Guy Kahane and Julian Savulescu respond to my paper “Valuing Disability, Causing Disability” by arguing that my assessment of objections to the mere-difference view of disability is unconvincing and fails to explain their conviction that it is impermissible to cause disability. In reply, I argue that their response misconstrues, somewhat radically, both what I say in my paper and the commitments of the mere-difference view more generally. It also fails to adequately appreciate the unique epistemic factors present in philosophical discussions (...) of disability. (shrink)

We often find ourselves in situations where it is up to us to make decisions on behalf of others. How can we determine whether such decisions are morally justified, especially if those decisions may change who it is these others end up becoming? In this paper, I will evaluate one plausible kind of justification that may tempt us: we may want to justify our decision by appealing to the likelihood that the other person will be glad we made that specific (...) choice down the line. Although it is tempting, I ultimately argue that we should reject this sort of appeal as a plausible justification for the moral permissibility of our vicarious decisions. This is because the decisions that we make on behalf of another may affect the interests and values that that person will hold in the future. As I will show, this complicates the justificatory relationship between present decisions and future attitudes, since the latter can depend on the former. This is not to say that the predicted future attitudes of others can play no significant role in justifying our decisions on others’ behalf. Rather, appealing to the future attitudes in our moral justifications may play an important role in our practical thinking but only when we consider the future attitudes of all relevant possible futures. (shrink)

Many economists and philosophers assume that status quo bias is necessarily irrational. I argue that, in some cases, status quo bias is fully rational. I discuss the rationality of status quo bias on both subjective and objective theories of the rationality of preferences. I argue that subjective theories cannot plausibly condemn this bias as irrational. I then discuss one kind of objective theory, which holds that a conservative bias toward existing things of value is rational. This account can fruitfully explain (...) some compelling aspects of common sense morality, and it may justify status quo bias. (shrink)

This paper argues that luck egalitarianism, especially in the guise of equality of opportunity for welfare, is in tension with the ideal of fair equality of opportunity in three ways. First, equal opportunity for welfare is compatible with a caste system in employment that is inconsistent with open competition for positions. Second, luck egalitarianism does not support hiring on the basis of qualifications. Third, amending luck egalitarianism to repair this problem requires abandoning fair access to qualifications. Insofar as luck egalitarianism (...) cannot support fair equality of opportunity, it cannot do justice to the claims of the disabled. Indeed, in the absence of fair equality of opportunity, disabled people are likely to be marginalized. (shrink)

Disabled people frequently find themselves in situations where their quality of life and wellbeing is being measured or judged by others, whether in decisions about health care provision or assessments for social supports. Recent debates about wellbeing and how it might be assessed (through subjective and/or objective measures) have prompted a renewed focus on disabled people’s wellbeing because of its seemingly ‘anomalous’ nature; that is, whilst to external (objective) observers the wellbeing of disabled people appears poor, based on subjective assessments, (...) people with disabilities report a good quality of life. In this paper, I examine an article by the philosopher Dan Moller in which he seeks to explain this ‘disability paradox’. Despite agreeing with his analysis that there is more to what people value than happiness, his explanation reflects some of the difficulties presented in philosophical accounts which seek to understand the lives of disabled people: this includes an analysis which fails to problematise definitions of wellbeing and who has the ‘voice’ to do the defining; which negates the multiple identities and subject positions that disabled people occupy; and which lacks recognition of the social contexts which mediate disabled people’s lives. I suggest that there is a need to incorporate disabled people’s voices into research which deepens our empirical knowledge about the relationship between impairment and wellbeing, including the social circumstances that shape disabled people’s agency. (shrink)

Let’s say that an act requires Person-Affecting Justification if and only if some alternative would have been better for someone. So, Lucifer breaking Xavier’s back requires Person-Affecting Justification because the alternative would have been better for Xavier. But the story continues: While Lucifer evades justice, Xavier moves on and founds a school for gifted children. Xavier’s deepest values become identified with the school and its community. When authorities catch Lucifer, he claims no Person-Affecting Justification is needed: because the attack set (...) Xavier on his life’s path, it’s no longer true that the alternative would have been better by the standard of what Xavier now values most. An unappealingly paternalistic way to hold Lucifer to account is to discount Xavier’s preferences as merely adaptive. Instead, I propose understanding the persons of Person-Affecting Justification to be not persons but person stages. This allows us to hold Lucifer to account without having to discount Xavier’s actual preferences, and has interesting implications for compensatory justice, including making sense of reparations for historical wrongs. (shrink)

Spanish Translation of "He/She/They/Ze" (Ergo, 2018).

