L. A. Paul has recently argued that the epistemically transformative nature of certain experiences makes it impossible to rationally decide whether to have the experience or not. We start by explaining why, contrary to what Paul claims, epistemically transformative experiences do not pose a general problem for the possibility of rational choice. However, we show there is a particular type of agent for whom the problem identified by Paul does arise. With this agent in mind, we examine Paul’s own suggestion (...) for how to approach a transformative decision problem, namely, that one should decide based on whether one would like to come to know the experience in question, and we conclude that Paul’s suggestion is no solution for this particular agent. In other words, Paul’s solution does not work for the only type of agent for whom the problem she has identified arises. (shrink)

I argue that we can understand the de se by employing the subjective mode of presentation or, if one’s ontology permits it, by defending an abundant ontology of perspectival personal properties or facts. I do this in the context of a discussion of Cappelen and Dever’s recent criticisms of the de se. Then, I discuss the distinctive role of the first personal perspective in discussions about empathy, rational deference, and self-understanding, and develop a way to frame the problem of lacking (...) prospective access to your future self as a problem with your capacity to imaginatively empathize with your future selves. (shrink)

In this paper, we explore the link between understanding and transformative decisions. Paul (2014) suggests that one important aspect of making some decisions is that we make them not just on the basis of what data from other people tell us, but based on our own acquaintance with how the decision affects us. In this paper, we draw out a parallel between the sort of reasoning that Paul argues is required for authentic decision making and the sort of epistemic grasp (...) of a subject matter that is required for understanding. The central claim of this paper is that one’s ability to make a decision authentically is proportional to one’s ability to model what it is like to have the possible resultant experience. We endorse a broad notion according to which one can model something by thinking about relevantly similar things. (shrink)

I summarize the main argument of Transformative Experience (OUP 2014). The book develops familiar examples from classical philosophical debates, as well as original examples, to argue that an agent’s decision to undergo a transformative experience—an experience constituted by radical personal and epistemic change for the agent—must either be authentic or irrational, but not both. The Precis of Transformative Experience walks the reader through the main ideas involved in epistemically and personally transformative experiences, the problems they pose for rational decision-making, and (...) discusses a number of key original examples of transformative experiences. (shrink)

In the recent literature on episodic memory, there has been increasing recognition of the need to provide an account of its adaptive function. In this context, it is sometimes argued that episodic memory is critical for certain forms of decision making about the future. We criticize existing accounts that try to give episodic memory a role in decision making, before giving a novel such account of our own. This turns on the thought of a link between episodic memory and the (...) emotion of regret. We discuss how both experienced and anticipated regret can have a distinctive influence on decision making, and argue that the ability to recollect past events in episodic memory underpins the capacity to engage in the sophisticated types of mental time travel recruited in experiencing and anticipating regret. (shrink)

Pascal’s Wager involves expected utilities. In this chapter, we examine the Wager in light of two main features of expected utility theory: utilities and probabilities. We discuss infinite and finite utilities, and zero, infinitesimal, extremely low, imprecise, and undefined probabilities. These have all come up in recent literature regarding Pascal’s Wager. We consider the problems each creates and suggest prospects for the Wager in light of these problems.

In recent years, an old challenge to informed consent has been rediscovered: the challenge of ignorance. Several authors argue that due to the presence of irreducible ignorance in certain treatments, giving informed consent to these treatments is not possible. The present paper examines in what ways ignorance is believed to prevent informed consent and which treatments are affected by that. At this, it becomes clear that if the challenge of ignorance truly holds, it poses a major problem to informed consent. (...) The paper argues, however, that from both an empirical and a theoretical point of view, it is not convincing that ignorance prevents informed consent. Still, it seems important that the presence of irreducible ignorance is openly discussed during the informed consent process. (shrink)

