In an important discussion of the problem of hiddenness, Michael Rea briefly presents and defends an argument from divine hiddenness which he thinks encapsulates the problem of divine hiddenness, and then develops a detailed and nuanced response to this argument. Importantly, Rea claims that his response does not depend on the commonly held theistic view that God allows hiddenness to secure human goods. In this paper I offer a detailed criticism of Rea’s account of what justifies God in allowing divine (...) hiddenness, arguing that Rea’s response to the argument from divine hiddenness is unsuccessful. (shrink)

The COVID-19 pandemic revealed numerous weaknesses in pandemic preparedness and response, including underfunding, inadequate surveillance, and inequitable distribution of countermeasures. To overcome these weaknesses for future pandemics, WHO released a zero draft of a pandemic treaty in February, 2023, and subsequently a revised bureau's text in May, 2023. COVID-19 made clear that pandemic prevention, preparedness, and response reflect choices and value judgements. These decisions are therefore not a purely scientific or technical exercise, but are fundamentally grounded in ethics. The latest (...) treaty draft reflects these ethical considerations by including a section entitled Guiding Principles and Approaches. Most of these principles are ethical—they establish core values that undergird the treaty. Unfortunately, the treaty draft's set of principles are numerous, overlapping, and show inadequate coherence and consistency. We propose two improvements to this section of the draft pandemic treaty. First, key guiding ethical principles should be clearer and more precise than they currently are. Second, the link between ethical principles and policy implementation should be clearly established and define boundaries on acceptable interpretation, ensuring that signatories abide by these principles. (shrink)

It is plausible that current generations owe something to future generations. One possibility is that we have a duty to not harm them. Another possibility is that we have a duty to protect them. In either case, however, to satisfy the duties to future generations from environmental or political degradation, we need to engage in widespread collective action. But, as we are, we have a limited ability to do so, in part because we lack the self-discipline necessary for successful collective (...) action. Given that having an obligation hinges on being able to satisfy it, the apparent duty to future generations is at odds with our apparent inability to satisfy it. Thus, we either need to rethink our duties to future generations or rethink the nature of our abilities. I argue in this chapter that we should rethink the nature of our abilities. Specifically, we should enhance our self-discipline, which is distinct from enhancements of motivation, judgment, or emotion. Even the most intelligent, motivated, and empathetic actor is likely to slip up, which encourages others to withdraw their cooperation. Without the necessary self-discipline to sustain our public cooperative behavior, collective action is likely to fail, leaving us with one alternative: to abandon our duties to future generations. (shrink)

We examine moving spotlight theories of time: theories according to which there are past and future events and an objective present moment. In Section 1, we briefly discuss the origins of the view. In Section 2, we describe the traditional moving spotlight view, which we understand as an ‘enriched’ B-theory of time, and raise some problems for that view. In the next two sections, we describe versions of the moving spotlight view that we think are better and which solve those (...) problems. In Section 3, we describe a version of the view that combines permanentism – the thesis that all things always exist – with propositional temporalism, the thesis that some propositions are sometimes true and sometimes false. In Section 4, we discuss a version of the view that is like an ‘enriched’ presentism. We conclude with some brief thoughts on issues that remain outstanding. (shrink)

The divine attributes of immensity and omnipresence have been integral to classical Christian confession regarding the nature of the triune God. Divine immensity and omnipresence are affirmed in doctrinal standards such as the Athanasian Creed (c. 500), the Fourth Lateran Council (1215), the Council of Basel (1431–49), the Second Helvetic Confession (1566), the Westminster Confession of Faith (1647), the Second London Baptist Confession (1689), and the First Vatican Council (1869–70). In the first section of this chapter, I offer a brief (...) historical overview of divine immensity and divine omnipresence in the Christian tradition. I then offer a brief taxonomy of contemporary models of divine omnipresence in the philosophical and theological landscape. In the second, more constructive section, I aim to gesture toward the retrieval of several classical insights regarding immensity and omnipresence that remain unexplored in contemporary analytic work. (shrink)

We thank all the thoughtful authors for their insightful comments. In this response, we try to address some of themes that emerged from the commentaries. We leave aside some of those comments that...

