Deep brain stimulation has been of considerable interest to bioethicists, in large part because of the effects that the intervention can occasionally have on central features of the recipient’s personality. These effects raise questions regarding the philosophical concept of authenticity. In this article, we expand on our earlier work on the concept of authenticity in the context of deep brain stimulation by developing a diachronic, value-based account of authenticity. Our account draws on both existentialist and essentialist approaches to authenticity, and (...) Laura Waddell Ekstrom’s coherentist approach to personal autonomy. In developing our account, we respond to Sven Nyholm and Elizabeth O’Neill’s synchronic approach to authenticity, and explain how the diachronic approach we defend can have practical utility, contrary to Alexandre Erler and Tony Hope’s criticism of autonomy-based approaches to authenticity. Having drawn a distinction between the authenticity of an individual’s traits and the authenticity of that person’s values, we consider how our conception of authenticity applies to the context of anorexia nervosa in comparison to other prominent accounts of authenticity. We conclude with some reflections on the prudential value of authenticity, and by highlighting how the language of authenticity can be invoked to justify covert forms of paternalism that run contrary to the value of individuality that seems to be at the heart of authenticity. (shrink)

“Bioconservatives” in the human enhancement debate endorse the conservative claim that we should reject the use of biotechnologies that enhance natural human capacities. However, they often ground their objections to enhancement with contestable claims about human nature that are also in tension with other common tenets of conservatism. We argue that bioconservatives could raise a more plausible objection to enhancement by invoking a strain of conservative thought developed by G.A. Cohen. Although Cohen’s conservatism is not sufficient to fully revive the (...) bioconservative objection, we argue that it can be supplemented by an account of reasonable partiality for humanity in a way that provides further support to the bioconservative position in a manner congruous with broader conservatism. We propose that the idea of partiality to humanity can buttress the bioconservative objection into its strongest possible form. However, we conclude by arguing that, even in this form, the objection cannot do all the work that bioconservatives expect of it. (shrink)

An abundance of data unequivocally shows that exercise can be an effective tool in the fight against obesity and its associated co-morbidities. Indeed, physical activity can be more effective than widely-used pharmaceutical interventions. Whilst metformin reduces the incidence of diabetes by 31% (as compared with a placebo) in both men and women across different racial and ethnic groups, lifestyle intervention (including exercise) reduces the incidence by 58%. In this context, it is notable that a group of prominent medics and exercise (...) scientists recently sent a well-publicised letter to the General Medical Council and Medical Schools Council calling for the introduction of evidence-based lifestyle education into all medical curricula. The letter warns that there is a lack of understanding of the impact that exercise and nutrition can have on physical health amongst doctors. In the absence of an educational overhaul, the signatories warn that the government is likely to fail to reach its goal of preventing tens of thousands of premature deaths from heart disease and cancer by 2020. Whilst we agree with the need to address this apparent lack of understanding, we argue that the ethical justification of doing so is not limited to this broadly beneficence-based justification. There is also a justification grounded in the duty of non-maleficence, that is, the duty to avoid unreasonably harming patients. This duty requires that doctors refrain from (i) preventing patients from undergoing beneficial treatment without good reason, (ii) exposing patients to unreasonable risks and (iii) reducing the therapeutic effect of an effective medical intervention. This requires an understanding of the physical impact of exercise. (shrink)

Jurgen Habermas has argued that carrying out pre-natal germline enhancements would be inimical to the future child's autonomy. In this article, I suggest that many of the objections that have been made against Habermas' arguments by liberals in the enhancement debate misconstrue his claims. To explain why, I begin by explaining how Habermas' view of personal autonomy confers particular importance to the agent's embodiment and social environment. In view of this, I explain that it is possible to draw two arguments (...) against germline enhancements from Habermas' thought. I call these arguments ‘the argument from negative freedom’ and ‘the argument from natality’. Although I argue that many of the common liberal objections to Habermas are not applicable when his arguments are properly understood, I go on to suggest ways in which supporters of enhancement might appropriately respond to Habermas' arguments. (shrink)

