Artificial intelligence (AI) is expected to revolutionise the practice of medicine. Recent advancements in the field of deep learning have demonstrated success in variety of clinical tasks: detecting diabetic retinopathy from images, predicting hospital readmissions, aiding in the discovery of new drugs, etc. AI’s progress in medicine, however, has led to concerns regarding the potential effects of this technology on relationships of trust in clinical practice. In this paper, I will argue that there is merit to these concerns, since AI (...) systems can be relied on, and are capable of reliability, but cannot be trusted, and are not capable of trustworthiness. Insofar as patients are required to rely on AI systems for their medical decision-making, there is potential for this to produce a deficit of trust in relationships in clinical practice. (shrink)

It is commonly accepted that clinicians are ethically obligated to disclose their use of medical machine learning systems to patients, and that failure to do so would amount to a moral fault for which clinicians ought to be held accountable. Call this ‘the disclosure thesis.’ Four main arguments have been, or could be, given to support the disclosure thesis in the ethics literature: the risk-based argument, the rights-based argument, the materiality argument and the autonomy argument. In this article, I argue (...) that each of these four arguments are unconvincing, and therefore, that the disclosure thesis ought to be rejected. I suggest that mandating disclosure may also even risk harming patients by providing stakeholders with a way to avoid accountability for harm that results from improper applications or uses of these systems. (shrink)

Artificial intelligence (AI) systems have demonstrated impressive performance across a variety of clinical tasks. However, notoriously, sometimes these systems are 'black boxes'. The initial response in the literature was a demand for 'explainable AI'. However, recently, several authors have suggested that making AI more explainable or 'interpretable' is likely to be at the cost of the accuracy of these systems and that prioritising interpretability in medical AI may constitute a 'lethal prejudice'. In this paper, we defend the value of interpretability (...) in the context of the use of AI in medicine. Clinicians may prefer interpretable systems over more accurate black boxes, which in turn is sufficient to give designers of AI reason to prefer more interpretable systems in order to ensure that AI is adopted and its benefits realised. Moreover, clinicians may be justified in this preference. Achieving the downstream benefits from AI is critically dependent on how the outputs of these systems are interpreted by physicians and patients. A preference for the use of highly accurate black box AI systems, over less accurate but more interpretable systems , may itself constitute a form of lethal prejudice that may diminish the benefits of AI to - and perhaps even harm - patients. (shrink)

Advocates of physician-assisted suicide often argue that, although the provision of PAS is morally permissible for persons with terminal, somatic illnesses, it is impermissible for patients suffering from psychiatric conditions. This claim is justified on the basis that psychiatric illnesses have certain morally relevant characteristics and/or implications that distinguish them from their somatic counterparts. In this paper, I address three arguments of this sort. First, that psychiatric conditions compromise a person’s decision-making capacity. Second, that we cannot have sufficient certainty that (...) a person’s psychiatric condition is untreatable. Third, that the institutionalisation of PAS for mental illnesses presents morally unacceptable risks. I argue that, if we accept that PAS is permissible for patients with somatic conditions, then none of these three arguments are strong enough to demonstrate that the exclusion of psychiatric patients from access to PAS is justifiable. (shrink)

Objectives: Machine learning (ML) has the potential to facilitate “continual learning” in medicine, in which an ML system continues to evolve in response to exposure to new data over time, even after being deployed in a clinical setting. In this article, we provide a tutorial on the range of ethical issues raised by the use of such “adaptive” ML systems in medicine that have, thus far, been neglected in the literature. -/- Target audience: The target audiences for this tutorial are (...) the developers of ML AI systems, healthcare regulators, the broader medical informatics community, and practicing clinicians. -/- Scope: Discussions of adaptive ML systems to date have overlooked the distinction between 2 sorts of variance that such systems may exhibit—diachronic evolution (change over time) and synchronic variation (difference between cotemporaneous instantiations of the algorithm at different sites)—and underestimated the significance of the latter. We highlight the challenges that diachronic evolution and synchronic variation present for the quality of patient care, informed consent, and equity, and discuss the complex ethical trade-offs involved in the design of such systems. (shrink)

A novel advantage of the use of machine learning (ML) systems in medicine is their potential to continue learning from new data after implementation in clinical practice. To date, considerations of the ethical questions raised by the design and use of adaptive machine learning systems in medicine have, for the most part, been confined to discussion of the so-called “update problem,” which concerns how regulators should approach systems whose performance and parameters continue to change even after they have received regulatory (...) approval. In this paper, we draw attention to a prior ethical question: whether the continuous learning that will occur in such systems after their initial deployment should be classified, and regulated, as medical research? We argue that there is a strong prima facie case that the use of continuous learning in medical ML systems should be categorized, and regulated, as research and that individuals whose treatment involves such systems should be treated as research subjects. (shrink)

