Decision-making Capacity matters to whether a patient’s decision should determine her treatment. But why it matters in this way isn’t clear. The standard story is that dmc matters because autonomy matters. And this is thought to justify dmc as a gatekeeper for autonomy – whereby autonomy concerns arise if but only if a patient has dmc. But appeals to autonomy invoke two distinct concerns: concern for authenticity – concern that a choice is consistent with an individual’s commitments; and concern for (...) sovereignty – concern that an individual exercises control over that which is hers to control. Here, I argue, neither concern can alone explain why dmc matters. Instead, dmc matters because it indicates a harmony between the two concerns – the demands of each concern are more likely to agree if a patient has dmc. This vindicates the standard story, but also makes clear that dmc is an inappropriate gatekeeper for autonomy. (shrink)

The notion of authenticity, i.e., being “genuine,” “real,” or “true to oneself,” is sometimes held as critical to a person’s autonomy, so that inauthenticity prevents the person from making autonomous decisions or leading an autonomous life. It has been pointed out that authenticity is difficult to observe in others. Therefore, judgments of inauthenticity have been found inadequate to underpin paternalistic interventions, among other things. This article delineates what justifies judgments of inauthenticity. It is argued that for persons who wish (...) to live according to the prevailing social and moral standards and desires that are seriously undesirable according to those standards, it is justified to judge that a desire is inauthentic to the extent that it is due to causal factors that are alien to the person and to the extent that it deviates from the person’s practical identity. The article contributes to a tradition of thinking about authenticity which is known mainly from Frankfurt and Dworkin, and bridges the gap between theoretical ideals of authenticity and real authenticity-related problems in practical biomedical settings. (shrink)

People increasingly form beliefs based on information gained from automatically filtered Internet ‎sources such as search engines. However, the workings of such sources are often opaque, preventing ‎subjects from knowing whether the information provided is biased or incomplete. Users’ reliance on ‎Internet technologies whose modes of operation are concealed from them raises serious concerns about ‎the justificatory status of the beliefs they end up forming. Yet it is unclear how to address these concerns ‎within standard theories of knowledge and justification. (...) To shed light on the problem, we introduce a ‎novel conceptual framework that clarifies the relations between justified belief, epistemic responsibility, ‎action, and the technological resources available to a subject. We argue that justified belief is subject to ‎certain epistemic responsibilities that accompany the subject’s particular decision-taking circumstances, ‎and that one typical responsibility is to ascertain, so far as one can, whether the information upon which ‎the judgment will rest is biased or incomplete. What this responsibility comprises is partly determined by ‎the inquiry-enabling technologies available to the subject. We argue that a subject’s beliefs that are ‎formed based on Internet-filtered information are less justified than they would be if she either knew how ‎filtering worked or relied on additional sources, and that the subject may have the epistemic ‎responsibility to take measures to enhance the justificatory status of such beliefs.‎. (shrink)

Epistemic decision theory (EDT) employs the mathematical tools of rational choice theory to justify epistemic norms, including probabilism, conditionalization, and the Principal Principle, among others. Practitioners of EDT endorse two theses: (1) epistemic value is distinct from subjective preference, and (2) belief and epistemic value can be numerically quantified. We argue the first thesis, which we call epistemic puritanism, undermines the second.

In “Can it be rational to have faith?”, it was argued that to have faith in some proposition consists, roughly speaking, in stopping one’s search for evidence and committing to act on that proposition without further evidence. That paper also outlined when and why stopping the search for evidence and acting is rationally required. Because the framework of that paper was that of formal decision theory, it primarily considered the relationship between faith and degrees of belief, rather than between faith (...) and belief full stop. This paper explores the relationship between rational faith and justified belief, by considering four prominent proposals about the relationship between belief and degrees of belief, and by examining what follows about faith and belief according to each of these proposals. It is argued that we cannot reach consensus concerning the relationship between faith and belief at present because of the more general epistemological lack of consensus over how belief relates to rationality: in particular, over how belief relates to the degrees of belief it is rational to have given one’s evidence. (shrink)

Standard decision theory, or rational choice theory, is often interpreted to be a theory of instrumental rationality. This dissertation argues, however, that the core requirements of orthodox decision theory cannot be defended as general requirements of instrumental rationality. Instead, I argue that these requirements can only be instrumentally justified to agents who have a desire to have choice dispositions that are stable over time and across different choice contexts. Past attempts at making instrumentalist arguments for the core requirements of (...) decision theory fail due to a pervasive assumption in decision theory, namely the assumption that the agent’s preferences over the objects of choice – be it outcomes or uncertain prospects – form the standard of instrumental rationality against which the agent’s actions are evaluated. I argue that we should instead take more basic desires to be the standard of instrumental rationality. But unless agents have a desire to have stable choice dispositions, according to this standard, instrumental rationality turns out to be more permissive than orthodox decision theory. (shrink)