A sensibility is, on a rough first pass, an emotional orientation to the world. It shapes how things appear to us, evaluatively speaking. By transfiguring things’ evaluative appearances, a change in sensibility can profoundly alter one’s overall experience of the world. I argue that some forms of sensibility change entail (1) risking one’s knowledge of what experiences imbued with one’s prior sensibility were like, and (2) surrendering one’s grasp on the intelligibility of one’s prior emotional apprehensions. These costs have consequences (...) for Laurie Paul’s ‘problem of transformative experience.’ Paul has argued that when we are poised to become someone new, our inexperience generates problems for authentic choice about our own futures. By reckoning with the epistemic losses involved in sensibility change, I show that this problem must not be confined to novel transformations. Prior experience does not guarantee the knowledge or understanding necessary for choosing authentically (in Paul’s sense). If the problem Paul highlights is indeed a problem _at all,_ then, it is a still more pervasive and intractable one than it has been taken to be. (shrink)

Disease radically changes the life of many people and satisfies formal criteria for being a transformative experience. According to the influential philosophy of Paul, transformative experiences undermine traditional criteria for rational decision-making. Thus, the transformative experience of disease can challenge basic principles and rules in medical ethics, such as patient autonomy and informed consent. This article applies Paul’s theory of transformative experience and its expansion by Carel and Kidd to investigate the implications for medical ethics. It leads to the very (...) uncomfortable conclusion that disease involves transformative experiences in ways that can reduce people’s rational decision-making ability and undermine the basic principle of respect for autonomy and the moral rule of informed consent. While such cases are limited, they are crucial for medical ethics and health policy and deserve more attention and further scrutiny. (shrink)

Hot-cold empathy gaps are a pervasive phenomena wherein one’s predictions about others tend to skew ‘in the direction’ of one’s own current visceral states. For instance, when one predicts how hungry someone else is, one’s prediction will tend to reflect one’s own current hunger state. These gaps also obtain intrapersonally, when one attempts to predict what one oneself would do at a different time. In this paper, we do three things: We draw on empirical evidence to argue that so-called hot-cold (...) empathy gaps arise when one projects one’s own current state into a simulation about another. Second, we argue that this process does not typically confer knowledge, even when the predictions it produces happen to be accurate. Third, we suggest that these results can be used to develop a challenge for L.A. Paul's view that authentic action sometimes requires subjective knowledge of one’s own values and how these values relate to relevant outcomes. We then sketch an alternative view of the epistemic grounds of authenticity, one on which authenticity requires a kind of understanding. The relevant form of understanding can be achieved by subjective knowledge but can also be achieved elsewise, such as through testimony from a close friend about what one values. (shrink)

This article is about the information relevant to decision-making capacity in refusal of life-prolonging medical treatment cases. We examine the degree to which the phenomenology of the options available to the agent—what the relevant states of affairs will feel like for them—forms part of the capacity-relevant information in the law of England and Wales, and how this informational basis varies across adolescent and adult medical treatment cases. We identify an important doctrinal phenomenon. In the leading authorities, the courts appear to (...) count the first-personal phenomenology of the available options among the information that adolescents seeking to refuse life-prolonging treatment must understand and appreciate in order to possess capacity; adults are not held to this (higher) standard. We evaluate this differential treatment in light of philosophical work on transformative choice—decisions involving options whose sensory character, and effect on our values and preferences, are grasped only through experience itself. (shrink)

Laurie Paul argues that, when it comes to many of your most significant life-changing decisions, the principles of rational choice are silent. That is because, in these cases, you anticipate that one of your choice options would yield a transformative experience. We argue that such decisions are best seen as ones in which you anticipate awareness growth. You do not merely lack knowledge about which possible outcome will arise from a transformative option; you lack knowledge about what are the possible (...) outcomes. We show how principles of rational choice can be extended to cases of anticipated awareness growth. (shrink)

When people are making certain medical decisions – especially potentially transformative ones – the specter of regret may color their choices. In this paper, I ask: can predicting that we will regret a decision in the future serve any justificatory role in our present decision-making? And if so, what role? While there are many pitfalls to such reasoning, I ultimately conclude that considering future retrospective emotions like regret in our decisionmaking can be both rational and authentic. Rather than indicating that (...) one is about to make a mistake or that there is some underlying value that one already cares about but is overlooking, the prediction that one will regret a decision in the future makes one confront how her present values and priorities may change as a result of her choice in ways she cannot presently anticipate. (shrink)

Commentary on Walsh, E. 2020. Cognitive transformation, dementia, and the moral weight of advance directives. The American Journal of Bioethics. 20(8): 54–64.