This paper compares two alternative explanations of pragmatic encroachment on knowledge (i.e., the claim that whether an agent knows that p can depend on pragmatic factors). After reviewing the evidence for such pragmatic encroachment, we ask how it is best explained, assuming it obtains. Several authors have recently argued that the best explanation is provided by a particular account of belief, which we call pragmatic credal reductivism. On this view, what it is for an agent to believe a proposition is (...) for her credence in this proposition to be above a certain threshold, a threshold that varies depending on pragmatic factors. We show that while this account of belief can provide an elegant explanation of pragmatic encroachment on knowledge, it is not alone in doing so, for an alternative account of belief, which we call the reasoning disposition account, can do so as well. And the latter account, we argue, is far more plausible than pragmatic credal reductivism, since it accords far better with a number of claims about belief that are very hard to deny. (shrink)

The understanding of the primary-secondary quality distinction has shifted focus from the mechanical philosophers’ proposal of primary qualities as explanatorily fundamental to current theorists’ proposal of secondary qualities as metaphysically perceiver dependent. The chapter critically examines this shift and current arguments to uphold the primary-secondary quality distinction on the basis of the perceiver dependence of color; one focus of the discussion is the role of qualia in these arguments. It then describes and criticizes reasons for characterizing color, smell, taste, sound, (...) and warmth and color as secondary qualities on the basis of our commonsense divisions among sensory modalities; Grice’s proposal for distinguishing among the sensory modalities is focal here. The general conclusion is that reasons for drawing the primary-secondary quality distinction are unconvincing. (shrink)

This chapter examines the spectrum inversion hypothesis as an argument against certain kinds of account of what it’s like to be conscious of color. The hypothesis aims to provide a counterexample to accounts of what it’s like to be conscious of color in non-qualitative terms, as well as to accounts of what it’s like to be conscious of color in terms of the representational content of conscious visual states (which, according to some philosophers, is in turn given an account in (...) non-qualitative terms). I explain the hypothesis’s reasoning in sections 1 and 2. I then take up background issues: since the counterexample provided by the hypothesis is typically given as a possibility rather than an actuality, I briefly discuss the kind of possibility involved in section 3, and the methodologies used to evaluate the plausibility of possibilities in section 4. In section 5, I describe some general considerations that are commonly used against the spectrum inversion hypothesis. I take up attempts to support the hypothesis with findings from color science in section 6. I end with comments skeptical of both the motivation for the spectrum inversion hypothesis and the methodology used to support it. (shrink)

Mental fictionalism is not the benign view that we may better understand the mind if we think of mental states as something like useful fictions, but the more radical view that mental states just are useful fictions. This paper argues that, if one were to treat mental states as a kind of fiction, the genre of fiction best suited to this purpose would be fantasy make-believe, in which magic is a central feature. After defending a promising fictionalist account of mental (...) discourse as a kind of prop-oriented make believe against recent criticism, the paper ultimately concludes that mental fictionalism faces further, potentially insurmountable, challenges. Most significantly, there is a problematic disanalogy between folk psychology and fiction: our mental state attributions aim to track truth, and this crucial aspect of our mental discourse cannot be captured if we interpret it as a kind of fictional discourse. For this and other reasons, the cost of adopting mental fictionalism likely outweighs its benefits. Whether or not these problems can be resolved, there is still much to be gained from taking mental fictionalism seriously: in doing so we may illuminate several important features of our own folk psychology that often go unnoticed. (shrink)

We initially characterize what we’ll call existence problems as problems where there is evidence that a putative entity exists and this evidence is not easily dismissed; however, the evidence is not adequate to justify the claim that the entity exists, and in particular the entity hasn’t been detected. The putative entity is elusive. We then offer a strategy for determining whether an existence problem is philosophical or scientific. According to this strategy (1) existence problems are characterized in terms of causal (...) roles, and (2) these problems are categorized as scientific or philosophical on the basis of the epistemic context of putative realizers. We argue that the first step of the strategy is necessary to avoid begging the question with regard to categorization of existence problems, and the second step categorizes existence problems on the basis of a distinction between two ways in which an entity can be elusive. This distinction between kinds of elusiveness takes as background a standard account of inference to the best explanation. Applying this strategy, we argue that the existence of a multiverse is a scientific problem. (shrink)

The practice of medicine frequently involves the unconsented restriction of liberty. The reasons for unilateral liberty restrictions are typically that being confined, strapped down, or sedated are necessary to prevent the person from harming themselves or others. In this paper, we target the ethics of chemical restraints, which are medications that are used to intentionally restrict the mental states associated with the unwanted behaviors, and are typically not specifically indicated for the condition for which the patient is being treated. Specifically, (...) we aim to identify the conditions under which chemical restraints are ethically permissible. It is wrong to assume that what is morally true of physical restraints is also true of chemical restraints. Our aim is thus to identify the conditions under which chemical restraints are permissible while distinguishing these conditions from those of the application of physical restraints. (shrink)

