If we were to connect two individuals’ brains together, how would this affect the individuals’ conscious experiences? In particular, it is possible for two people to share any of their conscious experiences; to simultaneously enjoy some token experiences while remaining distinct subjects? The case of the Hogan twins—craniopagus conjoined twins whose brains are connected at the thalamus—seems to show that this can happen. I argue that while practical empirical methods cannot tell us directly whether or not the twins share conscious (...) experiences, considerations about the locality of content processing in the brain entails that they most likely do so. (shrink)

This book defends Aestheticism- the claim that everything is aesthetically valuable and that a life lived in pursuit of aesthetic value can be a particularly good one. Furthermore, in distilling aesthetic qualities, artists have a special role to play in teaching us to recognize values; a critical component of virtue. I ground my account upon an analysis of aesthetic value as ‘objectified final value’, which is underwritten by an original psychological claim that all aesthetic values are distal versions of practical (...) values. This is followed by systematic accounts of beauty, sublimity, comedy, drama, and tragedy, as well as appendix entries on the cute, the cool, the kitsch, the uncanny, the horrific, the erotic, and the furious. (shrink)

The fear of death resists philosophical attempts at reconciliation. Building on theories of emotion, I argue that we can understand our fear as triggered by a de se mode of thinking about death which comes into conflict with our will to live. The discursive mode of philosophy may help us to avoid the de se mode of thinking about death, but it does not satisfactorily address the problem. I focus instead on the voluntary diminishment of one’s will to live. I (...) argue that we can encourage a natural tendency for the will to live to decline as we approach death. I then consider two objections: Is not the will to live too fundamental for us to control? And even if we can control it, would not a declining will to live result in a general despair that it is better to resist? I argue that both of these objections can be overcome. (shrink)

It is an important feature of creatures like us that our various motivations compete for control over our behaviour, including mental behaviour such as imagining and attending. In large part, this competition is adjudicated by the stimulation of affect — the intrinsically pleasant or unpleasant aspects of experience. In this paper I argue that the motivation-affect system controls a sub-type of attention called 'alerting attention' to bring various goals and stimuli to consciousness and thereby prioritize those contents for action. This (...) view allows me to flesh out the global workspace theory of consciousness, as well as some of the phenomenal characteristics of conscious experience. (shrink)

The literature on the venerable aesthetic category of the sublime often provides us with lists of sublime phenomena — mountains, storms, deserts, volcanoes, oceans, the starry sky, and so on. But it has long been recognized that what matters is the experience of such objects. We then find that one of the most consistent claims about this experience is that it involves an element of fear. Meanwhile, the recognition of the sublime as a category of aesthetic appreciation implies that attraction, (...) admiration or pleasure is also present.1However, there is also a sense of fear and attraction when we watch car chases or fights. Neither of these is an occasion for the sublime so much as a visceral sort of excitement.2 As .. (shrink)

In this paper I present an account of musical arousal that takes into account key demands of formalist philosophers such as Peter Kivy and Nick Zangwill. Formalists prioritise our understanding and appreciation of the music itself. As a result, they demand that any feelings we have in response to music must be directed at the music alone, without being distracted by non-musical associations. To accommodate these requirements I appeal to a mechanism of contagion which I synthesize with the expectation-based arousal (...) mechanism proposed by Leonard Meyer. This account connects musical expressivity and arousal in a way that formalists have rejected, but I argue that it provides the best explanation of our observations of listener responses while also focusing on the music itself. (shrink)

I argue for the possibility of an extremely intimate connection between the emotional content of the music and the emotional state of the person who produces that music. Under certain specified conditions, the music may not just influence, but also partially constitute the musician’s emotional state.

In this article we examine obsessive compulsive disorder (OCD). We examine and reject two existing models of this disorder: the Dysfunctional Belief Model and the Inference‐Based Approach. Instead, we propose that the main distinctive characteristic of OCD is a hyperactive sub‐personal signal of being in error, experienced by the individual as uncertainty about his or her intentional actions (including mental actions). This signalling interacts with the anxiety sensitivities of the individual to trigger conscious checking processes, including speculations about possible harms. (...) We examine the implications of this model for the individual's capacity to control his or her thoughts. (shrink)

This paper examines the causal basis of our ability to attribute emotions to music, developing and synthesizing the existing arousal, resemblance and persona theories of musical expressivity to do so. The principal claim is that music hijacks the simulation mechanism of the brain, a mechanism which has evolved to detect one's own and other people's emotions.

