Around the world, the population is ageing in ways that pose new challenges for healthcare providers. To date these have mostly been formulated in terms of challenges created by increasing costs, and the focus has been squarely on life-prolonging treatments. However, this focus ignores the ways in which many older people require life-enhancing treatments to counteract the effects of physical and mental decline. This paper argues that in doing so it misses important aspects of what justice requires when it comes (...) to older people. (shrink)

Accounts of the value of patient choice in contemporary medical ethics typically focus on the act of choosing. Being the one to choose, it is argued, can be valuable either because it enables one to bring about desired outcomes, or because it is a way of enacting one’s autonomy. This paper argues that all such accounts miss something important. In some circumstances, it is having the opportunity to choose, not the act of choosing, that is valuable. That is because in (...) many situations whether one has, or is denied, that opportunity conveys how one is seen. In particular, it conveys whether or not one is seen as an equal and competent member of society. Adequately recognising this fact has implications for what healthcare professionals should do, ones that require a move away from the current focus on autonomy. The paper draws out these implications by focusing on patients who may struggle to be recognised as competent and equal members of society, and whose autonomy may thus itself sometimes be in question. (shrink)

Moral indeterminacy can be problematic: prospectively it can give rise to deliberative anguish, and retrospectively, it can leave us in a limbo as to what attitudes it is appropriate to form with respect to past actions with indeterminate moral status. These problems give us reason to resolve ethical indeterminacy. One mechanism for doing so involves the use of our normative powers to place obligations on ourselves and to waive our claims against others. This mechanism could operate through an explicit agreement, (...) but could also operate through implicit endorsement of a social convention. However, there are important limits on when the mechanism can eliminate moral indeterminacy. (shrink)

Guided by the concept of bullshit, broadly defined as a deceptive form of rhetoric intended to distract and/or persuade, we examine how fabrications and false statements— when crafted and distributed by the president of the United States—impact not only foreign policy making and implementation but also erode democratic norms. Unconstrained by reality, and seemingly driven more by celebrity and showmanship than a genuine desire to govern, we argue that President Trump’s penchant for bullshit is part of a concerted strategy to (...) sideline critics while simultaneously undermining the ongoing investigations into the Trump campaign’s alleged collusion with the Russian government. (shrink)

Since 1989, widely circulating statistics on gay teen suicide in the United States have acted as catalysts for institutional reforms, scientific research, and the creation of an identity category “gay youth.” While one figure has been replicated scientifically, these numbers originated not from a scientific research study but as risk estimates developed by a social worker and published in a government document. Many people within the public took up these original numbers, attributing their author the status of scientific researcher. In (...) effect, the numbers became “black boxed,” often traveling without citation. Drawing on Ian Hacking’s “dynamic nominalist” perspective, this article utilizes interviews with the author of these statistics and other key claimants, along with textual analysis, to trace the origins, uptake, and effects of these figures. While making vital policy contributions, the numbers have led to some ironic consequences including the fostering of gay youth identification with suicide as a potential correlate of their identity and the potential antigay redeployment of decontextualized numbers. They have also led to a reaction in the form of “resilience” narratives. (shrink)

Clinical information about patients is increasingly being stored in electronic form and has therefore become more easily shareable. Data are collected as part of clinical care but have multiple other potential uses in relation to health system planning, audit and research. The use of clinical information for these secondary uses is controversial, and the ability to safeguard personal and sensitive data under current practices is contested.In this study, we investigate the attitudes of a representative sample of the Danish population towards (...) transfer of clinical data from their general practice for secondary use. We specifically study: patients’ trust in different types of healthcare professionals, their interest in being asked about secondary use of data and their willingness to dispense from a requirement of informed consent based on their trust in healthcare professionals.We find that adult Danes are positive towards research that use patient data, and they generally trust general practitioners, hospitals and researchers to treat their data confidentially.Nevertheless, they feel that they have a right to control the use of their data, only 7.3% disagreeing, and that the data belong to them, only 14.0% disagreeing. Answers to further questions about the relation between trust, information and consent show that although trust modifies the wish for information and consent, there is still a strong view that the patient should control the use of data. We find no differences between those who have frequent contact with the healthcare system and those who do not. (shrink)