Is authoritarian power ever legitimate? The contemporary political theory literature—which largely conceptualizes legitimacy in terms of democracy or basic rights—would seem to suggest not. I argue, however, that there exists another, overlooked aspect of legitimacy concerning a government’s ability to ensure safety and security. While, under normal conditions, maintaining democracy and rights is typically compatible with guaranteeing safety, in emergency situations, conflicts between these two aspects of legitimacy can and often do arise. A salient example of this is the COVID-19 (...) pandemic, during which severe limitations on free movement and association have become legitimate techniques of government. Climate change poses an even graver threat to public safety. Consequently, I argue, legitimacy may require a similarly authoritarian approach. While unsettling, this suggests the political importance of climate action. For if we wish to avoid legitimating authoritarian power, we must act to prevent crises from arising that can only be resolved by such means. (shrink)

Some theorists argue that moral bioenhancement ought to be compulsory. I take this argument one step further, arguing that if moral bioenhancement ought to be compulsory, then its administration ought to be covert rather than overt. This is to say that it is morally preferable for compulsory moral bioenhancement to be administered without the recipients knowing that they are receiving the enhancement. My argument for this is that if moral bioenhancement ought to be compulsory, then its administration is a matter (...) of public health, and for this reason should be governed by public health ethics. I argue that the covert administration of a compulsory moral bioenhancement program better conforms to public health ethics than does an overt compulsory program. In particular, a covert compulsory program promotes values such as liberty, utility, equality, and autonomy better than an overt program does. Thus, a covert compulsory moral bioenhancement program is morally preferable to an overt moral bioenhancement program. (shrink)

There is recent empirical evidence that personal identity is constituted by one’s moral traits. If true, this poses a problem for those who advocate for moral enhancement, or the manipulation of a person’s moral traits through pharmaceutical or other biological means. Specifically, if moral enhancement manipulates a person’s moral traits, and those moral traits constitute personal identity, then it is possible that moral enhancement could alter a person’s identity. I go a step further and argue that under the right conditions, (...) moral enhancement can constitute murder. I then argue that these conditions are not remote. (shrink)

Various thinkers are concerned that the Orthodox view of Ancestral Sin does not avoid the age-old Augustinian concern of Pelagianism. After all, the doctrine of Ancestral Sin maintains that fallen human beings do not necessarily or inevitably commit actual sins. In contemporary literature, this claim could be articulated as a denial of the ‘inevitability thesis.’ A denial of the inevitability thesis, so contemporary thinkers maintain, seems to imply both that human beings can place themselves in right relation to God as (...) well as the Pelagian denial that all require Christ's work to attain this right relation to God. This article demonstrates that the Ancestral Sin, along with a denial of the inevitability thesis, is neither Pelagian nor Semi-Pelagian. I show that the doctrine of Ancestral Sin denies (Semi-) Pelagianism in various ways. I show that, for Ancestral Sin to entail (Semi-) Pelagianism, one must commit to several assumptions, each of which is plausibly deniable and none of which Orthodox thinkers affirm. (shrink)

It has recently been argued that a person’s moral judgments (about both their own and others’ actions) are constrained by the nature and extent of their relevant ignorance and, thus, that such judgments are determined in the first instance by the person’s epistemic circumstances. It has been argued, in other words, that the epistemic is logically prior to other normative (e.g., ethical, prudential, pecuniary) considerations in human decision-making, that these other normative considerations figure in decision-making only after (logically and temporally) (...) relevant ignorance has constrained the decision-maker’s menu of options. If this is right, then a person’s moral judgments in some set of circumstances should vary with their knowledge and ignorance of these circumstances. In this study, we test the hypothesis of the logical priority of the epistemic. We describe two experiments in which subjects’ knowledge and ignorance of relevant consequences were manipulated. In the second experiment, we also compared the effect of ignorance on moral judgments with that of personal force, a factor previously shown to influence moral judgments. We found broad empirical support for the armchair arguments that epistemic considerations are logically prior to normative considerations. (shrink)

As the science and technology of the brain and mind develop, so do the ways in which brains and minds may be surveilled and manipulated. Some cognitive libertarians worry that these developments undermine cognitive liberty, or “freedom of thought.” I argue that protecting an individual’s cognitive liberty undermines others’ ability to use their own cognitive liberty. Given that the threatening devices and processes are not relevantly different from ordinary and frequent intrusions upon one’s brain and mind, strong protections of cognitive (...) liberty may proscribe neurotechnological intrusions, but also ordinary intrusions. Thus, the cognitive libertarian position “hog-ties” others’ use of their own liberties. This problem for the cognitive libertarian is the same problem that ordinary libertarianism faces in protecting individual rights to property and person. But the libertarian strategies for resolving the problem don’t work for the cognitive libertarian. I conclude that the right to mental privacy is weaker than what cognitive libertarians want it to be. (shrink)