While experience often affords important knowledge and insight that is difficult to garner through observation or testimony alone, it also has the potential to generate conflicts of interest and unrepresentative perspectives. We call this tension the paradox of experience. In this paper, we first outline appeals to experience made in debates about access to unproven medical products and disability bioethics, as examples of how experience claims arise in bioethics and some of the challenges raised by these claims. We then motivate (...) the idea that experience can be an asset by appealing to themes in feminist and moral epistemology, distinguishing between epistemic and justice-based appeals. Next, we explain the concern that experience may be a liability by appealing to empirical work on cognitive biases and theoretical work about the problem of partial representation. We conclude with preliminary recommendations for addressing the paradox and offer several questions for future discussion. (shrink)

In this paper, I defend a version of the medical model of disability, which defines disability as an enduring biological dysfunction that causes its bearer a significant degree of impairment. We should accept the medical model, I argue, because it succeeds in capturing our judgments about what conditions do and do not qualify as disabilities, because it offers a compelling explanation for what makes a condition count as a disability, and because it justifies why the federal government should spend hundreds (...) of billions of dollars, annually, on aid and accommodations for disabled people. After responding to a pair of objections Elizabeth Barnes has raised against the medical model, I contrast it with Guy Kahane and Julian Savulescu's welfarist account of disability, and with Barnes's own mere-difference view. Both of these accounts face serious challenges, although elements of Barnes's view can—and, in my opinion, should—be adopted by proponents of the medical model. (shrink)

The Bad-Difference View of disability says, roughly, that disability makes one worse off. The Mere-Difference View of disability says, roughly, that it doesn’t. In recent work, Barnes – a MDV proponent – offers a detailed exposition of the MDV. No BDV proponent has done the same. While many thinkers make it clear that they endorse a BDV, they don’t carefully articulate their view. In this paper, I clarify the nature of the BDV. I argue that its best interpretation is probabilistic (...) and comparative: it is the view that a person is likely to be, all things considered, worse off with a disability than without. As such, Barnes – who criticises the version of the BDV that disability by itself, intrinsically or automatically makes a person worse off – misses an opportunity to attack the most plausible and relevant version of the BDV, and the best version remains unchallenged. (shrink)

This paper defends the view that we have special relationship duties that do not derive from our moral duties. Our special relationship duties, I argue, are grounded in what I call close relationships. Sharing a close relationship with another person, I suggest, requires that both people conceive of themselves as being motivated to promote the other’s interests. So, staying true to oneself demands being committed to promoting the interests of those with whom we share a close relationship. Finally, I show (...) that the proposed account of special relationship duties circumvents two problems facing self-conception accounts of special relationship duties. (shrink)

In this article, we deal with the evaluation of the losses suffered by persons living in urban areas as a result of energy services. In the first part, we analyse how by adopting different informational foci we obtain contrasting interpersonal evaluations regarding the same loss. In the second part, we distinguish between a diachronic and a hypothetical/moralised threshold for harm in order to assess whether individuals are benefiting from or being harmed by a given energy service. Our argument is that (...) the most accurate evaluation of an individual damage caused by an energy service can be obtained by using capabilities as informational focus, instead of realised wellbeing or means to wellbeing, and by interpreting the loss in relation to a hypothetical/moralised threshold that corresponds to a list of central capabilities. In the last part, we address monetary and non-monetary compensations for a loss that is evaluated in terms of capabilities. Accordingly, we expound how compensation policies can either restore the capabilities lost due to energy services or monetarily compensate the individual for the fact that a given capability (or set of capabilities) has been irremediably lost. (shrink)

