“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)

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)

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)

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)

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)

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 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)

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)

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 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)

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)

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)

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)

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.

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.

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)

TB human challenge studies could accelerate TB vaccine development by reducing uncertainty in early-stage vaccine testing, selecting promising vaccine candidates for large-scale field trials, and identifying an immune correlate of protection. However, ethical concerns regarding the exposure of trial participants and bystanders to significant risk have been a limiting factor for TB human challenge models. We analyze the expected social value and risks of different types of TB human challenge models, and conclude that given the massive public health burden of (...) TB, challenge models with even scant probabilities of expediting TB vaccine authorization have enormous expected humanitarian value, saving between 33,000 and 1,375,000 lives over the next ten years. We argue that attenuated M.tb challenge trials can be conducted ethically, and discuss the benefits and drawbacks of conducting virulent M.tb challenge trials. (shrink)

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)

This article gives an overview of some recent debates about the relationship between reasons and rational requirements of coherence - e.g. the requirements to be consistent in our beliefs and intentions, and to intend what we take to be the necessary means to our ends.

Evidentialism is the thesis that all reasons to believe p are evidence for p. Pragmatists hold that pragmatic considerations – incentives for believing – can also be reasons to believe. Nishi Shah, Thomas Kelly and others have argued for evidentialism on the grounds that incentives for belief fail a ‘reasoning constraint’ on reasons: roughly, reasons must be considerations we can reason from, but we cannot reason from incentives to belief. In the first half of the paper, I show that this (...) argument fails: the claim that we cannot reason from incentives is either false or does not combine with the reasoning constraint to support evidentialism. However, the failure of this argument suggests an alternative route to evidentialism. Roughly, reasons must be premises of good reasoning, but it is not good reasoning to reason from incentives to belief. The second half of the paper develops and defends this argument for evidentialism. (shrink)

Causal claims are context sensitive. According to the old orthodoxy (Mackie 1974, Lewis 1986, inter alia), the context sensitivity of causal claims is all due to conversational pragmatics. According to the new contextualists (Hitchcock 1996, Woodward 2003, Maslen 2004, Menzies 2004, Schaffer 2005, and Hall ms), at least some of the context sensitivity of causal claims is semantic in nature. I want to discuss the prospects for causal contextualism, by asking why causal claims are context sensitive, what they are sensitive (...) to, and where they are sensitive to it. (shrink)

In the newly-discovered “On Principles and Matter”—we can definitely ascertain by Porphyry—the author concludes that there must be two principles responsible for all beings, or at least all sensible beings: God (the active cause) and matter (the passive cause). In large part this agrees with Atticus’ position, which the text also quotes, and which we also know Porphyry engaged with vigorously, from Proclus’ Timaeus Commentary. However there is a something odd about this text’s Porphyry: we seem to have a positive (...) argument for much of Antiochus’ framework of two principles, while in Proclus’ testimony we have a negative argument for the very same position. In this paper I analyze in detail the positive argument for the two principles given in “On Principles”, and I consider the degree to which Porphyry may be supplying a dialectical argument at this point in the text, before eventually criticizing the same view elsewhere (as in Proclus’ testimony). I also consider other points of contact for the text’s two-principles framework with Porphyry’s other extant works and show some consequences for Porphyry’s overall position. (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)

A number of philosophers have recently suggested that the role of intuitions in the epistemology of armchair philosophy has been exaggerated. This suggestion is rehearsed and endorsed. What bearing does the rejection of the centrality of intuition in armchair philosophy have on experimentalist critiques of the latter? I distinguish two very different kinds of experimentalist critique: one critique requires the centrality of intuition; the other does not.

Many philosophers have been attracted to the view that reasons are premises of good reasoning – that reasons to φ are premises of good reasoning towards φ-ing. However, while this reasoning view is indeed attractive, it faces a problem accommodating outweighed reasons. In this article, I argue that the standard solution to this problem is unsuccessful and propose an alternative, which draws on the idea that good patterns of reasoning can be defeasible. I conclude by drawing out implications for the (...) debate over pragmatic reasons for belief and other attitudes and for one influential form of reductionism about the normative. (shrink)

Sentience is the capacity to have feelings, such as feelings of pain, pleasure, hunger, thirst, warmth, joy, comfort and excitement. It is not simply the capacity to feel pain, but feelings of pain, distress or harm, broadly understood, have a special significance for animal welfare law. Drawing on over 300 scientific studies, we evaluate the evidence of sentience in two groups of invertebrate animals: the cephalopod molluscs or, for short, cephalopods (including octopods, squid and cuttlefish) and the decapod crustaceans or, (...) for short, decapods (including crabs, lobsters and crayfish). We also evaluate the potential welfare implications of current commercial practices involving these animals. (shrink)