Several philosophers have proposed Knowledge-Based Decision Theories (KDTs)—theories that require agents to maximize expected utility as yielded by utility and probability functions that depend on the agent’s knowledge. Proponents of KDTs argue that such theories are motivated by Knowledge-Reasons norms that require agents to act only on reasons that they know. However, no formal derivation of KDTs from Knowledge-Reasons norms has been suggested, and it is not clear how such norms justify the particular ways in which KDTs relate knowledge and (...) rational action. In this paper, I suggest a new axiomatic method for justifying KDTs and providing them with stronger normative foundations. I argue that such theories may be derived from constraints on the relation between knowledge and preference, and that these constraints may be evaluated relative to intuitions regarding practical reasoning. To demonstrate this, I offer a representation theorem for a KDT proposed by Hawthorne and Stanley (2008) and briefly evaluate it through its underlying axioms. -/- In section 1, I present knowledge-based decision theories generally and the versions of such theories suggested in the literature. In section 2, I argue that KDTs and theories of practical reasoning conjoined with Knowledge-Reasons norms generate constraints on the same relation—the relation between knowledge and preference. In section 3, I present a formal framework in which constraints on this relation may be expressed and from which KDTs may be derived. In section 4, I present a representation theorem for a specific KDT. In section 5, I briefly evaluate the axioms of the theory, and in section 6, I conclude. (shrink)

While most of healthcare research and practice fully endorses evidence-based healthcare, a minority view borrows popular themes from philosophy of science like underdetermination and value-ladenness to question the legitimacy of the evidence-based movement’s philosophical underpinnings. While the feminist origins go unacknowledged, those critics adopt a feminist reading of the “gap argument” to challenge the perceived objectivism of evidence-based practice. From there, the critics seem to despair over the “subjective elements” that values introduce to clinical reasoning, demonstrating that they do not (...) subscribe to feminist science studies’ normative program——where contextual values can enable good science and justified decisions. In this paper, I investigate why it is that the critics of evidence-based medicine adopt feminist science’s characterization of the problem but resist the productive solutions offered by those same theorists. I suggest that the common feminist empiricist appeal to idealized epistemic communities is impractical for those working within the current biomedical context and instead offer an alternate stream of feminist research into the empirical content of values (found in the work of Elizabeth Anderson and Sharyn Clough) as a more helpful recourse for facilitating the important task of legitimate and justified clinical decision-making. I use a case study on clinical decision-making to illustrate the fruitfulness of the latter feminist empiricist framework. -/- See response by Sharyn Clough: http://wp.me/p1Bfg0-1aN See reply by Maya Goldenberg: http://wp.me/p1Bfg0-1oY. (shrink)

How could the initial, drastic decisions to implement “lockdowns” to control the spread of COVID-19 infections be justifiable, when they were made on the basis of such uncertain evidence? We defend the imposition of lockdowns in some countries by first, and focusing on the UK, looking at the evidence that undergirded the decision, second, arguing that this provided us with sufficient grounds to restrict liberty given the circumstances, and third, defending the use of poorly-empirically-constrained epidemiological models as tools that (...) can legitimately guide public policy. (shrink)

The world's political and military leaders are under increasing pressure to intervene in the affairs of sovereign nations. Although the sovereignty of states and the corollary principle of nonintervention have been part of the foundation of international law, there is some latitude for states, as well as collective security organizations, to intervene in another state's domestic and foreign affairs, thus making sovereignty and the principle less than absolute. In this paper I first sketch a reasonable foundation for sovereignty of states (...) and the principle of nonintervention. Second, I offer a decision-making procedure for justified intervention. Finally, I argue that there is an important difference between the strategic argument and the humanitarian argument, a difference that may have profound implications for the future use of the latter argument by our political leaders. (shrink)

Non‐governmental aid programs are an important source of health care for many people in the developing world. Despite the central role non‐governmental organizations play in the delivery of these vital services, for the most part they either lack formal systems of accountability to their recipients altogether, or have only very weak requirements in this regard. This is because most NGOs are both self‐mandating and self‐regulating. What is needed in terms of accountability is some means by which all the relevant stakeholders (...) can have their interests represented and considered. An ideally accountable decision‐making process for NGOs should identify acceptable justifications and rule out unacceptable ones. Thus, the point of this paper is to evaluate three prominent types of justification given for decisions taken at the Dutch headquarters of Médecins sans Frontières. They are: population health justifications, mandate‐based justifications and advocacy‐based justifications. The central question at issue is whether these justifications are sufficiently robust to answer the concerns and objections that various stakeholders may have. I am particularly concerned with the legitimacy these justifications have in the eyes of project beneficiaries. I argue that special responsibilities to certain communities can arise out of long‐term engagement with them, but that this type of priority needs to be constrained such that it does not exclude other potential beneficiaries to an undesirable extent. Finally, I suggest several new institutional mechanisms that would enhance the overall equity of decisions and so would ultimately contribute to the legitimacy of the organization as a whole. (shrink)