Artificial intelligence (AI) systems have demonstrated impressive performance across a variety of clinical tasks. However, notoriously, sometimes these systems are “black boxes.” The initial response in the literature was a demand for “explainable AI.” However, recently, several authors have suggested that making AI more explainable or “interpretable” is likely to be at the cost of the accuracy of these systems and that prioritizing interpretability in medical AI may constitute a “lethal prejudice.” In this paper, we defend the value of interpretability (...) in the context of the use of AI in medicine. Clinicians may prefer interpretable systems over more accurate black boxes, which in turn is sufficient to give designers of AI reason to prefer more interpretable systems in order to ensure that AI is adopted and its benefits realized. Moreover, clinicians may be justified in this preference. Achieving the downstream benefits from AI is critically dependent on how the outputs of these systems are interpreted by physicians and patients. A preference for the use of highly accurate black box AI systems, over less accurate but more interpretable systems, may itself constitute a form of lethal prejudice that may diminish the benefits of AI to—and perhaps even harm—patients. (shrink)

In Deep Medicine, Eric Topol argues that the development of artificial intelligence (AI) for healthcare will lead to a dramatic shift in the culture and practice of medicine. Topol claims that, rather than replacing physicians, AI could function alongside of them in order to allow them to devote more of their time to face-to-face patient care. Unfortunately, these high hopes for AI-enhanced medicine fail to appreciate a number of factors that, we believe, suggest a radically different picture for the future (...) of healthcare. Far from facilitating a return to “the golden age of doctoring”, the role of economic and institutional considerations in determining how medical AI will be used mean that it is likely to further erode therapeutic relationships and threaten professional and patient satisfaction. (shrink)

A self-fulfilling prophecy is, roughly, a prediction that brings about its own truth. Although true predictions are hard to fault, self-fulfilling prophecies are often regarded with suspicion. In this article, we vindicate this suspicion by explaining what self-fulfilling prophecies are and what is problematic about them, paying special attention to how their problems are exacerbated through automated prediction. Our descriptive account of self-fulfilling prophecies articulates the four elements that define them. Based on this account, we begin our critique by showing (...) that typical self-fulfilling prophecies arise due to mistakes about the relationship between a prediction and its object. Such mistakes—along with other mistakes in predicting or in the larger practical endeavor—are easily overlooked when the predictions turn out true. Thus we note that self-fulfilling prophecies prompt no error signals; truth shrouds their mistakes from humans and machines alike. Consequently, self-fulfilling prophecies create several obstacles to accountability for the outcomes they produce. We conclude our critique by showing how failures of accountability, and the associated failures to make corrections, explain the connection between self-fulfilling prophecies and feedback loops. By analyzing the complex relationships between accuracy and other evaluatively significant features of predictions, this article sheds light both on the special case of self-fulfilling prophecies and on the ethics of prediction more generally. (shrink)

What does Artificial Intelligence (AI) have to contribute to health care? And what should we be looking out for if we are worried about its risks? In this paper we offer a survey, and initial evaluation, of hopes and fears about the applications of artificial intelligence in medicine. AI clearly has enormous potential as a research tool, in genomics and public health especially, as well as a diagnostic aid. It’s also highly likely to impact on the organisational and business practices (...) of healthcare systems in ways that are perhaps under-appreciated. Enthusiasts for AI have held out the prospect that it will free physicians up to spend more time attending to what really matters to them and their patients. We will argue that this claim depends upon implausible assumptions about the institutional and economic imperatives operating in contemporary healthcare settings. We will also highlight important concerns about privacy, surveillance, and bias in big data, as well as the risks of over trust in machines, the challenges of transparency, the deskilling of healthcare practitioners, the way AI reframes healthcare, and the implications of AI for the distribution of power in healthcare institutions. We will suggest that two questions, in particular, are deserving of further attention from philosophers and bioethicists. What does care look like when one is dealing with data as much as people? And, what weight should we give to the advice of machines in our own deliberations about medical decisions? (shrink)