Augustine’s privation theory of evil maintains that something is evil in virtue of a privation, a lack of something which ought to be present in a particular nature. While it is not evil for a human to lack wings, it is indeed evil for a human to lack rationality according to the end of a rational nature. Much of the literature on the privation theory focuses on whether it can successfully defend against counterexamples of positive evils, such as pain. This (...) focus of the discussion is not surprising, given that the privation theory is a theory about the nature of evil. But it is also a theory that protects venerable theological concerns, namely, that God is the good creator of everything, and that everything is good. It is the purpose of this article to further this discussion on both fronts. I argue that the counterexample of pain still defeats the privation theory despite the most recent defense. What is more, I suggest, this is not theologically disastrous. The individual who rejects the privation theory is not obligated to reject the theological theses which motivate it. To show how a rejection of the privation theory is a live option, I offer an alternative view of evil that also maintains these theological theses and encompasses both privative and positive evils. (shrink)

Moral bioenhancement is the potential practice of manipulating individuals’ moral behaviors by biological means in order to help resolve pressing moral issues such as climate change and terrorism. This practice has obvious ethical implications, and these implications have been and continue to be discussed in the bioethics literature. What have not been discussed are the epistemological implications of moral bioenhancement. This article details some of these implications of engaging in moral bioenhancement. The argument begins by making the distinction between moral (...) bioenhancement that manipulates the contents of mental states and that which manipulates other, non-representational states. Either way, I argue, the enhanced moral psychology will fail to conform to epistemic norms, and the only way to resolve this failure and allow the moral bioenhancement to be effective in addressing the targeted moral issues is to make the moral bioenhancement covert. (shrink)

The connection between whole and part is intimate: not only can we share the same space, but I’m incapable of leaving my parts behind; settle the nonmereological facts and you thereby settle what is a part of what; wholes don’t seem to be an additional ontological commitment over their parts. Composition as identity promises to explain this intimacy. But it threatens to make the connection too intimate, for surely the parts could have made a different whole and the whole have (...) had different parts. In this paper I attempt to offer an account of parthood that is intimate enough but not too intimate: the parts generate the whole, but they are not themselves the whole. (shrink)

Epistemic burdens – the nature and extent of our ignorance (that and how) with respect to various courses of action – serve to determine our incentive structures. Courses of action that seem to bear impossibly heavy epistemic burdens are typically not counted as options in an actor’s menu, while courses of action that seem to bear comparatively heavy epistemic burdens are systematically discounted in an actor’s menu relative to options that appear less epistemically burdensome. That ignorance serves to determine what (...) counts as an option means that epistemic considerations are logically prior to moral, prudential, and economic considerations: in order to have moral, prudential, or economic obligations, one must have options, and epistemic burdens serve to determine our options. One cannot have obligations without doing some epistemic work. We defend this claim on introspective grounds. We also consider how epistemic burdens distort surrogate decision-making. The unique epistemology of surrogate cases makes the priority of the epistemic readily apparent. We then argue that anyone who accepts a principle similar to ought implies can is committed to the logical priority of the epistemic. We also consider and reject several possible counterarguments. -/- . (shrink)

Despite the lack of evidence for their effectiveness, the use of physical restraints for patients is widespread. The best ethical justification for restraining patients is that it prevents them from harming themselves. We argue that even if the empirical evidence supported their effectiveness in achieving this aim, their use would nevertheless be unethical, so long as well known exceptions to informed consent fail to apply. Specifically, we argue that ethically justifiable restraint use demands certain necessary and sufficient conditions. These conditions (...) are that the physician obtain informed consent for their application, that their application be medically appropriate, and that restraints be the least liberty-restricting way of achieving the intended benefit. It is a further question whether their application is ever medically appropriate, given the dearth of evidence for their effectiveness. (shrink)

I first offer a broad taxonomy of models of divine omnipresence in the Christian tradition, both past and present. I then examine the recent model proposed by Hud Hudson (2009, 2014) and Alexander Pruss (2013)—ubiquitous entension—and flag a worry with their account that stems from predominant analyses of the concept of ‘material object’. I then attempt to show that ubiquitous entension has a rich Latin medieval precedent in the work of Augusine and Anselm. I argue that the model of omnipresence (...) explicated by Augustine and Anselm has the resources to avoid the noted worry by offering an alternative account of the divide between the immaterial and the material. I conclude by considering a few alternative analyses of ‘material object’ that make conceptual room for a contemporary Christian theist to follow suite in thinking that at least some immaterial entities are literally spatially located when relating to the denizens of spacetime. (shrink)