Big decisions in a person’s life often affect the preferences and standards of a good life which that person’s future self will develop after implementing her decision. This paper argues that in such cases the person might lack any reasons to choose one way rather than the other. Neither preference-based views nor happiness-based views of justified choice offer sufficient help here. The available options are not comparable in the relevant sense and there is no rational choice to make. (...) Thus, ironically, in many of a person’s most important decisions the idea of that person’s good seems to have no application. (shrink)

Many parents cite intimacy as one of their reasons for deciding to educate at home. It seems intuitively obvious that home education is conducive to intimacy because of the increased time families spend together. Yet what is not clear is whether intimacy can provide justification for one’s decision to home educate. To see whether this is so, we introduce the concept of ‘attentive parenting’, which encompasses a set of family characteristics, and we examine whether and under what conditions attentive parents (...) risk loss of intimacy by sending their children to school; or, alternatively, whether they can avoid this risk by educating children at home. What we will determine is whether families who exhibit the specified characteristics are prima facie justified in educating their children at home under the conditions of interest. We argue that, for attentive parents, home education not only promotes greater intimacy, but also provides insurance against the loss of intimacy that may occur under certain conditions when children attend schools. (shrink)

This article presents a fairness principle for evaluating decision-making based on predictions: a decision rule is unfair when the individuals directly impacted by the decisions who are equal with respect to the features that justify inequalities in outcomes do not have the same statistical prospects of being benefited or harmed by them, irrespective of their socially salient morally arbitrary traits. The principle can be used to evaluate prediction-based decision-making from the point of view of a wide range of antecedently (...) specified substantive views about justice in outcome distributions. (shrink)

In this paper, I develop and defend the ‘Justified Decision Perspective’ in answer to the question of when we should regret the things we have done. I claim that one should not regret a past decision one has made so long as it was justified in relation to the kind of person one was at the time of acting. On this time-indexing account, judging a decision to be justified – at least for the purposes of assessing one’s (...) regrets – is a matter of identifying the practical reasons that were epistemically available to the agent when she was deliberating about what to do. Accordingly, when responding to her regrets, an agent should not invoke reasons that existed but were epistemically unavailable to her when she was deliberating; or reasons that only came into existence after she acted. The JDP has important implications for prospective regret. In particular, it implies we should worry less about experiencing regret in the future than many of us do. Thus, my overall aim is to show that we often have reason to reject our regrets, which means that regret should play a less prominent and painful role in our lives than it does currently. (shrink)

Whether anorexic patients should be able to refuse treatment when this potentially has a fatal outcome is a vexed topic. A recent proposal for a new category of ‘terminal anorexia’ suggests criteria when a move to palliative care or even physician assisted suicide might be justified. I argue that this proposed diagnosis presents a false sense of certainty of the illness trajectory by conceptualizing anorexia in analogy with physical disorders and stressing the effects of starvation. Furthermore, this conceptualization is (...) in conflict with the claim that individuals who meet the diagnostic criteria for terminal anorexia have decision making capacity. It should therefore be rejected. (shrink)

We often show a greater inclination to assist and avoid harming people identified as those at high risk of great harm than to assist and avoid harming people who will suffer similar harm but are not identified (as yet). Call this the identified person bias. Some ethicists think such bias is justified; others disagree and claim that the bias is discriminatory against statistical people. While the issue is present in public policy and politics, perhaps the most notable examples can (...) be found in medical ethics such as in ICU triage decisions made during the COVID‐19 pandemic. The Rule of Rescue, as the application of the identified person bias is sometimes called, states that spending large amounts of resources rescuing identifiable individuals who are in imminent danger is justified. In this paper, I show that our distorted attitudes toward time play a role in identified person bias. I claim that ICU triage decisions are better explained by a preference to treat people sooner rather than later, which is at least partially due to near bias (positive events are to be preferred to be near rather than distant), than by a preference to treat identified lives over statistical lives. Thus, another bias, near bias, is involved in the reasoning behind the identified person bias and the Rule of Rescue. (shrink)

Most adult persons with anorexia satisfy the existing criteria widely used to assess decision-making capacity, meaning that incapacity typically cannot be used to justify coercive intervention. After rejecting two other approaches to justification, Professor Radden concludes that it is most likely not possible to justify coercive medical intervention for persons with anorexia in liberal terms, though she leaves it open whether some other framework might succeed. I shall assume here that the standard approach to assessing decisionmaking capacity is adequate.1 The (...) question then is whether we can justify—within a liberal framework—coercive intervention with the decision of a competent... (shrink)