It is commonly held that Kant ventured to derive morality from freedom in Groundwork III. It is also believed that he reversed this strategy in the second Critique, attempting to derive freedom from morality instead. In this paper, I set out to challenge these familiar assumptions: Kant’s argument in Groundwork III rests on a moral conception of the intelligible world, one that plays a similar role as the ‘fact of reason’ in the second Critique. Accordingly, I argue, there is no (...) reversal in the proof-structure of Kant’s two works. (shrink)

This chapter examines the place of India in eighteenth-century debates over the chronology of human history. It begins with Voltaire, who strategically praised ancient Brahmanic religion for upholding a pure form of monotheism and an equally pure form of morality. Voltaire’s aim was to upset the primacy assigned to the Mosaic tradition foundational to the Catholic church. The chapter then turns to Herder and his effort to improve upon the historical methods of Voltaire. While Herder is often considered to have (...) developed positive views toward ancient Indian culture, the chapter shows that his commitment to a biblical chronology was consistent throughout his career. (shrink)

In this article I offer a critical commentary on Jeanine Grenberg’s claim that, by the time of the second Critique, Kant was committed to the view that we only access the moral law’s validity through the feeling of respect. The issue turns on how we understand Kant’s assertion that our consciousness of the moral law is a ‘fact of reason’. Grenberg argues that all facts must be forced, and anything forced must be felt. I defend an alternative interpretation, according to (...) which the fact of reason refers to the actuality of our moral consciousness. (shrink)

Kant’s doctrine of the Fact of Reason is one of the most perplexing aspects of his moral philosophy. The aim of this paper is to defend Kant’s doctrine from the common charge of dogmatism. My defense turns on a previously unexplored analogy to the notion of ‘matters of fact’ popularized by members of the Royal Society in the seventeenth century. In their work, ‘facts’ were beyond doubt, often referring to experimental effects one could witness first hand. While Kant uses the (...) German equivalent in different contexts, I argue that the scientific analogy opens up a new framework for interpreting his strategy of justification in the Critique of Practical Reason. In the final section, I address a few possible objections to my reading, one of which I anticipate coming from Dieter Henrich and Ian Proops, who have argued that Kant’s Fact of Reason is best understood under a legal analogy. (shrink)

There is no question that Fichte's theory of conscience is central to his system of ethics. Yet his descriptions of its role in practical deliberation appear inconsistent, if not contradictory. Many scholars have claimed that for Fichte conscience plays a material role by providing the content of our moral obligations—the Material Function View. Some have denied this, however, claiming that conscience only plays a formal role by testing our moral convictions in any given case—the Formal Function View. My aim in (...) this paper is to offer a new contribution to this debate. I begin by supplying further evidence in support of the view that conscience only plays a formal function in Fichte's ethics. Then I call attention to a deeper problem this view faces, namely, that it invites an infinite regress by making one's conviction a matter of higher-order reflection. The key to overcoming this threat, I argue, lies in Fichte's doctrine of feeling, whereby the criterion of one's conviction lies, not in a cognitive state, but in an affective state. In closing, I discuss the relevance of Fichte's theory for current debates over the nature of moral error and moral deference. (shrink)

One of the most controversial issues to emerge in recent studies of Fichte concerns the status of his normative ethics, i.e., his theory of what makes actions morally good or bad. Scholars are divided over Fichte’s view regarding the ‘final end’ of moral striving, since it appears this end can be either a specific goal permitting maximizing calculations (the consequentialist reading defended by Kosch 2015), or an indeterminate goal permitting only duty-based decisions (the deontological reading defended by Wood 2016). While (...) I think each interpretive position contains an element of truth, my aim in this paper is to defend a third alternative, according to which Fichte’s normative ethics presents us with a unique form of social perfectionism. (shrink)

In this essay we provide (1) an argument for why ethics should be naturalized, (2) an analysis of why it is not yet naturalized, (3) a defense of ethical naturalism against two fallacies—Hume’s and Moore’s—that ethical naturalism allegedly commits, and (4) a proposal that normative ethics is best conceived as part of human ecology committed to pluralistic relativism. We explain why naturalizing ethics both entails relativism and also constrains it, and why nihilism about value is not an especially worrisome for (...) ethical naturalists. The substantive view we put forth constitutes the essence of Duke Naturalism. (shrink)

This article argues that a person’s well-being at a time and the goodness of her life are two distinct values. It is commonly accepted as platitudinous that well-being is what makes a life good for the person who lives it. Even philosophers who distinguish between well-being at a time and the goodness of a life still typically assume that increasing a person’s well-being at some particular moment, all else equal, necessarily improves her life on the whole. I develop a precise (...) statement of this standard assumption, and then show that it is subject to counterexamples. The possibility of such counterexamples depends only on premises similar to those sometimes invoked to argue that a person’s well-being over a long period is not simply the aggregate well-being of the shorter periods that compose the long period. The refutation of the standard assumption linking well-being and life-goodness entails that these are distinct and sometimes divergent values. As an alternative to the standard assumption, it is proposed that well-being is best understood as an ingredient in a good life. (shrink)