Testimony by disabled people concerning the relationship between their experiences and overall well-being has long been an object of social scientific and humanistic study. Often discussed in terms of “the disability paradox,” these studies contrast the intuitive horribleness of certain impaired states against the testimonial evidence suggesting that people in such states do not in fact experience their lives as horrible. Explanations for why such testimonial evidence is suspect range from claims about adaptive preferences to issues of qualitative research methodology. (...) In this paper, I argue that the problem lies not with the evidence, but the intuitions in question. Using the disability paradox as a case study, I further argue against the use of the concept of intuitive horribleness in social epistemology and beyond. I contend that testimonial and hermeneutical injustices are baked into most deployments of the concept, and even if one were to justify its use in select cases, it should be accompanied with prima facie suspicion. In conclusion, I discuss the implications of this analysis for the literature on transformative experience and also for the stakes of multi-cultural, historically informed philosophical inquiry more generally. (shrink)

Animals who live in cities must coexist with us. They are, as a result, entitled to the conditions of their flourishing. This article argues that, as the boundaries of cities and urban areas expand, the boundaries of our conception of captivity should expand too. Urbanization can undermine animals’ freedoms, hence their ability to live good lives. I draw the implications of an account of “pervasive captivity” against the background of the Capabilities Approach. I construe captivity, including that of urban animals, (...) as affecting a range of animal capabilities, understood as freedoms, and I address some tensions within Nussbaum’s treatment of human-animal conflicts. Using the Capabilities Approach as a guide, I will attempt to motivate a convergence between habitat preservation in urbanized environments, urban design guided by justice, and the individual freedoms of animals. (shrink)

Many endorse the Bad-Difference View of disability which says that disability makes one likely to be worse off even in the absence of discrimination against the disabled. Others defend the Mere-Difference View of disability which says that, discounting discrimination, disability does not make one likely to be worse off. A common motivation for the BDV is the Options Argument which identifies reduction in valuable options as a harm of disability. Some reject this argument, arguing that disabled people's prospects aren't hindered (...) by having fewer options. In this article, I defend the Options Argument by arguing that, in disability cases, possessing a greater number of valuable options seems to overall improve well-being prospects. As such, the Options Argument appears to be sound and – although it doesn't establish the BDV – it lends plausibility to the BDV by identifying a potentially significant cost of disability. (shrink)

Most people have a clear sense of what they mean by disability, and have little trouble identifying conditions they consider disabling. Yet providing a clear and consistent definition of disability is far from straightforward. Standardly, disability is understood as the restriction in our abilities to perform tasks, as a result of an impairment of normal physical or cognitive human functioning. However, which inabilities matter? We are all restricted by our bodies, and are all incapable of performing some tasks, but most (...) of these inabilities are not considered disabilities. If, then, we are to avoid the category of disability becoming overly broad—and thus politically and practically useless—we need some way of picking out the specific inabilities that are disabling. I argue that our answer should be informed by an account of the opportunities individuals are entitled to be able to perform as a matter of justice. Thus, to be disabled is to have these opportunities restricted, and not to deviate from the species norm or lack any ability that might improve our well-being. (shrink)

Health policymakers employ utility measures to inform resource allocation decisions. They often rely on a conceptual tool called the quality-adjusted life year that discounts the value of years lived in a state of disability relative to years lived in full health. A representative sample of the general public is asked to place values on hypothetical health states as part of a standard gamble or time trade-off task. Policymakers use the resulting values to calculate the number of QALYs gained through particular (...) interventions. Utilitarian reasoning mandates that policymakers maximize QALYs gained per unit cost.Although many scholars have explored the problems of distributive justice that arise from this system... (shrink)

Urban animals can benefit from living in cities, but this also makes them vulnerable as they increasingly depend on the advantages of urban life. This article has two aims. First, I provide a detailed analysis of the concept of captivity and explain why it matters to nonhuman animals—because and insofar as many of them have a (non-substitutable) interest in freedom. Second, I defend a surprising implication of the account—pushing the boundaries of the concept while the boundaries of cities and human (...) activities expand. I argue for the existence of the neglected problem of pervasive captivity, of which urban wildlife is an illustration. Many urban animals are confined, controlled and dependent, therefore often captive of expanding urban areas. While I argue that captivity per se is value-neutral, I draw the ethical and policy implications of harmful pervasive captivity. (shrink)

Disability-positive philosophers often note a troubling tendency to dismiss what disabled people say about their well-being. This chapter seeks to get clearer on why this tendency might be troubling. It argues that recent appeals to lived experience, testimonial injustice, and certain challenges to adaptive-preference reasoning do not fully explain what is wrong with questioning the happiness of disabled people. It then argues that common attempts to debunk the claim that disabled people are happy are worrisome because they threaten everyone’s well-being (...) and are further challenged by an argument from moral risk. (shrink)