Representation theorems are often taken to provide the foundations for decision theory. First, they are taken to characterize degrees of belief and utilities. Second, they are taken to justify two fundamental rules of rationality: that we should have probabilistic degrees of belief and that we should act as expected utility maximizers. We argue that representation theorems cannot serve either of these foundational purposes, and that recent attempts to defend the foundational importance of representation theorems are unsuccessful. As a result, we (...) should reject these claims, and lay the foundations of decision theory on firmer ground. (shrink)

A popular informal argument suggests that statistics about the preponderance of criminal involvement among particular demographic groups partially justify others in making defensive mistakes against members of the group. One could worry that evidence-relative accounts of moral rights vindicate this argument. After constructing the strongest form of this objection, I offer several replies: most demographic statistics face an unmet challenge from reference class problems, even those that meet it fail to ground non-negligible conditional probabilities, even if they did, they introduce (...) new costs likely to cancel out any justificatory contribution of the statistic, but even if they didn’t, demographic facts are the wrong sort to make a moral difference to agents’ negative rights. I conclude that the popular argument should be rejected, and evidence-relative theories do not have the worrisome implication. (shrink)

Moral latitude is only ever a matter of coincidence on the most popular decision procedure in the literature on moral uncertainty. In all possible choice situations other than those in which two or more options happen to be tied for maximal expected choiceworthiness, Maximize Expected Choiceworthiness implies that only one possible option is uniquely appropriate. A better theory of appropriateness would be more sensitive to the decision maker’s credence in theories that endorse agent-centred prerogatives. In this paper, we will develop (...) and defend a modified version of this view that allows for agent-centred prerogatives and supererogation as part of its verdicts about appropriateness. (shrink)

Imagine a group that faces a decision problem but does not agree on which decision procedure is appropriate. In that case, can a decision be reached that respects the procedural concerns of the group? There is a sense in which legitimate decisions are possible even if people disagree on which procedure to use. I propose to decide in favour of an option which maximizes the number of persons whose judged-right procedure happens to entail this decision given the profile. This (...) decision rule is based not only ona profile in the standard sense, but in addition on a profile of judged-right procedures. To justify this decision rule, I present a set of simple axioms leading to it as the only solution. (shrink)

I argue that contemporary liberal theory cannot give a general justification for the institution or practice of punishment, i.e., a justification that would hold across a broad range of reasonably realistic conditions. I examine the general justifications offered by three prominent contemporary liberal theorists and show how their justifications fail in light of the possibility of an alternative to punishment. I argue that, because of their common commitments regarding the nature of justification, these theorists have decisive reasons to reject punishment (...) in favor of a non-punitive alternative. I demonstrate the possibility of this alternative by means of a careful examination of the nature of punishment, isolating one essential characteristic—the aim to impose suffering—and showing how this characteristic need not guide enforcement. There is logical space for a forceful and coercive, yet non-punitive method of enforcement. This fact poses difficulties for many classical and contemporary justifications of punishment, but it poses particularly crippling problems for general liberal justifications. (shrink)

In this topical section, we highlight the next step of research on modeling aiming to contribute to the emerging literature that radically refrains from approaching modeling as a scientific endeavor. Modeling surpasses “doing science” because it is frequently incorporated into decision-making processes in politics and management, i.e., areas which are not solely epistemically oriented. We do not refer to the production of models in academia for abstract or imaginary applications in practical fields, but instead highlight the real entwinement of science (...) and policy and the real erosion of their boundaries. Models in decision making – due to their strong entwinement with policy and management – are utilized differently than models in science; they are employed for different purposes and with different constraints. We claim that “being a part of decision-making” implies that models are elements of a very particular situation, in which knowledge about the present and the future is limited but dependence of decisions on the future is distinct. Emphasis on the future indicates that decisions are made about actions that have severe and lasting consequences. In these specific situations, models enable not only the acquisition of knowledge (the primary goal of science) but also enable deciding upon actions that change the course of events. As a result, there are specific ways to construct effective models and justify their results. Although some studies have explored this topic, our understanding of how models contribute to decision making outside of science remains fragmentary. This topical section aims to fill this gap in research and formulate an agenda for additional and more systematic investigations in the field. (shrink)

