While Plantinga has famously argued that acceptance of neo-Darwinian theory commits one to the rejection of naturalism, Plantinga’s argument is vulnerable to an objection developed by Evan Fales. Not only does Fales’ objection undermine Plantinga’s original argument, it establishes a general challenge which any attempt to revitalize Plantinga’s argument must overcome. After briefly laying out the contours of this challenge, we attempt to meet it by arguing that because a purely naturalistic account of our etiology cannot explain the correlation between (...) our preference for simplicity and simplicity’s ability to serve as a veridical method of theory selection, the scientific realist is committed to the rejection of naturalism. (shrink)

The debate over risk-related standards of decisional capacity remains one of the most important and unresolved challenges to our understanding of the demands of informed consent. On one hand, risk-related standards benefit from significant intuitive support. On the other hand, risk-related standards appear to be committed to asymmetrical capacity—a conceptual incoherence. This latter objection can be avoided by holding that risk-related standards are the result of evidential considerations introduced by (i) the reasonable person standard and (ii) the standing assumption that (...) patients have capacity. This evidential approach to justifying risk-related standards of capacity avoids the most significant challenges faced by extant views while grounding risk-related standards in two fairly uncontroversial views in biomedical ethics. (shrink)

The traditional No-Miracles Argument (TNMA) asserts that the novel predictive success of science would be a miracle, and thus too implausible to believe, if successful theories were not at least approximately true. The TNMA has come under fire in multiple ways, challenging each of its premises and its general argumentative structure. While the TNMA relies on explaining novel predictive success via the truth of the theories, we put forth a deductive version of the No-Miracles argument (DNMA) that avoids inference to (...) the best explanation entirely. Instead, a relatively simple empirical framework and a probabilistic analysis can accomplish the ambitious goals of the TNMA while entirely sidestepping its problems. This close-but-distinct argument has many independent strengths and comparatively few weaknesses. Indeed, objections tailored specifically to the DNMA reveal surprising insights into how exactly NMAs are neither circular nor question-begging, as has been widely speculated. (shrink)

While copious quantities of ink have been spilled on the topic of autonomy in the context of health care, little has been written about autonomy in relation to intellectual disability. After presenting the received account of capacity, we argue that it cannot account for the moral permissibility of limiting an individual with intellectual disability’s access to diet soda. In cases of preventative medicine and intellectual disability, the philosophical motivation for the received account of capacity is incompatible with the actions it (...) recommends. We consider and reject several potential solutions; then, drawing on applied behavior analysis and the phenomenon of automatic reinforcement, we propose our own solution. The article concludes by considering the broader implications of our discussion. (shrink)

This paper focuses on a hypothetical case that represents an intervention request familiar to those who work with individuals with intellectual disability. Stacy has autism and moderate intellectual disability. Her parents have requested treatment for her hand flapping. Stacy is not competent to make her own treatment decisions; proxy consent is required. There are three primary justifications for proxy consent: the right to an open future, substituted judgment, and the best interest standard. The right to an open future justifies proxy (...) consent on the assumption of future autonomy whereas substituted judgment justifies proxy consent via reference to past autonomy. Neither applies. Stacy has not been, nor will she be, competent to make her own treatment decisions. The best interest standard justifies proxy consent on the grounds of beneficence. It is unlikely that hand flapping harms Stacy. None of the three primary means of justifying proxy consent apply to Stacy’s case. (shrink)

Explanation is the name for both the process we use to answer questions raised by observed ambiguities and for the conclusion we offer others. This divergence hints at the many conflicting approaches used to create our contemporary understanding of explanation. Modes of Explanation is the first book in decades to attempt to bring these conflicting approaches together and to offer a compelling narrative to explore how those conflicts can converge. In May 2013, fifty philosophers of science, cognitive scientists, systems scientists, (...) cyberneticists, semioticians, and humanities scholars gathered for three full days of debate. These scholars - including the contributors to this volume - compared insights into a variety of conceptions of explanation and their associated worldviews. Through examples such as the creationism/evolution debate, this volume illustrates the major issues regarding explanation through the dual lenses of scientific realism and pragmatic constructivism. Modes of Explanation is about how we make sense of, and create results in, our world. (shrink)

The recent success of Foldit in determining the structure of the Mason-Pfizer monkey virus (M-PMV) retroviral protease is suggestive of the power-solving potential of internet-facilitated game-like crowdsourcing. This research model is highly novel, however, and thus, deserves careful consideration of potential ethical issues. In this paper, we will demonstrate that the crowdsourcing model of research has the potential to cause harm to participants, manipulates the participant into continued participation, and uses participants as experimental subjects. We conclude that protocols relying on (...) this model require institutional review board (IRB) scrutiny. (shrink)

Though Black lives continue to be lost during encounters with law enforcement, we remain far from a policy solution. While leading presidential candidates fail to offer concrete proposals, the reco...

