: Ulysses contracts have faced paternalism objections since they first were proposed. Since the contracts are designed to override a present request from a legally competent patient in favor of a past request made by that patient, enforcement of these contracts was argued to be unjustifiable strong paternalism. Recent legal developments and new theories of practical reasoning suggest that the discussion of Ulysses contracts should be revived. This paper argues that with a proper understanding of the future-directed planning embodied in (...) Ulysses contracts, the charge of strong paternalism can be answered, and the enforcement of some Ulysses contracts may be justified under the rubric of weak paternalism. (shrink)

In clinical mental health research with children, both child and parent are essential members of the research team. The 3 R's of parent/child team membership are respect, rapport, and recognition. Respect and recognition include fair reimbursement for time, expense, and inconvenience, but the most important compensation for many families is the appreciation of the other team members for their sacrifice and cooperation. Reimbursement, although honoring the principles of justice and respect for persons, raises difficult issues about appropriate amount, particularly in (...) research involving children. The 3 R's are supported by the investigator 5 A's: attitude, adaptability, availability, attachment, and appreciation. Although the principles seem clear in the abstract, implementation encounters many practical problems. Perhaps the most difficult of these is determining the appropriate amount of compensation that avoids undue inducement but not at the expense of the 3 R's and 5 A's. (shrink)

In this article, we develop a non-rights-based argument based on beneficence (i.e., the welfare of individuals and communities) and justice as the disposition to act justly to promote equity in health care resource allocation. To this end, we structured our analysis according to the following main sections. The first section examines the work of Amartya Sen and his equality of capabilities approach and outlines a framework of health care as a fundamental human need. In the subsequent section, we provide a (...) definition of health equity based on the moral imperative to guarantee that every individual ought to have the freedom to pursue health goals and well-being. In the later part of the article, we outline a non-right approach to health care based on three pillars: (1) human flourishing, (2) justice as a disposition not a process, and (3) solidarity. (shrink)

How research studies should use social media to recruit research participants is a timely question. Importantly, the question is how, not if, studies should use...

Deception, cheating, and loopholes within the IRB approval process have received significant attention in the past several years. Surveys of clinical researchers indicate common deception ranging from omitting information to outright lying, and controversy surrounding the FDA's decision not to ban “IRB shopping” (the practice of submitting protocols to multiple IRBs until one is found that will approve the protocol) has raised legitimate concerns about the integrity of the IRB process. While at first blush these practices seem to cast aspersions (...) on the integrity of clinical researchers, the moral issues raised go deeper than the ethics of cheating. To the extent that these practices are common, or represent an IRB system that places unreasonable burdens on those seeking IRB approval, we should consider whether non-compliance reflects problems of normative legitimacy for the IRB system itself. (shrink)

Deception, cheating, and loopholes within the IRB approval process have received significant attention in the past several years. Surveys of clinical researchers indicate common deception ranging from omitting information to outright lying, and controversy surrounding the FDA's decision not to ban “IRB shopping” has raised legitimate concerns about the integrity of the IRB process. One author has described a multicenter trial as being withdrawn from consideration at one institution when rejection was imminent, in order to avoid informing other IRBs reviewing (...) the protocol of the study's rejection. This practice and IRB shopping seem at odds with the spirit, if not the “letter,” of the regulations. While at first blush these practices seem to cast aspersions on the integrity of clinical researchers, the moral issues raised go deeper than the ethics of cheating. (shrink)

Community and patient stakeholder partners serve in many roles. One particularly important role of community and patient organizations and representatives is to serve as gatekeepers; in this role, they monitor, and in some cases even determine, what research does and does not get conducted with their communities. Such gatekeeping can prevent “helicopter” research and community research fatigue. Gatekeeping can also aid in identifying and mitigating harms that might occur not only to individual participants but to third parties (who do not (...) provide consent for participation) or to the community as a whole. Although individual informed consent and independent review both aim to protect against research risks, in research with identifiable communities these protections may be insufficient to protect from other types of harms. Given the gaps in protection, the gatekeeping role of community research partners is an important supplement to informed consent and independent IRB review, but it also raises its own set of ethical challenges. Here, we discuss the limitations of informed consent and independent review in research with identifiable communities, the benefits of gatekeeping for protecting third parties and groups, types of gatekeepers, and issues in the selection of gatekeepers. (shrink)

In this case, it is noted that while DNA testing and methylation are being studied as biomarkers for high-grade squamous intraepithelial lesions in the anal canal, their efficacy is no...

The American Journal of Bioethics, Volume 12, Issue 7, Page 53-54, July 2012.