Plenitude, roughly, the thesis that for any non-empty region of spacetime there is a material object that is exactly located at that region, is often thought to be part and parcel of the standard Lewisian package in the metaphysics of persistence. While the wedding of plentitude and Lewisian four-dimensionalism is a natural one indeed, there are a hand-full of dissenters who argue against the notion that Lewisian four-dimensionalism has exclusive rights to plentitude. These ‘promiscuous’ three-dimensionalists argue that a temporalized version (...) of plenitude is entirely compatible with a three-dimensional ontology of enduring entities. While few would deny the coherence of such a position, and much work has been done by its proponents to appease critics, there has been surprisingly little by way of exploring the various forms such an ontology might take as well as the potential advantages of one plenitudinous three-dimensional ontology over another. Here I develop a novel form of plenitudinous three-dimensionalism, what John Hawthorne (Metaphysical essays, 2006a, b) has called “Neo-Aristotelian Plenitude,” and argue that if one is inclined to endorse an abundant three-dimensional ontology, one is wise to opt for a plenitude of accidental unities. (shrink)

In biomedical ethics, there is widespread acceptance of moral realism, the view that moral claims express a proposition and that at least some of these propositions are true. Biomedical ethics is also in the business of attributing moral obligations, such as “S should do X.” The problem, as we argue, is that against the background of moral realism, most of these attributions are erroneous or inaccurate. The typical obligation attribution issued by a biomedical ethicist fails to truly capture the person's (...) actual obligations. We offer a novel argument for rife error in obligation attribution. The argument starts with the idea of an epistemic burden. Epistemic burdens are all of those epistemic obstacles one must surmount in order to achieve some aim. Epistemic burdens shape decision-making such that given two otherwise equal options, a person will choose the option that has the lesser of epistemic burdens. Epistemic burdens determine one's potential obligations and, conversely, their non-obligations. The problem for biomedical ethics is that ethicists have little to no access to others' epistemic burdens. Given this lack of access and the fact that epistemic burdens determine potential obligations, biomedical ethicists often can only attribute accurate obligations out of luck. This suggests that the practice of attributing obligations in biomedical ethics is rife with error. To resolve this widespread error, we argue that this practice should be abolished from the discourse of biomedical ethics. (shrink)

Action must be taken to combat climate change. Yet, how the costs of climate action should be allocated among states remains a question. One popular answer—the polluter-pays principle (PPP)—stipulates that those responsible for causing the problem should pay to address it. While intuitively plausible, the PPP has been subjected to withering criticism in recent years. It is timely, following the Paris Agreement, to develop a new version: one that does not focus on historical production-based emissions but rather allocates climate burdens (...) in proportion to each state’s annual consumption-based emissions. This change in carbon accounting results in a fairer and more environmentally effective principle for distributing climate duties. (shrink)

In a recent issue of Bioethics, I argued that compulsory moral bioenhancement should be administered covertly. Alexander Zambrano has criticized this argument on two fronts. First, contrary to my claim, Zambrano claims that the prevention of ultimate harm by covert moral bioenhancement fails to meet conditions for permissible liberty‐restricting public health interventions. Second, contrary to my claim, Zambrano claims that covert moral bioenhancement undermines autonomy to a greater degree than does overt moral bioenhancement. In this paper, I rebut both of (...) these arguments, then finish by noting important avenues of research that Zambrano’s arguments motivate. (shrink)

We critically engage two traditional views of scientific data and outline a novel philosophical view that we call the pragmatic-representational view of data. On the PR view, data are representations that are the product of a process of inquiry, and they should be evaluated in terms of their adequacy or fitness for particular purposes. Some important implications of the PR view for data assessment, related to misrepresentation, context-sensitivity, and complementary use, are highlighted. The PR view provides insight into the common (...) but little-discussed practices of iteratively reusing and repurposing data, which result in many datasets’ having a phylogeny—an origin and complex evolutionary history—that is relevant to their evaluation and future use. We relate these insights to the open-data and data-rescue movements, and highlight several future avenues of research that build on the PR view of data. (shrink)

