Answers to the questions of what justifies conscientious objection in medicine in general and which specific objections should be respected have proven to be elusive. In this paper, I develop a new framework for conscientious objection in medicine that is based on the idea that conscience can express true moral claims. I draw on one of the historical roots, found in Adam Smith’s impartial spectator account, of the idea that an agent’s conscience can determine the correct moral norms, even if (...) the agent’s society has endorsed different norms. In particular, I argue that when a medical professional is reasoning from the standpoint of an impartial spectator, his or her claims of conscience are true, or at least approximate moral truth to the greatest degree possible for creatures like us, and should thus be respected. In addition to providing a justification for conscientious objection in medicine by appealing to the potential truth of the objection, the account advances the debate regarding the integrity and toleration justifications for conscientious objection, since the standard of the impartial spectator specifies the boundaries of legitimate appeals to moral integrity and toleration. The impartial spectator also provides a standpoint of shared deliberation and public reasons, from which a conscientious objector can make their case in terms that other people who adopt this standpoint can and should accept, thus offering a standard fitting to liberal democracies. (shrink)

Physicians frequently ask whether they should give patients what they want, usually when there are considerations pointing against doing so, such as medicine’s values and physicians’ obligations. It has been argued that the source of medicine’s values and physicians’ obligations lies in what has been dubbed “the internal morality of medicine”: medicine is a practice with an end and norms that are definitive of this practice and that determine what physicians ought to do qua physicians. In this paper, I defend (...) the claim that medicine requires a morality that is internal to its practice, while rejecting the prevalent characterization of this morality and offering an alternative one. My approach to the internal morality of medicine is constructivist in nature: the norms of medicine are constructed by medical professionals, other professionals, and patients, given medicine’s end of “benefitting patients in need of prima facie medical treatment and care.” I make the case that patients should be involved in the construction of medicine’s morality not only because they have knowledge that is relevant to the internal morality of medicine—namely, their own values and preferences—but also because medicine is an inherently relational enterprise: in medicine the relationship between physician and patient is a constitutive component of the craft itself. The framework I propose provides an authoritative morality for medicine, while allowing for the incorporation, into that very morality, of qualified deference to patient values. (shrink)

My question in the chapter is this: could (and should) the role of the physician be construed as that of a friend to the patient? I begin by briefly discussing the “friendship model” of the physician-patient relationship—according to which physicians and patients could, and perhaps should, be friends—as well as its history and limitations. Given these limitations, I focus on the more one-sided idea that the physician could, and perhaps should, be a friend to the patient (a “physician-qua-friend model” of (...) the physician-patient relationship). I show that given recent developments in our understanding of the physician-patient relationship, this idea is far from asinine. I then make the case that the most plausible conception of the physician-qua-friend model incorporates the following components: (a) a common goal, that is, one that physician and patient share; (b) certain forms of equality between physician and patient; (c) an ideal of a caring physician. Finally, I show how the model can be instantiated in a certain type of physician-patient interaction, namely, in physician-assisted dying. (shrink)

Two problems seem to plague Adam Smith’s account of sympathy and approbation in The Theory of Moral Sentiments (TMS). First, Smith’s account of sympathy at the beginning of TMS appears to be inconsistent with the account of sympathy at the end of TMS. In particular, it seems that Smith did not appreciate the distinction between ‘self-oriented sympathy’ and ‘other-oriented sympathy’, that is, between imagining being oneself in the actor’s situation and imagining being the actor in the actor’s situation. Second, Smith’s (...) account of approbation, according to which a sentiment of approval arises when there is recognition of concordance between the spectator’s sympathetic passion and the actor’s original passion, seems to face the following problem: since the spectator attains both his own sympathetic passion and the actor’s original passion by sympathizing with the actor, the sympathetic passion of the spectator and the original passion of the actor will necessarily be identical. Therefore, Smith’s account of approbation requires that the spectator utilize both self-oriented and other-oriented sympathy (‘the double-sympathy model of approbation’). I offer a novel developmental account of sympathy in TMS that renders Smith’s account of sympathy consistent and allows for the utilization of the double-sympathy model of approbation. (shrink)

The literature on conscientious objection in medicine presents two key problems that remain unresolved: Which conscientious objections in medicine are justified, if it is not feasible for individual medical practitioners to conclusively demonstrate the genuineness or reasonableness of their objections? How does one respect both medical practitioners’ claims of conscience and patients’ interests, without leaving practitioners complicit in perceived or actual wrongdoing? My aim in this paper is to offer a new framework for conscientious objections in medicine, which, by bringing (...) medical professionals’ conscientious objection into the public realm, solves the justification and complicity problems. In particular, I will argue that: an “Uber Conscientious Objection in Medicine Committee” —which includes representatives from the medical community and from other professions, as well as from various religions and from the patient population—should assess various well-known conscientious objections in medicine in terms of public reason and decide which conscientious objections should be permitted, without hearing out individual conscientious objectors; medical practitioners should advertise their conscientious objections, ahead of time, in an online database that would be easily accessible to the public, without being required, in most cases, to refer patients to non-objecting practitioners. (shrink)