This article reconsiders Hannah Arendt’s account of “totalitarianism” in light of the climate catastrophe and the apparent inability of our political-economic system to respond to it adequately. In the last two chapters of The Origins of Totalitarianism, Arendt focuses on the “ideology” of totalitarian regimes: a pathological denial of reality, a privileging of the ideological system over empirical evidence, and a simultaneous feeling of total impotence and total omnipotence—an analysis that maps remarkably well onto the climate zeitgeist. Thus, while Arendt (...) used the concept of “totalitarianism” to foreclose alternatives to liberal capitalist democracy, the climate impasse suggests that the totalitarian label more properly belongs to the prevailing system itself. (shrink)

This article defends a persona theory of musical expressivity. After briefly summarising the major arguments for this view, it applies persona theory to the issue of whether music can express complex emotions. The expression of jealousy is then discussed by analysis of two examples from Piazzolla and Janacek.

This paper identifies a tension between the commitment to forming rationally justified emotions and the happy life. To illustrate this tension I begin with a critical evaluation of the positive psychology technique known as ‘gratitude training’. I argue that gratitude training is at odds with the kind of critical monitoring that several philosophers have claimed is regulative of emotional rationality. More generally, critical monitoring undermines exuberance, an attitude that plays a central role in contemporary models of the happy life. Thus, (...) prominent notions of what it takes to maintain emotion rationality and what it takes to maintain happiness are in tension. To resolve this tension, I argue that some people have good reason to depreciate critical monitoring—even while maintaining the requirement of emotion rationality that we be sensitive to facts about how our concerns are faring. (shrink)

The author proposes a dimensional model of our emotion concepts that is intended to be largely independent of one’s theory of emotions and applicable to the different ways in which emotions are measured. He outlines some conditions for selecting the dimensions based on these motivations and general conceptual grounds. Given these conditions he then advances an 8-dimensional model that is shown to effectively differentiate emotion labels both within and across cultures, as well as more obscure expressive language. The 8 dimensions (...) are: (1) attracted—repulsed, (2) powerful—weak, (3) free—constrained, (4) certain—uncertain, (5) generalized—focused, (6) future directed—past directed, (7) enduring—sudden, (8) socially connected—disconnected. (shrink)

This paper contrasts individual and collective listening to music, with particular regard to the expressive qualities of music. In the first half of the paper a general model of joint attention is introduced. According to this model, perceiving together modifies the intrinsic structure of the perceptual task, and encourages a convergence of responses to a greater or lesser degree. The model is then applied to music, looking first at the silent listening situation typical to the classical concert hall, and second (...) the noisy listening situation typical to rock or jazz concerts. (shrink)

This article responds to four critics of Democracy in Spite of the Demos and reiterates its central thesis. Christopher Holman and Théophile Pénigaud attempt to maintain the critical value of democracy by invoking different elements of the deliberative tradition, while Benjamin Schupmann answers my charges by appealing to a strong liberal constitutionalism. I argue that these attempts repeat the ambivalence described and criticized in the book: democracy is taken as an end in itself, but with asterisks that introduce conditions and (...) qualifications. As long as democracy is only desirable given certain caveats, the critical weight is placed on these caveats and not on the figure of democracy. Andrew Norris takes a different approach, interrogating the book’s use of ideology critique and the concept of “socially necessary delusion.” This intervention presents difficulties to the concluding suggestion of the book, but I maintain that that these difficulties can be productive and generative rather than limiting or prohibitive. (shrink)

I argue that while the feeling of bodily responses is not necessary to emotion, these feelings contribute significant meaningful content to everyday emotional experience. Emotional bodily feelings represent a ‘state of self’, analysed as a sense of one's body affording certain patterns of interaction with the environment. Recognising that there are two sources of intentional content in everyday emotional experience allows us to reconcile the diverging intuitions that people have about emotional states, and to understand better the long-standing debate between (...) bodily feeling-based and appraisal-based theories of emotion. (shrink)