Humans are morally deficient in a variety of ways. Some of these deficiencies threaten the continued existence of our species. For example, we appear to be incapable of responding to climate change in ways that are likely to prevent the consequent suffering. Some people are morally better than others, but we could all be better. The price of not becoming morally better is that when those events that threaten us occur, we will suffer from them. If we can prevent this (...) suffering from occurring, then we ought to do so. That we ought to make ourselves morally better in order to prevent very bad things from happening justifies, according to some, the development and administration of moral enhancement. I address in this paper the idea that moral enhancement could give rise to moral transhumans, or moral post-persons. Contrary to recent arguments that we shouldn’t engender moral post-persons, I argue that we should. Roughly, the reasons for this conclusion are that we can expect moral post-persons to resemble the morally best of us, our moral exemplars. Since moral exemplars promote their interests by promoting the interests of others (or they promote others’ interests at the expense of their own) we can expect moral post-persons to pursue our interests. Since we should also pursue our own interests, we should bring about moral post-persons. (shrink)

Recent scholarship has drawn attention to John Rawls’s concern with stability—a concern that, as Rawls himself notes, motivated Part III of A Theory of Justice and some of the more important changes of his political turn. For Rawls, the possibility of achieving ‘stability for the right reasons’ depends on citizens possessing sufficient moral motivation. I argue, however, that the moral psychology Rawls develops to show how such motivation would be cultivated and sustained does not cohere with his specific descriptions of (...) ‘pluralist ’ doctrines. Considering Rawls’s claims that ‘most’ citizens—both in contemporary liberal democracies and in the well-ordered society—possess such doctrines, this incompatibility threatens to undermine his stability arguments. Despite the enormous importance of pluralist doctrines and the potential difficulties they pose for Rawls’s project, remarkably little attention has been paid to them. By critically examining these difficulties, the article begins to address this oversight. (shrink)

This article seeks to constructively retrieve Anselm’s theology of the Holy Spirit by responding to a recent criticism of his doctrine of atonement. This criticism is called the question of efficacy and focuses particularly on how Anselm holds humanity to participate in and receive the divine gift of atonement. In short, this paper argues that the Spirit’s prevenient and subsequent grace allow for an individual to respond freely and in faith to Christ’s work, resulting in three individually necessary and jointly (...) sufficient conditions for union to be restored with God and human flourishing to obtain in Anselm’s thinking. In order to argue this, the paper proceeds in four sections. First, it discusses the question of efficacy. Second, it discusses the Spirit’s work in relation to an individual initially accepting Christ’s Gift. The paper then proceeds by discussing the subsequent work of the Spirit and redemptive role of faith that are inherently tied to the initial work. The paper then concludes by analyzing alternative approaches to this question of efficacy. (shrink)

As the federal government distributed remdesivir to some of the states COVID-19 hit hardest, policymakers scrambled to develop criteria to allocate the drug to their hospitals. Our state, Michigan, was among those states to receive an initial quantity of the drug from the U.S. government. The disparities in burden of disease in Michigan are striking. Detroit has a death rate more than three times the state average. Our recommendation to the state was that it should prioritize the communities that bear (...) a disproportionate burden of suffering in the allocation of the new potential treatment. This recommendation is justified not only for new drugs with uncertain effects, but also for drugs of certain benefit or vaccines. For states with significant health disparities, such as Michigan, this allocation priority may help to repair them. In fact, any other allocation strategy may make them worse. (shrink)

Berger (forthcoming) states that moral intimacy is important in applying the best interests standard. But what he calls moral intimacy requires that someone has overcome epistemic burdens needed to represent the patient. We argue elsewhere that good surrogate decision-making is first and foremost a matter of overcoming epistemic burdens, or those obstacles that stand in the way of a surrogate decision-maker knowing what a patient wants and how to satisfy those preferences. Berger’s notion of moral intimacy depends on epistemic intimacy: (...) the fact that a surrogate's epistemic burdens with respect to the best interests of the incapacitated patient have been adequately surmounted, plus some other feature. Thus, where a particular patient-surrogate relationship fails to be morally intimate, what is lacking is either epistemic intimacy or this second feature. Furthermore, Berger uses the notion of moral intimacy as an explanans for the application of the best interests standard. We argue that the notions of epistemic intimacy and epistemic burdens not only help to explain the notion of moral intimacy, but also better explain the application of the best interests standard. Given the role of epistemic burdens and the epistemic intimacy that overcoming them enables, bioethicists and physicians should consider a surrogate’s epistemic standing relative to the patient’s best interests before pronouncing on the former’s ethical probity. (shrink)