Technological developments in the sphere of artificial intelligence (AI) inspire debates about the implications of autonomous weapon systems (AWS), which can select and engage targets without human intervention. While increasingly more systems which could qualify as AWS, such as loitering munitions, are reportedly used in armed conflicts, the global discussion about a system of governance and international legal norms on AWS at the United Nations Convention on Certain Conventional Weapons (UN CCW) has stalled. In this article we argue for the (...) necessity to adopt legal norms on the use and development of AWS. Without a framework for global regulation, state practices in using weapon systems with AI-based and autonomous features will continue to shape the norms of warfare and affect the level and quality of human control in the use of force. By examining the practices of China, Russia, and the United States in their pursuit of AWS-related technologies and participation at the UN CCW debate, we acknowledge that their differing approaches make it challenging for states parties to reach an agreement on regulation, especially in a forum based on consensus. Nevertheless, we argue that global governance on AWS is not impossible. It will depend on the extent to which an actor or group of actors would be ready to take the lead on an alternative process outside of the CCW, inspired by the direction of travel given by previous arms control and weapons ban initiatives. (shrink)

How wrong is it to deceive someone into sex by lying, say, about one's profession? The answer is seriously wrong when the liar's actual profession would be a deal breaker for the victim of the deception: this deception vitiates the victim's sexual consent, and it is seriously wrong to have sex with someone while lacking his or her consent.

We study first-order concatenation theory with bounded quantifiers. We give axiomatizations with interesting properties, and we prove some normal-form results. Finally, we prove a number of decidability and undecidability results.

There is widespread agreement that it would be both morally and legally wrong to treat a competent patient, or to carry out research with a competent participant, without the voluntary consent of that patient or research participant. Furthermore, in medical ethics it is generally taken that that consent must be informed. The most widely given reason for this has been that informed consent is needed to respect the patient’s or research participant’s autonomy. In this article I set out to challenge (...) this claim by considering in detail each of the three most prominent ways in which ‘autonomy’ has been conceptualized in the medical ethics literature. I will argue that whilst these accounts support the claim that consent is needed if the treatment of competent patients, or research on competent individuals, is to respect their autonomy, they do not support the claim that informed consent is needed for this purpose. (shrink)

It is generally held that doctors and researchers have an obligation to obtain informed consent. Over time there has been a move in relation to this obligation from a requirement to disclose information to a requirement to ensure that that information is understood. Whilst this change has been resisted, in this article I argue that both sides on this matter are mistaken. When investigating what information is needed for consent to be informed we might be trying to determine what information (...) a person would need in order to consent at all, or we might be trying to determine what information a person needs in order to make an informed choice about whether or not to consent. I argue that the obligation to ensure understanding only applies to information generated by the first type of enquiry; but that much of the information generally thought necessary in order for consent to be informed is only required if our concern is with the second type of enquiry. For this reason it is neither the case that doctors and researchers should ensure all the information they provide is understood, nor is it the case that their only obligation is to disclose it. (shrink)

It is well known that the structure of honest elementary degrees is a lattice with rather strong density properties. Let $\mbox{\bf a} \cup \mbox{\bf b}$ and $\mbox{\bf a} \cap \mbox{\bf b}$ denote respectively the join and the meet of the degrees $\mbox{\bf a}$ and $\mbox{\bf b}$ . This paper introduces a jump operator ( $\cdot'$ ) on the honest elementary degrees and defines canonical degrees $\mbox{\bf 0},\mbox{\bf 0}', \mbox{\bf 0}^{\prime \prime },\ldots$ and low and high degrees analogous to the corresponding (...) concepts for the Turing degrees. Among others, the following results about the structure of the honest elementary degrees are shown: There exist low degrees, and there exist degrees which are neither low nor high. Every degree above $\mbox{\bf 0}'$ is the jump of some degree, moreover, for every degree $\mbox{\bf c}$ above $\mbox{\bf 0}'$ there exist degrees $\mbox{\bf a},\mbox{\bf b}$ such that $\mbox{\bf c}=\mbox{\bf a} \cup \mbox{\bf b} = \mbox{{\bf a}}'=\mbox{\bf b}'$ . We have $\mbox{\bf a}'\cup \mbox{\bf b}' \leq (\mbox{\bf a}\cup\mbox{\bf b})'$ and $\mbox{\bf a}'\cap \mbox{\bf b}' \geq (\mbox{\bf a}\cap \mbox{\bf b})'$ . The jump operator is of course monotonic, i.e. $\mbox{\bf a}\leq\mbox{{\bf b}}\Rightarrow \mbox{\bf a}'\leq \mbox{\bf b}'$ . We prove that every situation compatible with $\mbox{\bf a}\leq\mbox{\bf b}\Rightarrow \mbox{\bf a}'\leq \mbox{\bf b}'$ is realized in the structure, e.g. we have incomparable degrees $\mbox{\bf a},\mbox{\bf b}$ such that $\mbox{\bf a}'<\mbox{\bf b}'$ and incomparable degrees $\mbox{\bf a},\mbox{\bf b}$ such that $\mbox{\bf a}' = \mbox{\bf b}'$ etcetera. We are able to prove all these results without the traditional recursion theoretic constructions. Our proof method relies on the fact that the growth of the functions in a degree is bounded. This technique also yields a very simple proof of an old result, namely that the structure is a lattice. (shrink)

