Background Best interests is a ubiquitous principle in medical policy and practice, informing the treatment of both children and adults. Yet theory underlying the concept of best interests is unclear and rarely articulated. This paper examines bioethical literature for theoretical accounts of best interests to gain a better sense of the meanings and underlying philosophy that structure understandings. Methods A scoping review of was undertaken. Following a literature search, 57 sources were selected and analysed using the thematic method. Results Three (...) themes emerged. The first placed best interests within the structure of wider theory, noting relationships with consequentialism, deontology, prudential value theory, rights and political philosophy. The second mapped a typology of processes of decision-making, among which best interests was ambiguously positioned. It further indicated factors that informed best interests decision-making, primarily preferences, dignity and quality of life. The final theme considered best interests from a relational perspective. Conclusions Characterisation of best interests as strictly paternalist and consequentialist is questionable: while accounts often suggested a consequentialist basis for best interests, arguments appeared philosophically weak. Deontological accounts, found in law and Kantianism, and theories of political liberalism influenced accounts of best interests, with accounts often associating best interests with negative patient preferences (i.e. individual refusals). There was much more emphasis on negative interests than positive interests. Besides preference, factors like dignity and quality of life were held to inform best interests decisions, but generally were weakly defined. To the extent that preferences were unable to inform decision making, decisions were either made by proxy authority or by an intersubjective process of diffuse authority. Differing approaches reflect bifurcations in liberal philosophy between new liberalism and neo-liberalism. Although neither account of authority appears dominant, bias to negative interests suggests that bioethical debate tends to reflect the widespread ascendancy of neo-liberalism. This attitude was underscored by the way relational accounts converged on private familial authority. The visible connections to theory suggest that best interests is underpinned by socio-political trends that may set up frictions with practice. How practice negotiates these frictions remains a key question. (shrink)

In the last twenty years, there has been an enormous growth of scientific research concerning the process of human moral reasoning and moral intuitions. In contemporary descriptive ethics, three dominant approaches can be found – heuristic approach, dual-process theory, and universal moral grammar. Each of these accounts is based on similar empirical evidence combining findings from evolutionary biology, moral psychology, and neuroethics. Nevertheless, they come to different conclusions about the reliability of moral intuitions. The aim of this paper is to (...) critically investigate each of these approaches and compare them with recent scientific findings. Last chapter addresses implications of these findings for moral epistemology and normative ethics. The aim is to show that despite different interpretations of available data, we can reach a satisfying pragmatical conclusion which would be in compliance with the empirical evidence, yet it would not necessarily depend on it. (shrink)

Matthew Liao’s edited collection Moral Brains: The Neuroscience of Morality covers a wide range of issues in moral psychology. The collection should be of interest to philosophers, psychologist, and neuroscientists alike, particularly those interested in the relation between these disciplines. I give an overview of the content and major themes of the volume and draw some important lessons about the connection between moral neuroscience and normative ethics. In particular, I argue that moving beyond some of the dichotomies implicit in some (...) of the debates advanced in the book makes the neuroscience of moral judgment much more useful in advancing normative ethics. (shrink)

Joshua Greene has put forward the bold empirical hypothesis that deontology is a confabulation of moral emotions. Deontological philosophy does not steam from "true" moral reasoning, but from emotional reactions, backed up by post hoc rationalizations which play no role in generating the initial moral beliefs. In this paper, I will argue against the confabulation hypothesis. First, I will highlight several points in Greene’s discussion of confabulation, and identify two possible models. Then, I will argue that the evidence does not (...) illustrate the relevant model of deontological confabulation. In fact, I will make the case that deontology is unlikely to be a confabulation because alarm-like emotions, which allegedly drive deontological theorizing, are resistant to be subject to confabulation. I will end by clarifying what kind of claims can the confabulation data support. The upshot of the final section is that confabulation data cannot be used to undermine deontological theory in itself, and ironically, if one commits to the claim that a deontological justification is a confabulation in a particular case, then the data suggests that in general deontology has a prima facie validity. (shrink)