In her ground-breaking and highly influential book Transformative Experience, L.A. Paul makes two claims: (1) one cannot evaluate and compare certain experiential outcomes (e.g. being a parent and being a non-parent) unless one can grasp what these outcomes are like; and (2) one can evaluate and compare certain intuitively horrible outcomes (e.g. being eaten alive by sharks) as bad and worse than certain other outcomes even if one cannot grasp what these intuitively horrible outcomes are like. We argue that the (...) conjunction of these two claims leads to an implausible discontinuity in the evaluability of outcomes. One implication of positing such a discontinuity is that evaluative comparisons of outcomes will not be proportionally sensitive to variation in the underlying features of these outcomes. This puts pressure on Paul to abandon either (1) or (2). But (1) is central to her view and (2) is very hard to deny. We call this the Shark Problem. (shrink)

The debate between Uniqueness and Permissivism concerns whether a body of evidence sometimes allows multiple doxastic attitudes towards a proposition. An important motivation for Uniqueness is the so-called ‘arbitrariness argument,’ which says that Permissivism leads to some unacceptable arbitrariness with regard to one's beliefs. An influential response to the argument says that the arbitrariness in beliefs can be avoided by invoking epistemic standards. In this paper, I argue that such a response to the arbitrariness argument is unsuccessful. Then I defend (...) a new response: contrary to common conception, the arbitrariness resulted by Permissivism is acceptable. The basic idea is that the arbitrariness resulted by Permissivism is analogous to the arbitrariness in permissive actions and the latter arbitrariness is intuitively acceptable. I answer three possible objections against this analogy, which are all motivated by the thought that beliefs aim at the truth. In addressing the last objection, I draw inspiration from the recent debate on transformative experience. (shrink)

We develop a broader, more fine-grained taxonomy of forms of ‘transformative experience’ inspired by the work of L.A. Paul. Our vulnerability to such experiences arises, we argue, due to the vulnerability, dependence, and affliction intrinsic to the human condition. We use this trio to distinguish a variety of positively, negatively, and ambivalently valenced forms of epistemically and/or personally transformative experiences. Moreover, we argue that many transformative experiences can arise gradually and cumulatively, unfolding over the course of longer periods of time.

Appealing to self-interest is a common way of justifying the rationality of religious faith. For instance, Pascal’s wager relies upon the expected value of choosing the life of faith being infinite. Similarly, many contemporary arguments for the rationality of faith turn on whether it is better for an agent to have faith rather than lack it. In this paper, I argue, contra Pascal, that considerations of self-interest do not make choosing faith rational because they fail to take into account the (...) way the self is transformed by faith. (shrink)

Laurie Paul has recently argued that transformative experiences pose a problem for decision theory. According to Paul, agents facing transformative experiences do not possess the states required for decision theory to formulate its prescriptions. Agents facing transformative experiences are impoverished relative to their decision problems, and decision theory doesn’t know what to do with impoverished agents. Richard Pettigrew takes Paul’s challenge seriously. He grants that decision theory cannot handle decision problems involving transformative experiences. To deal with the problems posed by (...) transformative experiences, Pettigrew proposes two alterations to decision theory. The first alteration is meant to handle the problem posed by epistemically transformative experiences, and the second alteration is meant to handle the problem posed by personally transformative experiences. I argue that Pettigrew’s proposed alterations are untenable. Pettigrew’s novel decision theory faces both formal and philosophical problems. It is doubtful that Pettigrew can formulate the sort of decision theory he wants, and further doubtful that he should want such a decision theory in the first place. Moreover, the issues with Pettigrew’s proposed alterations help reveal issues with Paul’s initial challenge to decision theory. I suggest that transformative experiences should not be taken to pose a problem for decision theory, but should instead be taken to pose a topic for ethics. (shrink)

