Introduction: Clinical practice guidelines (CPGs) are an important source of justification for clinical decisions in modern evidence-based practice. Yet, we have given little attention to how they argue their evidence. In particular, how do CPGs argue for treatment with long-term medications that are increasingly prescribed to older patients? Approach and rationale: I selected six disease-specific guidelines recommending treatment with five of the medication classes most commonly prescribed for seniors in Ontario, Canada. I considered the stated aims of these CPGs and (...) the techniques employed towards those aims. Finally, I reconstructed and logically analysed the arguments supporting recommendations for pharmacotherapy. Analysis: The primary function of CPGs is rhetorical, or persuasive, and their means of persuasion include both a display of their credibility and their argumentation. Arguments supporting pharmacotherapy recommendations for the target population follow a common inductive pattern: statistical generalization from randomized controlled trial (RCT) and meta-analysis evidence. Two of the CPGs also argue their treatment recommendations for older patients in this style, while three fail to justify pharmacotherapy specifically for the older population. Discussion: The arguments analysed lack the auxiliary assumptions that would warrant making a generalization about the clinical effectiveness of medications for the older population. Guidelines reason using simple induction, while ignoring important inferential gaps. Future guidelines should aspire to be well-reasoned rather than simply evidence-based; argue from a plurality of evidence; be wary of hasty inductions; appropriately limit the scope of their recommendations; and avoid making law-like, prescriptive generalizations. (shrink)

It is sometimes thought that randomized study group allocation is uniquely proficient at producing comparison groups that are evenly balanced for all confounding causes. Philosophers have argued that in real randomized controlled trials this balance assumption typically fails. But is the balance assumption an important ideal? I run a thought experiment, the CONFOUND study, to answer this question. I then suggest a new account of causal inference in ideal and real comparative group studies that helps clarify the roles of confounding (...) variables and randomization. 1Confounders and Causes2The Balance Assumption3The CONFOUND Study 3.1CONFOUND 13.2CONFOUND 24Disjunction C and the Ideal Study 4.1The ultimate ‘other cause’: C4.2The ideal comparative group study4.3Required conditions for causal inference5Confounders as Causes, Confounders as Correlates6Summary. (shrink)

Over the past 25 years, several new “medicines” have come screeching onto health care’s various platforms, including narrative medicine, personalized medicine, precision medicine and person-centred medicine. Philosopher Miriam Solomon calls the first three of these movements different “ways of knowing” or “methods,” and argues that they are each a response to shortcomings of methods that came before them. They should also be understood as reactions to the current dominant model of medicine. In this article, I will describe our dominant model, (...) which I call “the new medical model.” I will argue that several towering problems in modern medicine can be traced to its philosophical foundations, which calls for philosophical analysis. (shrink)

Many epidemics consist in individuals spreading infection to others. From the population perspective, they also have population characteristics important in modeling, explaining, and intervening in epidemics. I analyze epidemiology’s contemporary population perspective through the example of epidemics by examining two central principles attributed to Geoffrey Rose: a distinction between the causes of cases and the causes of incidence, and between “high-risk” and “population” strategies of prevention. Both principles require revision or clarification to capture the sense in which they describe distinct (...) perspectives on the same phenomenon, each perspective capturing a different level of contrastive analysis. (shrink)

Over the past several decades, we devoted much energy to generating, reviewing and summarizing evidence. We have given far less attention to the issue of how to thoughtfully apply the evidence once we have it. That’s fine if all we care about is that our clinical decisions are evidence-based, but not so good if we also want them to be well-reasoned. Let us not forget that evidence based medicine (EBM) grew out of an interest in making medicine ‘rational’, with the (...) idea that rational clinical evaluations should be evidence-based. I agree with the uncontroversial statement that the best decision is supported, at least in part, by the best available evidence. Rationality, however, is constituted by reasoning, not evidence. Complete arguments are necessary for rational evaluations, arguments that begin with general evidence and end in a conclusion about a particular patient. In order to traverse these inferential gaps, medicine must address the issue of how to establish, as an intermediate premise, what the evidence has to say about the efficacy of an intervention for particular patients in a particular practice setting. (shrink)

