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Medical Error and Moral Luck

HEC Forum 28 (3):229-243 (2016)

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  1. Philosophy's New challenge: Experiments and Intentional Action.N. Ángel Pinillos, Nick Smith, G. Shyam Nair, Peter Marchetto & Cecilea Mun - 2011 - Mind and Language 26 (1):115-139.
    Experimental philosophers have gathered impressive evidence for the surprising conclusion that philosophers' intuitions are out of step with those of the folk. As a result, many argue that philosophers' intuitions are unreliable. Focusing on the Knobe Effect, a leading finding of experimental philosophy, we defend traditional philosophy against this conclusion. Our key premise relies on experiments we conducted which indicate that judgments of the folk elicited under higher quality cognitive or epistemic conditions are more likely to resemble those of the (...)
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  • (1 other version)Judgment under Uncertainty: Heuristics and Biases.Amos Tversky & Daniel Kahneman - 1974 - Science 185 (4157):1124-1131.
    This article described three heuristics that are employed in making judgements under uncertainty: representativeness, which is usually employed when people are asked to judge the probability that an object or event A belongs to class or process B; availability of instances or scenarios, which is often employed when people are asked to assess the frequency of a class or the plausibility of a particular development; and adjustment from an anchor, which is usually employed in numerical prediction when a relevant value (...)
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  • Intentional action and side effects in ordinary language.J. Knobe - 2003 - Analysis 63 (3):190-194.
    There has been a long-standing dispute in the philosophical literature about the conditions under which a behavior counts as 'intentional.' Much of the debate turns on questions about the use of certain words and phrases in ordinary language. The present paper investigates these questions empirically, using experimental techniques to investigate people's use of the relevant words and phrases. g.
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  • Don’t Know, Don’t Kill: Moral Ignorance, Culpability, and Caution.Alexander A. Guerrero - 2007 - Philosophical Studies 136 (1):59-97.
    This paper takes on several distinct but related tasks. First, I present and discuss what I will call the “Ignorance Thesis,” which states that whenever an agent acts from ignorance, whether factual or moral, she is culpable for the act only if she is culpable for the ignorance from which she acts. Second, I offer a counterexample to the Ignorance Thesis, an example that applies most directly to the part I call the “Moral Ignorance Thesis.” Third, I argue for a (...)
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  • Chairmen, Cocaine, and Car Crashes: The Knobe Effect as an Attribution Error.Hanno Sauer & Tom Bates - 2013 - The Journal of Ethics 17 (4):305-330.
    In this paper, we argue that the so-called Knobe-Effect constitutes an error. There is now a wealth of data confirming that people are highly prone to what has also come to be known as the ‘side-effect effect’. That is, when attributing psychological states—such as intentionality, foreknowledge, and desiring—as well as other agential features—such as causal control—people typically do so to a greater extent when the action under consideration is evaluated negatively. There are a plethora of models attempting to account for (...)
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  • Clinical ethics: Ascribing intentions in clinical decision-making.L. A. Jansen & J. S. Fogel - 2010 - Journal of Medical Ethics 36 (1):2-6.
    Background: The intentions of clinicians are widely considered to be relevant to the ethical assessment of their actions. A better understanding of the psychological factors that influence the ascription of intentions in clinical practice is important for improving the self-understanding of clinical decision-making and, ultimately, the ethics of clinical care. Drawing on empirical research on intentionality that has been done in other contexts, this is the first study to test whether the “asymmetric effect” of intention ascription is exhibited by respondents (...)
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  • Individual differences in theory-of-mind judgments: Order effects and side effects.Adam Feltz & Edward T. Cokely - 2011 - Philosophical Psychology 24 (3):343 - 355.
    We explore and provide an account for a recently identified judgment anomaly, i.e., an order effect that changes the strength of intentionality ascriptions for some side effects (e.g., when a chairman's pursuit of profits has the foreseen but unintended consequence of harming the environment). Experiment 1 replicated the previously unanticipated order effect anomaly controlling for general individual differences. Experiment 2 revealed that the order effect was multiply determined and influenced by factors such as beliefs (i.e., that the same actor was (...)
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  • (1 other version)There Is No Door: Finally Solving the Problem of Moral Luck.Darren Domsky - 2004 - Journal of Philosophy 101 (9):445-464.
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  • (2 other versions)Subjective rightness.Holly M. Smith - 2010 - Social Philosophy and Policy 27 (2):64-110.
    Twentieth century philosophers introduced the distinction between “objective rightness” and “subjective rightness” to achieve two primary goals. The first goal is to reduce the paradoxical tension between our judgments of (i) what is best for an agent to do in light of the actual circumstances in which she acts and (ii) what is wisest for her to do in light of her mistaken or uncertain beliefs about her circumstances. The second goal is to provide moral guidance to an agent who (...)