[This paper was presented at the APA Eastern Division Conference in New York City, January 2024] -/- Can one reasonably doubt that one is voluntarily making a commitment, even when one is doing so? Given that one voluntarily makes a commitment if and only if one (personally) knows that one is doing so, the answer appears to be “No.” After all, knowing implies justifiably believing, and it seems impossible that one could (synchronically and from a single personal perspective) reasonably doubt (...) what one justifiably believes. Indeed, assuming that one reasonably doubts that P only if one has sufficient evidence to believe that not-P, traditional epistemologists may hold that such “epistemic ambivalence” entails one’s believing a contradiction, while some Bayesians should hold that it entails violating “probabilism” (the norm that credences must conform to the axioms of probability). However, I argue that in at least some cases of romantic commitment-making, such ambivalence may not only be epistemically permissible, but even required, and perhaps best dealt with pragmatically. (shrink)

This article reviews some of the ways in which philosophical problems concerning music can be informed by approaches from the cognitive sciences (principally psychology and neuroscience). Focusing on the issues of musical expressiveness and the arousal of emotions by music, the key philosophical problems and their alternative solutions are outlined. There is room for optimism that while current experimental data does not always unambiguously satisfy philosophical scrutiny, it can potentially support one theory over another, and in some cases allow us (...) to synthesize or reject traditional philosophical differences. (shrink)

In this chapter I analyse group flow: a state in which performers report intense interpersonal absorption with the music and each other. I compare group flow to individual flow, and argue that the same essential structure can be discerned. I argue that group flow does not justify an anti-representationalist enactivist interpretation. However, I claim that the cognitive task in which the music is produced is irreducibly collective.

I claim that the significance of comic works to influence our attitudes is limited by the conditions under which we find things funny. I argue that we can only find something funny if we regard it as norm-violating in a way that doesn’t make certain cognitive or pragmatic demands upon us. It is compatible with these conditions that humour reinforces our attitude that something is norm-violating. However, it is not compatible with these conditions that, on the basis of finding it (...) funny, we come to reject some existing attitude. Such a rejection would require that we recognize our attitude as norm-violating in a way that has pragmatic force. Thus if a humorous work reveals the absurdity of something, we can either find it funny and not have our attitudes significantly influenced, or else be significantly influenced but not find it funny. (shrink)

I examine the role that the musical instrument plays in shaping a performer's expressive activity and emotional state. I argue that the historical development of the musical instrument has fluctuated between two key values: that of sharing with other musicians, and that of creatively exploring new possibilities. I introduce 'the mood organ'- a sensor-based computer instrument that automatically turns signals of the wearer's emotional state into expressive music.

This paper develops a mechanistic account of basic mental agency by identifying similarities between two of its major exemplars: endogenous attention and imagination. Five key similarities are identified: i) that both capacities are driven by currently prioritised goals that are either person-level or apt to become person-level. ii) that both deliver their outputs to the working memory iii) that both range across all and only conceptual contents; iv) that both proceed under the guidance of norms and/or habits; and v) that (...) both directly activate rather than inhibit content. These five features are consolidated by proposing that basic mental agency is essentially the power to call for conceptual content and hold it within our working memories. (shrink)

I defend the claim that fictional narratives provide cognitive benefits to readers in virtue of helping them to understand character. Fictions allow readers to rehearse the skill of selecting and organizing into narratives those episodes of a life that reflect traits or values. Two further benefits follow: first, fictional narratives provide character models that we can apply to real-life individuals (including ourselves), and second, fictional narratives help readers to reflect on the value priorities that constitute character. I defend the plausibility (...) of these cognitive benefits against certain worries raised by Gregory Currie and Peter Goldie. (shrink)

This essay considers the catastrophe of anthropogenic climate change in relation to two possible critical-theoretic dispositions. The first, represented by an emblematic passage from Adorno, retains the hope for the realization of a “rational society.” The second, represented by a complementary passage from Foucault, enjoins critical theory to abandon any ambition toward criticizing or transforming society at a totalizing level. We argue that the unfolding climate catastrophe demands a conception of critical theory more in line with the first disposition, and (...) that the relevance of the skeptical disposition is likewise seriously undermined if climate change is taken into account. (shrink)

