Ethical evaluation of deep brain stimulation as a treatment for Parkinson’s disease is complicated by results that can be described as involving changes in the patient’s identity. The risk of becoming another person following surgery is alarming for patients, caregivers and clinicians alike. It is one of the most urgent conceptual and ethical problems facing deep brain stimulation in Parkinson’s disease at this time. In our paper we take issue with this problem on two accounts. First, we elucidate what is (...) meant by “becoming another person” from a conceptual point of view. After critically discussing two broad approaches we concentrate on the notion of “individual identity” which centers on the idea of “core attitudes”. Subsequently we discuss several approaches to determine what distinguishes core attitudes from those that are more peripheral. We argue for a “foundational-function model” highlighting the importance of specific dependency relations between these attitudes. Our second aim is to comment on the possibility to empirically measure changes in individual identity and argue that many of the instruments now commonly used in selecting and monitoring DBS-patients are inappropriate for this purpose. Future research in this area is advised combining a conceptual and an empirical approach as a basis of sound ethical appraisal. (shrink)

According to a widely held view, people's commitments to laws are dependent on the existence in their community of a conventional practice of complying with certain fundamental laws. This conventionalism has significantly hampered our attempts to explain the normative practice of law. Ronald Dworkin has argued against conventionalism by bringing up the phenomenon of persistent fundamental legal controversies, but neither Dworkin nor his legal positivist respondents have correctly understood the real significance of such controversies. This article argues that such controversies (...) pose a deep challenge to any conception of our legal practice as a genuinely normative, rule-mediated, practice. The article also argues that what is needed to deflect this challenge is a new understanding – different from the widely held conventionalist understanding – of how people's commitments to laws are predicated on their fellows’ like commitments. (shrink)

In this paper, I hope to provide an account of the conditions of moral realism whereby there are still significant metaphysical commitments made by the realist which set the view apart as a distinct position in the contemporary meta-ethical landscape. In order to do so, I will be appealing to a general account of what it is for realism to be true in any domain of experience, whether it be realism about universals, realism about unobservable scientific entities, realism about artifacts, (...) and so forth. (shrink)

We begin with a theory of the structure of sensory consciousness; a target phenomenon of 'presentation' can be clearly located within this structure. We then defend the rational-psychological necessity of presentation. We conclude with discussion of these philosophical challenges to the possibility of presentation. One crucial aspect of the discussion is recognition of the <cite>nonobjectivity</cite> of consciousness (a technical appendix explains what I mean by that). The other is a full-faced stare at the limitations of rational psychology: much of the (...) dialectic in the philosophy of perception pertains to matters beyond the limits of coherence---a breakwater against which philosophy crashes, and rolls back. (shrink)