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  • Medical Error, Malpractice and Complications: A Moral Geography. [REVIEW]David M. Zientek - 2010 - HEC Forum 22 (2):145-157.
    This essay reviews and defines avoidable medical error, malpractice and complication. The relevant ethical principles pertaining to unanticipated medical outcomes are identified. In light of these principles I critically review the moral culpability of the agents in each circumstance and the resulting obligations to patients, their families, and the health care system in general. While I touch on some legal implications, a full discussion of legal obligations and liability issues is beyond the scope of this paper.
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  • Person as scientist, person as moralist.Joshua Knobe - 2010 - Behavioral and Brain Sciences 33 (4):315.
    It has often been suggested that people’s ordinary capacities for understanding the world make use of much the same methods one might find in a formal scientific investigation. A series of recent experimental results offer a challenge to this widely-held view, suggesting that people’s moral judgments can actually influence the intuitions they hold both in folk psychology and in causal cognition. The present target article distinguishes two basic approaches to explaining such effects. One approach would be to say that the (...)
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  • Moral luck and the law.David Enoch - 2010 - Philosophy Compass 5 (1):42-54.
    Is there a difference in moral blameworthiness between a murderer and an attempted murderer? Should there be a legal difference between them? These questions are particular instances of the question of moral luck and legal luck (respectively). In this paper, I survey and explain the main argumentative moves within the general philosophical discussion of moral luck. I then discuss legal luck, and the different ways in which this discussion may be related to that of moral luck.
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  • The Epistemic Side-Effect Effect.James R. Beebe & Wesley Buckwalter - 2010 - Mind and Language 25 (4):474-498.
    Knobe (2003a, 2003b, 2004b) and others have demonstrated the surprising fact that the valence of a side-effect action can affect intuitions about whether that action was performed intentionally. Here we report the results of an experiment that extends these findings by testing for an analogous effect regarding knowledge attributions. Our results suggest that subjects are less likely to find that an agent knows an action will bring about a side-effect when the effect is good than when it is bad. It (...)
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  • The Institute of Medicine’s Reports on Quality and Safety: Paradoxes and Tensions. [REVIEW]George Khushf, James Raymond & Charles Beaman - 2008 - HEC Forum 20 (1):1-14.
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  • Intuitions and individual differences: The Knobe effect revisited.Shaun Nichols & Joseph Ulatowski - 2007 - Mind and Language 22 (4):346–365.
    Recent work by Joshua Knobe indicates that people’s intuition about whether an action was intentional depends on whether the outcome is good or bad. This paper argues that part of the explanation for this effect is that there are stable individual differences in how ‘intentional’ is interpreted. That is, in Knobe’s cases, different people interpret the term in different ways. This interpretive diversity of ‘intentional’ opens up a new avenue to help explain Knobe’s results. Furthermore, the paper argues that the (...)
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  • Knobe vs Machery: Testing the trade-off hypothesis.Ron Mallon - 2008 - Mind and Language 23 (2):247-255.
    Recent work by Joshua Knobe has established that people are far more likely to describe bad but foreseen side effects as intentionally performed than good but foreseen side effects (this is sometimes called the 'Knobe effect' or the 'side-effect effect.' Edouard Machery has proposed a novel explanation for this asymmetry: it results from construing the bad side effect as a cost that must be incurred to receive a benefit. In this paper, I argue that Machery's 'trade-off hypothesis' is wrong. I (...)
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  • Judgment Under Uncertainty: Heuristics and Biases.Daniel Kahneman, Paul Slovic & Amos Tversky (eds.) - 1982 - Cambridge University Press.
    The thirty-five chapters in this book describe various judgmental heuristics and the biases they produce, not only in laboratory experiments but in important...
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  • The Moral of Moral Luck.Susan Wolf - 2001 - Philosophic Exchange 31 (1).
    This essay is primarily concerned with one type of moral luck – luck in how things turn out. Do acts that actually lead to harm deserve the same treatment as similar acts that, by chance, do not lead to harm? This paper argues that we must recognize the truth in two, opposing tendencies in such cases.
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  • (1 other version)Judgement under Uncertainty: Heuristics and Biases.Daniel Kahneman, Paul Slovic & Amos Tversky - 1985 - British Journal for the Philosophy of Science 36 (3):331-340.
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  • (2 other versions)Subjective rightness: Holly M. Smith.Holly M. Smith - 2010 - Social Philosophy and Policy 27 (2):64-110.
    Twentieth century philosophers introduced the distinction between “objective rightness” and “subjective rightness” to achieve two primary goals. The first goal is to reduce the paradoxical tension between our judgments of what is best for an agent to do in light of the actual circumstances in which she acts and what is wisest for her to do in light of her mistaken or uncertain beliefs about her circumstances. The second goal is to provide moral guidance to an agent who may be (...)