to appear in Lambert, E. and J. Schwenkler (eds.) Transformative Experience (OUP) -/- L. A. Paul (2014, 2015) argues that the possibility of epistemically transformative experiences poses serious and novel problems for the orthodox theory of rational choice, namely, expected utility theory — I call her argument the Utility Ignorance Objection. In a pair of earlier papers, I responded to Paul’s challenge (Pettigrew 2015, 2016), and a number of other philosophers have responded in similar ways (Dougherty, et al. 2015, Harman (...) 2015) — I call our argument the Fine-Graining Response. Paul has her own reply to this response, which we might call the Authenticity Reply. But Sarah Moss has recently offered an alternative reply to the Fine-Graining Response on Paul’s behalf (Moss 2017) — we’ll call it the No Knowledge Reply. This appeals to the knowledge norm of action, together with Moss’ novel and intriguing account of probabilistic knowledge. In this paper, I consider Moss’ reply and argue that it fails. I argue first that it fails as a reply made on Paul’s behalf, since it forces us to abandon many of the features of Paul’s challenge that make it distinctive and with which Paul herself is particularly concerned. Then I argue that it fails as a reply independent of its fidelity to Paul’s intentions. (shrink)

Transformative experiences are epistemically and personally transformative: prior to having the experience, agents cannot predict the value of the experience and cannot anticipate how it will change their core values and preferences. Paul (2014, 2015) argues that these experiences pose a puzzle for standard decision-making procedures because values cannot be assigned to outcomes involving transformative experience. Responding philosophers are quick to point out that decision procedures are built to handle uncertainty, including the uncertainty generated by transformative experience. My paper enters (...) here and contributes two points. First, religious experiences are transformative experiences that are especially resistant to these responses. Second, a procedure that appeals to voluntarist reasons—reasons arising from an act of the will—can allow an agent to rationally decide to undergo or avoid an outcome involving transformative experience. Combining these two points results in some interesting implications with respect to practical aspects of religion. (shrink)

According to its quietist readings, skepticism can be dissolved by demonstrating that the notion of ‘absolute objectivity’ is confused. The dissolution of this confusion is supposed to lead us to acquiesce in our finite and plain everyday life without being bothered anymore about the supposed need for objective knowledge. In contrast, I want to propose a transformative reading of skepticism according to which the philosophical practice of skepticism can be ‘epistemically transformative’. To this end, I will transpose L.A. Paul's notion (...) of ‘epistemically transformative experience’ from decision theory to the realm of philosophical practice and argue that the modern skeptical problem of an external standpoint can evoke transformative experiences that lead to a new, albeit non-propositional, insight into the finitude of the human condition. (shrink)

ABSTRACT While pragmatic arguments are traditionally seen as supporting decision theory, recent discussions suggest the possibility of pragmatic arguments against this theory. I respond to two such arguments, and clarify what it would take for arguments of this sort to succeed.

When is it rational to undergo cognitive enhancement? In the case of what I’ll call massive cognitive enhancement, my answer is never. The reason is that one must base one’s decision to undergo massive cognitive enhancement on what I’ll call either phenomenal or non-phenomenal outcomes. If the former, the choice is not rational because massive cognitive enhancements are transformative and, I’ll argue with Paul (2015), transformative experiences cannot be chosen rationally. If the latter, the choice is not rational because it (...) ought to be based at least partly on phenomenal outcomes. This argument, however, leaves open the idea that it may nonetheless be rational to choose massive cognitive enhancement for others—for example, one’s children. The article explores this possibility, arguing that choosing enhancement for others can be rational or moral, but not both. (shrink)