The new field of meta-research investigates industry bias, publication bias, contradictions between studies, and other trends in medical research. I argue that its findings should be used as meta-evidence for evaluating therapies. ‘Meta-evidence’ is evidence about the support that direct ‘first-order evidence’ provides the hypothesis. I consider three objections to my proposal: the irrelevance objection, the screening-off objection, and the underdetermination objection. I argue that meta-research evidence works by rationally revising our confidence in first-order evidence and, consequently, in the hypothesis—typically, (...) downward. (shrink)

What meaning does epidemiological evidence have for the individual? In evidence-based medicine, epidemiological evidence measures the patient’s risk of the outcome or the change in risk due to an intervention. The patient’s risk is commonly understood as an individual probability. The problem of understanding epidemiological evidence and risk thus becomes the challenge of interpreting individual patient probabilities. I argue that the patient’s risk is interpreted ontically, as a propensity. After exploring formidable problems with this interpretation in the medical context, I (...) propose an epistemic reinterpretation of individual patient probabilities as credences. On this view, epidemiological evidence informs medical uncertainty. (shrink)

Last year saw the 20th anniversary edition of JECP, and in the introduction to the philosophy section of that landmark edition, we posed the question: apart from ethics, what is the role of philosophy ‘at the bedside’? The purpose of this question was not to downplay the significance of ethics to clinical practice. Rather, we raised it as part of a broader argument to the effect that ethical questions – about what we should do in any given situation – are (...) embedded within whole understandings of the situation, inseparable from our beliefs about what is the case, what it is that we feel we can claim to know, as well as the meaning we ascribe to different aspects of the situation or to our perception of it. Philosophy concerns fundamental questions: it is a discipline requiring us to examine the underlying assumptions we bring with us to our thinking about practical problems. Traditional academic philosophers divide their discipline into distinct areas that typically include logic: questions about meaning, truth and validity; ontology: questions about the nature of reality, what exists; epistemology: concerning knowledge; and ethics: how we should live and practice, the nature of value. Any credible attempt to analyse clinical reasoning will require us to think carefully about these types of question and the relationships between them, as they influence our thinking about specific situations and problems. So, the answers to the question we posed, about the role of philosophy at the bedside, are numerous and diverse, and that diversity is illustrated in the contributions to this thematic edition. (shrink)

This chapter begins with an empirical analysis of attitudes towards the law, which, in turn, inspires a philosophical re-examination of the moral status of the rule of law. In Section 2, we empirically analyse relevant survey data from the US. Although the survey, and the completion of our study, preceded the recent anti-police brutality protests sparked by the killing of George Floyd, the relevance of our observations extends to this recent development and its likely reverberations. Consistently with prior studies, we (...) find that people’s ascriptions of legitimacy to the legal system are predicted strongly by their perceptions of the procedural justice and lawfulness of police and court officials’ action. Two factors emerge as significant predictors of people’s compliance with the law: (i) their belief that they have a (content-independent, moral) duty to obey the law (which is one element of legitimacy, as defined here); and (ii) their moral assessment of the content of specific legal requirements (‘perceived moral content of laws’). We also observe an interactive relationship between these two factors. At higher levels of perceived moral content of laws, felt duty to obey is a better predictor of compliance. And, similarly, perceived moral content of laws is a better predictor of compliance at higher levels of felt duty to obey. This suggests that the moral content incorporated in specific laws interacts with the normative force people ascribe to legal authorities by virtue of other qualities, specifically here procedural justice and lawfulness. In Section 3, the focus shifts to a philosophical analysis, whereby we identify a parallel (similarly interactive) modality in the way that form and content mutually affect the value of the rule of law. We advocate a distinctive alternative to two rival approaches in jurisprudential discourse, the first of which claims that Lon Fuller’s eight precepts of legality embody moral qualities not contingent on the law’s content, while the second denies any independent moral value in these eight precepts, viewing them as entirely subservient to the law’s substantive goals. In contrast, on the view put forward here, Fuller’s principles possess (inter alia) an expressive moral quality, but their expressive effect does not materialise in isolation from other, contextual factors. In particular, the extent to which it materialises is partly sensitive to the moral quality of the law’s content. (shrink)