This is a defense of Rawls against recent criticism, ironically my own, though it is also a critique insofar as it addresses a problem that Rawls never does. As a defense, it is not a retraction of the original charges. As a critique, it is not more of the same op-position. In either capacity, it is not an afterthought. The charges were conceived from the outset with a specific solution in mind, which would have been too distracting to pursue in (...) the same article. This is that solution. It also highlights the problem. The original charges were that Rawls’s decision procedure for ethics does not justify his own moral principles, namely his principles of justice, and that the underlying problem may well keep the decision procedure from justifying any moral principles whatsoever, or at least any normatively useful ones. The underlying problem was, and still is, the model’s inherent universalism, which is built into the decision procedure through design specifications precluding relativism, yet only at the cost of limiting the relevant moral principles to generalities that are already widely accepted, thereby render-ing the procedure at best redundant and very likely vacuous as an ethical justification model. These difficulties are manifested in the work of Rawls as the dogmatism of champi-oning a distinctive conception of justice, a liberal one as he himself calls it, through a justification model that is too universalistic to permit such a bias and possibly also too universalistic to permit any substantive conclusions at all. The solution contemplated here is to position the decision procedure as a dynamic justification model responsive to moral progress, as opposed to a static one indifferent to such progress and equally open to all moral input, thus removing the inconsistency between the universalistic design and any distinctive or controversial principles, including the ones Rawls himself recommends, so long as they are consistent with moral progress. (shrink)

Condorcet's famous jury theorem reaches an optimistic conclusion on the correctness of majority decisions, based on two controversial premises about voters: they are competent and vote independently, in a technical sense. I carefully analyse these premises and show that: whether a premise is justi…ed depends on the notion of probability considered; none of the notions renders both premises simultaneously justi…ed. Under the perhaps most interesting notions, the independence assumption should be weakened.

Immanuel Kant’s theory of justifiable resistance to authority is complex and, at times, appears to conflict with his own practice, if not with itself. He distinguishes between the role of authority in “public” and “private” contexts. In private—e.g., when a person is under contract to do a specific job or accepts a social contract with one’s government—resistance is forbidden; external behavior must be governed by policy or law. In contexts involving the public use of reason, on the other hand—e.g., when (...) a person is faced with a moral decision or is engaged in a philosophical dispute—the freedom of conscience sometimes requires resistance, especially in cases where other persons inappropriately attempt to usurp authority over matters that are rightfully up to the individual to decide. In texts such as Perpetual Peace, Kant looks forward to a political situation wherein no political resistance (e.g., in the form of war) would be necessary. Yet in Metaphysics of Morals, he argues that a citizen never has the right to revolt against one’s government, suggesting we must cooperate even with war. On a personal level, Kant openly praised both the American and the French revolutions; yet when his own writings on religion were deemed by the censor to have come into conflict with the king’s edict, Kant failed to resist the (arguably unjust) authority; instead, he gave up his (apparently public) right to free philosophical expression, promising never to write or speak on religion again during the king’s reign. I shall argue that a key to resolving these tensions lies in the principle that universities must promote a healthy, public “conflict” between philosophers and all “private” employments of reason. The only ground for disallowing private resistance, therefore, is the underlying presence of genuine philosophical resistance. (shrink)

Looks into evaluation of information provision probability from different sources, based on use of linguistic variables. Formation of functions appurtenant for its unclear variables provides for adoption of decisions by the decision maker, in conditions of nonprobabilistic equivocation. The development of market relations in Ukraine increases the independence and responsibility of enterprises in justifying and making management decisions that ensure their effective, competitive activities. As a result of the analysis, it is determined that the condition of economic facilities (...) can be described and determined by the decision-maker, in the presence of the necessary information. The confidence of the decision-maker in the information received is different and the decisions made have a correspondingly different level of information risk. It is important to substantiate the procedure for assessing the numerical extent of information risk in decision-making based on the information obtained in conditions of uncertainty. The use of a linguistic variable in the processing of expert data presented in the form of a matrix of binary relations of values of the membership function, which allowed to move to further processing of knowledge to support decision-making in the management of industrial, commercial, financial and other activities. As a mathematical model for estimating the numerical measure of information risk when making decisions based on the information obtained in conditions of non-stochastic uncertainty, a model has been developed to model natural language uncertainties, which differs from existing ones by formalizing knowledge taking into account uncertainty of input information. Making such a clear decision in a fuzzy environment has appropriate values of effectiveness and risk. The paper proposes all the functions and accessories of indicators of both quantitative nature and qualitative nature to bring their values in the field of definition to one scale. Then the indicator of the effectiveness of decision-making will be a measure of the clarity of the cross-section of fuzzy subsets, which correspond to the introduced indicators of information risk. The condition of economic facilities can be described and determined by the decision-maker, if the necessary information is available. Decision-making on thenumerical measure of information risk must be determined by a set of basic indicators, which can be both quantitative and qualitative in nature. Predictive values of indicators should be determined in conditions of nonstochastic uncertainty. In this case, the indicators of a quantitative nature can be determined by fuzzy triangular numbers, which implement a high level of confidence in the subjective judgments of experts. Indicators of qualitative nature should be presented in linguistic variables. The values of the indicators of qualitative nature that are predicted must be considered for all fuzzy variable terms-sets of linguistic variables introduced into consideration. For any fuzzy variable, the introduction to the consideration of a clear set of values as carriers of the α-level of its membership function allows to reduce to a single interpretation of the predicted values of indicators of quantitative and qualitative nature in terms of non-stochastic uncertainty. (shrink)

Disorders of consciousness include coma, the vegetative state and the minimally conscious state. Such patients are often regarded as unconscious. This has consequences for end of life decisions for these patients: it is much easier to justify withdrawing life support for unconscious than conscious patients. Recent brain imaging research has however suggested that some patients may in fact be conscious.