L. A. Paul’s Transformative Experience makes the claim that many important life decisions are epistemically and personally transformative in a way that does not allow us to assign subjective values to their outcomes. As a result, we cannot use normative decision theory to make such decisions rationally, or when we modify it to do so, decision theory leads us to choose in a way that is in tension with our authenticity. This paper examines Paul’s version of decision theory, and whether (...) this version in fact admits of the challenge she wants to raise. I focus on her psychological realist view of utilities and beliefs and her notion of rational, authentic preferences as informed by imaginative acquaintance. I argue that Paul fails to engage critically with traditional accounts of decision theory and, on closer inspection, it is not clear that her version of decision theory entails a tension between rational and authentic choice. More importantly, I argue that if her contribution is instead to bring to light the importance of authenticity alongside rational decision-making, the definition she provides of authenticity in fact undermines her argument. (shrink)

In “What you can’t expect when you’re expecting,” I argue that, if you don’t know what it’s like to be a parent, you cannot make this decision rationally—at least, not if your decision is based on what you think it would be like for you to become a parent. My argument hinges on the idea that becoming a parent is a transformative experience. This unique type of experience often transforms people in a deep and personal sense, and in the process, (...) changes their preferences. In section 1, I will explain transformative experience in terms of radical first-personal epistemic and self change. In section 2, I’ll explain the notion of subjective value that I use to develop the decision problem. In section 3, I will discuss the way we ordinarily combine our introspective assessments with testimony and evidence. In section 4, I will discuss the problems for rational decision-making. In section 5, I will explore the problem of first-personally transformed future selves. In section 6, I will engage with the main themes and arguments and ideas of the authors of the papers contributed to this volume. (shrink)

Risk is inherent to many, if not all, transformative decisions. The risk of regret, of turning into a person you presently consider to be morally objectionable, or of value change are all risks of choosing to transform. This aspect of transformative decision-making has thus far been ignored, but carries important consequences to those wishing to defend decision theory from the challenge posed by transformative decision-making. I contend that a problem lies in a common method used to cardinalise utilities – the (...) von Neumann and Morgenstern (vNM) method – which measures an agent's utility function over sure outcomes. I argue that the risks involved in transformative experiences are constitutively valuable, and hence their value cannot be accurately measured by the vNM method. In Section 1, I outline what transformative experiences are and the problem they pose to decision theory. In Section 2, I outline Pettigrew's (2019, Choosing for Changing Selves) decision-theoretic response, and in Section 3, I present the case for thinking that risks can carry value. In Section 4, I argue for the claim that at least some transformative experiences involve constitutive risk. I argue that this causes a problem for decision-theoretic responses within the vNM framework in Section 5. (shrink)

In the real world, there can be constraints on rational decision-making: there can be limitations on what I can know and on what you can know. There can also be constraints on my ability to deliberate or on your ability to deliberate. It is useful to know what the norms of rational deliberation should be in ideal contexts, for fully informed agents, in an ideal world. But it is also useful to know what the norms of rational deliberation should be (...) in the actual world, in non-ideal contexts, for imperfectly informed agents, especially for big, life-changing decisions. That is, we want to know how to deliberate as best we can, given the real-world limitations on what we can know, and given real-world limitations on how we are able to deliberate. In this paper, our concern is with the norms of rational deliberation in certain, important, non-ideal contexts, where the reasoning occurs from the agent’s first person, subjective point of view. The norms governing the process of deliberation for real people in the sorts of non-ideal contexts we’ll consider need to reflect the way that real agents, with an incomplete grasp on the facts and an imperfect ability to deliberate, can be expected to proceed. Our central contention is that framing and exploring the deliberative process from the first person perspective allows us to uncover and explore important, real-world constraints on boundedly rational agents deliberating from the subjective perspective. (shrink)