This paper argues that it will be important for new genomic technologies to recognize the limits of traditional approaches to informed consent, so that other-regarding implications of genomic information can be properly contextualized and individual rights respected. Respect for individual autonomy will increasingly require dynamic consideration of the interrelated dimensions of individual and broader community interests, so that the interests of one do not undermine fundamental interests of the other. In this, protection of individual rights will be a complex interplay (...) between individual and community concerns. (shrink)

This volume concerns the status and ambitions of metaphysics as a discipline.

In his postapocalyptic novel, Those Who Remain, G. Michael Hopf (2016) makes an important observation about the effect crises can have on human psychology by noting that "hard times create strong [humans]" (loc. 200). While the catastrophic effects of the recent COVID-19 outbreak are incontestable, there are arguments to be made that the situation itself could be materia prima of a more grounded, and authentic generation of humanity, at least in theory. In this article I draw on Heidegger's early, implicit (...) ethic of finitude as well as his later work surrounding the nature of technology, and place them into dialogue with a global milieu contextualized by worldwide pandemic. I approach this discussion from two different angles: in the first part, I explicate the ethic of finitude, and use it as a framework to describe the observable behavior of communities worldwide in order to better understand how global crises impact the psychical welfare of individual human beings. In the second part, I apply lessons given to us by the later Heidegger, specifically those oriented around the movement away from calculative thinking, in an effort to define a loose, albeit fundamentally ennobling prescriptive aimed at easing the existential strain of the situation we have found ourselves in. *This is a pre-print of an article published in Human Arenas. The final authenticated version is available at DOI: 10.1007/s42087-020-00142-6. (shrink)

Ryan Wasserman explores a range of fascinating puzzles raised by the possibility of time travel, with entertaining examples from physics, science fiction, and popular culture, and he draws out their implications for our understanding of time, tense, freedom, fatalism, causation, counterfactuals, laws of nature, persistence, change, and mereology.

This book is the first comprehensive study of Schopenhauer's philosophy of religion. It develops a contextual account of Schopenhauer's relation to the religions of India by placing his interpretation of their main doctrines within the perspective of his diagnosis of the religious situation in nineteenth-century Europe, and his revised conception of the proper content and methods of metaphysical philosophy in the wake of Kant. It shows that Schopenhauer's encounter with the religions of India was the stimulus for his formulation of (...) a novel theory of a revitalised modern Christianity. The possibility of an oriental renaissance prompted Schopenhauer to argue that Christianity's immanent or ethical teachings needed to be severed from its supernatural or metaphysical doctrines, so that European culture could continue to satisfy the human need for a metaphysical interpretation of the world and life. This book will be of interest to philosophers, theologians, students of religion and modern intellectual history. (shrink)

AI and people do not compete on a level-playing field. Self-driving vehicles may be safer than human drivers, but laws often penalize such technology. People may provide superior customer service, but businesses are automating to reduce their taxes. AI may innovate more effectively, but an antiquated legal framework constrains inventive AI. In The Reasonable Robot, Ryan Abbott argues that the law should not discriminate between AI and human behavior and proposes a new legal principle that will ultimately improve human (...) well-being. This work should be read by anyone interested in the rapidly evolving relationship between AI and the law. (shrink)

When are morally good actions beautiful, when indeed they are? In this paper, it is argued that morally good actions are beautiful when they appear to express the deep or true self, and in turn tend to give rise to an emotion which is characterised by feelings of being moved, unity, inspiration, and meaningfulness, inter alia. In advancing the case for this claim, it is revealed that there are additional sources of well-formedness in play in the context of moral beauty (...) in addition to those that have tended to be focused on to date: one which is connected to imagining a deep location for the goodness concerned, and another which is connected to imagining that the goodness stems from capacities which are essential to the person. (shrink)

What is the nature of the concept BEAUTY? Does it differ fundamentally from nearby concepts such as PRETTINESS? It is argued that BEAUTY, but not PRETTINESS, is a dual-character concept. Across a number of contexts, it is proposed that BEAUTY has a descriptive sense that is characterised by, inter alia, having intrinsically pleasing appearances; and a normative sense associated with deeply-held values. This account is supported across two, pre-registered, studies (N=500), and by drawing on analysis of corpus data. It is (...) suggested that this can help to explain why beauty, unlike prettiness, is thought to be deep in both the sense of being important, and in the sense of being less closely tied to sensory surfaces. (shrink)