Most current dental ethics curricula use a deontological approach to biomedical and dental ethics that emphasizes adherence to duties and principles as properties that determine whether an act is ethical. But the actual ethical orientation of students is typically unknown. The purpose of the current study was to determine the ethical orientation of dental students in resolving clinical ethical dilemmas. First-year students from one school were invited to participate in an electronic survey that included eight vignettes featuring ethical conflicts common (...) to the health care setting. The Multidimensional Ethics Scale was used to evaluate the students’ ethical judgments of these conflicts. Students rated each vignette along 13 ethically relevant items using a 7-point scale. Nine of the thirteen items were analyzed because they represent the dominant ethical theories, including deontology. One hundred sixteen dental students successfully completed the survey. Of the analyzed items, those associated with deontology had comparatively weak associations with whether students judged the action to be ethical and whether students judged themselves likely to perform the action. Whether an action was judged to be caring had the strongest association with whether the action was judged to be ethical and whether students judged themselves likely to perform the action. These results suggest that adherence to duties or principles has weaker association with students’ ethical judgments and behavior compared to caring, which was found to be more influential in their ethical judgments and behavior. Current dental school curricula with a primary focus on deontology may no. (shrink)

Default positions, predetermined starting points that aid in complex decision-making, are common in clinical medicine. In this article, we identify and critically examine common default positions in clinical ethics practice. Whether default positions ought to be held is an important normative question, but here we are primarily interested in the descriptive, rather than normative, properties of default positions. We argue that default positions in clinical ethics function to protect and promote important values in medicine—respect for persons, utility, and justice. Further, (...) default positions in clinical ethics may also guard against harm. Where default positions exist, there are epistemic burdens to overturn them. The person wishing to reject the default position, rather than the person endorsing it, bears this burden. The person who bears the burden of meeting the epistemic requirements must provide evidence proportional to the degree of harm the default position protects against. Default positions that protect against significant harm impose significant epistemic requirements to overturn. This asymmetry not only makes medical decision-making more economical but also serves to promote and protect certain values. The identification and analysis of common and recognizable default positions can help to identify other default positions and the conditions under which their associated epistemic requirements are met. The article concludes with considerations of potential problems with the use of default positions in clinical ethics. (shrink)

We aim to establish the following claim: other factors held constant, the relative weights of the epistemic burdens of competing treatment options serve to determine the options that patient surrogates pursue. Simply put, surrogates confront an incentive, ceteris paribus, to pursue treatment options with respect to which their knowledge is most adequate to the requirements of the case. Regardless of what the patient would choose, options that require more knowledge than the surrogate possesses (or is likely to learn) will either (...) be neglected altogether or deeply discounted in the surrogate’s incentive structure. We establish this claim by arguing that the relation between epistemic burdens and incentives in decision-making is a general feature of surrogate decision-making. After establishing the claim, we draw out some of the implications for surrogate decision-making in medicine and offer philosophical and psychological explanations of the phenomenon. (shrink)

Brummett and Salter propose a useful and timely taxonomy of clinical ethics expertise (2019). As the field becomes further “professionalized” this taxonomy is important, and the core of it is right. It needs some refinement around the edges, however. In their conclusion, Brummett and Salter rightly point out that there is a significant difference between the ethicist whose recommendations are procedure- and process-heavy, consensus-driven, and dialogical and the authoritarian ethicist whose recommendations flow from “private moral views” (Brummett and Salter, 2019). (...) This admission doesn’t go far enough. Brummett and Salter’s taxonomy fails to capture the notion that offering recommendations whose normative force is moral is different in kind from recommendations whose normative force is non-moral, such as those recommendations that are free of moral content or justified by convention. The difference is in kind, not scale. I argue further that clinical ethics expertise, if possible, consists at least in offering recommendations whose normative force is moral. These two claims imply that the taxonomy fails to cut clinical ethics expertise at the joints: the ethicist who offers justified non-moral normative recommendations is a different kind of ethicist from the one who offers justified moral normative recommendations, yet both are categorized as clinical ethics experts. I finish by offering a refinement of the taxonomy that more precisely categorizes clinical ethicists. (shrink)

It has recently been argued that a person’s moral judgments (about both their own and others’ actions) are constrained by the nature and extent of their relevant ignorance and, thus, that such judgments are determined in the first instance by the person’s epistemic circumstances. It has been argued, in other words, that the epistemic is logically prior to other normative (e.g., ethical, prudential, pecuniary) considerations in human decision-making, that these other normative considerations figure in decision-making only after (logically and temporally) (...) relevant ignorance has constrained the decision-maker’s menu of options. If this is right, then a person’s moral judgments in some set of circumstances should vary with their knowledge and ignorance of these circumstances. In this study, we test the hypothesis of the logical priority of the epistemic. We describe two experiments in which subjects’ knowledge and ignorance of relevant consequences were manipulated. In the second experiment, we also compared the effect of ignorance on moral judgments with that of personal force, a factor previously shown to influence moral judgments. We found broad empirical support for the armchair arguments that epistemic considerations are logically prior to normative considerations. (shrink)