I offer a novel two-stage reconstruction of Hume’s general-point-of-view account, modeled in part on his qualified-judges account in ‘Of the Standard of Taste.’ In particular, I argue that the general point of view needs to be jointly constructed by spectators who have sympathized with (at least some of) the agents in (at least some of) the actor’s circles of influence. The upshot of the account is two-fold. First, Hume’s later thought developed in such a way that it can rectify the (...) problems inherent in his Treatise account of the general point of view. Second, the proposed account provides the grounds for an adequate and well-motivated modest ideal observer theory of the standard of virtue. (shrink)

John Rawls raises three challenges – to which one can add a fourth challenge – to an impartial spectator account: (a) the impartial spectator is a utility-maximizing device that does not take seriously the distinction between persons; (b) the account does not guarantee that the principles of justice will be derived from it; (c) the notion of impartiality in the account is the wrong one, since it does not define impartiality from the standpoint of the litigants themselves; (d) the account (...) would offer a comprehensive, rather than a political, form of liberalism. The narrow aim of the article is to demonstrate that Adam Smith's impartial spectator account can rise to Rawls's challenges. The broader aim is to demonstrate that the impartial spectator account offers the basis for a novel and alternative framework for developing principles of justice, and does so in the context of a political form of liberalism. (shrink)

The Humean Theory of Reasons, according to which all of our reasons for action are explained by our desires, has been criticized for not being able to account for “moral reasons,” namely, overriding reasons to act on moral demands regardless of one's desires. My aim in this paper is to utilize ideas from Adam Smith's moral philosophy in order to offer a novel and alternative account of moral reasons that is both desire-based and accommodating of an adequate version of the (...) requirement that moral demands have overriding reason-giving force. In particular, I argue that the standpoint of what Smith calls “the impartial spectator” can both determine what is morally appropriate and inappropriate and provide the basis for normative reasons for action—including reasons to act on moral demands—to nearly all reason-responsive agents and, furthermore, that these reasons have the correct weight. The upshot of the proposed account is that it offers an interesting middle road out of a dilemma pertaining to the explanatory and normative dimensions of reasons for informed-desire Humean theorists. (shrink)

I defend the feasibility of a medical conscience in the following sense: a medical professional can object to the prevailing medical norms because they are incorrect as medical norms. In other words, I provide an account of conscientious objection that makes use of the idea that the conscience can issue true normative claims, but the claims in question are claims about medical norms rather than about general moral norms. I further argue that in order for this line of reasoning to (...) succeed, there needs to be an internal morality of medicine that determines what medical professionals ought to do qua medical professionals. I utilize a constructivist approach to the internal morality of medicine and argue that medical professionals can conscientiously object to providing treatment X, if providing treatment X is not in accordance with norms that would have been constructed, in light of the end of medicine, by the appropriate agents under the appropriate conditions. (shrink)

I build on Adam Smith’s account of the impartial spectator in The Theory of Moral Sentiments in order to offer a modest ideal observer theory of moral judgment that is adequate in the following sense: the account specifies the hypothetical conditions that guarantee the authoritativeness of an agent’s (or agents’) responses in constituting the standard in question, and, if an actual agent or an actual community of agents are not under those conditions, their responses are not authoritative in setting this (...) standard. However, in the account that I provide, the hypothetical conditions can themselves be constructed from the psychology and interactions of actual human beings. In other words, facts about the morally appropriate and inappropriate are determined from hypothetical conditions that––while agents in a given society might have yet to attain them––can be constructed from those agents’ shared experiences. Thus, the account offers both an attainable standard of moral judgment and a standard that can transcend the biases of the society which gave rise to it. I also defend the account against three challenges: (a) ideal observer theories do not offer the right kind of motivation to act on the verdicts of the ideal observer; (b) ideal observer theories cannot explain why the idealization in question is well-motivated and not objectionably ad hoc; (c) the standard used in ideal observer theories cannot be defended upon further reflection, because we would need a non-arbitrary, second-order standard to govern our reflection on the first-order standard of moral judgment. (shrink)