This article develops an unconventional perspective on the utilitarianism of Bentham and Mill in at least four areas. First, it is shown that both authors conceived of utility as irreducibly multi-dimensional, and that Bentham in particular was very much aware of the ambiguity that multi-dimensionality imposes upon optimal choice under the greatest happiness principle. Secondly, I argue that any attribution of intrinsic worth to any form of human behaviour violates the first principles of Bentham's and Mill's utilitarianism, and that this (...) renders both authors immune to the claim by G. E. Moore that they committed a ‘naturalistic fallacy’. Thirdly, in light of these contentions, I find no flaw in Mill's ‘proof of utility’. Fourthly, I use the notion of intrapersonal utility weights to provide an interpretation of Mill's qualitative hedonism that is entirely consistent with his value monism. (shrink)

In a health service with limited resources we must make decisions about who to treat first. In this paper I develop a version of the restoration argument according to which those whose need for resources is a consequence of their voluntary choices should receive lower priority when it comes to health care. I then consider three possible problems for this argument based on those that have been raised against other theories of this type: that we don't know in a particular (...) case that the illness is self-inflicted, that it seems that all illness is self-inflicted in the sense used in my argument, and finally that this type of approach incorporates an unacceptable moralising element if it is to avoid giving those like fire-fighters a lower priority for treatment. I argue that the position outlined here has the resources to respond to each of these objections. (shrink)

The frequency of death from miscarriage is very high, greater than the number of deaths from induced abortion or major diseases.Berg (2017, Philosophical Studies 174:1217–26) argues that, given this, those who contend that personhood begins at conception (PAC) are obliged to reorient their resources accordingly—towards stopping miscarriage, in preference to stopping abortion or diseases. This argument depends on there being a basic moral similarity between these deaths. I argue that, for those that hold to PAC, there are good reasons to (...) think that there is no such similarity. There is a morally relevant difference between preventing killing and letting die, giving PAC supporters reasons to prioritize reducing abortion over reducing miscarriage. And the time-relative interest account provides a morally relevant difference in the badness of death of miscarriages and deaths of born adults, justifying attempts to combat major diseases over attempts to combat miscarriage. I consider recent developments in the literature and contend that these new arguments are unsuccessful in establishing moral similarities between deaths from miscarriage and abortion, and deaths from miscarriage and disease. (shrink)

Nearly everyone prefers pain to be in the past rather than the future. This seems like a rationally permissible preference. But I argue that appearances are misleading, and that future-biased preferences are in fact irrational. My argument appeals to trade-offs between hedonic experiences and other goods. I argue that we are rationally required to adopt an exchange rate between a hedonic experience and another type of good that stays fixed, regardless of whether the hedonic experience is in the past or (...) future. (shrink)

First Published in 2004. Routledge is an imprint of Taylor & Francis, an informa company.

The scope of someone's consent is the range of actions that they permit by giving consent. The Scope of Consent investigates the under-explored question of which normative principle governs the scope of consent. To answer this question, the book's investigation involves taking a stance on what constitutes consent. By appealing to the idea that someone can justify their behaviour by appealing to another person's consent, Dougherty defends the view that consent consists in behaviour that expresses a consent-giver's will for how (...) a consent-receiver behaves. The ultimate conclusion of the book is that the scope of consent is determined by certain evidence that bears on the appropriate interpretation of the consent. (shrink)

You are morally permitted to save your friend at the expense of a few strangers, but not at the expense of very many. However, there seems no number of strangers that marks a precise upper bound here. Consequently, there are borderline cases of groups at the expense of which you are permitted to save your friend. This essay discusses the question of what explains ethical vagueness like this, arguing that there are interesting metaethical consequences of various explanations.

First Published in 2004. Routledge is an imprint of Taylor & Francis, an informa company.