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

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

This chapter surveys a few of the central questions about philosophical perspectives on the ethics of belief, focusing especially on (1) questions about whether doxastic involuntarism is consistent with the normative approach to epistemology characteristic of any ethics of belief; (2) the status and interpretation of William Clifford's famous injunction against belief on "insufficient" evidence, and broader questions about the role of negative versus positive doxastic norms; (3) whether norms governing belief are distinctively epistemic norms, or are instead moral or (...) practical ones; and (4) how moral and political questions about belief bear on epistemic norms, including a discussion of doxastic wronging, racist beliefs, skepticism and rape culture, and epistemic partiality—whether, for instance, friendship requires beliefs that violate epistemic norms. (shrink)

My aim in this chapter is to clarify the nature of the shift in Feyerabend’s philosophical thinking in the 1970s, focusing on issues of realism, relativism, and pluralism. Contra-Preston, I argue that realism-relativism is a misleading variable for characterizing Feyerabend’s shift in the 1970s. Rather, I characterize this shift as Feyerabend’s expansion of pluralism and suggest that this shift appears in Feyerabend’s publications starting in the late-1960s (e.g., Feyerabend 1968b, 1969b, 1970a, 1970c). Adopting the terminology of Brown and Kidd (2016), (...) this shift is characterized by a move from arguments for pluralism within science to broader arguments for pluralism in society. I argue that this shift was largely due to: (1) Feyerabend’s rejection of an empiricist demarcation criterion for science in the mid-1960s, and (2) Feyerabend’s incorporation of Mill’s arguments for pluralism into his own publications starting in 1970. This shift can be characterized as a broadening or expanding the scope of Feyerabend’s arguments for pluralism from contexts of scientific knowledge to the broader context of social or cultural (including ethical) knowledge. I articulate this argument with reference to the framework for classifying Feyerabend’s works formulated by Brown and Kidd (2016). Against Brown and Kidd (and Preston), I argue that realism-relativism is a red-herring as a variable for distinguishing Feyerabend’s early and middle works. Brown and Kidd’s distinction between pluralism within science and pluralism in society is a more useful variable for characterizing Feyerabend’s shift in thinking in the 1970s. Whereas Preston (1997) and Brown and Kidd (2016) identify the beginning of Feyerabend’s pluralism in society phase in 1978 with the publication of Science in a Free Society (Feyerabend 1978), I suggest that the relevant shift occurs much earlier, and it appears in Feyerabend’s publications starting in 1970 (Feyerabend 1970a, 1970b). On this understanding, Feyerabend’s philosophical shift (c. 1970) should be viewed as an expansion (or broadening) of the scope of application of his pluralist arguments, inspired by Mill’s ethical arguments for pluralism in society (Mill 1859/1977). (shrink)

Is the brain really a computer? In particular, is our intelligence a computational achievement: is it because our brains are computers that we get on in the world as well as we do? In this paper I will evaluate an ambitious new argument to the contrary, developed in Landgrebe and Smith (2021a, 2022). Landgrebe and Smith begin with the fact that many dynamical systems in the world are difficult or impossible to model accurately (inter alia, because it is intractable to (...) find exact solutions to the differential equations that describe them—meaning we have to approximate—but at the same time they are such that small differences in starting conditions lead to big differences in final conditions, thwarting accurate approximation). Yet we manage to survive and thrive in a world full of such systems. Landgrebe and Smith argue from these premises that it is not because our brains are computers that we get on as well as we do: instead it is because of the various ways that we dynamically couple with such systems, these couplings themselves impossible to model well enough to emulate in silico. Landgrebe and Smith thus defend a dynamical systems model in the lineage of Gibson (1979), Van Gelder (1995), and Thompson (2007), though their focus is on decisively refuting the computationalist alternatives rather than developing the positive account. Here I will defend the claim that human intelligence is genuinely computational (and that whole brain emulation and others forms of AGI may be possible) against this argument. (shrink)