In The Sources of Normativity, Korsgaard argues for what can be called “The Universality of Humanity Claim” (UHC), according to which valuing humanity in one’s own person entails valuing it in that of others. However, Korsgaard’s reliance on the claim that reasons are essentially public in her attempt to demonstrate the truth of UHC has been repeatedly criticized. I offer a sentimentalist defense, based on Adam Smith’s moral philosophy, of a qualified, albeit adequate, version of UHC. In particular, valuing my (...) humanity, understood as (my awareness of) my perspective and the reasons determined from within it, entails valuing your humanity, understood as (your awareness of) your perspective and the reasons determined from within it. Given Korsgaard’s emphasis on the publicity of reasons in her argument for UHC, I also discuss the role of reasons in my account. I argue that the relative weights of (at least some of) an agent’s reasons are determined from within a shared evaluative point of view, namely, the standpoint of what Smith calls “the impartial spectator.” These reasons have normative authority over and constrain the agent’s private reasons, that is, those that are determined from within her own particular evaluative point of view. (shrink)

I demonstrate that analogies, both explicit and implicit, between Wittgenstein’s discussion of rituals, aesthetics, and psychoanalysis (and, indeed, his own philosophical methodology) suggest that he entertained the idea that Freud’s psychoanalytic project, when understood correctly—that is, as a descriptive project rather than an explanatory-hypothetical one—provides a “surveyable representation” (übersichtliche Darstellung) of certain psychological facts (as opposed to psychological concepts). The consequences of this account are that it offers an explanation of Wittgenstein’s admiration for and self-perceived affinity to Freud, as well (...) as of his apparent “know-nothing approach” to empirical psychology. (shrink)

In this paper, we illustrate some serious difficulties involved in conveying information about uncertain risks and securing informed consent for risky interventions in a clinical setting. We argue that in order to secure informed consent for a medical intervention, physicians often need to do more than report a bare, numerical probability value. When probabilities are given, securing informed consent generally requires communicating how probability expressions are to be interpreted and communicating something about the quality and quantity of the evidence for (...) the probabilities reported. Patients may also require guidance on how probability claims may or may not be relevant to their decisions, and physicians should be ready to help patients understand these issues. (shrink)

I demonstrate that analogies, both explicit and implicit, between Wittgenstein’s discussions of rituals, aesthetics, and aspect-perception, have important payoffs in terms of understanding his notion of a “surveyable representation” (übersichtliche Darstellung) as it applies to phenomena that are not exclusively grammatical in nature. In particular, I argue that a surveyable representation of certain anthropological and aesthetic facts allows us to see, qua form of aspect-perception, internal relations and formal connections, so that the inner nature of a ritual or the solution (...) of an aesthetic puzzle is exhibited. This particular form of seeing both explains why Wittgenstein thought that hypothetical explanations about the origins of a ritual are irrelevant to appreciating its meaning and elucidates his understanding of rituals, which involves seeing “internal relations” and “formal connections.” The upshots of the account for work in anthropology are discussed. (shrink)

I introduce a new distinction between two types of paternalism, which I call ‘internal’ and ‘external’ paternalism. The distinction pertains to the question of whether the paternalized subject’s current evaluative judgments are mistaken relative to a standard of correctness that is internal to her evaluative point of view—which includes her ‘true’ or ‘ideal’ self—as opposed to one that is wholly external. I argue that this distinction has important implications for (a) the distinction between weak and strong paternalism; (b) the distinction (...) between soft and hard paternalism; and (c) medical practice, where internal paternalism can, and probably often does, occur. (shrink)

Samuel Fleischacker’s Being Me Being You: Adam Smith & Empathy offers a new interpretation of Adam Smith’s conception of empathy—or ‘sympathy’, as Smith referred to the phenomenon in The Theory of...

Models are being used extensively for practicing and understanding scientific, engineering and mathematical subjects, but are rarely used as art analyzing tools, particularly, in learning environments. Contrarily, using art to explain mathematical ideas is not unprecedented. Strogatz (1988), for example, built a model based on Romeo and Juliet’s love story and used it to explain the idea of differential mathematics, and system dynamics. Artwork, specially written and plastic classics, is a fixed form of art. We frame them and put them (...) in a gallery, or a book (digital or physical). We don’t try to “fix” them or optimize their functioning, we analyze them to find meaning, intention, and patterns. In this article, we aim to show how, by building models combined with simple mathematical representations and analogies, it is possible to understand literary texts, from the prism of system and complexity theories, which emphasize the dynamic, non-linear, and non-reductionist aspects of the observed. We’ll demonstrate how modeling processes of three cultural assets, allow active correspondence with the original textual art, by treating them as systemic objects with interactions and dynamics. They will be analyzed while raising questions about the significance of modeling as a cognitive learning process. (shrink)