The prevailing discourse around AI ethics lacks the language and formalism necessary to capture the diverse ethical concerns that emerge when AI systems interact with individuals. Drawing on Sen and Nussbaum’s capability approach, we present a framework formalizing a network of ethical concepts and entitlements necessary for AI systems to confer meaningful benefit or assistance to stakeholders. Such systems enhance stakeholders’ ability to advance their life plans and well-being while upholding their fundamental rights. We characterize two necessary conditions for morally (...) permissible interactions between AI systems and those impacted by their functioning, and two sufficient conditions for realizing the ideal of meaningful benefit. We then contrast this ideal with several salient failure modes, namely, forms of social interactions that constitute unjustified paternalism, coercion, deception, exploitation and domination. The proliferation of incidents involving AI in high-stakes domains underscores the gravity of these issues and the imperative to take an ethics-led approach to AI systems from their inception. (shrink)

How should an agent act under normative uncertainty? We might extend the orthodox theory of rational choice to the case of uncertainty between competing normative theories. But this requires that the values assigned by different normative theories be comparable. This paper defends a strategy for avoiding the need for intertheoretic value comparisons: instead of comparing competing moral theories, I argue that values can be represented in terms of a de dicto specification of value. I provide a decision theory for de (...) dicto values that generalises expected utility theory, and I compare the proposal with alternative strategies for avoiding the problem of intertheoretic comparisons. (shrink)

The human enhancement debate has over the last few decades been concerned with ethical issues in methods for improving the physical, cognitive, or emotive states of individual people, and of the human species as a whole. Arguments in favour of enhancement defend it as a paradigm of rationality, presenting it as a clear-eyed, logical defence of what we stand to gain from transcending the typical limits of our species. If these arguments are correct, it appears that adults should in principle (...) be able to make rational and informed decisions about enhancing themselves. In this paper, however, we suggest that a rational and informed choice to enhance oneself may in some cases be impossible. Drawing on L. A. Paul’s work on ‘transformative experience’, we argue that some enhancements—such as certain moral or cognitive modifications—may give rise to unbridgeable epistemic gaps in key domains. Importantly, such gaps could prove to be not merely contingently unbridgeable due to a lack of information at a given moment, but radically unbridgeable, making someone in a non-enhanced state inherently unable to conceive of what it would be like to be enhanced in a particular way. Where this experience is key to understanding what values are being pursued by the enhancement itself, it may prove impossible for a person to be sufficiently informed, and to make a rational decision about whether or not to enhance herself. This poses a challenge for human enhancement proponents in general, and for transhumanists in particular. (shrink)

ABSTRACT Is uncertainty about preferences rationally possible? And if so, does it matter for rational decision? It is argued that uncertainty about preferences is possible and should play the same role in rational decision-making as uncertainty about worldly facts. The paper develops this hypothesis and defends it against various objections.

Summary of Transformative Experience by L.A. Paul and replies to symposiasts. Discussion of undefined values, preference change, authenticity, experiential value, collective minds, mind control.

Scepticism and negative theology are best understood not as theoretical positions, but rather as forms of philosophical practice that performatively undermine our knowledge claims or our seeming understanding of God. In particular, I am arguing that both scepticism and negative theology invoke the failure of the attempt to understand the absolute, be it God or the notion of absolute objectivity. However, with reference to L. A. Paul’s notion of epistemically transformative experience, I am arguing that we still understand something about (...) the absolute through the experience of failing to think it. This, of course, is a non-propositional form of understanding, and I am arguing that there is something about the finitude of the human condition that can only be understood through a transformative philosophical experience with respect to the absolute. (shrink)

Ignorance is said to be the most widely accepted explanation of what makes choices hard (Chang 2017). But despite its apparent popularity, the debate on hard choices has been dominated by tetrachotomist (e.g., “parity”) and vagueness views. In fact, there is no elaborate ignorance account of hard choices. This article closes this research gap. In so doing, it connects the debate on hard choices with that on transformative experiences (Paul 2014). More precisely, an option’s transformative character can prevent us from (...) epistemically accessing its expected value, promoting ignorance of how to rank the options. Methods of achieving an advance assessment of transformative experiences such as fine-graining, consulting testimony, and using higher-order facts can sometimes evade this epistemic blockade, but not always. Therefore, in cases where these methods fail, a choice can be hard because of our ignorance. The prominent hard choice between two careers could be such a case. (shrink)