According to the most important objection to the existence of moral beauty, true judgements of moral beauty are not possible as moral judgements require being motivated to act in line with the moral judgement made, and judgements of beauty require not being motivated to act in any way. Here, I clarify the argument underlying the objection, and show that it does not show that moral beauty does not exist. I present two responses: namely, that the beauty of moral beauty does (...) not lie in the moral goodness per se (the “adjacent properties” response); and that only a dispositional motivation to act is required for the moral judgements that are typically made as part of judgements of moral beauty, whereas aesthetic judgements only rule out state motivations to act (the “equivocation of motivation required” response). In addressing the objection, I show how moral beauty is consistent with disinterestedness, and so should be accepted more widely; and also clarify where the beauty in moral beauty resides, and how the moral-aesthetic distinction should be drawn. (shrink)

Very diverse societies pose real problems for Rawlsian models of public reason. This is for two reasons: first, public reason is unable accommodate diverse perspectives in determining a regulative ideal. Second, regulative ideals are unable to respond to social change. While models based on public reason focus on the justification of principles, this book suggests that we need to orient our normative theories more toward discovery and experimentation. The book develops a unique approach to social contract theory that focuses on (...) diverse perspectives. It offers a new moral stance that author Ryan Muldoon calls, "The View From Everywhere," which allows for substantive, fundamental moral disagreement. This stance is used to develop a bargaining model in which agents can cooperate despite seeing different perspectives. Rather than arguing for an ideal contract or particular principles of justice, Muldoon outlines a procedure for iterated revisions to the rules of a social contract. It expands Mill's conception of experiments in living to help form a foundational principle for social contract theory. By embracing this kind of experimentation, we move away from a conception of justice as an end state, and toward a conception of justice as a trajectory. (shrink)

Why are moral actions beautiful, when indeed they are? This paper assesses the view, found most notably in Schiller, that moral actions are beautiful just when they present the appearance of freedom by appearing to be the result of internal harmony (the Schillerian Internal Harmony Thesis). I argue that while this thesis can accommodate some of the beauty involved in contrasts of the ‘continent’ and the ‘fully’ virtuous, it cannot account for all of the beauty in such contrasts, and so (...) needs to be weakened considerably (to the Internal Harmony Thesis). To account for the remaining beauty that cannot be fully accommodated even by this revised thesis, as well as the beauty contained in contrasts that involve agents who experience internal conflict as a result of being sensitive to different sources of moral value to an appropriate extent, a number of further theses need to be posited: namely, that the beauty of some moral actions is to be accommodated in terms of internal disharmony (the Internal Disharmony Thesis), and in terms of a felt harmony between the appreciator of the action and the executor of the action (the Affective Harmony Thesis). As such, in contrast to Schiller, I suggest that we need to take a pluralist and context-sensitive approach to accommodating the beauty of moral actions. (shrink)

This book explores the constraints which justice imposes on immigration policy. Like liberal nationalists, Ryan Pevnick argues that citizens have special claims to the institutions of their states. However, the source of these special claims is located in the citizenry's ownership of state institutions rather than in a shared national identity. Citizens contribute to the construction and maintenance of institutions, and as a result they have special claims to these institutions and a limited right to exclude outsiders. Pevnick shows (...) that the resulting view justifies a set of policies - including support for certain types of guest worker programs - which is distinct from those supported by either liberal nationalists or advocates of open borders. His book provides a framework for considering a number of connected topics including issues related to self-determination, the scope of distributive justice and the significance of shared national identity. (shrink)

In The Conditions for Ethical Chemical Restraint, Crutchfield and Redinger (2024) propose ethical standards for the use of chemical restraints, which they consider normatively distinct from physica...

Coronavirus disease 2019 can lead to respiratory failure. Some patients require extracorporeal membrane oxygenation support. During the current pandemic, health care resources in some cities have been overwhelmed, and doctors have faced complex decisions about resource allocation. We present a case in which a pediatric hospital caring for both children and adults seeks to establish guidelines for the use of extracorporeal membrane oxygenation if there are not enough resources to treat every patient. Experts in critical care, end-of-life care, bioethics, and (...) health policy discuss if age should guide rationing decisions. (shrink)

Most accounts of cognitive scaffolding focus on ways that external structure can support or augment an agent’s cognitive capacities. We call cases where the interests of the user are served benign scaffolding and argue for the possibility and reality of hostile scaffolding. This is scaffolding which depends on the same capacities of an agent to make cognitive use of external structure as in benign cases, but that undermines or exploits the user while serving the interests of another agent. We develop (...) criteria for scaffolding being hostile and show by reference to examples including the design features of electronic gambling machines and casino management systems that hostile scaffolding exists and can be highly effective. In cases where the scaffolding is deep and permits the offloading of significant cognitive work, hostile scaffolding exploitatively manipulates cognitive processing itself. Given the extent of human reliance on scaffolding this is an important and neglected vulnerability. [This is an updated version of the paper, added in February 2023.]. (shrink)

