories of the social contract and the public interest to identify (...) an approach to serving the public interest that will help practitioners reconcile moral obligations to themselves, their client organizations, and the public. It concludes that combining superior individual interests with John Dewey's public philosophy will contribute to the moral development and improvement of practitioners and the public. (shrink)

Very often when the vast majority of experts agree on some scientific issue, laypeople nonetheless regularly consume articles, videos, lectures, etc., the principal claims of which are inconsistent with the expert consensus. Moreover, it is standardly assumed that it is entirely appropriate, and perhaps even obligatory, for laypeople to consume such anti-consensus material. I maintain that this standard assumption gets things backwards. Each of us is particularly vulnerable to false claims when we are not experts on some topic – such (...) falsehoods have systematic negative impacts on our doxastic attitudes that we can neither prevent nor correct. So, when there is clear expert consensus on a given scientific issue, while it is permissible for experts to consume anti-consensus material, laypeople have an epistemic obligation to avoid such material. This argument has important consequences for philosophical discussions of our epistemic obligations to perform or omit belief-influencing actions. Such discussions typically abstract away from the important differences between experts and laypeople. Accordingly, we should reject this typical practice as problematic, and insist instead that laypeople and experts have fundamentally different epistemic obligations. (shrink)

In “The Paradox of the Knower without Epistemic Closure”, MIND 110:319-33, 2001, I develop a version of the Knower Paradox which does not assume epistemic closure, and I use it to argue that the original Knower Paradox does not support an argument against epistemic closure. In “The Paradox of the Knower without Epistemic Closure?”, MIND 113:95-107, 2004, Gabriel Uzquiano, using his own result, argues that my rebuttal to the anti-closure argument is not (...) successful. I respond here by arguing that in order to use Uzquiano’s result in an argument against closure, one must assume an implausible skepticism about arithmetic. (shrink)

In this essay I present a new version of the Paradox of the Knower and show that this new paradox vitiates a certain argument against epistemic closure. I then prove a theorem that relates the new paradox to epistemological scepticism. I conclude by assessing the use of the Knower in arguments against syntactical treatments of knowledge.

Largely thanks to Mill’s influence, the suggestion that the state ought to restrict the distribution of misinformation will strike most philosophers as implausible. Two of Mill’s influential assumptions are particularly relevant here: first, that free speech debates should focus on moral considerations such as the harm that certain forms of expression might cause; second, that false information causes minimal harm due to the fact that human beings are psychologically well equipped to distinguish truth and falsehood. However, in addition to our (...) moral obligations, we also have a distinct set of epistemic obligations—and even when a false belief doesn’t harm anyone, it constitutes an epistemically bad outcome. Moreover, Mill was profoundly mistaken about human psychology: human beings are vulnerable to the influence of a wide variety of false claims via a wide variety of psychological mechanisms. Consequently, there is a purely epistemic justification for restricting the distribution of misinformation: because each of us has an individual epistemic obligation to avoid unnecessary exposure to misinformation, and because avoiding such exposure is simply too difficult when acting alone, we all have a shared epistemic obligation to establish laws or regulations restricting the widespread distribution of misinformation. (shrink)

Kyle Stanford’s reformulation of the problem of underdetermination has the potential to highlight the epistemic obligations of scientists. Stanford, however, presents the phenomenon of unconceived alternatives as a problem for realists, despite critics’ insistence that we have contextual explanations for scientists’ failure to conceive of their successors’ theories. I propose that responsibilist epistemology and the concept of “role oughts,” as discussed by Lorraine Code and Richard Feldman, can pacify Stanford’s critics and reveal broader relevance of the “new induction.” The (...) possibility of unconceived alternatives pushes us to question our contemporary expectation for scientists to reason outside of their historical moment. (shrink)

In a recent paper, Sven Danielsson argued that the ‘original paradoxes' of deontic logic, in particular Ross's paradox and Prior's paradox of derived obligation, can be solved by restricting the modal inheritance rule. I argue that this does not solve the paradoxes.

The Paradox of the Knower was originally presented by Kaplan and Montague [26] as a puzzle about the everyday notion of knowledge in the face of self-reference. The paradox shows that any theory extending Robinson arithmetic with a predicate K satisfying the factivity axiom K → A as well as a few other epistemically plausible principles is inconsistent. After surveying the background of the paradox, we will focus on a recent debate about the role of epistemic (...) closure principles in the Knower. We will suggest this debate sheds new light on the concept of knowledge which is at issue in the paradox – i.e. is it a “thin” notion divorced from concepts such as evidence or justification, or is it a “thick” notion more closely resembling mathematical provability? We will argue that a number of features of the paradox suggest that the latter option is more plausible. Along the way, we will provide a reconstruction of the paradox using a quantified extension of Artemovʼs [2] Logic of Proofs, as well as a series of results linking the original formulation of the paradox to reflection principles for formal arithmetic. On this basis, we will argue that while the Knower can be understood to motivate a distinction between levels of knowledge, it does not provide a rationale for recognizing a uniform hierarchy of knowledge predicates in the manner suggested by Anderson. (shrink)