John Rawls is famous for two things: his attempt to ground morality in rationality and his conception of justice as fairness. He has developed and polished both in conjunction over the course of half a century. Yet the moral principles he advocates have always been more doctrinaire than the corresponding justification model should have ever allowed with design details explicitly promising objectivity. This article goes to the beginning, or to a reasonable proxy for it, in the “Outline of a Decision (...) Procedure for Ethics,” with the aim of exposing and examining the discrepancy where it originates. The goal is not to prey on the earliest version of an initiative later undergoing revision but to identify and investigate the inception of a systematic bias that is retained rather than revised in subsequent iterations. (shrink)

In his recent book Is a Good God Logically Possible? and article by the same name, James Sterba argued that the existence of significant and horrendous evils, both moral and natural, is incompatible with the existence of God. He advances the discussion by invoking three moral requirements and by creating an analogy with how the just state would address such evils, while protecting significant freedoms and rights to which all are entitled. I respond that his argument has important ambiguities and (...) that consistent application of his moral principles will require that God remove all moral and natural evils. This would deleteriously restrict not only human moral decision making, but also the knowledge necessary to make moral judgments. He replies to this critique by appealing to the possibility of limited divine intervention, to which I rejoin with reasons why his middle ground is not viable. (shrink)

This essay discusses implications of incommensurability of values for justified decision-making, ethics and justice. Under particular conditions incommensurability of values causes what might be called ‘incomplete comparability’ of options. Some leading theorists interpret this in terms of ‘imprecise equality’ and ‘imprecise comparability.’ This interpretation is mistaken and conceals the implications of incommensurability for practical and ethical reasoning. The aim of this essay is to show that, in many cases, incommensurability prevents the assignment of determinate weights to competing values. This (...) may have problematic consequences for a complete and impartial justification of decisions concerning conflicting values to the extent that they depend on the need of weighing them. (shrink)

In the United States, the Presidential Commission for the Study of Bioethical Issues has proposed deliberative democracy as an approach for dealing with ethical issues surrounding synthetic biology. Deliberative democracy might similarly help us as we update the regulation of human subjects research. This paper considers how the values that deliberative democratic engagement aims to realize can be realized in a human subjects research context. Deliberative democracy is characterized by an ongoing exchange of ideas between participants, and an effort to (...) justify decisions that bind participants by appeal to reasons that the participants can understand and share. Even when unanimous agreement is not reached, the active participation of everyone along with the requirement that reasons be made accessible enhances the legitimacy of the ultimate outcome. Importantly, deliberative democratic structures avoid strict hierarchies and place participants, as much as possible, in the position of equals. Human subjects research has some features that may make deliberative democratic principles seem initially unappealing. For one, there are asymmetries in knowledge between expert researchers conducting the research and participants in the research process. For another, statistical validity is made easiest by research paradigms that produce standardized, quantitative data, which can be difficult to achieve if research participants are given the power to deliberatively reshape the research design as it progresses. These and other problems have tended to produce a human subjects research process where subjects do not actively participate in shaping research, but rather consent to a predefined set of interventions designed by expert researchers and vetted by Institutional Review Boards (IRBs). In this paper, I suggest some ways in which human subjects research could do more to realize deliberative democratic values, and, in particular, how a revised Common Rule might help to realize these values. First, research participants could be treated not as passive subjects but instead involved in research design, ethical review, and the ongoing conduct and dissemination of research. Such participation might involve, for instance, including people who have served as research subjects on IRBs, or replacing IRB oversight for certain forms of research exempted from IRB oversight under a revised Common Rule with oversight by a body of community members or research subjects. It might also involve having the oversight of research that uses more participatory models be more participatory and less hierarchical in nature. I also raise questions about the exemption of research on public benefit programs from any research-level oversight and from consent requirements. While IRBs are likely not the correct overseers, there may be good reason to view such research with a critical eye, because of its potential for long-range impacts on the lives of participants. By giving research subjects a greater voice in research that aims at fine-tuning public benefit programs on which subjects rely, a deliberative oversight process has the potential to recast research participation as a form of active democratic participation and to address a “democratic deficit” in public health. Numerous proposals regarding health care have called for greater participation by laypeople and a more nonhierarchical approach to setting health priorities. Involving lay research subjects in the conduct of public benefits research and other forms of public health research may help to further these goals. (shrink)