In this article, I examine A. John Simmons’s philosophical anarchism, and specifically, the problems that result from the combination of its three foundational principles: the strong correlativity of legitimacy rights and political obligations; the strict distinction between justified existence and legitimate authority; and the doctrine of personal consent, more precisely, its supporting assumptions about the natural freedom of individuals and the non-natural states into which individuals are born. As I argue, these assumptions, when combined with the strong correlativity and strict (...) distinction theses, undermine Simmons’s claim, which is central to his philosophical anarchism, that a state may be justified in enforcing the law, even if illegitimate or unjustified in existing. (shrink)

In epistemology and the philosophy of science, there has been an increasing interest in the social aspects of belief acquisition. In particular, there has been a focus on the division of cognitive labor in science. This essay explores several different models of the division of cognitive labor, with particular focus on Kitcher, Strevens, Weisberg and Muldoon, and Zollman. The essay then shows how many of the benefits of the division of cognitive labor flow from leveraging agent diversity. The essay concludes (...) by examining the benefits and burdens of diversity, particularly in the evaluative diversity that can be found in interdisicplinary science. (shrink)

In recent years the doctrine of divine simplicity has become a topic of interest in the philosophical theological community. In particular, the modal collapse argument against divine simplicity has garnered various responses from proponents of divine simplicity. Some even claiming that the modal collapse argument is invalid. It is our contention that these responses have either misunderstood or misstated the argument, and have thus missed the force of the objection. Our main aim is to clarify what the modal collapse argument (...) in fact says, and explain why the recent responses do not succeed. In order to argue our case, we will proceed in several steps. First, we aim to systematically articulate the doctrine of divine simplicity. Second, articulate the Christian conviction that God is free to create any feasible world or no world at all. Third, argue that divine simplicity suffers a modal collapse and thus undermines God's freedom. Fourth, respond to potential objections to modal collapse. Fifth, we offer some concluding remarks. (shrink)

In this paper we argue that there is a kind of moral disagreement that survives the Rawlsian veil of ignorance. While a veil of ignorance eliminates sources of disagreement stemming from self-interest, it does not do anything to eliminate deeper sources of disagreement. These disagreements not only persist, but transform their structure once behind the veil of ignorance. We consider formal frameworks for exploring these differences in structure between interested and disinterested disagreement, and argue that consensus models offer us a (...) solution concept for disagreements behind the veil of ignorance. (shrink)

The problem : commerce and corruption -- Smith's defense of commercial society -- What is corruption? : political and psychological perspectives -- Smith on corruption : from the citizen to the human being -- The solution : moral philosophy -- Liberal individualism and virtue ethics -- Social science vs. moral philosophy -- Types of moral philosophy : natural jurisprudence vs. ethics -- Types of ethics : utilitarianism, deontology, and virtue ethics -- Virtue ethics : modern, ancient, and Smithean -- Interlude (...) : the what and the how of TMS VI -- The what : Sith's "practical system of morality" -- The how : rhetoric, audience, and the methods of practical ethics -- The how : the ascent of self-love in three stages -- Prudence or commercial virtue -- The challenge : from praise to prudence -- Educating the vain : fathers and sons -- Self-interest rightly understood -- The advantages and disadvantages of prudence -- Magnanimity or classical virtue -- The problems of prudence and the therapy of magnanimity -- Up from individualism : desert, praiseworthiness, conscience -- Modernity, antiquity, and magnanimity -- The dangers of magnanimity -- Beneficence or christian virtue -- Between care and caritas -- Benevolence and beneficence and the human telos -- The character and purposes of the wise and virtuous man -- Wisdom and virtue and Adam Smith's apology -- Epilogue: The "economy of greatness". (shrink)

This essay explores the relation between democracy and social equality. It critically evaluates the relational egalitarian view that democracy is necessary for full social equality and that democracy is an important constituent of social equality. On such a view, inequalities in power an de facto authority are taken, in certain circumstances, to constitute a form of social inequality. On the basis of a series of cases, I argue that such a view is mistaken, and that political inequalities are, at best, (...) empirically and contingently related to social inequality. I argue that what is primarily wrong with inequalities in power and de facto authority is not that, in certain circumstances, they constitute a form of social inequality, but rather that they can be used to extract greater consideration for those with greater power. (shrink)