In many jurisdictions, an offender’s remorse is considered to be a relevant factor to take into account in mitigation at sentencing. The growing philosophical interest in the use of neurointerventions in criminal justice raises an important question about such remorse-based mitigation: to what extent should technologically facilitated remorse be honoured such that it is permitted the same penal significance as standard instances of remorse? To motivate this question, we begin by sketching a tripartite account of remorse that distinguishes cognitive, affective (...) and motivational elements of remorse. We then describe a number of neurointerventions that might plausibly be used to enhance abilities that are relevant to these different elements of remorse. Having described what we term the ‘moral value’ view of the justification of remorse-based mitigation, we then consider whether using neurointerventions to facilitate remorse would undermine its moral value, and thus make it inappropriate to honour such remorse in the criminal justice system. We respond to this question by claiming that the form of moral understanding that is incorporated into a genuinely remorseful response grounds remorse’s moral value. In view of this claim, we conclude by arguing that neurointerventions need not undermine remorse’s moral value on this approach, and that the remorse that such interventions might facilitate could also be authentic to the recipient of the neurointerventions that we discuss. (shrink)

A prominent objection to non-cognitive moral bio-enhancements is that they would compromise the recipient’s ‘freedom to fall’. I begin by discussing some ambiguities in this objection, before outlining an Aristotelian reading of it. I suggest that this reading may help to forestall Persson and Savulescu’s ‘God-Machine’ criticism; however, I suggest that the objection still faces the problem of explaining why the value of moral conformity is insufficient to outweigh the value of the freedom to fall itself. I also question whether (...) the objection is compatible with Neil Levy’s parity principle. Accordingly, I go on to consider an alternative relational freedom-based objection to NCMBEs that aims to explain the fundamental moral importance of the freedom that NCMBEs would violate. I argue that although this strategy might allow the critic of NCMBEs to bypass a powerful criticism of Harris’ objection, it also weakens the freedom-based objection’s compatibility with the parity principle. (shrink)

A central tenet of medical ethics holds that it is permissible to perform a medical intervention on a competent individual only if that individual has given informed consent to the intervention. However, in some circumstances it is tempting to say that the moral reason to obtain informed consent prior to administering a medical intervention is outweighed. For example, if an individual’s refusal to undergo a medical intervention would lead to the transmission of a dangerous infectious disease to other members of (...) the community, one might claim that it would be morally permissible to administer the intervention even in the absence of consent. Indeed, as we shall discuss below, there are a number of examples of public health authorities implementing compulsory or coercive measures for the purposes of infectious disease control (IDC). The plausibility of the thought that non-consensual medical interventions might be justified when performed for the purpose of IDC raises the question of whether such interventions might permissibly be used to realize other public goods. In this article we focus on one possibility: whether it could be permissible to non-consensually impose certain interventions that alter brain states or processes through chemical or physical means on serious criminal offenders. We shall suggest that some such interventions might be permissible if they safely and effectively serve to facilitate the offender’s rehabilitation and thereby prevent criminal recidivism. (shrink)

According to a number of influential views in penal theory, 1 one of the primary goals of the criminal justice system is to rehabilitate offenders. Rehabilitativemeasures are commonly included as a part of a criminal sentence. For example, in some jurisdictions judges may order violent offenders to attend anger management classes or to undergo cognitive behavioural therapy as a part of their sentences. In a limited number of cases, neurointerventions — interventions that exert a direct biological effect on the brain (...) — have been used as aids to rehabilitation, typically being imposed as part of criminal sentences, separate treatment orders, or conditions of parole. Examples of such interventions include medications intended to attenuate addictive desires in substance-abusing offenders and agents intended to suppress libido in sex offenders.This chapter reviews some of the ethical issues raised by the use of neurointerventions as aids to rehabilitation. (shrink)

Mosquito-borne diseases represent a significant global disease burden, and recent outbreaks of such diseases have led to calls to reduce mosquito populations. Furthermore, advances in ‘gene-drive’ technology have raised the prospect of eradicating certain species of mosquito via genetic modification. This technology has attracted a great deal of media attention, and the idea of using gene-drive technology to eradicate mosquitoes has been met with criticism in the public domain. In this paper, I shall dispel two moral objections that have been (...) raised in the public domain against the use of gene-drive technologies to eradicate mosquitoes. The first objection invokes the concept of the ‘sanctity of life’ in order to claim that we should not drive an animal to extinction. In response, I follow Peter Singer in raising doubts about general appeals to the sanctity of life, and argue that neither individual mosquitoes nor mosquitoes species considered holistically are appropriately described as bearing a significant degree of moral status. The second objection claims that seeking to eradicate mosquitoes amounts to displaying unacceptable degrees of hubris. Although I argue that this objection also fails, I conclude by claiming that it raises the important point that we need to acquire more empirical data about, inter alia, the likely effects of mosquito eradication on the ecosystem, and the likelihood of gene-drive technology successfully eradicating the intended mosquito species, in order to adequately inform our moral analysis of gene-drive technologies in this context. (shrink)