Loneliness in medicine is a serious problem not just for patients, for whom illness is intrinsically isolating, but also for physicians in the contemporary condition of medicine. We explore this problem by investigating the ideal physician-patient relationship, whose analogy with friendship has held enduring normative appeal. Drawing from Talbot Brewer and Nir Ben-Moshe, we argue that this appeal lies in a dynamic form of companionship incompatible with static models of friendship-like physician-patient relationships: a mutual refinement of embodied virtue that (...) draws both persons together. The ideal physician-patient relationship has a dialectical character that fosters each member's improvement of phenomenologically recognizing and embodying moral virtues. A key component of this dynamic is a commitment to the common goal of the patient's health, realized through joint interactivities and conversations over time. The physician's presence to the patient's suffering—understood best as an alienating phenomenological condition for the patient—orients and discloses possibilities for virtuous caregiving by structuring the meanings of the goals, conversations, and joint narrative constitutive of their relationship. Presence to suffering, paradoxically, is perhaps an important prerequisite for this dynamic partnership. These activities dialectically build an interpretive horizon of understanding through which moral goods and character refinement—in and for the other—may become revealed for both persons in their shared being-in-the-world. This analysis of suffering, mood, and revealing of (possible) moral goods has implications for addressing the modern problem of loneliness for patients and physicians, who are increasingly inhibited from building flourishing relationships with each other. (shrink)

Artefacts do not always do what they are supposed to, due to a variety of reasons, including manufacturing problems, poor maintenance, and normal wear-and-tear. Since software is an artefact, it should be subject to malfunctioning in the same sense in which other artefacts can malfunction. Yet, whether software is on a par with other artefacts when it comes to malfunctioning crucially depends on the abstraction used in the analysis. We distinguish between “negative” and “positive” notions of malfunction. A negative malfunction, (...) or dysfunction, occurs when an artefact token either does not or cannot do what it is supposed to. A positive malfunction, or misfunction, occurs when an artefact token may do what is supposed to but, at least occasionally, it also yields some unintended and undesirable effects. We argue that software, understood as type, may misfunction in some limited sense, but cannot dysfunction. Accordingly, one should distinguish software from other technical artefacts, in view of their design that makes dysfunction impossible for the former, while possible for the latter. (shrink)

Philosophers of logic are particularly interested in understanding the aims, epistemology, and methodology of logic. This raises the question of how the philosophy of logic should go about these enquires. According to the practice-based approach, the most reliable method we have to investigate the methodology and epistemology of a research field is by considering in detail the activities of its practitioners. This holds just as true for logic as it does for the recognised empirical and abstract sciences. If we wish (...) to systematically understand the aims and epistemology of logic, we are best placed achieving this by looking at what logicians do, rather than reflecting upon the nature of logic itself. In this entry, we outline the motivations for a practice-based approach towards the philosophy of logic and highlight its advantages over more “top-down” approaches, which attempt to infer conclusions about the nature of logic and its methodology on the basis of traditional assumptions about knowledge, metaphysics, or logic itself. We end by addressing several prominent concerns raised against the practice-based approach. (shrink)

The fundamental error of the metaphysical tradition, according to Heidegger, is the subordination of general ontology to the ontology of a special, exemplary entity (God, the soul, etc.). But Being and Time itself treats one kind of entity as exemplary, namely Dasein. Does this mean that Heidegger fails to free himself from the kind of metaphysics that he sought to criticize? To show how he avoids this charge I propose to examine the parallels between the methodology of Being and Time (...) and the methodology Heidegger ascribes to Aristotle's Metaphysics. Heidegger takes the virtue of Aristotle's inquiry to reside in the way he resists the subordination of general to special ontology: Aristotle was guided by a "double concept" of metaphysics, pursued two irreducibly distinct methods of inquiry, and avoided the temptation to unite them. In proposing to similarly pursue a "double task" in Being and Time Heidegger seeks to apply this insight to his own work. Alongside the task of fundamental ontology, Heidegger spells out the shape of a second task, Destruktion, understood as a historical critique that traces ontological concepts back to their ontic roots. But Destruktion is not a mere addendum to fundamental ontology; the two tasks are meant to counterbalance one another and thereby prevent the collapse of the ontological difference between being and beings. Indeed, Heidegger proposes to apply Destruktion to the results of his own fundamental ontology. He hopes to thereby achieve a transformation of the philosophical attitude which underpins the metaphysical tradition. (shrink)