The Knower Paradox has had a brief but eventful history, and principles of epistemic closure (which say that a subject automatically knows any proposition she knows to be materially implied, or logically entailed, by a proposition she already knows) have been the subject of tremendous debate in epistemic logic and epistemology more generally, especially because the fate of standard arguments for and against skepticism seems to turn on the fate of closure. As far as I can tell, (...) however, no one working in either area has emphasized the result I emphasize in this paper: the Knower Paradox just falsifies even the most widely accepted general principles of epistemic closure. After establishing that result, I discuss five of its more important consequences. (shrink)

In his later lectures, published as The Hermeneutics of the Subject, Michel Foucault surveys different modalities of obtaining ‘truth’ about one's self and the world: from Socrates to the Cynics, Stoics, Epicureans and early church writers. Genealogically tracing this opposition between knowing self and world, he occasionally invites phenomenological enquiry into how this epistemic couplet bears on education. Drawing on three vignettes familiar to educators, my investigation explores modes of discovering self and world through counselling, distributed governance in the (...) classroom and the arts of writing. In each case we confront a paradox of freedom, in that agency is needed, already, to liberate the self from the world. An exegetical task is to show how Foucault worked through this philosophical problem, of relevance to many situations in education, by re-reading Kant, Nietzsche and Heidegger. (shrink)

The use of decision-making capacity assessments in clinical medicine is an underdeveloped yet quickly growing practice. Despite the ethical and clinical importance of these assessments as a means of protecting patient autonomy, clinicians, philosophers, and ethicists have identified a number of practical and theoretical hurdles which remain unresolved. One ethically important yet largely unaddressed issue is whether, and to what extent physicians ought to inform and obtain consent from patients prior to initiating a capacity assessment. In what follows, I address (...) the following question: Must, or should, physicians obtain consent for capacity assessments? I argue that physicians have an ethical obligation to obtain express patient consent for capacity assessments, and in doing so, I challenge the predominant view which requires physicians to merely inform patients without obtaining consent. I then identify an underlying philosophical paradox that complicates the clinician's duty to obtain consent: in short, consent is needed for an assessment of one's ability to consent. Finally, I recommend a practical solution to this paradox of consent for capacity assessments by proposing a model of double consent from both the patient and health care representative. (shrink)

The Brandenburger–Keisler paradox is a self-referential paradox in epistemic game theory which can be viewed as a two-person version of Russell’s Paradox. Yablo’s Paradox, according to its author, is a non-self referential paradox, which created a significant impact. This paper gives a Yabloesque, non-self-referential paradox for infinitary players within the context of epistemic game theory. The new paradox advances both the Brandenburger–Keisler and Yablo results. Additionally, the paper constructs a paraconsistent model (...) satisfying the paradoxical statement. (shrink)

We combine linear temporal logic (with both past and future modalities) with a deontic version of justification logic to provide a framework for reasoning about time and epistemic and normative reasons. In addition to temporal modalities, the resulting logic contains two kinds of justification assertions: epistemic justification assertions and deontic justification assertions. The former presents justification for the agent’s knowledge and the latter gives reasons for why a proposition is obligatory. We present two kinds of semantics for the (...) logic: one based on Fitting models and the other based on neighborhood models. The use of neighborhood semantics enables us to define the dual of deontic justification assertions properly, which corresponds to a notion of permission in deontic logic. We then establish the soundness and completeness of an axiom system of the logic with respect to these semantics. Further, we formalize the Protagoras versus Euathlus paradox in this logic and present a precise analysis of the paradox, and also briefly discuss Leibniz’s solution. (shrink)

The ancient puzzle of the Liar was shown by Tarski to be a genuine paradox or antinomy. I show, analogously, that certain puzzles of contemporary game theory are genuinely paradoxical, i.e., certain very plausible principles of rationality, which are in fact presupposed by game theorists, are inconsistent as naively formulated. ;I use Godel theory to construct three versions of this new paradox, in which the role of 'true' in the Liar paradox is played, respectively, by 'provable', 'self-evident', (...) and 'justifiable'. I also construct in modal operator logic a paradox involving reflexive empirical reasoning. Unlike the paradox of the Liar, the paradox of reflexive reasoning does not depend on self-reference. ;I consider various solutions to the Liar paradox and evaluate how well these solutions cope with the paradox of reflexive reasoning. I then formalize the solution to the paradoxes which I favor: the indexical-hierarchical approach, first sketched out by Charles Parsons and Tyler Burge. In this solution, occurrences of the predicate 'true' in sentence-tokens are contextually relativized to levels of a hierarchy. Drawing also on some brief remarks of Bertrand Russell and Charles Parsons, I develop an account of the kind of schematic generality needed for this theory to be statable. ;Finally, I demonstrate that the principles shown to be paradoxical are in fact presupposed by contemporary game theorists in their reliance on the notion of common knowledge or, more precisely, mutual belief. I create novel analyses of and corresponding solutions to several recalcitrant puzzles within game theory, including the "chain-store paradox". (shrink)