From mitochondria to meerkats, the natural world is full of spectacular examples of social behaviour. In the early 1960s W. D. Hamilton changed the way we think about how such behaviour evolves. He introduced three key innovations - now known as Hamilton's rule, kin selection, and inclusive fitness - and his pioneering work kick-started a research program now known as social evolution theory. This is a book about the philosophical foundations and future prospects of that program. [Note: only the Introduction (...) is available to download.]. (shrink)

In a 1997 paper, Salvatore Lilla pinpointed multiple textual parallels between Damascius and the Pseudo-Dionysius, showing certain conceptual parallels. For instance, both Ps.-Dionysius and Damascius speak of the first cause, or God, as being all things, i.e. as “encompassing” (περιληπτική) or as “anticipating” (προληπτική) all things, at the same time that God transcends all things. In my chapter I expand on Lilla’s findings by showing how Ps.-Dionysius’ conception of God fits more closely with Damascius’ framework for the One, especially Damascius' (...) description of the triad of principles (i.e. the One-All, All-One, and Unified) at the One’s level which closely parallels Ps.-Dionysius’ description of the Christian Trinitarian persons (i.e. the Father, the Son, and the Holy Spirit). The chapter also shows striking parallels between Damascius and Ps.-Dionysius elevating divine revelation as a primary means of communicating knowledge about the first cause’s mode of being (correcting certain claims of Lilla), while it also shows how the parallels drawn between Proclus’ henadology and Ps.-Dionysius make more sense when looking at Damascius’ own adaptation of Proclus’ henadology with his conception of the One’s triad of principles. (shrink)

In debates about animal sentience, the precautionary principle is often invoked. The idea is that when the evidence of sentience is inconclusive, we should “give the animal the benefit of the doubt” or “err on the side of caution” in formulating animal protection legislation. Yet there remains confusion as to whether it is appropriate to apply the precautionary principle in this context, and, if so, what “applying the precautionary principle” means in practice regarding the burden of proof for animal sentience. (...) Here I construct a version of the precautionary principle tailored to the question of animal sentience together with a practical framework for implementing it. I explain and defend the key features of this framework, argue that it is well-aligned with current practice in animal welfare science, and consider and reject a number of influential counterarguments to the use of precautionary reasoning in this area. (shrink)

In this paper we propose an Ontology of Commercial Exchange (OCE) based on Basic Formal Ontology. OCE is designed for re-use in the Industrial Ontologies Foundry (IOF) and in other ontologies addressing different aspects of human social behavior involving purchasing, selling, marketing, and so forth. We first evaluate some of the design patterns used in the Financial Industry Business Ontology (FIBO) and Product Types Ontology (PTO). We then propose terms and definitions that we believe will improve the representation of contractual (...) obligations, sales processes, and their associated documents. A commercial exchange, for instance, involves mutual agreement to reciprocate actions, such as transferring money, performing a service, or transferring goods. (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)

In this introduction we explore a number of puzzles that arise concerning epistemic autonomy, and introduce the sections and chapters of the book. There are four broad types of puzzles to be explored, corresponding to the four sections of the book. The first set of puzzles concerns the nature of epistemic autonomy. Here, questions arise such as what is epistemic autonomy? Is epistemic autonomy valuable? What are we epistemically autonomous about? The second set of puzzles concern epistemic paternalism. Paternalistic acts (...) interfere with an agent’s autonomy. Here, questions arise concerning the permissibility of epistemic paternalism as well the extension of epistemically paternalistic acts. The third set of puzzles concerns the relation of epistemic autonomy to epistemic value and to intellectual virtues and vices. Is there epistemic value to being epistemically autonomous? How does epistemic autonomy relate to different intellectual virtues and vices? Finally, the fourth set of puzzles concerns the role of epistemic autonomy within a social epistemology. How does epistemic autonomy square with a reliance on expertise? Does thinking about epistemic autonomy add to the debates about the epistemic significance of disagreement or epistemic injustice? (shrink)

In this chapter I develop and motivate and account of epistemic autonomy as an intellectual character virtue. In Section one, I clarify the concept of an intellectual virtue and character intellectual virtues in particular. In Section two, I clear away some misconceptions about epistemic autonomy to better focus on our target. In Section three, I examine and evaluate several extant accounts of the virtue of epistemic autonomy, noting problems with each. In Section four, I provide my positive account of the (...) virtue of epistemic autonomy and explain how it meets the desiderata for such an account while avoiding the problems with extant accounts. Finally, in Section five, I fill the account out by digging into the factors that guide epistemically autonomous agents in having an appropriate reliance on their own thinking. (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)

This paper addresses philosophical issues concerning whether mental disorders are natural kinds and how the DSM should classify mental disorders. I argue that some mental disorders (e.g., schizophrenia, depression) are natural kinds in the sense that they are natural classes constituted by a set of stable biological mechanisms. I subsequently argue that a theoretical and causal approach to classification would provide a superior method for classifying natural kinds than the purely descriptive approach adopted by the DSM since DSM-III. My argument (...) suggests that the DSM should classify natural kinds in order to provide predictively useful (i.e., projectable) diagnostic categories and that a causal approach to classification would provide a more promising method for formulating valid diagnostic categories. (shrink)

This editorial introduces the Journal of Consciousness Studies special issue on "Animal Consciousness". The 15 contributors and co-editors answer the question "How should we study animal consciousness scientifically?" in 500 words or fewer.