Both Heidegger and Wittgenstein consider the possibility of a philosophical inquiry of an absolutely universal scope—an inquiry into the being of all beings, in Heidegger’s case, and into the logical form of everything that can be meaningfully said, in Wittgenstein’s. Moreover, they both raise the worry that the theoretical language by means of which we speak of particular beings and assert particular facts is not suited to this task. And yet their own philosophical work seems to include many assertions of (...) ordinary, theoretical language. Are they being inconsistent? Or are they hoping to use theoretical language in a way that conveys what cannot be said in that language? Much of the scholarship on each of these thinkers takes the form of one of the two horns of this dilemma. In the context of Wittgenstein scholarship, however, a third alternative has been proposed: the Resolute Reading of the Tractatus. My aim is to establish the availability of a similar solution to Heidegger’s predicament. It will emerge that Heidegger rejects the possibility of a theoretical account of being and pursues a project of a radically different sort, whose goal is to bring about a transformation of our fundamental relation to being. (shrink)

Is the mathematical function being computed by a given physical system determined by the system’s dynamics? This question is at the heart of the indeterminacy of computation phenomenon (Fresco et al. [unpublished]). A paradigmatic example is a conventional electrical AND-gate that is often said to compute conjunction, but it can just as well be used to compute disjunction. Despite the pervasiveness of this phenomenon in physical computational systems, it has been discussed in the philosophical literature only indirectly, mostly with reference (...) to the debate over realism about physical computation and computationalism. A welcome exception is Dewhurst’s ([2018]) recent analysis of computational individuation under the mechanistic framework. He rejects the idea of appealing to semantic properties for determining the computational identity of a physical system. But Dewhurst seems to be too quick to pay the price of giving up the notion of computational equivalence. We aim to show that the mechanist need not pay this price. The mechanistic framework can, in principle, preserve the idea of computational equivalence even between two different enough kinds of physical systems, say, electrical and hydraulic ones. (shrink)

Wittgenstein seeks to throw light on our concept of understanding by looking at how misunderstandings arise and what kinds of failure they involve. He discerns a peculiar sort of misunderstanding in the writings of the social anthropologist James Frazer. In Frazer’s hands, the anthropological project of enabling us to understand human behavior seems to yield the result that there are certain forms of human behavior that simply cannot be understood. The source of Frazer’s misunderstanding, according to Wittgenstein, is that he (...) places narrow requirements on what could count as meaningful, prior to and independently of his encounter with the subjects of his interpretation. Frazer, like some of the philosophers Wittgenstein addresses in his other works, succumbs to nonsense in his very attempt to draw the limits of sense. My aim in this chapter is to clarify the connections between Wittgenstein’s criticism of Frazer and his criticism of his fellow philosophers, in particular of Frege. The materials I draw on stem from various periods in Wittgenstein’s career, and they reveal, in my mind, an important continuity in Wittgenstein’s thought: addressing misunderstanding, in Wittgenstein’s view, is fundamentally an ethical problem, not a theoretical one. (shrink)

Wittgenstein’s Tractatus construes the nature of reasoning in a manner which sharply conflicts with the conventional wisdom that logic is normative, not descriptive of thought. For although we sometimes seem to reason incorrectly, Wittgenstein denies that we can make logical mistakes (5.473). My aim in this paper is to show that the Tractatus provides us with good reasons to rethink some of the central assumptions that are standardly made in thinking about the relation between logic and thought. In particular, the (...) rejection of logical mistakes is to be understood in connection with Wittgenstein’s non-psychological approach to the thinking subject (5.641). On Wittgenstein's view, inference, understanding, and meaning are holistically related; cases of defective reasoning are to be explained in terms of a defective grasp of meaning which manifests in an indeterminate use of signs. Invalid reasoning therefore does not count for Wittgenstein as a species of reasoning, but rather as the mere illusion of reasoning. The rejection of logical mistakes thus gives voice to a radical disjunctivist approach. (shrink)

The notion of the riddle plays a pivotal role in Wittgenstein’s Tractatus . By examining the comparisons he draws between philosophical problems and riddles, this paper offers a reassessment of the aims and methods of the book. Solving an ordinary riddle does not consist in learning a new fact; what it requires is that we transform the way we use words. Similarly, Wittgenstein proposes to transform the way philosophers understand the nature of their problems. But since he holds that these (...) problems are ultimately unsolvable, rather than attempting to solve the riddles of philosophy, he aims to dissolve them. (shrink)

I argue that we can visually perceive others as seeing agents. I start by characterizing perceptual processes as those that are causally controlled by proximal stimuli. I then distinguish between various forms of visual perspective-taking, before presenting evidence that most of them come in perceptual varieties. In doing so, I clarify and defend the view that some forms of visual perspective-taking are “automatic”—a view that has been marshalled in support of dual-process accounts of mindreading.