In this paper, I provide an account of subjective epistemic obligations. In instances of peer disagreement, one possesses at least two types of obligations: objective epistemic obligations and subjective epistemic obligations. While objective epistemic obligations, such as conciliationism and remaining steadfast, have been much discussed in the literature, subjective epistemic obligations have received little attention. I develop an account of subjective epistemic obligations in the context of worldview disagreements. In recent literature, the notion of (...) worldview disagreement has been receiving increasing attention, and I discuss how understanding worldview disagreements through different classes of beliefs might clarify our understanding of subjective epistemic obligations. I first distinguish between three classes of beliefs, by virtue of their justificatory functions within worldviews: fundamental, crucial and incidental. I then discuss four kinds of worldview disagreements based on this account. Finally, I argue that each disagreement results in different subjective epistemic obligations for each disputant. I conclude by discussing some implications this analysis has for issues such as defeat, peerhood, and epistemic injustice. (shrink)

The epistemic paradox of 'belief instability' has recently received notable attention from many philosophers. Understanding this paradox is very important because belief is a central notion of psychologically motivated semantic theories in philosophy, linguistics, and cognitive science, and this paradox poses serious problems for these theories. In this dissertation I criticize previous proposals and offer a new proposal, which I call a 'revision theory of belief'. -/- My revision theory of belief is in many respects an (...) application of Gupta's and Belnap's revision theory of truth, which is proposed to deal with the Liar paradox. They argue that truth is a circular notion because Tarski biconditionals provide circular, partial definitions of truth. And this circularity of truth is the source of the Liar paradox. I offer a similar proposal for handling the paradox of belief instability. In particular, I argue that our notion of belief involved in the paradox of belief instability is circular, and that is why this paradox arises. -/- If the notion of belief involved in the paradox is circular, we have to employ a hypothetical evaluation of the belief predicate, and if we do so through a revision process, we can avoid the contradiction which seems to be generated by some paradoxical belief sentences. But it is not easy to show that our notion of belief is circular. Especially, there is nothing like Tarski biconditionals in the case of belief. Nonetheless, I show in this dissertation that there is a certain schema, which I call the B-schema, whose instances can be taken as circular, partial definitions of a notion of belief, and it is that notion of belief which is involved in the paradox of belief instability. In this dissertation I also show that the revision approach can be extended for handling the Knower paradox. I argue that the Knower paradox arises because our notion of knowledge involved in the paradox is circular. (shrink)

Many proposed moral principles are such that it would be difficult or impossible to always correctly identify which act is required by that principle in a given situation. To deal with this problem, theorists typically offer various methods of determining what to do in the face of epistemic limitations, and we are then told that the right thing to do – given these limitations – is to perform the act identified by the given method. But since the method and (...) the underlying principle can diverge, it would seem that in such cases we are being given contradictory advice: some particular act will be both right and not right. Various attempts to resolve this apparent paradox are surveyed, but none are completely satisfactory. (shrink)

In this precis, I explain the basic commitments and the master argument from my book, Epistemic Care: Vulnerability, Inquiry, and Social Epistemology (2023), in which I explore the normative implications of a central observation from social epistemology: we are epistemically interdependent. We depend on other inquirers as we ask questions, assess evidence, and form beliefs—in short, in our inquiry. This means that our inquiry stands to go better or worse depending on the actions that other inquirers take or have (...) taken. We are, therefore, vulnerable in our inquiry. Vulnerability, according to care ethics, generates obligations in many cases. Care epistemology echoes this commitment. We can evaluate communities of inquiry for how well the epistemic vulnerabilities of their members are met. Adequate epistemic care is a necessary requirement for an epistemically admirable community. (shrink)

The following principles may plausibly be included in a wide range of theories of epistemic justification: (1) There are circumstances in which an agent is justified in believing a falsehood, (2) There are circumstances in which an agent is justified in believing a principle of epistemic justification, (3) Beliefs acquired in compliance with a justifiably-believed epistemic principle are justified. I argue that it follows from these three individually plausible claims that an agent's belief may be both justified (...) and unjustified. I consider how theories may avoid this paradox, and conclude that deontological theories of epistemic justification face considerable, perhaps insurmountable, difficulties. (shrink)

Supererogatory acts—good deeds “beyond the call of duty”—are a part of moral common sense, but conceptually puzzling. I propose a unified solution to three of the most infamous puzzles: the classic Paradox of Supererogation (if it’s so good, why isn’t it just obligatory?), Horton’s All or Nothing Problem, and Kamm’s Intransitivity Paradox. I conclude that supererogation makes sense if, and only if, the grounds of rightness are multi-dimensional and comparative.