Examining folk intuitions about philosophical questions lies at the core of experimental philosophy. This requires both a good account of what intuitions are and methods allowing to assess them. We propose to combine philosophical and psychological conceptualisations of intuitions by focusing on three of their features: immediacy, lack of inferential relations, and stability. Once this account of intuition is at hand, we move on to propose a methodology that can test all three characteristics without eliminating any of them. In the (...) final part of the paper, we propose implementations of the new methodology as applied to the experimental investigation of the so-called overdemandingness objection to consequentialism. (shrink)

In moral epistemology, the method of reflective equilibrium is often characterized in terms of intuitions or understood as a method for justifying intuitions. An analysis of reflective equilibrium and current theories of moral intuitions reveals that this picture is problematic. Reflective equilibrium cannot be adequately characterized in terms of intuitions. Although the method presupposes that we have initially credible commitments, it does not presuppose that they are intuitions. Nonetheless, intuitions can enter the process of developing a reflective equilibrium and, if (...) the process is successful, be justified. Since the method of reflective equilibrium does not essentially involve intuitions, it does not constitute a form of intuitionism in any substantial sense. It may be classified as intuitionist only in the minimal sense of not reducing justification to a matter of inference relations alone. (shrink)

For some reason, participants hold agents more responsible for their actions when a situation is described concretely than when the situation is described abstractly. We present examples of this phenomenon, and survey some attempts to explain it. We divide these attempts into two classes: affective theories and cognitive theories. After criticizing both types of theories we advance our novel hypothesis: that people believe that whenever a norm is violated, someone is responsible for it. This belief, along with the familiar workings (...) of cognitive dissonance theory, is enough to not only explain all of the abstract/concrete paradoxes, but also explains seemingly unrelated effects, like the anthropomorphization of malfunctioning inanimate objects. (shrink)

Recent work in social psychology suggests that people harbor “implicit race biases,” biases which can be unconscious or uncontrollable. Because awareness and control have traditionally been deemed necessary for the ascription of moral responsibility, implicit biases present a unique challenge: do we pardon discrimination based on implicit biases because of its unintentional nature, or do we punish discrimination regardless of how it comes about? The present experiments investigated the impact such theories have upon moral judgments about racial discrimination. The results (...) show that different theories differ in their impact on moral judgments: when implicit biases are defined as unconscious, people hold the biased agent less morally responsible than when these biases are defined as automatic (i.e., difficult to control), or when no theory of implicit bias is provided. (shrink)

Moral intuitions are generally understood as automatic strong responses to moral facts. In this paper, I offer a metacognitive account according to which the strength of moral intuitions denotes the level of confidence of a subject. Confidence is a metacognitive appraisal of the fluency with which a subject processes information from a morally salient stimulus. I show that this account is supported by some empirical evidence, explains the main features of moral intuition and is preferable to emotional or quasi-perceptual views (...) of moral intuition. (shrink)

ABSTRACT ABSTRACT: This paper provides a multifaceted account of intuition. The paper integrates apparently disparate conceptions of intuition, shows how the notion has figured in epistemology as well as in intuitionistic ethics, and clarifies the relation between the intuitive and the self-evident. Ethical intuitionism is characterized in ways that, in phenomenology, epistemology, and ontology, represent an advance over the position of W. D. Ross while preserving its commonsense normative core and intuitionist character. This requires clarifying the sense in which intuitions (...) are non-inferential and explaining how self-evident principles may be maintained without dogmatism, how intuition is significantly analogous to perception, and how rational disagreements can extend even to the self-evident. The paper distinguishes between two orders of normative disagreement, shows how intuition can contribute to resolving normative disagreements, and represents ethical intuitionism as capable of modified forms that depart from its traditional claims in being neutral with respect to both ethical naturalism and metaphysical realism. (shrink)

Dual-process theories of the mind emphasize how reasoning is an interplay between intuitive and reflective thinking. This paper aims to understand how the two types of processing interact in the moral domain. According to a ‘default-interventionist’ model of moral reasoning intuition and reflection are conflicting cognitions: intuitive thinking would elicit heuristic and deontological responses, whereas reflection would favour utilitarian judgements. However, the evidence for the default interventionist view is inconclusive and challenged by a growing amount of counterevidence in recent years. (...) The recent empirical findings favour an interdependent rather than conflicting view of the two types of information processing in the moral domain. In this view, which I call dual-process reflective equilibrium, intuition and reflection cooperate in moral reasoning to reach a reflective goal, which is supposedly normative justification. In sum, on the one hand, the scope of moral intuitions extends to selecting relevant information and calling for reflection whenever a problem presents conflicting aspects; on the other hand, the purpose of moral reflection is to rationalize pre-reflective intuitions to provide articulated and accessible reasons. (shrink)