In this paper I present objections to the Fading Qualia and Dancing Qualia thought experiments, which David Chalmers uses to argue that functional organization fully determines conscious experience.

The world’s first COVID-19 human challenge trial using the D614G strain of SARS-CoV-2 is underway in the United Kingdom. The Wellcome Trust is funding challenge stock preparation of the Beta variant (B.1.351) for a follow-up human challenge trial, and researchers at Imperial College London are considering conducting that trial. However, little has been written thus far about the ethical justifiability of human challenge trials with SARS-CoV-2 variants of concern. While vaccine resistance as such does not increase risks for volunteers in (...) COVID-19 challenge trials, we explore two specific characteristics of some variants that may initially be thought to make such trials unethical and conclude that SARS-CoV-2 variant challenge trials can remain ethical. (shrink)

Philosophers have been contemplating the nature of the mind for centuries and have produced mountains of intricate jargon, thought experiments, and views, that map a landscape of interminable disputes. One such dispute is between philosophers who believe that the mind can be explained as a mechanism and philosophers who insist it cannot. In this paper I take a look at this dispute and argue that it is unique in philosophy and a key to the nature of the mind.

In Tractatus 5.132 Wittgenstein argues that inferential justification depends solely on the understanding of the premises and conclusion, and is not mediated by any further act. On this basis he argues that Frege’s and Russell’s rules of inference are “senseless” and “superfluous”. This line of argument is puzzling, since it is unclear that there could be any viable account of inference according to which no such mediation takes place. I show that Wittgenstein’s rejection of rules of inference can be motivated (...) by taking account of his holistic construal of the relation between inference and understanding. (shrink)

This paper defends the view, put roughly, that to think that p is to guess that p is the answer to the question at hand, and that to think that p rationally is for one’s guess to that question to be in a certain sense non-arbitrary. Some theses that will be argued for along the way include: that thinking is question-sensitive and, correspondingly, that ‘thinks’ is context-sensitive; that it can be rational to think that p while having arbitrarily low credence (...) that p; that, nonetheless, rational thinking is closed under entailment; that thinking does not supervene on credence; and that in many cases what one thinks on certain matters is, in a very literal sense, a choice. Finally, since there are strong reasons to believe that thinking just is believing, there are strong reasons to think that all this goes for belief as well. (shrink)

The historical consensus is that logical evidence is special. Whereas empirical evidence is used to support theories within both the natural and social sciences, logic answers solely to a priori evidence. Further, unlike other areas of research that rely upon a priori evidence, such as mathematics, logical evidence is basic. While we can assume the validity of certain inferences in order to establish truths within mathematics and test scientifi c theories, logicians cannot use results from mathematics or the empirical sciences (...) without seemingly begging the question. Appeals to rational intuition and analyticity in order to account for logical knowledge are symptomatic of these commitments to the apriority and basicness of logical evidence. This chapter argues that these historically prevalent accounts of logical evidence are mistaken, and that if we take logical practice seriously we fi nd that logical evidence is rather unexceptional, sharing many similarities to the types of evidence appealed to within other research areas. (shrink)

This chapter investigates how a reading of Wittgenstein along the lines laid out by Cora Diamond makes room for a novel approach to ethical truth. Following Diamond, I develop the connection between the kinds of elucidatory propositions by means of which we spell out and maintain the shape of our theoretical thinking, such as “‘someone’ is not the name of someone” and “five plus seven equals twelve,” and the kind of propositions by means of which we spell out and maintain (...) the shape of ethical thinking, such as “slavery is unjust.” As Diamond points out in connection with the last example, this is a proposition that we take to be an undeniable truth; for anyone who would attempt to negate it would become unintelligible to us. In this sense this ethical truth spells out the limits of ethical thinking. And yet what counts as coherent thought about such matters tends to shift over time. Indeed the great difficulty of overcoming ethical disagreements has to do with the fact that what is at stake in them is not just the content, but the form and limits of thought. Nonetheless, Diamond proposes that ethical propositions may count as genuine truths. For this to make sense, a middle path between realism and relativism must be found. In order to show how this is possible, and in order to defend Diamond’s view, I propose to approach ethical truth by means of a disjunctivist strategy. On this approach, while we, just as much as our interlocutor, may at times be misled in our ethical thinking, and while we may at times fail to shape our ethical thought in ways that prevent us from gaining clarity on ethical matters, this does not detract from the fact that we may at times be right, and that we may then genuinely possess ethical truth. (shrink)