Let T 0?T 1 denote that each computable function, which is provable total in the first order theory T 0, is also provable total in the first order theory T 1. Te relation ? induces a degree structure on the sound finite Π2 extensions of EA (Elementary Arithmetic). This paper is devoted to the study of this structure. However we do not study the structure directly. Rather we define an isomorphic subrecursive degree structure <≤,?>, and then we study <≤,?> by (...) ubrecursive and computability-theoretic means. Furthermore, we introduce and investigate some operators on the degrees of <≤,?>. These operators corresponds to inferencerules in formal arithmetic. One operator corresponds to the Σ1 collection rule. Another operator corresponds to the Σ1 induction rule. (shrink)

Coherence-spaces and domains with totality are used to give interpretations of inductively defined types. A category of coherence spaces with totality is defined and the closure of positive inductive type constructors is analysed within this category. Type streams are introduced as a generalisation of types defined by strictly positive inductive definition. A semantical analysis of type streams with continuous recursion theorems is established. A hierarchy of domains with totality defined by positive induction is defined, and density for a sub-hierarchy is (...) proved. (shrink)

Scientists are seekers of truth; but where science breaks into the everyday world should they be held accountable for the outcome of their actions? The contributors to this volume believe that scientists are more than mere cogs in a machine - science, technology and politics are inseparable. Part 1 describes current scientific practice from three personal perspectives; part 2 looks at the ways in which science, society and the environment could interact given the chance; and part 3 examines the more (...) general aspects of Western science and their relevance to our relationship with the environment, society and all global issues. (shrink)

Psychological altruism (being motivated by the needs of others) has a tendency to produce behaviour that is costly in evolutionary terms. How, then, could the capacity for psychological altruism evolve? One suggestion is that it is the result of sexual selection. There are, however, two problems that face such an account: first, it is not clear that the resulting behaviour would be altruistic in the relevant sense, and second, it does not seem to fit with key features of our actual (...) helping behaviour. I will argue that both of these problems can be avoided if we adopt a modular account of desire formation. (shrink)

Healthcare ethics has to date had very little to say about the treatment of chronic illness. That is problematic. Chronic illness differs from other illnesses in that: 1. in most cases it cannot be cured; 2. patients can live with it for many years; and 3. its day to day management is typically carried out, not by healthcare professionals, but by the patient and/or members of their family. These features problematise key distinctions that underlie much existing work in healthcare ethics (...) — including those between beneficence and autonomy, between treatment and prevention, and between the recipient and provider of treatment. They also raise ethical questions that have not to date been addressed in any detail — including what healthcare professionals should do when patients are managing their illness poorly, or when changes occur that affect their patients. For these reasons chronic illness provides a lens through which to challenge the adequacy of existing approaches to healthcare ethics, exposing the gaps and false assumptions built into them. In doing so it also provides the materials to build a more philosophically adequate account of healthcare professionals’ moral obligations than exists to date. Providing such an account is the aim of this monograph. (shrink)

In an influential paper, L. A. Paul argues that one cannot rationally decide whether to have children. In particular, she argues that such a decision is intractable for standard decision theory. Paul's central argument in this paper rests on the claim that becoming a parent is ``epistemically transformative''---prior to becoming a parent, it is impossible to know what being a parent is like. Paul argues that because parenting is epistemically transformative, one cannot estimate the values of the various outcomes of (...) a decision whether to become a parent. In response, we argue that it is possible to estimate the value of epistemically transformative experiences. Therefore, there is no special difficulty involved in deciding whether to undergo epistemically transformative experiences. Insofar as major life decisions do pose a challenge to decision theory, we suggest that this is because they often involve separate, familiar problems. (shrink)

The anglophone philosophy profession has a well-known problem with gender equity. A sig-nificant aspect of the problem is the fact that there are simply so many more male philoso-phers than female philosophers among students and faculty alike. The problem is at its stark-est at the faculty level, where only 22% - 24% of philosophers are female in the United States (Van Camp 2014), the United Kingdom (Beebee & Saul 2011) and Australia (Goddard 2008).<1> While this is a result of the (...) percentage of women declining at each point through-out the standard career trajectory, recent large-scale studies in the United States (Paxton et al. 2012) and Australia (Goddard et al. 2008) have identified a key drop-off point as the transi-tion between taking introductory classes and majoring in philosophy. So why do dispropor-tionately few female students choose to major in philosophy? (shrink)

Ulysses contracts are a method by which one person binds himself by agreeing to be bound by others. In medicine such contracts have primarily been discussed as ways of treating people with episodic mental illnesses, where the features of the illness are such that they now judge that they will refuse treatment at the time it is needed. Enforcing Ulysses contracts in these circumstances would require medical professionals to override the express refusal of the patient at the time treatment is (...) required, something that is generally problematic both ethically and legally. In this paper I will argue that despite appearances Ulysses contracts can make it the case that treating a patient in such circumstances is an instance of treating him with his consent, although safeguards are needed to ensure that this is the case. Given the potential benefits to patients I further argue that modified Ulysses contracts should be made legally enforceable. (shrink)