The ‘Ordinary Language’ philosophy of the early 20th century is widely thought to have failed. It is identified with the broader so-called ‘linguistic turn’, a common criticism of which is captured by Devitt and Sterelny (1999), who quip: “When the naturalistic philosopher points his finger at reality, the linguistic philosopher discusses the finger.” (p 280) The implication is that according to ‘linguistic’ philosophy, we are not to study reality or truth or morality etc, but the meaning of the words ‘reality’, (...) ‘truth’, ‘morality’ etc. Ordinary Language philosophy has fallen so thoroughly into disrepute because it is supposed to advocate that not only are we to study words and meanings rather than the phenomena themselves (which is apparently bad enough), but we must restrict that study to words and meanings as they occur in the language used by the ordinary speaker. A number of preposterous corollaries have been taken to follow from this view. Most seriously, perhaps, and irritatingly, is that any theory which contains ‘non-ordinary’ uses of expressions is thereby ‘meaningless’ or simply false – which is clearly absurd. In this paper I show that this is a completely inaccurate picture of Ordinary Language philosophy. My aim is to correct these persistent misinterpretations, and make possible a more sensible reassessment of the philosophy. (shrink)

Recent work by Stout and colleagues indicates that the neural correlates of language and Early Stone Age toolmaking overlap significantly. The aim of this paper is to add computational detail to their findings. I use an error minimisation model to outline where the information processing overlap between toolmaking and language lies. I argue that the Early Stone Age signals the emergence of complex structured representations. I then highlight a feature of my account: It allows us to understand the early evolution (...) of syntax in terms of an increase in the number and complexity of models in a cognitive system, rather than the development of new types of processing. (shrink)

This paper deals with a collection of concerns that, over a period of time, led the author away from the Routley–Meyer semantics, and towards proof- theoretic approaches to relevant logics, and indeed to the weak relevant logic MC of meaning containment.

Central to W.E.B. Du Bois’s political theory is a conception of “world” remarkably similar to that put forward, years later, by Martin Heidegger. This point is more methodological than historical: I claim that approaching Du Bois’s work as a source, rather than as a product, of concepts that resonated with subsequent thinkers allows us to better appreciate the novelty and vision of his political theory. Exploring this resonance, I argue, helps to refine the notions of world and founding present in (...) each theorist’s work. Yet, it is only by remaining attentive to their differences that we can understand how Du Bois and Heidegger could endorse such dramatically opposed political programs despite similar theoretical starting points. (shrink)

The collapse of society is inevitable, even if it is in the distant future. When it collapses, it is likely to do so within the lifetimes of some people. These people will have matured in pre-collapse society, experience collapse, and then live the remainder of their lives in the post-collapse world. I argue that this group of people—the transitional generation—will be the worst off from societal collapse, far worse than subsequent generations. As the transitional generation, they will suffer disparately. This (...) intergenerational disparity in suffering is inequitable. Given that other disparities in suffering are worthy of remediation, this intergenerational disparity in suffering is worthy of remediation. However, the only way to do so is to target the mental states of the members of the transitional generation. (shrink)

Conducting research on animals is supposed to be valuable because it provides information on how human mechanisms work. But for the use of animal models to be ethically justified, it must be epistemically justified. The inference from an observation about an animal model to a conclusion about humans must be warranted for the use of animals to be moral. When researchers infer from animals to humans, it’s an extrapolation. Often non-human primates are used as animal models in laboratory behavioral research. (...) The target populations are humans and other non-human primates. I argue that the epistemology of extrapolation renders the use of non-human primates in laboratory behavioral research unreliable. If the model is relevantly similar to the target, then the experimental conditions introduce confounding variables. If the model is not relevantly similar to the target, then the observations of the model cannot be extrapolated to the target. Since using non-human primates in as animal models in laboratory behavioral research is not epistemically justified, using them as animal models in laboratory behavioral research is not ethically justified. (shrink)

Many people find the manipulation of the human germline—editing the DNA of sperm or egg cells such that these genetic changes are passed to the resulting offspring—to be morally impermissible. In this paper, I argue for the claim that editing the human germline is morally permissible. My argument starts with the claim that outcome uncertainty regarding the effects of germline editing shows that the duty to not harm cannot ground the prohibition of germline editing. Instead, if germline editing is wrong, (...) it is wrong because it violates a duty to protect. However, we also have an epistemic duty to gather evidence regarding the effects of editing the human germline which overrides any moral duty to protect future generations. Thus, we have a duty to gather evidence regarding the effects of editing the human germline, which is to say that we have a duty to edit the human germline. (shrink)