According to what Douglas calls ‘the consent requirement’, neuro-correctives can only permissibly be provided with the valid consent of the offender who will undergo the intervention. Some of those who endorse the consent requirement have claimed that even though the requirement prohibits the imposition of mandatory neurocorrectives on criminal offenders, it may yet be permissible to offer offenders the opportunity to consent to undergoing such an intervention, in return for a reduction to their penal sentence. I call this the neurocorrective (...) offer. In this chapter I consider the coercion-based objection to the neurocorrective offer, which claims that offenders cannot provide valid consent to undergoing a neurocorrective on the basis of this offer because it is inherently coercive. Having outlined early formulations of this argument, I point out that there are in fact two different versions of this objection, which appeal to different understandings of the concepts of coercion, consent and voluntariness. (shrink)

In the first wave of the COVID-19 pandemic, healthcare workers in some countries were forced to make distressing triaging decisions about which individual patients should receive potentially life-saving treatment. Much of the ethical discussion prompted by the pandemic has concerned which moral principles should ground our response to these individual triage questions. In this paper we aim to broaden the scope of this discussion by considering the ethics of broader structural allocation decisions raised by the COVID-19 pandemic. More specifically, we (...) consider how nations ought to distribute a scarce life-saving resource across healthcare regions in a public health emergency, particularly in view of regional differences in projected need and existing capacity. We call this the regional triage question. Using the case study of ventilators in the COVID-19 pandemic, we show how the moral frameworks that we might adopt in response to individual triage decisions do not translate straightforwardly to this regional-level triage question. Having outlined what we take to be a plausible egalitarian approach to the regional triage question, we go on to propose a novel way of operationalising the ‘save the most lives’ principle in this context. We claim that the latter principle ought to take some precedence in the regional triage question, but also note important limitations to the extent of the influence that it should have in regional allocation decisions. (shrink)

In an intriguing essay, G. A. Cohen has defended a conservative bias in favour of existing value. In this paper, we consider whether Cohen’s conservatism raises a new challenge to the use of human enhancement technologies. We develop some of Cohen’s suggestive remarks into a new line of argument against human enhancement that, we believe, is in several ways superior to existing objections. However, we shall argue that on closer inspection, Cohen’s conservatism fails to offer grounds for a strong sweeping (...) objection to enhancement, and may even offer positive support for forms of enhancement that preserve valuable features of human beings. Nevertheless, we concede that Cohen’s arguments may suggest some plausible and important constraints on the modality of legitimate and desirable enhancements. (shrink)

Deep Brain Stimulation is currently being investigated as an experimental treatment for patients suffering from treatment-refractory AN, with an increasing number of case reports and small-scale trials published. Although still at an exploratory and experimental stage, initial results have been promising. Despite the risks associated with an invasive neurosurgical procedure and the long-term implantation of a foreign body, DBS has a number of advantageous features for patients with SE-AN. Stimulation can be fine-tuned to the specific needs of the particular patient, (...) is relatively reversible, and the technique also allows for the crucial issue of investigating and comparing the effects of different neural targets. However, at a time when DBS is emerging as a promising investigational treatment modality for AN, lesioning procedures in psychiatry are having a renaissance. Of concern it has been argued that the two kinds of interventions should instead be understood as rivaling, yet “mutually enriching paradigms” despite the fact that lesioning the brain is irreversible and there is no evidence base for an effective target in AN. We argue that lesioning procedures in AN are unethical at this stage of knowledge and seriously problematic for this patient group, for whom self-control is particularly central to wellbeing. They pose a greater risk of major harms that cannot justify ethical equipoise, despite the apparent superiority in reduced short term surgical harms and lower cost. (shrink)