Adaptive preference formation is the unconscious altering of our preferences in light of the options we have available. Jon Elster has argued that this is bad because it undermines our autonomy. I agree, but think that Elster's explanation of why is lacking. So, I draw on a richer account of autonomy to give the following answer. Preferences formed through adaptation are characterized by covert influence (that is, explanations of which an agent herself is necessarily unaware), and covert influence undermines our (...) autonomy because it undermines the extent to which an agent's preferences are ones that she has decided upon for herself. This answer fills the lacuna in Elster's argument. It also allows us to draw a principled distinction between adaptive preference formation and the closely related phenomenon of character planning. (shrink)

In this paper, I reconstruct Robert Nozick's experience machine objection to hedonism about well-being. I then explain and briefly discuss the most important recent criticisms that have been made of it. Finally, I question the conventional wisdom that the experience machine, while it neatly disposes of hedonism, poses no problem for desire-based theories of well-being.

I introduce a distinction between health need and medical need, and raise several questions about their interaction. Health needs are needs that relate directly to our health condition. Medical needs are needs which bear some relation to medical institutions or processes. I suggest that the question of whether medical insurance or public care should cover medical needs, health needs, or only needs which fit both categories is a political question that cannot be resolved definitionally. I also argue against an overly (...) strict definition of medical need on the grounds that this presupposes, wrongly, that medical intervention should always be a last resort. (shrink)

This paper concerns Wittgenstein’s conception of philosophical and mathematical problems. Both in his earlier and in his later writings Wittgenstein grapples with the tendency of philosophers to misconstrue the nature of the difficulties that they are facing. Whereas philosophers tend to assume that their problems are comparable to those that come up in the sciences, and take these problems to consist in questions the answers to which will provide them with substantive knowledge, Wittgenstein compares philosophical problems with riddles. What is (...) characteristic of riddles is that solving them involves an alteration of the use of language, but it does not tend to involve the acquisition of new knowledge. In his middle and later period, the comparison with riddles serves to highlight and resolve a related confusion in the way philosophers of mathematics understand the nature of mathematical problems. Wittgenstein rejects the realist approach according to which every mathematical theorem, whether proven or not, meaningfully specifies a possible fact which would make it true or false. By contrast, Wittgenstein construes unproven conjectures on the model of riddle phrases, whose meaning, prior to our finding the solution to them, has not been determined. Moreover, Wittgenstein draws our attention to the fact that we can be caught up in an attempt to solve a riddle even if the riddle does not have a solution; the same applies, in his mind, to our engagement with philosophical and mathematical problems. When it comes to philosophical riddles, Wittgenstein is convinced that they do not have a solution at all. The specific difficulty presented by unproven mathematical conjectures is different; in this case, we cannot tell in advance whether or not they present us with a solvable riddle. The paper situates these issues in the context of ongoing debates in the scholarship concerning Wittgenstein’s conception of nonsense, his methodology, his engagement with mathematical realism and verificationism, and his response to skepticism. (shrink)

According to attitudinal theories of pleasure and pain, what makes a given sensation count as a pleasure or a pain is just the attitudes of the experiencing agent toward it. In a previous article, I objected to such theories on the grounds that they cannot account for pleasures and pains whose subjects are entirely unaware of them at the time of experience. Recently, Chris Heathwood and Fred Feldman, the two leading contemporary defenders of attitudinal theories, have responded to this objection, (...) in very different ways. In this paper, I reconstruct and evaluate these responses. My conclusion is that neither response succeeds. (shrink)

There is an ongoing increase in the use of mobile health technologies that patients can use to monitor health-related outcomes and behaviours. While the dominant narrative around mHealth focuses on patient empowerment, there is potential for mHealth to fit into a growing push for patients to take personal responsibility for their health. I call the first of these uses ‘medical monitoring’, and the second ‘personal health surveillance’. After outlining two problems which the use of mHealth might seem to enable us (...) to overcome—fairness of burdens and reliance on self-reporting—I note that these problems would only really be solved by unacceptably comprehensive forms of personal health surveillance which applies to all of us at all times. A more plausible model is to use personal health surveillance as a last resort for patients who would otherwise independently qualify for responsibility-based penalties. However, I note that there are still a number of ethical and practical problems that such a policy would need to overcome. The prospects of mHealth enabling a fair, genuinely cost-saving policy of patient responsibility are slim. (shrink)