I argue for three central theses: ‘intuition’ is ambiguous, in material object metaphysics ‘intuition’ refers to pre-theoretical beliefs, and these pre-theoretical beliefs are generated by an innate physical reasoning system. I begin by outlining the relevant background discussions on the nature of intuitions and their role in philosophy to motivate the need for a more careful investigation of the meaning of ‘intuition’ and the role of intuitions in specific sub-disciplines of philosophy. In chapters one and two I argue that ‘intuition’ (...) is ambiguous between an inflationary and deflationary sense. In the inflationary sense, ‘intuition’ refers to a priori intellectual seemings with a special phenomenology, conceptual etiology, and modal content. In the deflationary sense, ‘intuition’ refers to beliefs or inclinations to believe. In chapter three I specifically examine the use of intuitions in material object metaphysics and conclude that in this sub-community ‘intuition’ is used in the deflationary sense to refer to pre-theoretical beliefs. Drawing from research on infant cognition, in the final chapter I argue that intuitions regarding material object metaphysics are those judgments that arise from an innate physical reasoning system. Based on this empirical observation, I argue that metaphysicians ought to give preference to abstract intuitions over intuitions regarding concrete cases because these abstract intuitions reflect the innate structure of our physical reasoning mechanisms. (shrink)

Research suggests that intuitions about thought experiments are vulnerable to a wide array of seemingly irrelevant factors. I argue that when arguments hinge on the use of intuitions about thought experiments, research on the subtle factors that affect intuitions must be taken seriously. To demonstrate how failing to consider such psychological influences can undermine an argument, I discuss Pereboom’s four-case manipulation argument. I argue that by failing to consider the impact of subtle psychological influences such as order effects, Pereboom likely (...) mis-identifies what really leads us to have the intuitions that we have about his cases, and this in turn undermines his argument for incompatibilism. Last, I consider objections and discuss how to empirically test my hypothesis. (shrink)

Gigerenzer’s ‘external validity argument’ plays a pivotal role in his critique of the heuristics and biases research program (HB). The basic idea is that (a) the experimental contexts deployed by HB are not representative of the real environment and that (b) the differences between the setting and the real environment are causally relevant, because they result in different performances by the subjects. However, by considering Gigerenzer’s work on frequencies in probability judgments, this essay attempts to show that there are fatal (...) flaws in the argument. Specifically, each of the claims is controversial: whereas (b) is not adequately empirically justified, (a) is inconsistent with the ‘debiasing’ program of Gigerenzer’s ABC group. Therefore, whatever reason we might have for believing that the experimental findings of HB lack experimental validity, this should not be based on Gigerenzer’s version of the argument. (shrink)

In principle, all patients deserve to receive optimal medical treatment equally. However, in situations in which there is scarcity of time or resources, medical treatment must be prioritized based on a triage. The conventional guidelines of medical triage mandate that treatment should be provided based solely on medical necessity regardless of any non-medical value-oriented considerations (“worst-first”). This study empirically examined the influence of value-oriented considerations on medical triage decision–making. Participants were asked to prioritize medical treatment relating to four case scenarios (...) of an emergency situation resulting from a car collision. The cases differ by situational characteristics pertaining to the at-fault driver, which were related to culpability attribution. In three case scenarios most participants gave priority to the most severely injured individual, unless the less severely injured individual was their brother. Nevertheless, in the aftermath of a vehicle-ramming terror attack most participants prioritized the less severely injured individual (“victim-first”). Our findings indicate that when caregivers are presented with concrete highly conflictual triage situations their choices may be based on value-oriented considerations related to contextual characteristics of the emergency situation. Philosophical and practical ramifications of our findings are discussed. (shrink)