In this paper, I argue that deceptive placebo use can be morally permissible, on the grounds that the deception involved in the prescription of deceptive placebos can differ in kind to the sorts of deception that undermine personal autonomy. In order to argue this, I shall first delineate two accounts of why deception is inimical to autonomy. On these accounts, deception is understood to be inimical to the deceived agent’s autonomy because it either involves subjugating the deceived agent’s will to (...) another’s authority or because it precludes the agent from acting effectively in pursuit of their ends. I shall argue that providing an agent with false beliefs is not inimical to their autonomy if they are only able to effectively pursue their autonomously chosen ends by virtue of holding those particular false beliefs. Finally, I show that deceptive placebo use need only involve this latter sort of deception. (shrink)

Under the current Mental Health Act of England and Wales, it is lawful to perform deep brain stimulation in the absence of consent and independent approval. We argue against the Care Quality Commission's preferred strategy of addressing this problematic issue, and offer recommendations for deep brain stimulation-specific provisions in a revised Mental Health Act.

Would compulsory treatment or vaccination for Covid-19 be justified? In England, there would be significant legal barriers to it. However, we offer a conditional ethical argument in favour of allowing compulsory treatment and vaccination, drawing on an ethical comparison with external constraints—such as quarantine, isolation and ‘lockdown’—that have already been authorised to control the pandemic. We argue that, if the permissive English approach to external constraints for Covid-19 has been justified, then there is a case for a similarly permissive approach (...) to compulsory medical interventions. (shrink)

In response to the COVID‐19 pandemic philosophers and governments have proposed scarce resource allocation guidelines. Their purpose is to advise healthcare professionals on how to ethically allocate scarce medical resources. One challenging feature of the pandemic has been the large numbers of patients needing mechanical ventilatory support. Guidelines have paradigmatically focused on the question of what doctors should do if they have fewer ventilators than patients who need respiratory support: which patient should get the ventilator? There is, however, an important (...) higher level allocation problem. Namely, how are we to ethically distribute newly obtained ventilators across hospitals: which hospital should get the ventilator(s)? In this paper, we identify a set of principles for allocating newly obtained ventilators across hospitals. We focus particularly on low and middle income countries, who frequently have limited pre‐existing intensive care capacity, and have needed to source additional ventilators. We first provide some background. Second, we argue that the main population healthcare aim during the COVID‐19 pandemic should be to save the most lives. Next, we assess a series of potential heuristics or principles that could be used to guide allocation: allocation to the most densely populated cities, random allocation, allocation based on the ratio of patients to ICU personnel, prioritisation in terms of intrahospital mortality, prioritisation of younger populations, and prioritisation in terms of population mortality. We conclude by providing a plausible ranking of the principles, while noting a number of epistemological challenges, in terms of how they best further the aim of increasing the probability of saving the most lives. (shrink)

Violence risk assessment tools are increasingly used within criminal justice and forensic psychiatry, however there is little relevant, reliable and unbiased data regarding their predictive accuracy. We argue that such data are needed to (i) prevent excessive reliance on risk assessment scores, (ii) allow matching of different risk assessment tools to different contexts of application, (iii) protect against problematic forms of discrimination and stigmatisation, and (iv) ensure that contentious demographic variables are not prematurely removed from risk assessment tools.

Methadone maintenance therapy is a cost-effective, evidence-based treatment for heroin dependence. In the USA, a majority of heroin-dependent offenders are forced to detox from methadone when incarcerated. Recent research published in The Lancet has demonstrated the negative health and economic outcomes associated with such policies. Methadone Continuation Versus Forced Withdrawal on Incarceration in a Combined US Prison and Jail: A Randomised, Open Label Trial. The Lancet, 386, 350–359). This novel evidence raises questions as to the justification for current policies of (...) forced detox in American prisons. Opponents of methadone provision in prisons might offer arguments from retributivism, resource allocation and curative effectiveness to justify their position. This article contends that these arguments do not stand up to ethical scrutiny. In light of this, we hold that American policymakers should reform criminal justice policies to allow the initiation and continuation of methadone treatment in correctional settings. This would be consistent with both international recommendations and the example set by a number of other Western countries. (shrink)