[To readers: Please consider visiting the journal's website to read this work.] In spite of referring to the human tendency to "breath together" or share the same spirit, the word "conspire" has developed a negative connotation in contemporary society, specifically as it pertains to theorizing about conspiracies as a result of the human proclivity to recognize patterns recognition and coalesce common themes amongst those with shared perceptions into something resembling a unified narrative. This proclivity has only become more pronounced with (...) the dawn of the Internet age, and as a result, the tendency to assume the actuality of certain conspiracies and insulate ourselves from viable, competing ideas has led to a series of microenvironments not dissimilar from those that allow for the proliferation of cancerous cells in the human body. In this article, I draw out the analogy between cancer and conspiracy theorizing in order to present readers with a clearer picture of the deleterious effects of the contemporary phenomena such as unbridled political polarization and the effect of sociopolitical news coverage presented by low-correlation outlets, otherwise known as "echo chambers.". (shrink)

This paper focuses on a recently articulated, emergentist conception of ethical naturalism and its commitment to causal efficacy, or the idea that moral properties have causal powers, along with its supporting commitment to moral causation. After I reconstruct the theory, I explain how it offers some interesting theoretical benefits to moral realists in virtue of its commitment to causal efficacy. Then, after locating some examples of moral causation in support of this commitment, I present and respond to five objections to (...) such causation, which all threaten to undermine this support. Lastly, I consider a very serious problem that the theory faces in virtue of positing emergent moral properties as responsible for moral causation – namely, the problem of downward moral causation. I describe this problem in detail and argue that, as it stands, it does not spell doom for the theory. (shrink)

Deep brain stimulation is an experimental procedure for treatment-resistant depression. Some results show promise, but blinded trials had limited success. Ethical questions center on vulnerability: especially on whether depressed patients can weigh the risks and benefits effectively, whether depression causes “desperation,” and whether media portrayals create unrealistic hopes. We interviewed 24 psychiatric inpatients with treatment-resistant depression, qualitatively analyzing their comments. Most had minimal interest in deep brain stimulators. Some might consider them if their depression worsened, if alternatives were exhausted, or (...) if the evidence were stronger. Fears focused on the surgery, adverse effects, and the novelty of the device. Patients felt the depression interfered with their ability to weigh the risks and benefits. Patients seemed highly attuned to the risks, and were skeptical that the treatment would be effective. We conclude that ethical concerns about vulnerability remain, yet patients with treatment-resistant depression were thoughtful and cautious about trying a novel therapy. (shrink)

DNA sequencers, Twitter, MRIs, Facebook, particle accelerators, Google Books, radio telescopes, Tumblr: what do these things have in common? According to the evangelists of “data science,” all of these are instruments for observing reality at unprecedentedly large scales and fine granularities. This perspective ignores the social reality of these very different technological systems, ignoring how they are made, how they work, and what they mean in favor of an exclusive focus on what they generate: Big Data. But no data, big (...) or small, can be interpreted without an understanding of the process that generated them. Statistical data science is applicable to systems that have been designed as scientific instruments, but is likely to lead to confusion when applied to systems that have not. In those cases, a historical inquiry is preferable. (shrink)

Does the formation of delusions involve abnormal reasoning? According to the prominent ‘two-factor’ theory of delusions (e.g. Coltheart, 2007), the answer is yes. The second factor in this theory is supposed to affect a deluded individual's ability to evaluate candidates for belief. However, most published accounts of the two-factor theory have not said much about the nature of this second factor. In an effort to remedy this shortcoming, Coltheart, Menzies and Sutton (2010) recently put forward a Bayesian account of inference (...) in delusions. I outline some criticisms of this important account, and sketch an alternative account of delusional inference that, I argue, avoids these criticisms. Specifically, I argue that the second factor in delusion formation involves a systematic deviation from Bayesian updating, a deviation that may be characterized as a bias towards ‘explanatory adequacy’. I present a numerical model of this idea and show that my alternative account is broadly consistent with prominent prediction error models of delusion formation (e.g. Corlett, Murray et al., 2007). (shrink)

What role should the physician's conscience play in the practice of medicine? Much controversy has surrounded the question, yet little attention has been paid to the possibility that disputants are operating with contrasting definitions of the conscience. To illustrate this divergence, we contrast definitions stemming from Abrahamic religions and those stemming from secular moral tradition. Clear differences emerge regarding what the term conscience conveys, how the conscience should be informed, and what the consequences are for violating one's conscience. Importantly, these (...) basic disagreements underlie current controversies regarding the role of the clinician's conscience in the practice of medicine. Consequently participants in ongoing debates would do well to specify their definitions of the conscience and the reasons for and implications of those definitions. This specification would allow participants to advance a more philosophically and theologically robust conversation about the means and ends of medicine. (shrink)