This paper provides an assessment of the bodily-attitudinal theory of emotions, according to which emotions are felt bodily attitudes of action readiness. After providing a reconstruction of the view and clarifying its central commitments two objections are considered. An alternative object side interpretation of felt action readiness is then provided, which undermines the motivation for the bodily-attitudinal theory and creates problems for its claims concerning the content of emotional experience. The conclusion is that while the bodily-attitudinal theory marks out a (...) distinctive proposal concerning the question of what emotions are, there remain significant issues which need addressing if it is to be a plausible competitor to existing theories of emotion. (shrink)

In this article, I argue that depression and suicide are natural kinds insofar as they are classes of abnormal behavior underwritten by sets of stable biological mechanisms. In particular, depression and suicide are neurobiological kinds characterized by disturbances in serotonin functioning that affect various brain areas (i.e., the amygdala, anterior cingulate, prefrontal cortex, and hippocampus). The significance of this argument is that the natural (biological) basis of depression and suicide allows for reliable projectable inferences (i.e., predictions) to be made about (...) individual members of a kind. In the context of assisted suicide, inferences about the decision-making capacity of depressed individuals seeking physician-assisted suicide are of special interest. I examine evidence that depression can hamper the decision-making capacity of individuals seeking assisted suicide and discuss some implications. (shrink)

This is an edited transcript of a lecture given at the LSE in March 2023. The lecture introduces the “meaning of life” question via Tolstoy’s Confession, then considers the strengths and limitations of religious and secular answers to the question.

It would be unwise to dismiss the possibility of human brain organoids developing sentience. However, scepticism about this idea is appropriate when considering current organoids. It is a point of consensus that a brainstem-dead human is not sentient, and current organoids lack a functioning brainstem. There are nonetheless troubling early warning signs, suggesting organoid research may create forms of sentience in the near future. To err on the side of caution, researchers with very different views about the neural basis of (...) sentience should unite behind the “brainstem rule”: if a neural organoid develops or innervates a functioning brainstem that registers and prioritizes its needs, regulates arousal, and leads to sleep-wake cycles, then it is a sentience candidate. If organoid research leads to the creation of sentience candidates, a moratorium or indefinite ban on the creation of the relevant type of organoid may be appropriate. A different way forward, more consistent with existing approaches to animal research, would be to require ethical review and harm-benefit analysis for all research on sentience candidates. (shrink)

According to some philosophers, the mind enjoys a form of presence to itself. That is to say, in addition to being aware of whatever objects it is aware of, it is also (co-presently) aware of itself. This paper explores the proposal that we should think about this kind of experiential-presence in terms of a form of non-intentional awareness. Various candidates for the relevant form of awareness, as constituting supposed non-intentional experiential-presence, are considered and are shown to encounter significant problems. The (...) fact that a plausible account of the non-intentional awareness which experience putatively has of itself cannot be framed with reference to such forms of awareness is grounds for scepticism concerning the cogency of non-intentional experiential presence. (shrink)

A large part of the controversy surrounding the publication of DSM-5 stems from the possibility of replacing the purely descriptive approach to classification favored by the DSM since 1980. This paper examines the question of how mental disorders should be classified, focusing on the issue of whether the DSM should adopt a purely descriptive or theoretical approach. I argue that the DSM should replace its purely descriptive approach with a theoretical approach that integrates causal information into the DSM’s descriptive diagnostic (...) categories. The paper proceeds in three sections. In the first section, I examine the goals (viz., guiding treatment, facilitating research, and improving communication) associated with the DSM’s purely descriptive approach. In the second section, I suggest that the DSM’s purely descriptive approach is best suited for improving communication among mental health professionals; however, theoretical approaches would be superior for purposes of treatment and research. In the third section, I outline steps required to move the DSM towards a hybrid system of classification that can accommodate the benefits of descriptive and theoretical approaches, and I discuss how the DSM’s descriptive categories could be revised to incorporate theoretical information regarding the causes of disorders. I argue that the DSM should reconceive of its goals more narrowly such that it functions primarily as an epistemic hub that mediates among various contexts of use in which definitions of mental disorders appear. My analysis emphasizes the importance of pluralism as a methodological means for avoiding theoretical dogmatism and ensuring that the DSM is a reflexive and self-correcting manual. (shrink)