In this paper, we engage in dialogue with Jonathan Pugh, Hannah Maslen, and Julian Savulescu about how to best interpret the potential impacts of deep brain stimulation on the self. We consider whether ordinary people’s convictions about the true self should be interpreted in essentialist or existentialist ways. Like Pugh et al., we argue that it is useful to understand the notion of the true self as having both essentialist and existentialist components. We also consider two ideas (...) from existentialist philosophy – Jean-Paul Sartre and Simone de Beauvoir’s ideas about “bad faith” and “ambiguity” – to argue that there can be value to patients in regarding themselves as having a certain amount of freedom to choose what aspects of themselves should be considered representative of their true selves. Lastly, we consider the case of an anorexia nervosa-patient who shifts between conflicting mind-sets. We argue that mind-sets in which it is easier for the patient and his or her family to share values can plausibly be considered to be more representative of the patient’s true self, if this promotes a well-functioning relationship between the patient and the family. However, we also argue that families are well-advised to give patients room to figure out what such shared values mean to them, since it can be alienating for patients if they feel that others try to impose values on them from the outside. (shrink)

This paper focuses on an underexplored challenge in infinite ethics. On realistic assumptions, if our universe is infinite, every nomologically possible history is actual and nothing we ever do makes a difference to the moral quality of the world as a whole. Call this thought Every History. This paper unpacks Every History and explores some of its ethical implications. Specifically, I argue that if Every History is true and the universe turns out to be infinite (1) our lives are globally (...) insignificant, (2) moral principles enjoining the promotion of value need to be given an appropriately scope-restricted interpretation, and (3) impersonal consequentialism faces a serious challenge. (shrink)

According to an intriguing though somewhat enigmatic line of thought first proposed by Jonathan Bennett, if humanity went extinct any time soon this would be unfortunate because important business would be left unfinished. This line of thought remains largely unexplored. I offer an interpretation of the idea that captures its intuitive appeal, is consistent with plausible constraints, and makes it non-redundant to other views in the literature. The resulting view contrasts with a welfare-promotion perspective, according to which extinction would (...) be bad because it would come at a massive opportunity cost in terms of feasibly achievable welfare over the lifetime of our species. (shrink)

This paper looks at Gregory of Nyssa's so-called "bundle theory" sensible individuals and matter (as recently argued by Gerd Van Riel and Thomas Wauters in a 2020 article) amidst the broader context of Gregory's view of created beings and his reception of Neoplatonist, Stoic, and Aristotelian conceptions of particulars and matter. I argue that Gregory's position is closer to an Aristotelian position, despite the parallels to Plotinus and other contemporaneous bundle theory positions: in arguing against prime matter, and insofar as (...) he emphasizes the identity of each kind of created being with its material substrate—understood as a "bundle" of properties—Gregory inadvertently upholds a reading of Aristotle that refutes an ontological notion of prime matter. (shrink)

Altruistic deception (or the telling of “white lies”) is common in humans. Does it also exist in non-human animals? On some definitions of deception, altruistic deception is impossible by definition, whereas others make it too easy by counting useful-but-ambiguous information as deceptive. I argue for a definition that makes altruistic deception possible in principle without trivializing it. On my proposal, deception requires the strategic exploitation of a receiver by a sender, where “exploitation” implies that the sender elicits a behaviour in (...) the receiver that is beneficial in a different type of situation and is expressed only because the signal raises the probability, from the receiver’s standpoint, of that type of situation. I then offer an example of a real signal that is deceptive in this sense, and yet potentially altruistic (and certainly cooperative): the purr call of the pied babbler. Fledglings associate purr calls with food, and adults exploit this learned association, in the absence of food, to lead fledglings away from predators following an alarm call. I conclude by considering why altruistic deception is apparently so rare in non-human animals. (shrink)

In evolutionary medicine and other related fields, the concept of evolutionary mismatch is used to explain phenomena whereby traits reduce in adaptive value and eventually become maladaptive as the environment changes. This article argues that there is a similar problem of persistent adaptivity—what has been called the problem of evolutionary novelty—and it introduces the concept of mismatch resistance in order to explain phenomena whereby traits retain their adaptive value in novel environments that are radically different from the organisms’ environment of (...) evolutionary adaptedness (EEA). The possible role of variability selection in the evolution of mismatch-resistant traits is discussed, and it is suggested that mismatch resistance provides a useful tool for making progress on certain issues related to evolutionary theory, such as the modularity debate, cases of adaptivity outside of organisms’ ancestral environment, and the viability of naturalism as an overarching philosophical framework for understanding the natural world. (shrink)