Sexual lust – understood as a feeling of sexual attraction towards another – has traditionally been viewed as a sort of desire or at least as an appetite akin to hunger. I argue here that this view is, at best, significantly incomplete. Further insights can be gained into certain occurrences of lust by noticing how strongly they resemble occurrences of “attitudinal” (“object-directed”) emotion. At least in humans, the analogy between the object-directed appetites and attitudinal emotions goes well beyond their psychological (...) structure to include similar ways in which their occurrence can be introspectively recognized, resulting in similar extensions of their functionality and meaningfulness to the subject. I conclude that although further research is needed, given the strength of the analogy, the ability of lust to satisfy some general requirements for being an emotion, and perhaps certain neurological findings, lust may somewhat uniquely straddle the line between appetite and emotion. (shrink)

In this brief comment on a target article by Koelsch et al., I argue that emotions are more sensitive to context than other affective states.

In this essay, I attempt to measure various prevailing democratic theories against an argument that Carl Schmitt advances in the first chapter of his ‘Crisis of Parliamentary Democracy’. In practice, he claims there, democratic politics is compelled to introduce a distinction between ‘the will of the people’ and the behaviour of the empirical people, thus justifying the bracketing and unlimited suspension of the latter in the name of the former, even to the point of dictatorship. I argue that no contemporary (...) approach to democracy as a fundamental value is able to mount a compelling response to this critique and that we should therefore reconsider the status of democracy as a normative commitment. I proceed by carefully and closely reading Schmitt’s chapter and then by juxtaposing various currents of democratic theory (including liberal, deliberative, epistemic and various hybrids thereof) with the trajectory of Schmitt’s argument. This essay is therefore less of a contribution to Schmitt scholarship, in the sense that it does not take a panoramic view of his corpus to determine his final stance on democracy, and more of an intervention into contemporary democratic theory using Schmitt’s argument as a kind of lever. (shrink)

A summary of The Emotional Mind: A Control Theory of Affective States is presented: I claim that a convincing account of the emotions requires a rethink of how the mind as a whole is structured. I provide this reconceptualization by introducing a fundamental type of mental concept called “valent representation" and then systematically elaborating this fundamental type in stages. In this way, accounts are provided of the various sorts of affective states ranging from pains and pleasures to character traits.

I believe the first thing to say about value is that it is something that we do. We value things. There is no value out there independent of valuing beings. Thi.

In this article, I present some worries about the possible impact of global efforts to aid the needy in some of the world’s most desperate regions. Among the worries I address are possible unintended negative consequences that may occur elsewhere in a society when aid agencies hire highly qualified local people to promote their agendas; the possibility that foreign interests and priorities may have undue influence on a country’s direction and priorities, negatively impacting local authority and autonomy; and the related (...) problem of outside interventions undermining the responsiveness of local and national governments to their citizens. -/- Another issue I discuss is the possibility that efforts to aid the needy may involve an Each-We Dilemma, in which case conflicts may arise between what is individually rational or moral, and what is collectively rational or moral. Unfortunately, it is possible that if each of us does what we have most reason to do, morally, in aiding the needy, we together will bring about an outcome which is worse, morally, in terms of its overall impact on the global needy. -/- The article ends by briefly noting a number of claims and arguments that I made in my 2017 Uehiro Lectures regarding how good people should respond in a world of need. As I have long argued, I have no doubt that those who are well off are open to serious moral criticism if they ignore the plight of the needy. Unfortunately, however, for a host of both empirical and philosophical reasons, what one should do in light of that truth is much more complex, and murky, than most people have realized. (shrink)

