Identification of factors that predict recurrent antisocial behavior is integral to the social sciences, criminal justice procedures, and the effective treatment of high-risk individuals. Here we show that error-related brain activity elicited during performance of an in- hibitory task prospectively predicted subsequent rearrest among adult offenders within 4 y of release (N =96). The odds that an offender with relatively low anterior cingulate activity would be rearrested were approximately double that of an offender with high activity in this region, holding (...) constant other observed risk factors. These results suggest a potential neurocognitive biomarker for persistent antisocial behavior. (shrink)

Legal theorists have characterized physical evidence of brain dysfunction as a double-edged sword, wherein the very quality that reduces the defendant’s responsibility for his transgression could simultaneously increase motivations to punish him by virtue of his apparently increased dangerousness. However, empirical evidence of this pattern has been elusive, perhaps owing to a heavy reliance on singular measures that fail to distinguish between plural, often competing internal motivations for punishment. The present study employed a test of the theorized double-edge pattern using (...) a novel approach designed to separate such motivations. We asked a large sample of participants (N = 330) to render criminal sentencing judgments under varying conditions of the defendant’s mental health status (Healthy, Neurobiological Disorder, Psychological Disorder) and the disorder’s treatability (Treatable, Untreatable). As predicted, neurobiological evidence simultaneously elicited shorter prison sentences (i.e., mitigating) and longer terms of involuntary hospitalization (i.e., aggravating) than equivalent psychological evidence. However, these effects were not well explained by motivations to restore treatable defendants to health or to protect society from dangerous persons but instead by deontological motivations pertaining to the defendant’s level of deservingness and possible obligation to provide medical care. This is the first study of its kind to quantitatively demonstrate the paradoxical effect of neuroscientific trial evidence and raises implications for how such evidence is presented and evaluated. (shrink)

We examine whether the "evidence of evidence is evidence" principle is true. We distinguish several different versions of the principle and evaluate recent attacks on some of those versions. We argue that, whatever the merits of those attacks, they leave the more important rendition of the principle untouched. That version is, however, also subject to new kinds of counterexamples. We end by suggesting how to formulate a better version of the principle that takes into account those new counterexamples.

Suppose we learn that we have a poor track record in forming beliefs rationally, or that a brilliant colleague thinks that we believe P irrationally. Does such input require us to revise those beliefs whose rationality is in question? When we gain information suggesting that our beliefs are irrational, we are in one of two general cases. In the first case we made no error, and our beliefs are rational. In that case the input to the contrary is misleading. In (...) the second case we indeed believe irrationally, and our original evidence already requires us to fix our mistake. In that case the input to that effect is normatively superfluous. Thus, we know that information suggesting that our beliefs are irrational is either misleading or superfluous. This, I submit, renders the input incapable of justifying belief revision, despite our not knowing which of the two kinds it is. (shrink)

ABSTRACTShould conciliating with disagreeing peers be considered sufficient for reaching rational beliefs? Thomas Kelly argues that when taken this way, Conciliationism lets those who enter into a disagreement with an irrational belief reach a rational belief all too easily. Three kinds of responses defending Conciliationism are found in the literature. One response has it that conciliation is required only of agents who have a rational belief as they enter into a disagreement. This response yields a requirement that no one should (...) follow. If the need to conciliate applies only to already rational agents, then an agent must conciliate only when her peer is the one irrational. A second response views conciliation as merely necessary for having a rational belief. This alone does little to address the central question of what is rational to believe when facing a disagreeing peer. Attempts to develop the response either reduce to the first response, or deem necessary an unnecessary doxastic revision, or imply that rational dilemmas obtain in cases where intuitively there are none. A third response tells us to weigh what our pre-disagreement evidence supports against the evidence from the disagreement itself. This invites epistemic akrasia. (shrink)