In this dissertation, I argue that all extant theories of prudential value are either a) enumeratively deficient, in that they are unable to accommodate everything that, intuitively, is a basic constituent of prudential value, b) explanatorily deficient, in that they are at least sometimes unable to offer a plausible story about what makes a given thing prudentially valuable, or c) both. In response to the unsatisfactory state of the literature, I present my own account, the Disjunctive Hybrid Theory or DHT. (...) DHT answers to and remedies each of the above inadequacies in a way that no other approach can. This account has the following general structure:Disjunctive Hybrid Theory (DHT): Thing x is basically good for person P if and only if x is either a) cared about (sufficiently and in the right way) by P, b) a bearer of (the right kind of) attitude-independent value, or c) both.Although it follows other recent accounts in combining elements from objective and subjective theories, DHT is a hybrid theory of a quite new kind. This is because it denies both subjective necessity (the constraint that, if thing x is to be basically good for person P, P must have some pro-attitude toward x) and objective necessity (the constraint that, if thing x is to be basically good for person P, x must have some attitude-independent value). I argue that the rejection of both necessity claims is called for if we are to move beyond the enumerative and explanatory limitations of existing accounts.I begin by outlining the general structure of DHT. I then argue, against various recent authors, that desire-satisfactionism remains the most appealing subjectivist approach to prudential value, in that it is best able to capture the central subjectivist insight. This insight is that a person can confer prudential value upon things by caring about them (sufficiently and in the right way). The subjectivist strand of DHT will thus be a version of desire-satisfactionism, which must be interpreted in line with what I call the object, as opposed to the combo, view. I move on to further motivate and develop the second, objectivist strand of DHT. This part of the theory involves a commitment to robustly attitude-independent prudential goods. I close by addressing some puzzles for the theory, and considering some of its more specific applications. (shrink)

The view that it is better for life to be created free of disability is pervasive in both common sense and philosophy. We cast doubt on this view by focusing on an influential line of thinking that manifests it. That thinking begins with a widely-discussed principle, Procreative Beneficence, and draws conclusions about parental choice and disability. After reconstructing two versions of this argument, we critique the first by exploring the relationship between different understandings of well-being and disability, and the second (...) by more briefly focusing on the idea of a significant reason. By placing these results against the broader historical and ongoing contexts in which the lives of those with disabilities have been deemed of inferior quality, we conclude with a call for greater humility about disability and well-being in thought and practice. (shrink)

The choice argument against sweatshop regulations states that public officials should not prohibit workers from accepting jobs that require long hours, low pay, and poor working conditions, because enforcing such regulations would be disrespectful to the workers who choose to work in sweatshops. Critics of the choice argument reply that these regulations can be justified when workers only choose to work in sweatshops because they lack acceptable alternatives and are unable to coordinate to achieve better conditions for all workers. My (...) thesis is that the presence of unacceptable alternatives to sweatshop labor or barriers to coordination cannot justify sweatshop regulations such as minimum wage and maximum hour laws. Although officials should promote alternatives to difficult and dangerous sweatshop labor, they should not do so by limiting workers’ and employers’ options through coercive regulation. And the fact that sweatshop workers may face coordination problems does not undermine the claim that sweatshop workers choose to work in sweatshops, just as other workers face coordination problems but nevertheless make occupational choices. Furthermore, efforts to restrict sweatshop workers’ choices are morally risky and may not promote workers’ wellbeing or wellbeing in general. (shrink)

Many critics of medicalization express concern that the process privileges individualised, biologically grounded interpretations of medicalized phenomena, inhibiting understanding and communication of aspects of those phenomena that are less relevant to their biomedical modelling. I suggest that this line of critique views medicalization as a hermeneutical injustice—a form of epistemic injustice that prevents people having the hermeneutical resources available to interpret and communicate significant areas of their experience. Interpreting the critiques in this fashion shows they frequently fail because they: neglect (...) the ways in which medicalization may not obscure, but rather illuminate, individuals’ experiences; and neglect the testimony of those experiencing first-hand medicalized problems, thus may be guilty of perpetrating testimonial injustice. However, I suggest that such arguments are valuable insofar as they highlight the unwarranted epistemic privilege frequently afforded to medical institutions and medicalized models of phenomena, and a consequent need for greater epistemic humility on the part of health workers and researchers. (shrink)