Imagine you are casually browsing an online bookstore, looking for an interesting novel. Suppose the store predicts you will want to buy a particular novel: the one most chosen by people of your same age, gender, location, and occupational status. The store recommends the book, it appeals to you, and so you choose it. Central to this scenario is an automated prediction of what you desire. This article raises moral concerns about such predictions. More generally, this article examines the ethics (...) of artificial social cognition—the ethical dimensions of attribution of mental states to humans by artificial systems. The focus is presumptuous aim attributions, which are defined here as aim attributions based crucially on the premise that the person in question will have aims like superficially similar people. Several everyday examples demonstrate that this sort of presumptuousness is already a familiar moral concern. The scope of this moral concern is extended by new technologies. In particular, recommender systems based on collaborative filtering are now commonly used to automatically recommend products and information to humans. Examination of these systems demonstrates that they naturally attribute aims presumptuously. This article presents two reservations about the widespread adoption of such systems. First, the severity of our antecedent moral concern about presumptuousness increases when aim attribution processes are automated and accelerated. Second, a foreseeable consequence of reliance on these systems is an unwarranted inducement of interpersonal conformity. (shrink)

This article addresses three questions about well-being. First, is well-being future-sensitive? I.e., can present well-being depend on future events? Second, is well-being recursively dependent? I.e., can present well-being depend on itself? Third, can present and future well-being be interdependent? The third question combines the first two, in the sense that a yes to it is equivalent to yeses to both the first and second. To do justice to the diverse ways we contemplate well-being, I consider our thought and discourse about (...) well-being in three domains: everyday conversation, social science, and philosophy. This article’s main conclusion is that we must answer the third question with no. Present and future well-being cannot be interdependent. The reason, in short, is that a theory of well-being that countenances both future-sensitivity and recursive dependence would have us understand a person’s well-being at a time as so intricately tied to her well-being at other times that it would not make sense to consider her well-being an aspect of her state at particular times. It follows that we must reject either future-sensitivity or recursive dependence. I ultimately suggest, especially in light of arguments based on assumptions of empirical research on well-being, that the balance of reasons favors rejecting future-sensitivity. (shrink)

Despite Kant’s lasting influence on philosophical accounts of moral motivation, many details of his own position remain elusive. In the Critique of Practical Reason, for example, Kant argues that our recognition of the moral law’s authority must elicit both painful and pleasurable feelings in us. On reflection, however, it is unclear how these effects could motivate us to act from duty. As a result, Kant’s theory of moral sensibility comes under a skeptical threat: the possibility of a morally motivating feeling (...) seems incoherent. My aim in this paper is to reconstruct Kant’s theory in a way that overcomes this threat. By way of conclusion, I show how my reconstruction brings a new perspective to a long-standing dispute over intellectualist and affectivist views of moral motivation. (shrink)

Free will skepticism is radical in its core claim that free will is illusory. Criminal law, however, appears to presuppose that persons are free and hence, morally responsible for their actions. So, if free will skepticism is true, our current practices that hold people to account for their wrongs appears unjustified–even immoral. This paper will challenge the free will skeptic’s core claim that free will does not exist and defend current practices of moral responsibility by offering (and defending) a Frankfurtian-compatibilist (...) approach to the topics of free will and determinism. (shrink)

Owen Ware here develops and defends a novel interpretation of Fichte’s moral philosophy as an ethics of wholeness. While virtually forgotten for most of the twentieth century, Fichte’s System of Ethics is now recognized by scholars as a masterpiece in the history of post-Kantian thought and a key text for understanding the work of later German idealist thinkers. This book provides a careful examination of the intellectual context in which Fichte’s moral philosophy evolved and of the specific arguments he (...) offers in response to Kant and his immediate successors. A distinctive feature of this study is a focus on the foundational concepts of Fichte’s ethics—freedom, morality, feeling, conscience, community—and their connection to his innovative but largely misunderstood theory of drives. By way of conclusion, the book shows that what appears to be two conflicting commitments in Fichte’s ethics—a commitment to the feelings of one's conscience and a commitment to engage in open dialogue with others—are two aspects of his theory of moral perfection. The result is a sharp understanding of Fichte's System of Ethics as offering a compelling resolution to the personal and interpersonal dimensions of moral life. (shrink)