Respect for patients’ autonomy has taken a central place in the practice of medicine. Received wisdom holds that respect for autonomy allows overriding a patient’s treatment preferences only if the patient has been found to lack capacity. This understanding of respect for autonomy requires a dichotomous approach to assessing capacity, whereby a patient must be found either to have full capacity to make some particular treatment decision or must be found to lack capacity to make that decision. However, clinical reality (...) is more complicated, and, in borderline cases, different physicians may arrive at disparate judgments of capacity. In such cases, when capacity-determination protocols fail to achieve consensus, physicians would benefit from guidance regarding the clinical decision-making process necessary to elucidate the most ethically sound course of action. This article considers one such case and argues that, in a limited number of cases, respect for autonomy may require overriding a patient’s stated treatment preference when a capacity determination is equivocal, even though the patient has not clearly demonstrated a lack of capacity. (shrink)

In their recent article, Graber and Golemon (_Sophia_ 1–18, 2019 ) argue that any attempted evolutionary debunking of naturalism faces a dilemma. First, in order to be evolutionarily plausible, the skeptical implications must not be too broad. Second, in order to constitute a genuine challenge to scientific realism, the skeptical implications must not be too narrow. Graber and Golemon further develop an evolutionary debunking argument that avoids both horns of this dilemma. De Ray (_Erkenntnis_ 1–21, 2020 ) criticizes Graber and (...) Golemon’s debunking argument then develops his own, competing debunking argument. We first respond to de Ray’s criticisms by showing how Graber and Golemon’s argument can be extended so as to avoid de Ray’s critique. We then show that de Ray’s argument debunking argument is impaled by both horns of Graber and Golemon’s dilemma. The ultimate result will be both a better understanding of the desiderata and the argumentative contours of a successful evolutionary debunking argument. (shrink)

Accountable Care Organizations are a key mechanism of the Patient Protection and Affordable Care Act. ACOs will influence incentives for providers, who must understand these changes to make well-considered treatment decisions. Our paper defines an ethical framework for physician decisions and action within ACOs. Emerging ethical pressures providers will face as members of an ACO were classified under major headings representing three of the four principles of bioethics: autonomy, beneficence, and justice. Conflicts include a bias against transient populations, a motive (...) to undertreat conditions lacking performance measures, and the mandate to improve population health incentivizing life intrusions. After introducing and explaining each conflict, recommendations are offered for how providers ought to precede in the face of novel ethical choices. Our description of novel ethical choices will help providers know what to expect and our recommendations can guide providers in choosing well. (shrink)

In a recent article in this journal, Kowalik argues that compulsory vaccination unjustifiably infringes on the autonomy of vaccine refusers. While accepting Kowalik’s central premises, we argue that, when appropriately expanded in scope, autonomy considerations do not undermine the justifiability of compulsory vaccination. Vulnerable individuals—including the very old, the very young and those with compromised immune systems—face an omnipresent risk of contracting a potentially fatal vaccine-preventable illness and are thus prevented from accessing public goods by coercive pressure. Consequently, when we (...) consider an appropriately broad scope of autonomy constraints, autonomy considerations do not undermine the case for mandating vaccination. (shrink)

While cochlear implantation is now considered routine in many parts of the world, the debate over how to ethically implement this technology continues. One’s stance on implantation often hinges on one’s understanding of deafness. On one end of the spectrum are those who see cochlear implants as a much needed cure for an otherwise intractable disability. On the other end of the spectrum are those who view the Deaf as members of a thriving culture and see the cochlear implant as (...) an attempt to eliminate this culture. Rather than take a stance in this debate, we will argue that the informed consent process for cochlear implantation must include access to Deaf perspectives. Deaf individuals know best what it is like to be a member of the Deaf community; the reasonable person would put significant weight on the testimony of Deaf individuals when considering whether to undergo cochlear implantation. The reasonable person standard determines what information careproviders must present as part of the informed consent process; thus, informed consent for cochlear implantation requires access to the testimony of Deaf individuals. (shrink)

The aim of this dissertation is to show that, if one is committed to the scientific worldview, one is thereby committed to ethical non-naturalism. In the first chapter I offer the reader an outline of the three primary domains of ethical inquiry: normative ethics, applied ethics, and meta-ethics. I commit myself to a meta-ethical thesis--ethical non-naturalism--and contrast ethical non-naturalism with its competitors. In the second chapter I offer a cursory defense of the moral realist's semantic thesis. I offer reason to (...) think the realist has the correct semantic account and argue against the semantic accounts offered by the realist's primary opponents. In the third chapter of the dissertation I argue that commitment to the scientific worldview requires that one think that the methods of the sciences provide privileged access to facts about the external world and I offer a brief sketch of inference to the best explanation--the primary method I will employ in offering a defense of ethical non-naturalism. In the fourth chapter I develop a method for identifying non-natural properties. The method relies heavily on the predictive power that can be gained by the accurate application of predicates. In the fifth chapter I apply the method developed in the previous chapter. The results are mixed. The method fails to demonstrate that there are non-natural moral facts; however, it does demonstrate that there are non-natural normative facts. Using this result as a lemma, I identify a hypothesis--"[H]"--that, if true, would vindicate ethical non-naturalism. In the sixth chapter I rely on [H] to respond to evolutionary criticisms of ethical non-naturalism and argue that, if morality evolved, we have good reason to believe [H]. In the final chapter, I defend the view I have developed from objections arising from the existence of moral disagreement and I argue that [H] provides the best explanation of the existence of actual moral disagreement. (shrink)