Ordinary Language Philosophy has largely fallen out of favour, and with it the belief in the primary importance of analyses of ordinary language for philosophical purposes. Still, in their various endeavours, philosophers not only from analytic but also from other backgrounds refer to the use and meaning of terms of interest in ordinary parlance. In doing so, they most commonly appeal to their own linguistic intuitions. Often, the appeal to individual intuitions is supplemented by reference to dictionaries. In recent times, (...) Internet search engine queries for expressions of interest have become quite popular. Apparently, philosophers attempt to surpass the limits of their own linguistic intuitions by appealing to experts or to factual uses of language. I argue that this attempt is commendable but that its execution is wanting. Instead of appealing to dictionaries or Internet queries, philosophers should employ computer-based linguistic corpora in order to confirm or falsify hypotheses about the factual use of language. This approach also has some advantages over methods employed by experimental philosophers. If the importance of ordinary language is stressed, the use of linguistic corpora is hardly avoidable. (shrink)

We use “I’ll be glad I did it” reasoning all the time. For example, last night I was trying to decide whether to work on this paper or go out to a movie. I realized that if I worked on the paper, then today I would be glad I did it. Whereas, if I went out to the movie, today I would regret it. This enabled me to see that I should work on the paper rather than going out to (...) a movie. This looks like excellent reasoning: Paper argument: 1. If I work on my paper, I’ll be glad I did it. 2. Therefore, I should work on my paper. When we’re having trouble making a big life decision, we often try to picture what will happen each way we might choose, and imagine how we’ll feel in that outcome. When choosing between two jobs, we might use this reasoning. Suppose you are choosing between two jobs and you know quite a lot about what the two jobs will be like. In one, you will make a lot of money but have to work eighty-hour weeks and see little of your family. In the other, you will make considerably less money—though enough to support yourself and your family. You’ll have much more time for your family. The money is attractive. But overall, you realize you’ll be glad to have the time with your family if you take the second job—you’ll be glad you made that choice. It seems this is a good way of realizing that you should take the second job. (shrink)

We use “I’ll be glad I did it” reasoning all the time. For example, last night I was trying to decide whether to work on this paper or go out to a movie. I realized that if I worked on the paper, then today I would be glad I did it. Whereas, if I went out to the movie, today I would regret it. This enabled me to see that I should work on the paper rather than going out to (...) a movie. This looks like excellent reasoning: Paper argument: 1. If I work on my paper, I’ll be glad I did it. 2. Therefore, I should work on my paper. When we’re having trouble making a big life decision, we often try to picture what will happen each way we might choose, and imagine how we’ll feel in that outcome. When choosing between two jobs, we might use this reasoning. Suppose you are choosing between two jobs and you know quite a lot about what the two jobs will be like. In one, you will make a lot of money but have to work eighty-hour weeks and see little of your family. In the other, you will make considerably less money—though enough to support yourself and your family. You’ll have much more time for your family. The money is attractive. But overall, you realize you’ll be glad to have the time with your family if you take the second job—you’ll be glad you made that choice. It seems this is a good way of realizing that you should take the second job. (shrink)

Just last week (October 4, 2022), the U.S. White House released a blueprint for an A.I. Bill of Rights, consisting of “five principles and associated practices to help guide the design, use, and de...

People who have not experienced diseases and health conditions tend to judge them to be worse than they are reported to be by people who have experienced them. This phenomenon, known as the disability paradox, presents a challenge for health policy, and in particular, healthcare resource distribution. This divergence between patient and public preferences is most plausibly explained as a result of hedonic adaptation, a widespread phenomenon in which people tend to adapt fairly quickly to the state they are in, (...) good or bad, and adjust their baseline utility accordingly.If patient utilities can be shown to be inappropriate for use in public policy decision making, the disability paradox fades away. This paper offers a critique of one such attempt: the idea that adaptation leads to adaptive preferences. I argue that none of the main accounts of adaptive preferences in fact characterise adapted patient preferences as irrational. Adapted preferences should not, therefore, be treated as synonymous with adaptive preferences. I suggest that much patient adaptation should be understood as a form of the ubiquitous human ability to respond to environmental change. Consequently, we ought not to discount patient preferences. (shrink)