Jesse Prinz (2004) argues that emotional feelings (“state emotions”) can by themselves perceptually represent significant organism-environment relations. I object to this view mainly on the grounds that (1) it does not rule out the at least equally plausible view that emotional feelings are non-representational sensory registrations rather than perceptions, as Tyler Burge (2010) draws the distinction, and (2) perception of a relation requires perception of at least one of the relation’s relata, but an emotional feeling by itself perceives neither the (...) subject’s environment, nor in many cases the relevant subject itself. I then explore two ways in which emotional feelings as non-perceptual sensory registrations might still contribute to significant relation representation when associated with representations of the subject and/or its environment. After briefly discussing some difficulties presented by a multimodal, sensory-perceptual view of such representation, I argue in favor of a “cognitive recognition theory” that holds that significant relation instances are represented during emotion occurrences via applications of emotion-type concepts to "incoming" emotional feelings and their associated mental states. (shrink)

Barbara Fried described John Rawls’s response to libertarianism as “the unwritten theory of justice.” This paper argues that while there is no need for a new theory of justice to address the libertarian challenge, there is a need for an additional chapter. Taking up Fried’s suggestion that the Rawlsian response would benefit from a revised list of primary goods, I propose to add employment to the list, thus leading to adoption of a full employment principle in the original position that (...) ensures that anyone who wants to work will be able to do so. I argue that although Rawls famously proposed government as employer of last resort, he never integrated that comment into his theory, which lacks a full employment principle and says nothing about the injustice of involuntary unemployment in its ideal theory. I first refute the received view of Rawls’s treatment of employment as required by its importance for citizens’ self-respect, then show that in fact, the full employment assumption is the result of the role of general equilibrium theory in Rawls’s model of a well-ordered society, and indicate why developments in economic theory and economic policy support the proposed revision. (shrink)

Charles Mills adhered to the highest standards of philosophical scholarship, while seeing his work firmly as a contribution to the cause of social justice. He had a deep appreciation for historical context and a history of ideas approach to racial/philosophical questions. He was one of the foremost Rawls interpreters or our time, though only a few years before his passing was he so recognized. He channeled his analytic training in his habit of demonstrating how a view is strengthened when an (...) author shows how objections can be systematically replied to. I wish he had tried to integrate class and race into a larger theoretical system, of both an explanatory and normative character. Class is sometimes an unnoted presence in his explanation of white supremacy. Charles saw himself contributing to a collective scholarly social justice project and was happy to acknowledge the greater expertise of others in allied areas to his. (shrink)

Can one’s belief that one romantically loves another be false? If so, under what conditions may one come to reasonably doubt, or at least suspend belief, that one does so? To begin to answer these questions, I first outline an affective/volitional view of love similar to psychologist R. J. Sternberg’s “triangular theory”, which analyzes types of love in terms of the degrees to which they include states of passion, emotion, and commitment. I then outline two sources of potential bias that (...) may cause one to believe that one romantically loves another when one does not. Partly on the basis of those potential sources of bias and partly on the basis of more specific issues, I then argue that at least to the extent that one is aware of these issues, one may reasonably doubt that one is experiencing romantic love’s emotional feelings, and one may reasonably doubt that one is making romantic love’s commitments. Finally, I order by relative dubitability the propositions that must be true about one’s passions, emotions, and commitments toward another in order for one to romantically love them. (shrink)

Constellations, Volume 28, Issue 3, Page 368-378, September 2021.

Human subjects seem to have a type of introspective access to their mental states that allows them to immediately judge the types and intensities of their occurrent emotions, as well as what those emotions are about or “directed at”. Such judgments manifest what I call “emotion-direction beliefs”, which, if reliably produced, may constitute emotion-direction knowledge. Many psychologists have argued that the “directed emotions” such beliefs represent have a componential structure, one that includes feelings of emotional responses and related but independent (...) representations of what those feelings are about. I argue that such componentiality may help to explain how emotion-direction knowledge is achievable. I begin by developing a hybrid view of introspection that combines David Chalmers’ phenomenal realism with Alvin Goldman’s “partial redeployment” account of meta-belief content. I then provide a process-reliabilist account of introspectively gained emotion-direction knowledge that outlines the minimum conditions of reliably forming emotion-direction beliefs, and specifies several ways in which the warrant of such beliefs could be defeated by relevant counterfactual alternatives. The overall account suggests how distinct introspective processes might be epistemically synergistic. (shrink)