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  • Norms Inform Mental State Ascriptions: A Rational Explanation for the Side-Effect Effect.Kevin Uttich & Tania Lombrozo - 2010 - Cognition 116 (1):87–100.
    Theory of mind, the capacity to understand and ascribe mental states, has traditionally been conceptualized as analogous to a scientific theory. However, recent work in philosophy and psychology has documented a "side-effect effect" suggesting that moral evaluations influence mental state ascriptions, and in particular whether a behavior is described as having been performed 'intentionally.' This evidence challenges the idea that theory of mind is analogous to scientific psychology in serving the function of predicting and explaining, rather than evaluating, behavior. In (...)
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  • Medical Malpractice, Mistake Prevention, and Compensation.Thomas May & Mark P. Aulisio - 2001 - Kennedy Institute of Ethics Journal 11 (2):135-146.
    Clinicians' fear of malpractice litigation is the most significant obstacle to the open reporting of medical mistakes. Without open reporting of medical mistakes, however, root cause analysis of mistakes cannot be done, thus undermining efforts to implement safeguards to minimize the occurrence of future mistakes. Efforts to prevent medical mistakes, therefore, must first directly address cliniciansÕ fear of malpractice litigation. In this paper, we explore the relationship between the current malpractice system and cliniciansÕ fear of litigation. Ultimately, we argue that (...)
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  • The case against moral luck.David Enoch & Andrei Marmor - 2007 - Law and Philosophy 26 (4):405-436.
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  • The armchair and the trolley: an argument for experimental ethics.Guy Kahane - 2013 - Philosophical Studies 162 (2):421-445.
    Ethical theory often starts with our intuitions about particular cases and tries to uncover the principles that are implicit in them; work on the ‘trolley problem’ is a paradigmatic example of this approach. But ethicists are no longer the only ones chasing trolleys. In recent years, psychologists and neuroscientists have also turned to study our moral intuitions and what underlies them. The relation between these two inquiries, which investigate similar examples and intuitions, and sometimes produce parallel results, is puzzling. Does (...)
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  • Moral responsibility and ignorance.Michael J. Zimmerman - 1997 - Ethics 107 (3):410-426.
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  • Taking luck seriously.Michael Zimmerman - 2002 - Journal of Philosophy 99 (11):553-576.
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  • Moral Luck.B. A. O. Williams & T. Nagel - 1976 - Aristotelian Society Supplementary Volume 50 (1):115-152.
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  • Cognitive Biases and Moral Luck.David Enoch - 2010 - Journal of Moral Philosophy 7 (3):372-386.
    Some of the recent philosophical literature on moral luck attempts to make headway in the moral-luck debate by employing the resources of empirical psychology, in effect arguing that some of the intuitive judgments relevant to the moral-luck debate are best explained - and so presumably explained away - as the output of well-documented cognitive biases. We argue that such attempts are empirically problematic, and furthermore that even if they were not, it is still not at all clear what philosophical significance (...)
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  • (1 other version)Is consequential luck morally inconsequential? Empirical psychology and the reassessment of moral luck.Edward Royzman & Rahul Kumar - 2004 - Ratio 17 (3):329–344.
    Philosophical discussions of the phenomenon that has come to be known as ‘moral luck’ have either dismissed it as illusory or touted it as the evidence for doubting the probative value of our commitment to certain widely avowed views concerning interpersonal assessments of responsibility. In this discussion, we present a third, distinctive interpretation of the moral luck phenomenon. Drawing upon empirically robust results from psychological studies of judgment bias, we argue that the phenomenon of moral luck is demonstrably not illusory. (...)
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  • (1 other version)Is Consequential Luck Morally Inconsequential? Empirical Psychology and the Reassessment of Moral Luck.Rahul Kumar Edward Royzman - 2004 - Ratio 17 (3):329-344.
    Philosophical discussions of the phenomenon that has come to be known as ‘moral luck’ have either dismissed it as illusory or touted it as the evidence for doubting the probative value of our commitment to certain widely avowed views concerning interpersonal assessments of responsibility. In this discussion, we present a third, distinctive interpretation of the moral luck phenomenon. Drawing upon empirically robust results from psychological studies of judgment bias, we argue that the phenomenon of moral luck is demonstrably not illusory. (...)
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  • Intentions in critical clinical settings: a study of medical students' perceptions.N. Juth, T. Tillberg & N. Lynoe - 2011 - Journal of Medical Ethics 37 (8):483-486.
    The aim of this pilot study was to develop a realistic clinical case for identifying Knobe's asymmetric effect, ie, the tendency to ascribe intentions to a larger extent when an act is considered wrong, as well as to compare medical students at the beginning and end of their curriculum. A vignette about a critically ill 72-year-old patient in need of an operation was used, with two different outcomes: the patient dies or the patient recovers. Approximately half of the students received (...)
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