Research on the capacity to understand others' minds has tended to focus on representations ofbeliefs,which are widely taken to be among the most central and basic theory of mind representations. Representations ofknowledge, by contrast, have received comparatively little attention and have often been understood as depending on prior representations of belief. After all, how could one represent someone as knowing something if one does not even represent them as believing it? Drawing on a wide range of methods across cognitive science, (...) we ask whether belief or knowledge is the more basic kind of representation. The evidence indicates that nonhuman primates attribute knowledge but not belief, that knowledge representations arise earlier in human development than belief representations, that the capacity to represent knowledge may remain intact in patient populations even when belief representation is disrupted, that knowledge (but not belief) attributions are likely automatic, and that explicit knowledge attributions are made more quickly than equivalent belief attributions. Critically, the theory of mind representations uncovered by these various methods exhibits a set of signature features clearly indicative of knowledge: they are not modality-specific, they are factive, they are not just true belief, and they allow for representations of egocentric ignorance. We argue that these signature features elucidate the primary function of knowledge representation: facilitating learning from others about the external world. This suggests a new way of understanding theory of mind – one that is focused on understanding others' minds in relation to the actual world, rather than independent from it. (shrink)

In the exceptional book _Divine Holiness and Divine Action_, Mark Murphy defends what he calls the _holiness framework _for divine action. The purpose of our essay-response to Murphy’s book is to consider an alternative framework for divine action, what we call the _agapist framework_. We argue that the latter framework is more probable than Murphy’s holiness framework with respect to_ select _theological desiderata.

In this paper I examine a recent incarnation of common objection to evidentialism. According to this common objection, evidentialism gives the wrong verdicts in cases where the subject has been irresponsible in inquiry. Sandy Goldberg (2021) has argued that a particularly vivid instance of this problem occurs when an individual violates normative expectations that have been placed on them in their inquiry. Having laid out Goldberg’s case, I argue that the desirable verdicts can be better attained by endorsing evidentialism and (...) supplementing it with an account of robust justification that I have defended elsewhere. (shrink)

What makes fast, cumulative cultural evolution work? Where did it come from? Why is it the sole preserve of humans? We set out a self-assembly hypothesis: cultural evolution evolved culturally. We present an evolutionary account that shows this hypothesis to be coherent, plausible, and worthy of further investigation. It has the following steps: (0) in common with other animals, early hominins had significant capacity for social learning; (1) knowledge and skills learned by offspring from their parents began to spread because (...) bearers had more offspring, a process we call CS1 (or Cultural Selection 1); (2) CS1 shaped attentional learning biases; (3) these attentional biases were augmented by explicit learning biases (judgements about what should be copied from whom). Explicit learning biases enabled (4) the high-fidelity, exclusive copying required for fast cultural accumulation of knowledge and skills by a process we call CS2 (or Cultural Selection 2), and (5) the emergence of cognitive processes such as imitation, mindreading and metacognition – ‘cognitive gadgets’ specialised for cultural learning. This self-assembly hypothesis is consistent with archaeological evidence that the stone tools used by early hominins were not dependent on fast, cumulative cultural evolution, and suggests new priorities for research on ‘animal culture’. (shrink)

Consent theory in sexual ethics, Jonathan Ichikawa argues, has a Euthyphro problem. -/- It is widely held that sexual violations are explicable in terms of nonconsensual sexual contact. But a notion of consent adequate to explain many moral judgments typical of sexual ethics — a notion that vindicates the idea that consent cannot be coerced, that it must be sober, that children cannot consent to sex with adults, etc. — cannot, Ichikawa argues, be articulated, motivated, or explained in a (...) way independently of moral judgments about sexual wrongs. Consequently, if there is as tight a connection between consent and sexual violation as many people think there is, there is good reason to suppose that that connection must ultimately explain consent in terms of sexual wronging, rather than vice versa. The paper highlights some costs and drawbacks to this horn of the Euthyphro dilemma in sexual ethics. One central upshot of the argument will be that mainstream accounts of sexual ethics fail in their explanatory ambitions. Consent cannot play its canonical explanatory role. (shrink)