This paper develops an understanding of climate denial as an expression of alienation in the sense described by Marx. We first argue for an expanded and differentiated conception of climate denial, theorizing four distinct types that go beyond the simple rejection of an anthropogenic warming trend: naturalist denialism, technological denialism, gradualist denialism, and politicized denialism. We then claim that these forms of climate denial illustrate and are illustrative of Marx’s concept of alienation from species-being (Gattungswesen). The article is intended as (...) a contribution to the growing literature on climate denial as a social and ideological problem rather than as an individual epistemic or moral issue. (shrink)

An ongoing debate in the philosophy of emotion concerns the relationship between two prima facie aspects of emotional states. The first is affective: felt and/or motivational. The second, which I call object-identifying, represents whatever the emotion is about or directed towards. “Componentialists” – such as R. S. Lazarus, Jesse Prinz, and Antonio Damasio – assume that an emotion’s object-identifying aspect can have the same representational content as a non-emotional state’s, and that it is psychologically separable or dissociable from the emotion’s (...) affective aspect. Some further hold that emotions have no object-identifying aspects of their own, and can properly be said to be about things only in virtue of their associations with other mental states (such as beliefs or perceptions). By contrast, “blenderists” – such as Peter Goldie, York Gunther, and Matthew Ratcliffe – insist that the two aspects are indissociable, because the affective aspect “infuses” the object-identifying aspect, altering the subject’s concept or percept of the object. As a result, an emotion’s object-identifying aspect cannot possibly have the same representational content as any non-emotional state’s. I argue that the strongest blenderist arguments fail to rule out plausible componentialist alternatives, and that the blenderists’ broader motivations are orthogonal to structural issues. (shrink)

Attempts to unify Marxist and feminist social critique have been vexed by the fact that ‘patriarchy’ predates the advent of capitalism (its transhistorical status). Feminists within the Marxist, socialist, and materialist traditions have responded to this point by either granting patriarchy a certain autonomy relative to capitalism (the ‘dual/triple systems’ approach), or by suggesting that patriarchal relations have a foundational and necessary status in the history of capitalist development (which we term the ‘origins-subsistence’ approach). This paper offers an alternative account (...) of the relationship between capitalism and the transhistorical status of ‘patriarchy’. In aid of a ‘unitary theory’ of Marxist Feminism, we argue that the transhistorical status of patriarchy is better understood through an application of Marx’s concepts of formal and real subsumption. A modified version of these concepts can illuminate not only capitalist appropriation of antecedent social and economic forms, but also its capacity to produce new forms of gendered exploitation and oppression. (shrink)

Review of OUP volume on collective emotions which provides a taxonomy of the different theories, raising potential objections for each.

Among moral philosophers, general disapproval of genetic enhancement has in recent years given way to the view that the permissibility of a eugenic policy depends only on its particular features. Buchanan, Brock, Daniels, and Wikler have extensively defended such a view. However, while these authors go so far as to argue that there are conditions under which parents are not only permitted but also obligated to procure genetic treatments for their intended child, they stop short of arguing that there are (...) conditions under which parents are required to procure enhancements. By contrast, David Heyd argues that parents are required to procure treatments or enhancements for their future child, but only if the intervention would not alter the future child’s personal identity. In this paper I take the case for genetic enhancement a step further by arguing that there are conditions under which parents are morally required to procure genetic interventions for their intended child, regardless of whether the intervention is a treatment or an enhancement, and regardless of whether it would alter the child’s personal identity. (shrink)

The article reflects on where AI is headed and the world along with it, considering trust, ethics and safety. Implicit in artificial thinking and doomsday appraisals is the engineered divorce from reality of sublime human embodiment. Jeffrey White, Dietrich Brandt, Jan Soeffner, and Larry Stapleton, four scholars associated with AI & Society, address these issues, and more, in the following exchange.