Recent articles published in this journal have highlighted the shortcomings of individualistic approaches to health promotion, and the potential contributions of relational analyses of autonomy to public health ethics. I argue that the latter helps to elucidate the former, by showing that an inadequate analysis of autonomy leads to misassignment of both forward-looking and backward-looking responsibility for health outcomes. Health promotion programmes predicated on such inadequate analyses are then ineffective, because they assign responsibility to agents whose social environment inhibits their (...) ability to act on such responsibilities; inequitable, because the social barriers to autonomous agency display a socio-economic gradient; and stigmatizing, because they license blaming of individuals for their own poor health without taking into account how reasonable it is to hold these individuals responsible, given the social barriers to autonomy they face. I further sketch how incorporating a relational understanding of autonomy could help to produce health promotion programmes that do not succumb to these difficulties, while avoiding coercive paternalism, exploring potential applications in ecological approaches to health promotion. (shrink)

ABSTRACT:Current literature in moral and political philosophy is rife with discussion of adaptive preferences. This is no accident: while preferences are generally thought to play an important role in a number of normative domains, adaptive preferences seem exceptions to this general rule—they seem problematic in a way that preference-respecting theories of these domains cannot adequately capture. Thus, adaptive preferences are often taken to be theoretically explanatory: a reason for adjusting our theories of the relevant normative domains. However, as I shall (...) argue here, the relentless focus on the phenomenon of preference adaptation is a mistake. While I do not take a stand on whether typical examples of adaptive preferences are or are not problematic, I argue here that if they are problematic, it cannot be because they are adaptive. (shrink)

Distributive egalitarians believe that distributive justice is to be explained by the idea of distributive equality (DE) and that DE is of intrinsic value. The socio-relational critique argues that distributive egalitarianism does not account for the “true” value of equality, which rather lies in the idea of “equality as a substantive social value” (ESV). This paper examines the socio-relational critique and argues that it fails because – contrary to what the critique presupposes –, first, ESV is not conceptually distinct from (...) DE, and second, the idea of ESV cannot serve as a “foundation” or “root” of distributive egalitarianism. (shrink)

Accounts of adaptive preferences are of two kinds: well-being accounts fully theorized for their own sake and political accounts theorized to facilitate the political project of reducing oppression and marginalization. Given their practical role, the latter are often less fully theorized, and are therefore less robust to theoretical criticism. In this paper, I first draw on well-being accounts to identify the well-theorized elements that political accounts should want to adopt in order to strengthen their project and avoid common criticisms. Second, (...) I appeal to the political project to show the shortcomings of the well-being accounts on which I draw. (shrink)

The suggestion that individuals should be considered disadvantaged, and consequently entitled to compensation, only if they consider themselves disadvantaged (Dworkin’s ‘continuity test’) is initially appealing. However, it also faces problems. First, if individuals are routinely mistaken, then we routinely fail to assist the deserving. Second, if individuals assess their circumstances differently then the state will provide different levels of assistance to people in identical situations. Thus, should we instead ignore individuals’ convictions and provide assistance that some, at least, do not (...) feel they need? One set of cases where this dilemma is salient are those in which disabled individuals disagree over whether they are disadvantaged. Focussing on these, I argue that despite objections, individuals should have a voice in determining whether they are disadvantaged. However, I contend that our goal should not be ensuring continuity with individuals’ ethical convictions (concerning the pursuits they deem worthwhile or valuable), but their convictions regarding whether they are relevantly disadvantaged (whether they have what they are entitled to). (shrink)

The principle of respect for autonomy in clinical ethics is frequently linked to bioethics’ neglect of community-level ethical considerations. I argue that the latter is not an inevitable consequence of the former; rather, that neglect results from a common interpretation of respect for autonomy in solely synchronic and individual terms. A relational understanding of autonomy reveals the way in which respect inescapably involves diachronic and social dimensions. When these are acknowledged, the association between respect for autonomy and liberal individualism is (...) weakened. Such respect has more in common with communitarian approaches, and it need not conflict with the incorporation of collective-level values into ethical deliberation. (shrink)