Various decision theories share a troubling implication. They imply that, for any finite amount of value, it would be better to wager it all for a vanishingly small probability of some greater value. Counterintuitive as it might be, this _fanaticism_ has seemingly compelling independent arguments in its favour. In this paper, I consider perhaps the most _prima facie_ compelling such argument: an _Egyptology argument_ (an analogue of the Egyptology argument from population ethics). I show that, despite recent objections from Russell (...) (Noûs, 2023) and Goodsell (Analysis 81(3):420–426, 2021), the argument’s premises can be justified and defended, and the argument itself remains compelling. (shrink)

Scientists have the ability to influence policy in important ways through how they present their results. Surprisingly, existing codes of scientific ethics have little to say about such choices. I propose that we can arrive at a set of ethical guidelines to govern scientists’ presentation of information to policymakers by looking to bioethics: roughly, just as a clinician should aim to promote informed decision-making by patients, a scientist should aim to promote informed decision-making by policymakers. Though this may sound like (...) a natural proposal, I show it offers guidance that conflicts with standard scientific practices. I conclude by considering one cost of the proposal: that it would prevent scientists from acting as advocates in a way that is currently common in certain fields. I accept that the proposal would restrict scientists’ political advocacy rights, but argue that the benefits of adopting it — promoting democratic governance — justify the restriction. (shrink)

In decision-making based on multiple criteria, situations may arise where agents find their options to be neither better than, worse than nor equal to each other with respect to the relevant criteria. How, if at all, can a justified choice be made between such options? Are the options incomparable? This article explores a hypothetical case that illustrates how such a situation can arise in an environmental context; more specifically, it considers the deliberations of an imagined 'ethics committee' as it (...) struggles to decide whether or not a deep-sea mining project should be allowed to proceed. I argue that the case is best understood as involving options that are comparable in the sense of being 'on a par'. Working out from a discussion of Ruth Chang's 'self-governance' theory of choice in cases of parity, I suggest that, in the environmental context, the idea of choices expressing a moral identity may lead us in the direction of a plausible solution to these particularly challenging cases. (shrink)

Moral dilemmas can arise from uncertainty, including uncertainty of the real values involved. One interesting example of this is that of experimentation on human embryos and foetuses, If these have a moral stauts similar to that of human persons then there will be server constraitns on what may be done to them. If embryous have a moral status similar to that of other small clusters of cells, then constraints will be motivated largely by consideration for the persons into whom the (...) embryos may develop. If the truth lies somewhere between these two extremes, the embryo having neither the full moral weight of persons, nor a completely negligible moral weight, then different kinds of constraints will be appropriate. On the face of it, in order to know what kinds of experiements, if any, we are morally justified in performing on embryos we have to know what the moral weight of the embryo is. But then an impasse threatens, for it seems implausible that we can settle with certainty the exact moral status of the human embryo. It is the purpose of this paper to show that moral uncertainty need not make rational moral justification impossible. I develop a framework which distinguishes between what is morally right/wrong, and what is morally justified/unjustified, and applies standard decision theoretic tools to the case of moral uncertainties. (This was the first published account of what has subsequently become known as Expected Moral Value Theory. An earlier version of the paper, "A decision theoretic argument against human embryo experimentation", was published in M. Fricke (ed.), Essays in honor of Bob Durrant. (University of Otago Press, 1986) 111-27.). (shrink)

Respect for autonomy is a central moral principle in bioethics. It is sometimes argued that authenticity, i.e., being “real,” “genuine,” “true to oneself,” or similar, is crucial to a person’s autonomy. Patients sometimes make what appears to be inauthentic decisions, such as when anorexia nervosa patients refuse treatment to avoid gaining weight, despite that the risk of harm is very high. If such decisions are inauthentic, and therefore non-autonomous, it may be the case they should be overridden for (...) paternalist reasons. However, it is not clear what justifies the judgment that someone or something is inauthentic. This article discusses one recent theory of what justifies judgments of inauthenticity. It is argued that the theory is seriously limited, as it only provides guidance in three out of nine identified cases. There are at least six authenticity-related problems to be solved, and autonomy theorists thus have reason to engage with the topic of authenticity in practical biomedicine. (shrink)

Deception, like coercion, can invalidate the moral force of consent. In the sexual domain, when someone is deceived about some feature of their partner, knowledge of which would be dispositive of their decision to have sex – a dealbreaker – the moral validity of their consent is undermined. I argue that in order to determine whether someone has discharged their duties of disclosure in the sexual domain, we should ask whether, upon receiving a token of consent to sex, they have (...) a justified belief that their partner would consent to the sexual encounter given all the features that it has. I argue that whether an agent has a justified belief in this proposition is a function of the agent’s body of evidence and which alternatives uneliminated. (shrink)