Jonathan Y. Tsou examines and defends positions on central issues in philosophy of psychiatry. The positions defended assume a naturalistic and realist perspective and are framed against skeptical perspectives on biological psychiatry. Issues addressed include the reality of mental disorders; mechanistic and disease explanations of abnormal behavior; definitions of mental disorder; natural and artificial kinds in psychiatry; biological essentialism and the projectability of psychiatric categories; looping effects and the stability of mental disorders; psychiatric classification; and the validity of the (...) DSM's diagnostic categories. The main argument defended by Tsou is that genuine mental disorders are biological kinds with harmful effects. This argument opposes the dogma that mental disorders are necessarily diseases that result from biological dysfunction. Tsou contends that the broader ideal of biological kinds offers a more promising and empirically ascertainable naturalistic standard for assessing the reality of mental disorders and the validity of psychiatric categories. (shrink)

Peter Carruthers has recently argued for a surprising conditional: if a global workspace theory of phenomenal consciousness is both correct and fully reductive, then there are no substantive facts to discover about phenomenal consciousness in nonhuman animals. I present two problems for this conditional. First, it rests on an odd double-standard about the ordinary concept of phenomenal consciousness: its intuitive non-gradability is taken to be unchallengeable by future scientific developments, whereas its intuitive determinacy is predicted to fall by the wayside. (...) Second, it relies on dismissing, prematurely, the live empirical possibility that phenomenal consciousness may be linked to a core global broadcast mechanism that is shared by a wide range of animals. Future developments in the science of consciousness may lead us to reconsider the non-gradability of phenomenal consciousness, but they are unlikely to lead us to accept that there are no facts to discover outside the paradigm case of a healthy adult human. (shrink)

This is a response to the nine commentaries on our target article “Unlimited Associative Learning: A primer and some predictions”. Our responses are organized by theme rather than by author. We present a minimal functional architecture for Unlimited Associative Learning that aims to tie to together the list of capacities presented in the target article. We explain why we discount higher-order thought theories of consciousness. We respond to the criticism that we have overplayed the importance of learning and underplayed the (...) importance of spatial modelling. We decline the invitation to add a negative marker to our proposed positive marker so as to rule out consciousness in plants, but we nonetheless maintain that there is no positive evidence of consciousness in plants. We close by discussing how UAL relates to development and to its material substrate. (shrink)

When agents violate norms, they are typically judged to be more of a cause of resulting outcomes. In this paper, we suggest that norm violations also affect the causality attributed to other agents, a phenomenon we refer to as "causal superseding." We propose and test a counterfactual reasoning model of this phenomenon in four experiments. Experiments 1 and 2 provide an initial demonstration of the causal superseding effect and distinguish it from previously studied effects. Experiment 3 shows that this causal (...) superseding effect is dependent on a particular event structure, following a prediction of our counterfactual model. Experiment 4 demonstrates that causal superseding can occur with violations of non-moral norms. We propose a model of the superseding effect based on the idea of counterfactual sufficiency. (shrink)

This article offers an account of moods as distinctive kinds of personal level affective-evaluative states, which are both intentional and rationally intelligible in specific ways. The account contrasts with those who claim moods are non-intentional, and so also arational. Section 1 provides a conception of intentionality and distinguishes moods, as occurrent experiential states, from other states in the affective domain. Section 2 argues moods target the subject’s total environment presented in a specific evaluative light through felt valenced attitudes (the Mood-Intentionality (...) thesis). Section 3 argues some moods are experienced as rationally intelligible responses, and so epistemically appropriate, to the way ‘the world’ presents itself (the Mood-Intelligibility thesis). Finally, section 4 discusses the epistemology of moods. (shrink)

According to many of its proponents, shared decision making ("SDM") is the right way to interpret the clinician-patient relationship because it respects patient autonomy in decision-making contexts. In particular, medical ethicists have claimed that SDM respects a patient's relational autonomy understood as a capacity that depends upon, and can only be sustained by, interpersonal relationships as well as broader health care and social conditions. This paper challenges that claim. By considering two primary approaches to relational autonomy, this paper argues that (...) standard accounts of SDM actually undermine patient autonomy. It also provides an overview of the obligations generated by the principle of respect for relational autonomy that have not been captured in standard accounts of SDM and which are necessary to ensure consistency between clinical practice and respect for patient autonomy. (shrink)