This paper offers a new interpretation of Kant's relationship with skepticism in the Groundwork for the Metaphysics of Morals. My position differs from commonly held views in the literature in two ways. On the one hand, I argue that Kant's relationship with skepticism is active and systematic (contrary to Hill, Wood, Rawls, Timmermann, and Allison). On the other hand, I argue that the kind of skepticism Kant is interested in does not speak to the philosophical tradition in any straightforward sense (...) (contrary to Forster and Guyer). On my reading, Kant takes up a skeptical method in the Groundwork as a way of exposing certain obstacles in our ordinary and philosophical thinking about morality. The central obstacle he is interested in is practical in character, arising from a natural tendency we have to rationalize against the moral law. In attempting to resolve this tendency, I argue, the Groundwork turns out to have a profoundly educative task. (shrink)

Just as humans can draw conclusions responsibly or irresponsibly, so too can computers. Machine learning systems that have been trained on data sets that include irresponsible judgments are likely to yield irresponsible predictions as outputs. In this paper I focus on a particular kind of inference a computer system might make: identification of the intentions with which a person acted on the basis of photographic evidence. Such inferences are liable to be morally objectionable, because of a way in which they (...) are presumptuous. After elaborating this moral concern, I explore the possibility that carefully procuring the training data for image recognition systems could ensure that the systems avoid the problem. The lesson of this paper extends beyond just the particular case of image recognition systems and the challenge of responsibly identifying a person’s intentions. Reflection on this particular case demonstrates the importance (as well as the difficulty) of evaluating machine learning systems and their training data from the standpoint of moral considerations that are not encompassed by ordinary assessments of predictive accuracy. (shrink)

Kant is well known for claiming that we can never really know our true moral disposition. He is less well known for claiming that the injunction "Know Yourself" is the basis of all self-regarding duties. Taken together, these two claims seem contradictory. My aim in this paper is to show how they can be reconciled. I first address the question of whether the duty of self-knowledge is logically coherent (§1). I then examine some of the practical problems surrounding the duty, (...) notably, self-deception (§2). Finding none of Kant's solutions to the problem of self-deception satisfactory, I conclude by defending a Kantian account of self-knowledge based on his theory of conscience (§3). (shrink)

It is well known that Kant seeks to discredit rational psychology on the grounds that we cannot access the nature of the soul by reflecting upon the ‘I think’ of self-consciousness. What is far less understood, however, is why Kant still believes the theorems of rational psychology are analytically true insofar as they represent the ‘I’ through the categories of substance, reality, unity, and existence. Early post-Kantian thinkers like Fichte would abandon this restriction and approach the concept of the ‘I’ (...) instead through the category of community or reciprocal interaction. The result was nothing less than a radical shift in thinking about persons after Kant, yet in a way that would bear a striking affinity to the substance monism of Spinoza. The aim of this chapter is to trace the origin of this shift and its aftermath in Fichte’s effort to defend a new conception of the ‘I’. (shrink)

Moral enhancement is an ostensibly laudable project. Who wouldn’t want people to become more moral? Still, the project’s approach is crucial. We can distinguish between two approaches for moral enhancement: direct and indirect. Direct moral enhancements aim at bringing about particular ideas, motives or behaviors. Indirect moral enhancements, by contrast, aim at making people more reliably produce the morally correct ideas, motives or behaviors without committing to the content of those ideas, motives and/or actions. I will argue, on Millian grounds, (...) that the value of disagreement puts serious pressure on proposals for relatively widespread direct moral enhancement. A more acceptable path would be to focus instead on indirect moral enhancements while staying neutral, for the most part, on a wide range of substantive moral claims. I will outline what such indirect moral enhancement might look like, and why we should expect it to lead to general moral improvement. (shrink)

The current prevailing view is that participation in biomedical research is above and beyond the call of duty. While some commentators have offered reasons against this, we propose a novel public goods argument for an obligation to participate in biomedical research. Biomedical knowledge is a public good, available to any individual even if that individual does not contribute to it. Participation in research is a critical way to support an important public good. Consequently, all have a duty to participate. The (...) current social norm is that individuals participate only if they have a good reason to do so. The public goods argument implies that individuals should participate unless they have a good reason not to. Such a shift would be of great aid to the progress of biomedical research, eventually making society significantly healthier and longer lived. (shrink)