Non‐governmental aid programs are an important source of health care for many people in the developing world. Despite the central role non‐governmental organizations play in the delivery of these vital services, for the most part they either lack formal systems of accountability to their recipients altogether, or have only very weak requirements in this regard. This is because most NGOs are both self‐mandating and self‐regulating. What is needed in terms of accountability is some means by which all the relevant stakeholders (...) can have their interests represented and considered. An ideally accountable decision‐making process for NGOs should identify acceptable justifications and rule out unacceptable ones. Thus, the point of this paper is to evaluate three prominent types of justification given for decisions taken at the Dutch headquarters of Médecins sans Frontières. They are: population health justifications, mandate‐based justifications and advocacy‐based justifications. The central question at issue is whether these justifications are sufficiently robust to answer the concerns and objections that various stakeholders may have. I am particularly concerned with the legitimacy these justifications have in the eyes of project beneficiaries. I argue that special responsibilities to certain communities can arise out of long‐term engagement with them, but that this type of priority needs to be constrained such that it does not exclude other potential beneficiaries to an undesirable extent. Finally, I suggest several new institutional mechanisms that would enhance the overall equity of decisions and so would ultimately contribute to the legitimacy of the organization as a whole. (shrink)

Abstract: In The Imaginary Jean-Paul Sartre makes what will strike many as an implausibly strong claim, namely that perception and imagination are incompatible kinds of experience - I call this the exclusion claim. This paper offers a reconstruction of Sartre’s exclusion claim. First, it frames the claim in terms of cross-modal attention distribution, such that it is not possible to simultaneously attend to what one is imagining and what one is perceiving. However, this leaves it open that a subject can (...) simultaneously imagine and perceive on the condition that either the perceived or imagined objects are not attended to. While this is a philosophically plausible position it fails to do justice to Sartre’s intended position, which suggests a more radical exclusion between perception and imagination. In light of this section 3 develops a supplementary argument to remove one of the possible configurations of attention that the ban on divided attention leaves in place by arguing that the objects of imagining must be attended to, which follows from Sartre’s characterisation of imagination as spontaneous. The resulting exclusion is as follows: attentive perception excludes imagination (and vice versa), given that the latter is necessarily attentive, but attentive imagination can co-occur with non-attentive or background perception (in this sense the exclusion is asymmetric in a way that Sartre fails to recognise). In concluding I detail how from this exclusion we get an important consequence – which Sartre wants the exclusion claim to have – namely that it rules out an imagination-based solution to the problem of perceptual presence. (shrink)

Political polarization is one of the most discussed challenges facing contemporary democracies and is often associated with a broader epistemic crisis. While inspiring a large literature in political science, polarization’s epistemic problems also have significance for normative democratic theory, and this study develops a new approach aimed at understanding them. In contrast to prominent accounts from political psychology—group polarization theory and cultural cognition theory—which argue that polarization leads individuals to form unreliable political beliefs, this study focuses on system-level diversity. It (...) argues that polarization’s epistemic harms are best located in its tendency to reduce the diversity of perspectives utilized in a democratic system and in how this weakens the system’s ability to identify and address problems of public concern. Understanding such harms is also argued to require a greater consideration of the political dynamics of polarization and issues of elite discourse, alongside political psychology. (shrink)

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

In this paper, I explore the Guam Department of Education's (GDOE) decolonization efforts and the potential role of Philosophy for Children (P4C) as a strategic tool for its advancement. I begin with a discussion of Guam's colonial context and its implications for contemporary education on the island. While the GDOE's current attempts to decolonize Guam's public education emphasize the need for an "official body of knowledge," many CHamoru scholars and activists have argued that it is not enough. This paper agrees (...) that such content-based reforms are insufficient and advocates for a more nuanced approach to education through P4C. Drawing on the P4C literature and decolonial education, I argue that while P4C alone may not bring about structural change, its pedagogical framework offers a promising alternative when adapted to indigenous contexts. The paper proposes that P4C can serve as a "Trojan Horse" within public schools, fostering decolonial acts of resurgence by elevating indigenous knowledge, welcoming indigenous masters, and empowering CHamoru students within a Westernized educational setting. (shrink)