The principal aim of this book is to develop and defend an analysis of the concept of moral obligation. The analysis is neutral regarding competing substantive theories of obligation, whether consequentialist or deontological in character. What it seeks to do is generate solutions to a range of philosophical problems concerning obligation and its application. Amongst these problems are deontic paradoxes, the supersession of obligation, conditional obligation, prima facie obligation, actualism and possibilism, dilemmas, supererogation, and (...) cooperation. By virtue of its normative neutrality, the analysis provides a theoretical framework within which competing theories of obligation can be developed and assessed. This study is a major contribution to metaethics that will be of particular interest to all philosophers concerned with normative ethical theory. (shrink)

According to a widely held view epistemic justification is a normative notion. According to another widely held assumption, epistemic justification comes in degrees. Given that gradability requires a context-sensitivity that normativity seems to lack, these two assumptions stand in tension. Giving up the assumption of gradability of justification represents a lesser theoretical cost.

A combination of epistemic logic and dynamic logic of programs is presented. Although rich enough to formalize some simple game-theoretic scenarios, its axiomatization is problematic as it leads to the paradoxical conclusion that agents are omniscient. A cut-free labelled Gentzen-style proof system is then introduced where knowledge and action, as well as their combinations, are formulated as rules of inference, rather than axioms. This provides a logical framework for reasoning about games in a modular and systematic way, and to (...) give a step-by-step reconstruction of agents omniscience. In particular, its semantic assumptions are made explicit and a possible solution can be found in weakening the properties of the knowledge operator. (shrink)

Presents a /simple/ epistemic solution to the paradox of the surprise test, suitable for undergraduates. Given the Gazette's audience, recalcitrant versions, such as Sorenson's, would have been inappropriate to even mention. It is also classified under "logical paradoxes," because it can be argued that given the existence of logical, rather than epistemic, solutions, so also the paradox is logical, rather than epistemic. -/- The author was not sent proofs, because the /Gazette/ was then run on (...) a "shoestring budget"; the 2009 article is just as intended, and the journal is now typeset well. (shrink)

Populist protests against Coronavirus-related restrictions in the US appear paradoxical in three respects. Populism is generally hostile to expertise, yet it has flourished at a moment when expertise has seemed more indispensable than ever. Populism thrives on crisis and indeed often depends on fabricating a sense of crisis, yet it has accused mainstream politicians and media of overblowing and even inventing the Corona crisis. Populism, finally, is ordinarily protectionist, yet it has turned anti-protectionist during the pandemic and challenged the allegedly (...) overprotective restrictions of the nanny-state. I address each apparent paradox in turn before speculating in conclusion about how populist distrust of expertise, antipathy to government regulation, and skepticism toward elite overprotectiveness may come together – in the context of intersecting medical, economic, political, and epistemic crises – in a potent and potentially dangerous mix. (shrink)

We shall evaluate two strategies for motivating the view that knowledge is the norm of belief. The first draws on observations concerning belief's aim and the parallels between belief and assertion. The second appeals to observations concerning Moore's Paradox. Neither of these strategies gives us good reason to accept the knowledge account. The considerations offered in support of this account motivate only the weaker account on which truth is the fundamental norm of belief.

Como posso estar certo de que existe qualquer coisa de externa aos meus próprios pensamentos? Muitos filósofos procuraram ou apresentar uma prova da existência do mundo externo, ou rejeitar a inteligibilidade da própria ideia de uma “prova” nesse contexto. O objetivo desse artigo é mostrar que o denominado “problema do mundo externo” decorre de uma má compreensão acerca do que seja justificativa epistêmica. Apresento o que denomino “paradoxo de Berkeley” de modo a mostrar que o uso ordinário da linguagem não (...) deve funcionar como critério de correção para a aplicação de conceitos como conhecimento e existência. Concluo que tanto as tentativas tradicionais de se apresentar uma prova da existência do mundo externo quanto as tentativas de se mostrar que o problema não faz sentido são equivocadas. O que deve ser levado em conta no exame do problema do mundo externo é o contexto em que a proposta cética é feita. (shrink)

Stewart Shapiro has objected to the epistemicist theory of vagueness on grounds that it gives counterintuitive predictions about cases involving conditional obligation. This paper details a response on the epistemicist’s behalf. I first argue that Shapiro’s own presentation of the objection is unsuccessful as an argument against epistemicism. I then reconstruct and offer two alternative arguments inspired by Shapiro’s considerations, and argue that these fail too, given the information-sensitive nature of conditional obligations.