The predominant view is that a study using health data is observational research and should require individual consent unless it can be shown that gaining consent is impractical. But recent arguments have been made that citizens have an ethical obligation to share their health information for research purposes. In our view, this obligation is sufficient ground to expand the circumstances where secondary use research with identifiable health information is permitted without explicit subject consent. As such, for some studies the Institutional (...) Review Board/Research Ethics Committee review process should not assess the practicality of gaining consent for data use. Instead the review process should focus on assessing the public good of the research, public engagement and transparency. (shrink)

Kant’s arguments for the reality of human freedom and the normativity of the moral law continue to inspire work in contemporary moral philosophy. Many prominent ethicists invoke Kant, directly or indirectly, in their efforts to derive the authority of moral requirements from a more basic conception of action, agency, or rationality. But many commentators have detected a deep rift between the _Groundwork for the Metaphysics of Morals_ and the _Critique of Practical Reason_, leaving Kant’s project of justification exposed to conflicting (...) assessments and interpretations. In this major re-reading of Kant, Owen Ware defends the controversial view that Kant’s mature writings on ethics share a unified commitment to the moral law’s primacy. Using both close analysis and historical contextualization, Owen Ware overturns a paradigmatic way of reading Kant’s arguments for morality and freedom, situating them within Kant’s critical methodology at large. The result is a novel understanding of Kant that challenges much of what goes under the banner of Kantian arguments for moral normativity today. (shrink)

_Kant’s Reason_ (2023) is an excellent study that develops an original set of interpretive claims and shows their relevance for contemporary theories of rationality. At the core of Karl Schafer’s project is the following thesis: that Kant’s account of reason is unified as a power of comprehension in both its theoretical and practical activities. The aim of my paper is to examine this thesis against Kant’s doctrine of the Highest Good. In §1, I question some claims Schafer makes about the (...) Highest Good. Then, in §2 and §3, I consider how we might develop a more detailed reading of this doctrine along the lines of Schafer’s project. §4 concludes. (shrink)

The concept of respect for persons is often rejected as a basis for understanding forgiveness. As many have argued, to hold your offender responsible for her actions is to respect her as a person; but this kind of respect is more likely to sustain, rather than dissolve, your resentment toward her (Garrard & McNaughton 2003; 2011; Allais 2008). I seek to defend an alternative view in this paper. To forgive, on my account, involves ceasing to identify your offender with her (...) wrongdoing, and this requires a corresponding affective change on your behalf. While there are different ways this may happen, I argue that respect for your offender as a person can play a significant role in the process. (shrink)

While philosophers are often concerned with the conditions for moral knowledge or justification, in practice something arguably less demanding is just as, if not more, important – reliably making correct moral judgments. Judges and juries should hand down fair sentences, government officials should decide on just laws, members of ethics committees should make sound recommendations, and so on. We want such agents, more often than not and as often as possible, to make the right decisions. The purpose of this paper (...) is to propose a method of enhancing the moral reliability of such agents. In particular, we advocate for a procedural approach; certain internal processes generally contribute to people’s moral reliability. Building on the early work of Rawls, we identify several particular factors related to moral reasoning that are specific enough to be the target of practical intervention: logical competence, conceptual understanding, empirical competence, openness, empathy and bias. Improving on these processes can in turn make people more morally reliable in a variety of contexts and has implications for recent debates over moral enhancement. (shrink)

It is commonly held that since non-human animals are not persons, they are not objects of due regard and care in the same way that humans are. But how might we begin to think about recognizing animals as persons? This chapter attempts to reconstruct an answer by drawing on the resources of the Pātañjalayogaśāstra (the Yoga Sūtras of Patañjali, 200-400 CE). Animals are persons from the perspective of this tradition, and so animals are proper objects of due regard and care. (...) According to classical Yoga philosophy, however, this form of recognition is not easy to attain. The discerning insight that allows one to “see” the personhood of other living beings requires a discipline of attention, one that constitutes the practice of yoga itself. (shrink)

Consciousness and evolution are complex phenomena. It is sometimes thought that if adaptation explanations for some varieties of consciousness, say, conscious visual perception, can be had, then we may be reassured that at least those kinds of consciousness are not epiphenomena. But what if other varieties of consciousness, for example, dreams, are not adaptations? We sort out the connections among evolution, adaptation, and epiphenomenalism in order to show that the consequences for the nature and causal efficacy of consciousness are not (...) as dire as has sometimes been supposed. (shrink)