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)

Deliberative democracy is increasingly criticised as out of touch with the realities of partisan politics. This paper considers the rise of fake and hyperpartisan news as one source of this scepticism. While popular accounts often blame such content on citizens’ political biases and motivated reasoning, I survey the empirical evidence and argue that it does not support strong claims about the inability of citizens to live up to deliberative ideals. Instead, much of this research is shown to support the deliberative (...) capacities of citizens and points to their potential in helping to reduce the spread of false and misleading content. (shrink)

Thomas Pogge and Andrew Kuper suggest that we should promote an ‘institutional’ solution to global poverty. They advocate the institutional solution because they think that non-governmental organizations (NGOs) can never be the primary agents of justice in the long run. They provide several standard criticisms of NGO aid in support of this claim. However, there is a more serious problem for institutional solutions: how to generate enough goodwill among rich nation-states that they would be willing to commit themselves to supranational (...) institutional reforms. In the current international political climate, the implementation of such institutional reforms introduces several intractable problems, including difficulties of global coordination and enforcement. I defend the solution of NGO aid from the criticisms presented by Pogge and Kuper, and propose how it might be reformed. My main suggestion is that all practising NGOs should be required to be ‘accountable for reasonableness’ in the sense that Norman Daniels and James Sabin have outlined. (shrink)

This article is a response to William Lynch’s, ‘Social Epistemology Transformed: Steve Fuller’s Account of Knowledge as a Divine Spark for Human Domination,’ an extended and thoughtful reflection on my Knowledge: The Philosophical Quest in History. I grant that Lynch has captured well, albeit critically, the spirit and content of the book – and the thirty-year intellectual journey that led to it. In this piece, I respond at two levels. First, I justify my posture towards my predecessors and contemporaries, (...) which Lynch shrewdly sees as my opposition to deference. However, most of the response concerns an elaboration of my theodicy-focussed sense of social epistemology, which is long-standing but only started to become prominent about ten years ago, in light of my involvement in the evolution controversies. Here I aim to draw together a set of my abiding interests – scientific, theological and philosophical – in trying to provide a normative foundation for the future of humanity. (shrink)

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

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

Epistemic Courage is a timely and thought-provoking exploration of the ethics of belief, which shows why epistemology is no mere academic abstraction - the question of what to believe couldn't be more urgent. Jonathan Ichikawa argues that a skeptical, negative bias about belief is connected to a conservative bias that reinforces the status quo.

Citizens of liberal, affluent societies are regularly encouraged to support reforms meant to improve conditions for badly-off people in the developing world. Our economic and political support is solicited for causes such as: banning child labor, implementing universal primary education, closing down sweatshops and brothels, etc. But what if the relevant populations or individuals in the developing world do not support these particular reforms or aid programs? What if they would strongly prefer other reforms and programs, or would rank the (...) various benefits that might be offered differently than seems reasonable to the Western, liberal supporters of these campaigns and organizations? What is the proper liberal response here? I argue that the proper liberal response is to support those programs and reforms that the global poor most value. The bulk of the paper is devoted to arguing against the popular liberal argument which states that we can safely disregard the preferences of the oppressed when they seem very unreasonable because these individuals suffer from “adaptive preferences.” This typically is taken to mean that their preferences are “not their own” in an important sense. I put forward various different proposals for why adaptive preferences can be safely dismissed, but ultimately argue that they are not persuasive. And if it is no longer legitimate to appeal to adaptive preferences as a basis for disregarding what oppressed people want, then I argue that to do so is straightforward paternalism, and so is unjustifiable in all but the most extreme cases. Finally, I argue for the following concrete recommendations: Given that resources are not infinite, we should (1) Support programs that give oppressed people increased access to information, such as access to technology, (2) support those reforms and aid programs that the oppressed themselves regard as most important, with special emphasis on those opportunities for education that they deem valuable, and (3) refrain from supporting coercive policies intended to thwart adaptive preferences. (shrink)