Most of us are “time-biased” in preferring pains to be past rather than future and pleasures to be future rather than past. However, it turns out that if you are risk averse and time-biased, then you can be turned into a “pain pump”—in order to insure yourself against misfortune, you will take a series of pills which leaves you with more pain and better off in no respect. Since this vulnerability seems rationally impermissible, while time-bias and risk aversion seem rationally (...) permissible, we are left with a puzzle. (shrink)

Why is there female under-representation among philosophy majors? We survey the hypotheses that have been proposed so far, grouping similar hypotheses together. We then propose a chronological taxonomy that distinguishes hypotheses according to the stage in undergraduates’ careers at which the hypotheses predict an increase in female under-representation. We then survey the empirical evidence for and against various hypotheses. We end by suggesting future avenues for research.

The author proposes a dimensional model of our emotion concepts that is intended to be largely independent of one’s theory of emotions and applicable to the different ways in which emotions are measured. He outlines some conditions for selecting the dimensions based on these motivations and general conceptual grounds. Given these conditions he then advances an 8-dimensional model that is shown to effectively differentiate emotion labels both within and across cultures, as well as more obscure expressive language. The 8 dimensions (...) are: (1) attracted—repulsed, (2) powerful—weak, (3) free—constrained, (4) certain—uncertain, (5) generalized—focused, (6) future directed—past directed, (7) enduring—sudden, (8) socially connected—disconnected. (shrink)

We argue that abduction does not work in isolation from other inference mechanisms and illustrate this through an inference scheme designed to evaluate multiple hypotheses. We use game theory to relate the abductive system to actions that produce new information. To enable evaluation of the implications of this approach we have implemented the procedures used to calculate the impact of new information in a computer model. Experiments with this model display a number of features of collective belief-revision leading to consensus-formation, (...) such as the influence of bias and prejudice. The scheme of inferential calculations invokes a Peircian concept of ‘belief’ as the propensity to choose a particular course of action. (shrink)

To develop a theoretical framework for drawing moral distinctions between instances of sexual misconduct, I defend the “Ameliorative View” of consent, according to which there are three possibilities for what effect, if any, consent has: “fully valid consent” eliminates a wronging, “fully invalid consent” has no normative effect, and “partially valid consent” has an ameliorative effect on a wronging in the respect that it makes the wronging less grave. I motivate the view by proposing a solution to the problem of (...) characterizing the moral effect of consent that is given in response to minor coercion. (shrink)

According to the “Textbook View,” there is an extensional dispute between consequentialists and deontologists, in virtue of the fact that only the latter defend “agent-relative” principles—principles that require an agent to have a special concern with making sure that she does not perform certain types of action. I argue that, contra the Textbook View, there are agent-neutral versions of deontology. I also argue that there need be no extensional disagreement between the deontologist and consequentialist, as characterized by the Textbook View.

In this essay, I discuss why consent is invalidated by duress that involves attaching penalties to someone's refusal to give consent. At the heart of my explanation is the Complaint Principle. This principle specifies that consent is defeasibly invalid when the consent results from someone conditionally imposing a penalty on the consent‐giver's refusal to give the consent, such that the consent‐giver has a legitimate complaint against this imposition focused on how it is affects their incentives for consenting. The Complaint Principle (...) says that this consent is defeasibly invalid to make room for the Authorization Principle, which allows sincere authorizations to constitute valid consent, even when these are issued by an agent acting under duress. The Authorization Principle has application only in cases of third‐party duress because when the consent‐receiver is the source of the duress, the consent‐giver is not sincerely authorizing the action. (shrink)

In the middle of the last century, it was common to explain the notion of necessity in linguistic terms. A necessary truth, it was said, is a sentence whose truth is guaranteed by linguistic rules. Quine famously argued that, on this view, de re modal claims do not make sense. “Porcupettes are porcupines” is necessarily true, but it would be a mistake to say of a particular porcupette that it is necessarily a porcupine, or that it is possibly purple. Linguistic (...) theories of necessity fell out of favour with the publication of Kripke’s Naming and Necessity, and Quine’s arguments were put aside. In her recent book, Norms and Necessity, Amie Thomasson presents her modal normativism, which is an updated version of the mid-century theories just described. Quine’s arguments are thus relevant once again. We recapitulate Quine’s central argument, in the context of modal normativism. We then criticise Amie Thomasson’s discussion of de re modality. We finish by briefly presenting an alternative account of de re modal statements, which is compatible with modal normativism. (shrink)