I propose a construal of aesthetic value that gives us reason to emphasize some aesthetic practices over others. This construal rests on the existence of a central aesthetic value, namely apprehension-testing intricacy within an appropriate domain. I address three objections: the objection that asks how an aesthetic value based on intricacy can account for the value of minimalism; the objection that asks about the difference between intricacy within a medium and intricacy between media; and the objection that asks about the (...) danger of a regress. I then say that, although this central aesthetic value can in principle allow us to adjudicate between aesthetic practices, we have epistemic limits (about the potential of certain artistic domains to allow for apprehension-testing intricacy) that prevent adjudication in some cases. Even if there is a difference between the vastness of the potential-intricacy-fields somewhere down the line, it is too far for us to see. (shrink)

Despite the plethora of freedom of religion literature (under section 2(a) of the Canadian Charter of Rights and Freedoms), the corresponding literature on the freedom of conscience is minimal. To further the discussion on the freedom of conscience, I rely heavily on the philosophical literature to make an important distinction; the difference between individual- based and communal-based conceptions of conscience. Whereas the former is plagued with subjectivity, making it difficult to conceptualize a working framework for the Charter right, the latter (...) offers a promising foothold to rise above subjectivity and find a firm footing based on communal relations. In emphasizing the importance of the dialogical nature of human beings and the relational necessity undergirding moral judgements, I argue that the concept of conscience should be understood and practiced in community, rather than individually. (shrink)

This paper examines the distinction between self-love and self-conceit in Kant's moral psychology. It motivates an alternative account of the origin of self-conceit by drawing a parallel to what Kant calls transcendental illusion.

In Measuring the Immeasurable Mind: Where Contemporary Neuroscience Meets the Aristotelian Tradition, Matthew Owen argues that despite its nonphysical character, it is possible to empirically detect and measure consciousness. -/- Toward the end of the previous century, the neuroscience of consciousness set its roots and sprouted within a materialist milieu that reduced the mind to matter. Several decades later, dualism is being dusted off and reconsidered. Although some may see this revival as a threat to consciousness science aimed at (...) measuring the conscious mind, Owen argues that measuring consciousness, along with the medical benefits of such measurements, is not ruled out by consciousness being nonphysical. Owen proposes the Mind-Body Powers model of neural correlates of consciousness, which is informed by Aristotelian causation and a substance dualist view of human nature inspired by Thomas Aquinas, who often followed Aristotle. In addition to explaining why there are neural correlates of consciousness, the model provides a philosophical foundation for empirically discerning and quantifying consciousness. En route to presenting and applying the Mind-Body Powers model to neurobiology, Owen rebuts longstanding objections to dualism related to the mind-body problem. With scholarly precision and readable clarity, Owen applies an oft forgotten yet richly developed historical vantage point to contemporary cognitive neuroscience. (shrink)

It is often assumed that Fichte's aim in Part I of the System of Ethics is to provide a deduction of the moral law, the very thing that Kant – after years of unsuccessful attempts – deemed impossible. On this familiar reading, what Kant eventually viewed as an underivable 'fact' (Factum), the authority of the moral law, is what Fichte traces to its highest ground in what he calls the principle of the 'I'. However, scholars have largely overlooked a passage (...) in the System of Ethics where Fichte explicitly invokes Kant's doctrine of the fact of reason with approval, claiming that consciousness of the moral law grounds our belief in freedom (GA I/5:65). On the reading I defend, Fichte's invocation of the Factum is consistent with the structure of Part I when we distinguish (a) the feeling of moral compulsion from (b) the moral law itself. (shrink)

While Kant’s claim that the moral law discloses our freedom to us has been extensively discussed in recent decades, the reactions to this claim among Kant’s immediate successors have gone largely overlooked by scholars. Reinhold, Creuzer, and Maimon were among three prominent thinkers of the era unwilling to follow Kant in making the moral law the condition for knowing our freedom. Maimon went so far as to reject Kant’s method of appealing to our everyday awareness of duty on the grounds (...) that common human understanding is susceptible to error and illusion. In this paper I shall examine how these skeptical reactions to Kant’s position shaped the background for Fichte’s method of moral justification, leading up to his own deduction of the moral law in the System of Ethics. By way of conclusion, I shall propose a new interpretation of how consciousness of the moral law serves as an entry-point to Fichte’s form of idealism. (shrink)