Who should decide who gets to say what on online social media platforms like Facebook, Twitter, and YouTube? American legal scholars have often thought that the private owners of these platforms should decide, in part because such an arrangement is thought to serve valuable free speech interests. This standard view has come under pressure with the enactment of statutes like Texas House Bill 20, which forbids certain platforms from “censoring” user content based on viewpoint. Such efforts to regulate the speech (...) policies of online platforms have been challenged for undermining the editorial speech rights of these platforms and allowing the proliferation of hate speech. This Article develops a democratic theory of free speech, according to which one of the most important reasons for protecting robust free speech rights is that free speech can contribute not only to democratic elections but to a democratic culture more generally. To achieve robust cultural democracy, a community’s speech environment must enable people not only to rationally persuade one another about matters of public importance and convey mutual respect to one another as political equals but also allow people to influence each other in a less articulate and rational manner—to “democratically vibe” with one another. This theory yields a qualified normative defense of government regulation of the speech policies of large social media platforms that can help to realize cultural democracy, suggesting that First Amendment doctrine should focus to a greater extent on protecting the speech rights of platform users, rather than platform owners. Although far from a ringing endorsement of H.B. 20 or S.B. 7072, this Article suggests that First Amendment law should be friendlier to state regulation of platform speech than many critics have thought. (shrink)

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

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)

Recent scientific research has settled on a purely descriptive definition of happiness that is focused solely on agents’ psychological states (high positive affect, low negative affect, high life satisfaction). In contrast to this understanding, recent research has suggested that the ordinary concept of happiness is also sensitive to the moral value of agents’ lives. Five studies systematically investigate and explain the impact of morality on ordinary assessments of happiness. Study 1 demonstrates that moral judgments influence assessments of happiness not only (...) for untrained participants, but also for academic researchers and even in those who study happiness specifically. Studies 2 and 3 then respectively ask whether this effect may be explained by general motivational biases or beliefs in a just world. In both cases, we find evidence against these explanations. Study 4 shows that the impact of moral judgments cannot be explained by changes in the perception of descriptive psychological states. Finally, Study 5 compares the impact of moral and non-moral value, and provides evidence that unlike non-moral value, moral value is part of the criteria that govern the ordinary concept of happiness. Taken together, these studies provide a specific explanation of how and why the ordinary concept of happiness deviates from the definition used by researchers studying happiness. (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.

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

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

Following John Rawls, nonideal theory is typically divided into: (1) “partial-compliance theory” and (2) “transitional theory." The former is concerned with those circumstances in which individuals and political regimes do not fully comply with the requirements of justice, such as when people break the law or some individuals do not do their fair share within a distributive scheme. The latter is concerned with circumstances in which background institutions may be unjust or may not exist at all. This paper focuses on (...) issues arising in transitional theory. In particular, I am concerned with what Rawls’ has called “burdened societies," that is, those societies that find themselves in unfavorable conditions, such that their historical, social or economic circumstances make it difficult to establish just institutions. The paper investigates exactly how such burdened societies should proceed towards a more just condition in an acceptable fashion. Rawls himself tells us very little, except to suggest that societies in this condition should look for policies and courses of action that are morally permissible, politically possible and likely to be effective. In this paper I first try to anticipate what a Rawlsian might say about the best way for burdened societies to handle transitional problems and so move towards the ideal of justice. Next, I construct a model of transitional justice for burdened societies. Ultimately, I argue for a model of transitional justice that makes use of a nonideal version of Rawls’ notion of the worst-off representative person. (shrink)

How does consciousness vary across the animal kingdom? Are some animals ‘more conscious’ than others? This article presents a multidimensional framework for understanding interspecies variation in states of consciousness. The framework distinguishes five key dimensions of variation: perceptual richness, evaluative richness, integration at a time, integration across time, and self-consciousness. For each dimension, existing experiments that bear on it are reviewed and future experiments are suggested. By assessing a given species against each dimension, we can construct a consciousness profile for (...) that species. On this framework, there is no single scale along which species can be ranked as more or less conscious. Rather, each species has its own distinctive consciousness profile. (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)

Built-in decision thresholds for AI diagnostics are ethically problematic, as patients may differ in their attitudes about the risk of false-positive and false-negative results, which will require that clinicians assess patient values.