When two agents engage in a joint action, such as rowing together, they exercise joint know-how. But what is the relationship between the joint know-how of the two agents and the know-how each agent possesses individually? I construct an “active mutual enablement” account of this relationship, according to which joint know-how arises when each agent knows how to predict, monitor, and make failure-averting adjustments in response to the behaviour of the other agent, while actively enabling the other to make such (...) adjustments. I defend the AME account from three objections, and I then use this account as the platform for an examination of the reducibility of joint know-how to joint propositional knowledge. A summative account of joint propositional knowledge is incompatible with the reduction of joint know-how to joint propositional knowledge, whereas a distributive account is not. I close by highlighting some open questions the AME account brings into view concerning the evolutionary origin and scaling up of joint know-how. (shrink)

According to the Ontological Innocence Thesis (OIT), grounded entities are ontologically innocent relative to their full grounds. I argue that OIT entails a contradiction, and therefore must be discarded. My argument turns on the notion of “groundmates,” two or more numerically distinct entities that share at least one of their full grounds. I argue that, if OIT is true, then it is both the case that there are groundmates and that there are no groundmates. Therefore, so I conclude, OIT is (...) false. Moreover, once we have seen why OIT is false, only three heterodox views about reality's structure remain. So this paper’s second conclusion is that, even after we have discarded OIT, we are in for an additional surprise. (shrink)

Many philosophers have understood the representational dimension of affective states along the model of sense-perceptual experiences, even claiming the relevant affective experiences are perceptual experiences. This paper argues affective experiences involve a kind of personal level affective representation disanalogous from the representational character of perceptual experiences. The positive thesis is that affective representation is a non-transparent, non-sensory form of evaluative representation, whereby a felt valenced attitude represents the object of the experience as minimally good or bad, and one experiences that (...) evaluative standing as having the power to causally motivate the relevant attitude. I show this view can make sense of distinctive features of affective experiences, such as their valence and connection to value in a way which moves beyond current evaluativist views of affect. (shrink)

Self-interest voting is irrational when it has even a small cost, but it can be rational for those who care about others; its expected utility (EU) may exceed its cost. For cosmopolitan voters (those who care about outsiders), the EU of voting increases with the number of affected others. The EU of voting for the good of the world now and in the future can thus be large. In some cases, the EU of parochial voting (e.g., considering only one's nation) (...) may not cross the cost threshold, but cosmopolitan voting can cross it. I apply these principles to various kinds of voting. And I compare voting to charity. Voting has the advantage of enlisting the coercive power of the state, but charity can be more focused on effective policies. I discuss campaign contributions, and I conclude with a discussion of the existence of utilitarian voters. (shrink)

This paper defends a 'fitting attitudes' view of value on which what it is for something to be good is for there to be reasons to favour that thing. The first section of the paper defends a 'linking principle' connecting reasons and value. The second and third sections argue that this principle is better explained by a fitting-attitudes view than by 'value-first' views on which reasons are explained in terms of value.

This article responds to two arguments against ‘Epistemic Perceptualism’, the view that emotional experiences, as involving a perception of value, can constitute reasons for evaluative belief. It first provides a basic account of emotional experience, and then introduces concepts relevant to the epistemology of emotional experience, such as the nature of a reason for belief, non-inferentiality, and prima facie vs. conclusive reasons, which allow for the clarification of Epistemic Perceptualism in terms of the Perceptual Justificatory View. It then challenges two (...) arguments which purport to show that emotional experience is not a source of reasons for evaluative belief. The first argument claims that because normative why-questions are always appropriate in the case of emotions, then emotions can never be conclusive reasons for corresponding evaluative beliefs. The second purports to show that appeal to emotional experience as a source of reasons for evaluative beliefs renders emotions problematically self-justifying, and since emotions cannot be self-justifying, they cannot provide any sort of reason for corresponding evaluative beliefs. This article responds to these arguments, and in doing so shows there is still much to be learned about the epistemology of emotional experience by drawing analogies with perceptual experience. (shrink)

In this paper, we defend Lucretian Presentism. Although the view faces many objections and has proven unpopular with presentists, we rehabilitate Lucretianism and argue that none of the objections stick.

Recently, some have attempted to reformulate debates in first-order metaphysics, particularly in the metaphysics of time and modality, for reasons due to Williamson. In this paper, we focus on the ways in which the likes of Cameron, Correia and Rosenkranz, Deasy, Ingram, Tallant, Viebahn, inter alia, have initiated and responded to attempts to capture the core of presentism using a formal, logical machinery. We argue that such attempts are doomed to fail because there is no theoretical core to presentism. There (...) is no single view or family of views that is presentism. (shrink)