Epistemically akratic agents believe both p and that believing p is irrational for them. Some of the costs of thinking that epistemic akrasia can be rational are clear. It is hypocritical, and outright weird, to have beliefs that we consider irrational, let alone to reason with or act on those beliefs. However, as Maria Lasonen-Aarnio (2020) and Brian Weatherson (2019) have argued, the weirdness of akrasia does not obviously tell against its rationality. Here I argue that views permitting epistemic akrasia (...) fare worse than previously thought. These views imply that we should sometimes have beliefs that we know for certain are either irrational or false. And while having a belief that we know to be irrational is straightforwardly irrational, the additional possibility that the belief may be false cannot make having it any more rational. (shrink)

Is it ever rational to suspend judgment about whether a particular doxastic attitude of ours is rational? An agent who suspends about whether her attitude is rational has serious doubts that it is. These doubts place a special burden on the agent, namely, to justify maintaining her chosen attitude over others. A dilemma arises. Providing justification for maintaining the chosen attitude would commit the agent to considering the attitude rational—contrary to her suspension on the matter. Alternatively, in the absence of (...) such justification, the attitude would be arbitrary by the agent's own lights, and therefore irrational from the agent's own perspective. So, suspending about whether an attitude of ours is rational does not cohere with considering it rationally preferable to other attitudes, and leads to a more familiar form of epistemic akrasia otherwise. (shrink)

What it means for an action to have moral worth, and what is required for this to be the case, is the subject of continued controversy. Some argue that an agent performs a morally worthy action if and only if they do it because the action is morally right. Others argue that a morally worthy action is that which an agent performs because of features that make the action right. These theorists, though they oppose one another, share something important in (...) common. They focus almost exclusively on the moral worth of right actions. But there is a negatively valenced counterpart that attaches to wrong actions, which we will call moral counterworth. In this paper, we explore the moral counterworth of wrong actions in order to shed new light on the nature of moral worth. Contrary to theorists in both camps, we argue that more than one kind of motivation can affect the moral worth of actions. (shrink)

Richard Feldman has proposed and defended different versions of a principle about evidence. In slogan form, the principle holds that ‘evidence of evidence is evidence’. Recently, Branden Fitelson has argued that Feldman’s preferred rendition of the principle falls pray to a counterexample related to the non-transitivity of the evidence-for relation. Feldman replies arguing that Fitelson’s case does not really represent a counterexample to the principle. In this note, we argue that Feldman’s principle is trivially true.

When a belief is self-fulfilling, having it guarantees its truth. When a belief is self-defeating, having it guarantees its falsity. These are the cases of “self-impacting” beliefs to be examined below. Scenarios of self-defeating beliefs can yield apparently dilemmatic situations in which we seem to lack sufficient reason to have any belief whatsoever. Scenarios of self-fulfilling beliefs can yield apparently dilemmatic situations in which we seem to lack reason to have any one belief over another. Both scenarios have been used (...) independently to challenge Evidentialism, on which what we may rationally believe is all and only what fits our current evidence. Here we tie the two scenarios together and explore what a knowledge-sensitive evidentialist approach to one implies for the other. (shrink)

The world’s first COVID-19 human challenge trial using the D614G strain of SARS-CoV-2 is underway in the United Kingdom. The Wellcome Trust is funding challenge stock preparation of the Beta variant (B.1.351) for a follow-up human challenge trial, and researchers at Imperial College London are considering conducting that trial. However, little has been written thus far about the ethical justifiability of human challenge trials with SARS-CoV-2 variants of concern. While vaccine resistance as such does not increase risks for volunteers in (...) COVID-19 challenge trials, we explore two specific characteristics of some variants that may initially be thought to make such trials unethical and conclude that SARS-CoV-2 variant challenge trials can remain ethical. (shrink)

In many countries, the COVID‐19 pandemic varied starkly between different racial and ethnic groups. Before vaccines were approved, some considered assigning priority access to worse‐hit racial groups. That debate can inform rationing in future pandemics and in some of the many areas outside COVID‐19 that admit of racial health disparities. However, concerns were raised that “race‐responsive” prioritizations would be ruled unlawful for allegedly constituting wrongful discrimination. This legal argument relies on an understanding of discrimination law as demanding color‐blindness. We argue (...) that a, color‐blind understanding of discrimination would be hostile only to one of two rationales for prioritizing the relevant racial minorities in settings of racial health disparities. We also propose a method for incorporating appropriate race‐responsive concerns that is in many ways ethically and legally superior to ones suggested thus far. That method turns artificial intelligence, thanks precisely to its artificial and “black box” nature (features that underlie recent concerns about artificial intelligence's discriminatory potential), into an instrument of social justice. (shrink)