In Climate Leviathan, Mann and Wainwright address the political implications of climate change by theorizing four possible planetary futures: Climate Leviathan as capitalist planetary sovereignty, Climate Mao as non-capitalist planetary sovereignty, Climate Behemoth as capitalist non-planetary sovereignty, and Climate X as non-capitalist non-planetary sovereignty. The authors of the present article agree that the depth and scale of destabilizations induced by climate change cannot be navigated justly from within the present social-political-economic system. We disagree, however, on which of the non-capitalist orientations (...) is better suited for generating viable alternatives to the worst dystopian futures. The article thus stages a debate to elucidate the theoretical and political divergence between Climate X and Climate Mao. (shrink)

The chromodielectric soliton model is Lorentz and chirally invariant. It has been demonstrated to exhibit dynamical chiral symmetry breaking and spatial confinement in the locally uniform approximation. We here study the full nonlocal quark self-energy in a color-dielectric medium modeled by a two-parameter Fermi function. Here color confinement is manifest. The self-energy thus obtained is used to calculate quark wave functions in the medium which, in turn, are used to calculate the nucleon and pion masses in the one-gluon-exchange approximation. The (...) nucleon mass is fixed to its empirical value using scaling arguments; the pion mass (for massless current quarks) turns out to be small but nonzero, depending on the model parameters. (shrink)

Drugs used to provide improvement of cognitive functioning have been shown to be effective in healthy individuals. It is sometimes assumed that the use of these drugs constitutes cheating in an academic context. We examine whether this assumption is ethically sound. Beyond providing the most up-to-date discussion of modafinil use in an academic context, this contribution includes an overview of the safety of modafinil use in greater depth than previous studies addressing the issue of cheating. Secondly, we emphasize two crucial, (...) but hitherto nearly overlooked, nuances to the issues: the potential for modafinil to decrease inequality and disadvantage in academic settings, and the fact that how modafinil is used dramatically impacts its effects on health, coercion, fairness, authenticity and effort. Finally, we explicitly defend the position that there are no qualitatively morally relevant differences between modafinil use and other enhancement modalities; any such differences are in degree,... (shrink)

Summary Background Self-binding directives instruct clinicians to overrule treatment refusal during future severe episodes of illness. These directives are promoted as having potential to increase autonomy for individuals with severe episodic mental illness. Although lived experience is central to their creation, service users’ views on self-binding directives have not been investigated substantially. This study aimed to explore whether reasons for endorsement, ambivalence, or rejection given by service users with bipolar disorder can address concerns regarding self-binding directives, decision-making capacity, and human (...) rights. Methods This study used qualitative data from an internet-based survey distributed to the mailing list of the UK charity Bipolar UK, which contained multiple closed and open questions on advance decision-making in bipolar disorder. Quantitative analysis of a closed question about self-binding directives had already demonstrated endorsement amongst a very high proportion of participants with bipolar disorder who completed the survey. We conducted thematic analysis of responses from those participants who answered a subsequent open question about reasons for their view. Research was co-produced within a multi-disciplinary team, with clinical, legal, and ethical expertise, and lived experience of bipolar disorder. Ideas and methodologies associated with all these areas of expertise were used in the analysis of these reasons and to gain insight into the thoughts of individuals with bipolar disorder about self-binding directives and associated issues. Findings Between Oct 23 and Dec 5, 2017, 932 individuals with a self-reported clinical diagnosis of bipolar disorder completed the internet survey, with 565 (154 men; 400 women; 11 transgender or other) providing free text answers to the open question. A large majority of respondents endorsed self-binding directives, nearly all describing a determinate shift to types of distorted thinking and decision-making when unwell as their key justification. Responses indicating ambivalence were dominated by logistical concerns about the drafting and implementation of self-binding directives, while those who rejected self-binding directives also cited logistical concerns, validity of their thinking when unwell, and potential contravention of human rights. Interpretation This study is, to our knowledge, the first large study of reasons why mental health service users might endorse or reject the use of self-binding directives. The findings provide empirical support for introducing self-binding directives into mental health advance decision-making practice and policy and may help to address enduring ethical concerns surrounding possible implementation of the directive while a person retains decision-making capacity. The opinions expressed here in responses given by multiple service users with bipolar disorder challenge a prominent view within international disability rights debates that involuntary treatment and recognition of impaired mental capacity constitute inherent human rights violations. Funding The Wellcome Trust . (shrink)