Abstract: In recent work Stephen Darwall has attacked what he calls J. G. Fichte's ‘voluntarist’ thesis, the idea—on Darwall's reading—that I am bound by obligations of respect to another person by virtue of my choice to interact with him. Darwall argues that voluntary choice is incompatible with the normative force behind the concept of a person, which demands my respect non-voluntarily. He in turn defends a ‘presuppositional’ thesis which claims that I am bound by obligations of respect simply by recognizing (...) the other as a person. In this paper I argue Darwall has misidentified the voluntary element in Fichte's account (sections 4–5). This requires me first to explain what Fichte's voluntarism really consists in (sections 1–3), and I suggest an apparent ambiguity in Fichte's position is responsible for Darwall's misreading. Clarifying this ambiguity, however, exposes some limitations to Darwall's thesis, and I end by discussing what those limitations are and what we can learn from them (sections 6–8). (shrink)

It is generally unquestioned that human subjects research review boards should assess the ethical acceptability of protocols. It says so right on the tin, after all: they are explicitly called research ethics committees in the UK. But it is precisely those sorts of unchallenged assumptions that should, from time to time, be assessed and critiqued, in case they are in fact unfounded. John Stuart Mill's objection to suppressers of dissent is instructive here: “If the opinion is right, they are deprived (...) of the opportunity of exchanging error for truth: if wrong, they lose, what is almost as great a benefit, the clearer perception and livelier impression of truth, produced by its collision with error”.1 Andrew Moore and Andrew Donnelly's compelling article, “The job of ‘ethics committees’”, is just this sort of challenge to conventional wisdom, a rejection of the notion that review boards should be considering ethical matters at all.2 If true, we should be substantially reforming our research ethics policies. And if false, rebuttals would help strengthen and ground the otherwise unquestioned assumption of the role of ethics committees. As it happens, I will argue that their critiques fall into the second category. While mistaken, they present a valuable opportunity to clarify the role of ethics committees and their relationship to relevant codes. In particular, I will defend a hybrid account where codes have strict primacy, but leave significant room for review boards …. (shrink)

Some have objected to human enhancement on the grounds that it violates the autonomy of the enhanced. These objections, however, overlook the interesting possibility that autonomy itself could be enhanced. How, exactly, to enhance autonomy is a difficult problem due to the numerous and diverse accounts of autonomy in the literature. Existing accounts of autonomy enhancement rely on narrow and controversial conceptions of autonomy. However, we identify one feature of autonomy common to many mainstream accounts: reasoning ability. Autonomy can then (...) be enhanced by improving people’s reasoning ability, in particular through cognitive enhancement; given how valuable autonomy is usually taken to be, this gives us extra reason to pursue such cognitive enhancements. Moreover, autonomy-based objections will be especially weak against such enhancements. As we will argue, those who are worried that enhancements will inhibit people’s autonomy should actually embrace those enhancements that will improve autonomy. (shrink)

With the recent report of a live birth after use of Mitochondrial replacement therapy, sometimes called ‘Three-parent IVF’, the clinical application of the technique is fast becoming a reality. While the United Kingdom allows the procedure under regulatory scrutiny, it remains effectively outlawed in many other countries. We argue that such prohibitions may violate individuals’ procreative rights, grounded in individuals’ interest in genetic affinity. The interest in genetic affinity was recently endorsed by Singapore’s highest court, reflecting an emphasis on the (...) importance of biological ties found across the globe. We apply that reasoning to make the case for a right to ‘Three-parent IVF’. (shrink)

A self-fulfilling prophecy in neuroprognostication occurs when a patient in coma is predicted to have a poor outcome, and life-sustaining treatment is withdrawn on the basis of that prediction, thus directly bringing about a poor outcome for that patient. In contrast to the predominant emphasis in the bioethics literature, we look beyond the moral issues raised by the possibility that an erroneous prediction might lead to the death of a patient who otherwise would have lived. Instead, we focus on the (...) problematic epistemic consequences of neuroprognostic SFPs in settings where research and practice intersect. When this sort of SFP occurs, the problem is that physicians and researchers are never in a position to notice whether their original prognosis was correct or incorrect, since the patient dies anyway. Thus, SFPs keep us from discerning false positives from true positives, inhibiting proper assessment of novel prognostic tests. This epistemic problem of SFPs thus impedes learning, but ethical obligations of patient care make it difficult to avoid SFPs. We then show how the impediment to catching false positive indicators of poor outcome distorts research on novel techniques for neuroprognostication, allowing biases to persist in prognostic tests. We finally highlight a particular risk that a precautionary bias towards early withdrawal of life-sustaining treatment may be amplified. We conclude with guidelines about how researchers can mitigate the epistemic problems of SFPs, to achieve more responsible innovation of neuroprognostication for patients in coma. (shrink)