This report by the WHO Consultative Group on Equity and Universal Health Coverage addresses how countries can make fair progress towards the goal of universal coverage. It explains the relevant tradeoffs between different desirable ends and offers guidance on how to make these tradeoffs.

The goal of achieving Universal Health Coverage (UHC) can generally be realized only in stages. Moreover, resource, capacity and political constraints mean governments often face difficult trade-offs on the path to UHC. In a 2014 report, Making fair choices on the path to UHC, the WHO Consultative Group on Equity and Universal Health Coverage articulated principles for making such trade-offs in an equitable manner. We present three case studies which illustrate how these principles can guide practical decision-making. These case studies (...) show how progressive realization of the right to health can be effectively guided by priority-setting principles, including generating the greatest total health gain, priority for the worse off, and financial risk protection. They also demonstrate the value of a fair and accountable process of priority setting. (shrink)

La cobertura universal de salud está en el centro de la acción actual para fortalecer los sistemas de salud y mejorar el nivel y la distribución de la salud y los servicios de salud. Este documento es el informe fi nal del Grupo Consultivo de la OMS sobre la Equidad y Cobertura Universal de Salud. Aquí se abordan los temas clave de la justicia (fairness) y la equidad que surgen en el camino hacia la cobertura universal de salud. Por lo (...) tanto, el informe es pertinente para cada agente que infl uye en ese camino y en particular para los gobiernos, ya que se encargan de supervisar y guiar el progreso hacia la cobertura universal de salud. (shrink)

This report from the WHO Consultative Group on Equity and Universal Health Coverage offers advice on how to make progress fairly towards universal health coverage.

Eyal et al have recently argued that researchers should consider conducting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) human challenge studies to hasten vaccine development. We have conducted (J. L.) and overseen (L. D.) human challenge studies and agree that they can be useful in developing anti-infective agents. We also agree that adults can autonomously choose to undergo risks with no prospect of direct benefit to themselves. However, we disagree that SARS-CoV-2 challenge studies are ethically appropriate at this time, (...) for 3 reasons: (1) current scientific knowledge of SARS-CoV-2 infection is insufficient to manage risks; (2) autonomous decision making, while necessary, does not override concerns about risk; and (3) undertaking challenge studies now would imperil confidence in the research enterprise, potentially undermining the global response to the coronavirus disease 2019 (COVID-19) pandemic. (shrink)