The philosophical study of well-being concerns what makes lives good for their subjects. It is now standard among philosophers to distinguish between two kinds of well-being: - lifetime well-being, i.e., how good a person's life was for him or her considered as a whole, and - temporal well-being, i.e., how well off someone was, or how they fared, at a particular moment in time or over a period of time longer than a moment but shorter than a whole life, say, (...) a day, month, year, or chapter of a life. Many theories have been offered of each of these kinds of well-being. A common view is that lifetime well-being is in some way constructed out of temporal well-being. This book argues that much of this literature is premised on a mistake. Lifetime well-being cannot be constructed out of temporal well-being, because there is no such thing as temporal well-being. The only genuine kind of well-being is lifetime well-being. The Passing of Temporal Well-Being will prove essential reading for professional philosophers, especially in moral and political philosophy. It will also be of interest to welfare economists and policy-makers who appeal to well-being. (shrink)

By means of a reductio argument, Wittgenstein’s Tractatus calls into question the very idea that we can represent logical form. My paper addresses three interrelated questions: first, what conception of logical form is at issue in this argument? Second, whose conception of logic is this argument intended to undermine? And third, what could count as an adequate response to it? I show that the argument construes logical form as the universal, underlying correlation of any representation and the reality it represents. (...) I further show that the argument seeks to undermine core commitments of Frege’s and Russell’s. But the reductio, as I read it, is not intended to establish the falsity of any of their specific assumptions. Rather, its aim is to make manifest the indeterminacies that underlie the language in which these assumptions are framed, and establish the need for a transformation of that language. So understood, Wittgenstein’s argument exemplifies his idea that philosophy is not a theory, but an activity of elucidation. The interpretation I propose bears on one of the central debates in the literature, namely how we should understand Wittgenstein’s contention that his elucidations succeed despite being nonsensical. (shrink)

A considerable literature has emerged around the idea of using ‘personal responsibility’ as an allocation criterion in healthcare distribution, where a person's being suitably responsible for their health needs may justify additional conditions on receiving healthcare, and perhaps even limiting access entirely, sometimes known as ‘responsibilisation’. This discussion focuses most prominently, but not exclusively, on ‘luck egalitarianism’, the view that deviations from equality are justified only by suitably free choices. A superficially separate issue in distributive justice concerns the two–way relationship (...) between health and other social goods: deficits in health typically undermine one's abilities to secure advantage in other areas, which in turn often have further negative effects on health. This paper outlines the degree to which this latter relationship between health and other social goods exacerbates an existing problem for proponents of responsibilisation (the ‘harshness objection’) in ways that standard responses to this objection cannot address. Placing significant conditions on healthcare access because of a person's prior responsibility risks trapping them in, or worsening, negative cycles where poor health and associated lack of opportunity reinforce one another, making further poor yet ultimately responsible choices more likely. It ends by considering three possible solutions to this problem. (shrink)

Animals suffer harms not only in human captivity but in the wild as well. Some of these latter harms are due to humans, but many of them are not. Consider, for example, the harms of predation, i.e. of being hunted, killed, and eaten by other animals. Should we intervene in nature to prevent these harms? In this article, I consider two possible ways in which we might do so: (1) by herbivorising predators (i.e. genetically modify them so that their offspring (...) gradually evolve into herbivores) and (2) by painlessly killing predators. I argue that, among these options, painlessly killing predators would be preferable to herbivorising them. I then argue that painlessly killing predators, despite its costs to predators, might under certain circumstances be justifiable. (shrink)

A clear and provocative introduction to the ethics of COVID-19, suitable for university-level students, academics, and policymakers, as well as the general reader. It is also an original contribution to the emerging literature on this important topic. The author has made it available Open Access, so that it can be downloaded and read for free by all those who are interested in these issues. Key features include: -/- A neat organisation of the ethical issues raised by the pandemic. An exploration (...) of the many complex interconnections between these issues. A succinct case for a continued lockdown until we develop a vaccine. An original account of the Deep Moral Problem of the Pandemic, and a Revolutionary Argument for how we should change society post-pandemic. References to, and engagement with, many of the best writings on the pandemic so far (both in popular media and academic journals). -/- ISBN: 978-0-6489016-0-0. (shrink)

According to the Standard View, a doctor who withdraws life-sustaining treatment does not kill the patient but rather allows the patient to die—an important distinction, according to some. I argue that killing can be understood in either of two ways, and given the relevant understanding, the Standard View is insulated from typical criticisms. I conclude by noting several problems for the Standard View that remain to be fully addressed.

In this paper, I set out and defend a new theory of value, whole-life welfarism. According to this theory, something is good only if it makes somebody better off in some way in his life considered as a whole. By focusing on lifetime, rather than momentary, well-being, a welfarist can solve two of the most vexing puzzles in value theory, The Badness of Death and The Problem of Additive Aggregation.

This paper defends the simple view that in asserting that p, one lies iff one knows that p is false. Along the way it draws some morals about deception, knowledge, Gettier cases, belief, assertion, and the relationship between first- and higher-order norms.