The debate over the grounds of full moral status relies heavily on the “method of cases.” In the method of cases intuitions about particular cases are taken as evidence for philosophical theories. Much in the debate over the grounds of full moral status turns on our intuitions regarding the moral status of individuals with intellectual disability. This paper argues that the intuitions of those in close personal relationships with individuals with intellectual disability are more reliable than the intuitions of those (...) who lack such a relationship. When theorizing about full moral status, we should privilege the intuitions of those who have a close personal relationship with an individual with intellectual disability. (shrink)

Personal identity is critical to provider–patient interactions. Patients and doctors tend to self-select, ideally forming therapeutic units that maximise the patients' benefit. Recently, however, ‘reality’ has changed. The internet and virtual worlds such as Second Life allow models of identity and provider–patient interactions that go beyond the limits of mainstream personal identity. In this paper some of the ethical implications of virtual patient–provider interactions, especially those that have to do with personal identity, are explored.

In this paper I will argue that there is a bi-directional relationship between philosophy and meaning such that doing philosophy can change the meaning of terms. A rhetorically powerful work of philosophy that garners widespread interest has the potential to change how people use a predicate. This gives rise to three concerns. First, one’s conclusion can become right in virtue of one doing a particularly good job arguing for it. Second, it may be implausible to take philosophy to be a (...) primarily descriptive enterprise. Part of the job of the philosopher is to proselytize about the correct usage of a word. Lastly, and most worrisome of all, the age-old method of the dialectic, a centerpiece of the philosophical project for thousands of years, threatens to plunge a range of domains of philosophical discourse into incoherence. (shrink)

Frantic warnings about the threat the Internet poses to our privacy are now a dime-a-dozen. Though gallons of ink have been spilled on the topic, it has largely gone unanalyzed from the perspective...

In a methodological milieu characterized by efforts to bring the methods of philosophy closer to the methods of the sciences, one can find, with increasing regularity, meta-ethical arguments relying on scientific theory or data. The received view appears to be that, not only is it implausible to think that a scientific vindication of a non-mentalist moral semantics will be forthcoming but that evidence from a variety of sciences threatens to undermine non-mentalist views. My aim is to push back against this (...) apparent consensus. The well-established phenomenon whereby moral judgments influence our attributions of putatively purely descriptive properties has come to be known as the Knobe Effect. Joshua Knobe has attempted to explain this surprising phenomenon by arguing that our folk psychological judgments are partially constituted by moral judgments. Drawing on an argument originally offered by Moore, I argue that if some instantiation of Knobe’s explanatory strategy is accurate, we have good reason to believe that mentalist moral semantics are untenable. (shrink)

Though accountable care organizations are increasingly important to American healthcare, ethical inquiry into ACOs remains in its nascent stages. Several articles have raised the concern that ACOs have an incentive to avoid enrolling high-cost patients and, thereby, have an incentive to deny care to those who need it the most. This concern is borne out by the reports of consultants working with newly formed ACOs. This paper argues that, contra initial appearances, there is no financial incentive for ACOs to avoid (...) enrolling high-cost patients. (shrink)

Abstract Street has argued that the meta-ethical realist is faced with a dilemma. Either evolutionary forces have had a distorting influenced on our ability to track moral properties or evolutionary forces influenced our beliefs in the direction of tracking moral properties. Street argues that if the realist accepts the first horn of the dilemma, the realist must accept implausible skepticism regarding moral beliefs. If the realist accepts the second horn of the dilemma, the realist owes an explanation of the fitness (...) producing nature of moral beliefs. As Street establishes the dialectic, the anti-realist’s explanation is better. I will argue that Street’s first horn is question begging then I will grasp the second horn of the dilemma and argue that only the realist can explain the role of moral beliefs in our evolutionary history. My argument will take the form of a dilemma. For our evaluative judgments to be fitness conducive, they must be responsive to the right sort of external world properties. The non-reductive realist can provide such a set of properties. On the first horn of the dilemma, the anti-realist cannot. The realist, unlike the anti-realist, can explain why our evaluative judgments are fitness conducive. The realist has won the explanatory battle. On the second horn of the dilemma, the anti-realist can provide a set of non-normative external world properties that our evaluative attitudes are responsive to. In doing so, the anti-realist has provided the heretofore-missing component of the reductive realist’s project. Again, the realist has won. (shrink)