Eyal Shahar’s essay review [1] of James Penston’s remarkable book [2] seems more inspired playful academic provocation than review or essay, expressing dramatic views of impossible validity. The account given of modern biostatistical causation reveals the slide from science into the intellectual confusion and non-science RCTs have created: “…. the purpose of medical research is to estimate the magnitude of the effect of a causal contrast, for example the probability ratio of a binary outcome …” But Shahar’s world is (...) simultaneously not probabilistic, but of absolute uncertainty: “We should have no confidence in any type of evidence ….. We should have no confidence at all”. Shahar’s "Causal contrast" is attractive. It seems to make sense, but bypasses in two words the means of establishing causation by the scientific method. This phrase assumes a numeric statistically significant “contrast” is causal rather than a potential correlation requiring further investigation. The concept of “causal contrast” is a slippery slope from sense into biostatistical non-science. This can be illustrated with an hypothetical RCT where 100% of interventions exhibit a posited treatment effect and 0% of placebo controls. Internal validity is seemingly quite reasonably assumed satisfied (common-sense dictating the likelihood of an awesome magnificent fraud, bias or plain error of the magnitude required is infinitesimal). Scientific method appears satisfied. The RCT demonstrates: (1) strict regularity of outcome in the presence of posited cause; (2) the absence of outcome in its absence and (3) an intervention (experiment) showing the direction of causation is from posited cause to posited effect. Now travel further down the slope from science. Assume 50% of interventions and 0% of controls are positive. We compromise scientific method, but justify this by assuming a large subgroup which we say surely must on these figures be exhibiting the posited treatment effect. But what of 10% of interventions and 9% of placebo controls exhibiting the posited treatment effect? Our biostatistician says the 1% “causal contrast” is statistically significant. But we have: (1) minimal evidence of regularity; (2) the posited outcome irrespective of presence of posited cause and (3) our intervention is at the highest equivocal in demonstrating any form of causation. This is not science. It is, however, where biostatistics has unthinkingly taken us, as Penston has shown comprehensively [2]. We, the audience of published medical research, are now for the 10% / 9% example well down the slope from science. An unattractive hypothesis results requiring numerous assumptions similar to these:- "There is a 'contrast' which is ‘causal’, albeit the method employed is not scientific. An effect of the intervention has been observed in a very small subgroup. This subgroup is susceptible to treatment. The similar number of placebo controls exhibiting the outcome sought is irrelevant, because the 1% difference between intervention and controls is statistically significant. The statistical analysis is valid and reliable. The RCT’s internal validity is sufficiently satisfied. No funding or bias or fraud has affected the results or their analysis.” As Penston notes: “Confirming and refuting the results of research is crucial to science …. But … there’s no way of testing the results of any particular large-scale RCT or epidemiological study. Each study … is left hanging in the air, unsupported.” It gets worse. To identify a rare serious adverse reaction of a frequency of 1:10,000 can require a trial of 200,000 or larger split between controls and interventions. This is not done. But for every 100 who prospectively benefit from the intervention, 9,900 also receive it. And for every 100 benefiting one person (who likely gains no benefit) will suffer a serious unidentified adverse reaction. This is also without taking account of more common adverse reactions whether serious or otherwise. References [1] Shahar, E. (2011) Research and medicine: human conjectures at every turn. International Journal of Person Centered Medicine 1 (2), 250-253. [2] Penston, J. (2010). stats.con: How we’ve been fooled by statistics-based research in medicine. London: The London Press, UK. (shrink)

In his editorial, Nir Eyal argues that a nudge can exploit our propensity to feel shame in order to steer us toward certain choices. We object that shame is a cost and therefore cannot figure in the apparatus of a nudge.

I consider what prima facie attractive communitarian ethical perspectives salient among indigenous African peoples entail for distributive justice within a state, and I argue that they support a form of economic egalitarianism that differs in several important ways from varieties common in contemporary Anglo-American political philosophy. In particular, the sort of economic egalitarianism I advance rivals not only luck-oriented variants from the likes of Ronald Dworkin, G. A. Cohen and theorists inspired by them such as Richard Arneson, Carl Knight and (...) Nir Eyal, but also more ‘social’ kinds advocated by Elizabeth Anderson, Samuel Scheffler and Jonathan Wolff. Although I do not argue that these broadly Kantian egalitarianisms are less plausible than the Afro-communitarian version, I do aim to establish that it should be taken as seriously as they, at this stage of the debate. (shrink)

In his influential history of the post-1967 history of the Palestinian Occupation, radical Israeli architect Eyal Weizman show how even well-meaning decolonial efforts from privileged allies can be coopted by the colonizers, in what I call “de-decolonizing.” Here I focus on one of his examples, namely IDF (Israeli Defense Force) military professors repurposing the anarcho-communist philosophy of French postmodernist Gilles Deleuze into a weapon against Palestinian guerrilla resistance. My conclusion is that attempted decolonizing via (inevitably complicit) privileged allies must (...) include what Weizman calls “co-resistance,” and I call “reconstruction.” In other words, when a Deleuzian “line of flight” to “escape” is impossible, as arguably for Palestinians today, then one should follow the heroic example of the Bedouins, who (as Weizman acknowledges) are the only Arabs who have never stopped rebuilding their Palestine. (shrink)