According to L. A. Paul, the subjective value of an outcome is normally assessed by running a cognitive model of what it would be like if that outcome were to occur. However, cognitive models, along with the expectations in which they result, are unreliable for application to transformative experiences because we cannot know what it would be like for an outcome to occur if we have never experienced it before. This paper argues that despite their unreliability, expectations are still important (...) in the case of chosen and unchosen transformative experiences because expectations about an outcome can systematically influence the very experience of that outcome. More precisely, empirical research shows that affective experiences tend to assimilate to affective expectations. In turn, more positive affective experiences lead, ceteris paribus, to higher subjective value. Therefore, rational agents confronting transformative outcomes should form or cultivate positive/optimistic affective expectations since, all else being equal, that maximizes subjective value. (shrink)

In the last seven years, philosophers have discussed the topic of transformative experiences. In this paper, we contribute to a crucial issue that is currently under-researched: transformative experiences' influence on cognitive modelling. We argue that cognitive modelling can be operationalized as affective forecasting, and we compare transformative and non-transformative experiences with respect to the ability of affective forecasting. Our finding is that decision-makers’ performance in cognitively modelling transformative experiences does not systematically differ from decision-makers’ performance in cognitively modelling non-transformative experiences. (...) This claim stands in strict opposition to L.A. Paul’s main argument. (shrink)

Midwest Studies In Philosophy, EarlyView.

A psychedelic renaissance is currently taking place in mental healthcare. The number of psychedelic-assisted therapy trials is growing steadily, and some countries already grant psychiatrists special permission to use psychedelics in non-research contexts under certain conditions. These clinical advances must be accompanied by ethical inquiry. One pressing ethical question involves whether patients can even give informed consent to psychedelic-assisted therapy: the treatment’s transformative nature seems to block its assessment, suggesting that patients are unable to understand what undergoing psychedelic-assisted therapy actually (...) means for them and whether it aligns with their values. The present paper argues that patients often have sufficient knowledge to give informed consent because they know that they want to change their negative status quo and that psychedelic-assisted therapy offers an effective way to do so. Accordingly, patients can understand what the transformative nature of psychedelic-assisted therapy means for them and a make a value-aligned choice even if they are unable to anticipate the manifestation of a psychedelic experience. (shrink)

Much of the human enhancement literature focuses on the ethical, social, and political challenges we are likely to face in the future. I will focus instead on whether we can make decisions to modify ourselves that are known to be likely to satisfy our preferences. It seems plausible to suppose that, if a subject is deciding whether to select a reasonably safe and morally unproblematic enhancement, the decision will be an easy one. The subject will simply figure out her preferences (...) and decide accordingly. The problem, however, is that there is substantial evidence that we are not very good at predicting what will satisfy our preferences. This is a general problem that applies to many different types of decisions, but I argue that there are additional complications when it comes to making decisions about enhancing ourselves. These arise not only for people interested in selecting enhancements but also for people who choose to abstain. (shrink)

According to Paul (Transformative experience, 1st edn, Oxford University Press, 2014), transformative experiences pose a challenge to decision theory since their value cannot be anticipated. Building on Pettigrew’s (in: Lambert, Schwenkler (eds) Becoming someone new: essays on transformative experience, choice, and change, Oxford University Press, pp 100–121, 2020) redescription, this paper presents a new approach to how and when transformative decisions can nevertheless be made rationally. Thanks to fundamental higher-order facts that apply to any kind of experience, an agent always (...) at least knows the general shape of the utility space. This in combination with the knowledge about the non-transformative alternative in the choice set can enable rational decision-making despite the presence of a transformative experience. For example, this paper’s approach provides novel arguments for why gender transition (cf. McKinnon in Res Philosophica 92(2):419–440, 2015) or staying childfree (cf. Barnes in Philos Phenomenol Res 91(3):775–786, 2015) can be rational. (shrink)