The article, first, reconstructs and criticizes Sandro Nannini’s incompatibilistic concept of freedom of decision and, second, develops a compatibilistic alternative, a synthesis of a rationalistic and an autonomous approach. Nannini justifies his conception primarily from a naturalistic point of view: it reflects our sense of agency, so he says. This is criticized as empirically wrong and methodically mistaken: The theory of freedom of decision is, actually, normative; it is about good decisions; naturalism cannot establish normative claims. The alternative is (...) based, methodically, on an idealizing hermeneutics, which tries to reconstruct the point of free decisions, and then justifies the resulting concept practically: Free decisions, conceived in this way, realize optimally our autonomous desires. (shrink)

The article, first, reconstructs and criticizes Sandro Nannini’s incompatibilistic concept of freedom of decision and, second, develops a compatibilistic alternative, a synthesis of a rationalistic and an autonomous approach. Nannini justifies his conception primarily from a naturalistic point of view: it reflects our sense of agency, so he says. This is criticized as empirically wrong and methodically mistaken: The theory of freedom of decision is, actually, normative; it is about good decisions; naturalism cannot establish normative claims. The alternative is (...) based, methodically, on an idealizing hermeneutics, which tries to reconstruct the point of free decisions, and then justifies the resulting concept practically: Free decisions, conceived in this way, realize optimally our autonomous desires. (shrink)

Qu’est-ce qui justifie des normes comme « Tu ne tueras point » ou «Nul ne peut être soumis à la torture »? -/- C’est autour de cette question fondamentale que se sont constituées les trois grandes théories morales : l’éthique des vertus (inspirée d’Aristote), l’éthique des devoirs (mise en forme par Kant) et l’éthique des conséquences (matrice de l’utilitarisme). Qu’est-ce qui distingue ces trois approches ? Y a-t-il des raisons décisives d’en préférer une ? -/- Dans ce livre, Ruwen Ogien (...) et Christine Tappolet montrent que, pour trancher ce débat, il faut clarifier les deux concepts-clés de l’éthique et analyser leurs relations : les normes (qui posent des obligations, des interdictions, des permissions) et les valeurs (qui disent ce qui est bien ou désirable). -/- Ils proposent une hypothèse simple, mais iconoclaste : si pour justifier les normes, il faut nécessairement faire appel à des valeurs, c’est que, contre Kant et Aristote, il faut être conséquentialiste. (shrink)

The aim of this doctoral thesis is to bridge the gap between theoretical ideals of authenticity and practical authenticity-related problems in healthcare. In this context, authenticity means being "genuine," "real," "true to oneself," or similar, and is assumed to be closely connected to the autonomy of persons. The thesis includes an introduction and four articles related to authenticity. The first article collects various theories intended to explain the distinction between authenticity and inauthenticity in a taxonomy that enables oversight and analysis. (...) It is argued that (in-)authenticity is difficult to observe in others. The second article offers a solution to this difficulty in one theory of authenticity. It is proposed that under certain circumstances, it is morally justified to judge that the desires underlying a person's decisions are inauthentic. The third article incorporates this proposition into an already established theory of personal autonomy. It is argued that the resulting conceptualization of autonomy is fruitful for action-guidance in authenticity-related problems in healthcare. The fourth article collects nine cases of possible authenticity-related problems in healthcare. The theory developed in the third article is applied to the problems, when this is allowed by the case-description, to provide guidance with regard to them. It is argued that there is not one universal authenticity-related problem but many different problems, and that there is thus likely not one universal solution to such problems but various particular solutions. (shrink)

This chapter explores the idea that phylogenetic diversity plays a unique role in underpinning conservation endeavour. The conservation of biodiversity is suffering from a rapid, unguided proliferation of metrics. Confusion is caused by the wide variety of contexts in which we make use of the idea of biodiversity. Characterisations of biodiversity range from all-variety-at-all-levels down to variety with respect to single variables relevant to very specific conservation contexts. Accepting biodiversity as the sum of a large number of individual measures results (...) in an empirically intractable framework. However, large-scale decisions cannot be based on biodiversity variables inferred from local conservation imperatives because the variables relevant to the many systems being compared would be incommensurate with one another. We therefore need some general conception of biodiversity that would make tractable such large-scale environmental decision-marking. We categorise the large array of strategies for the measurement of biodiversity into four broad groups for consideration as general measures of biodiversity. We compare common moral justifications for the conservation of biodiversity and conclude that some form of instrumental value is the most plausible justification for biodiversity conservation. Although this is often interpreted as a reliance on option value, we opt for a broadly consequentialist characterisation of biodiversity conservation. We conclude that the best justified general measure of biodiversity will be some form of phylogenetic diversity. (shrink)

Many have claimed that epistemic rationality sometimes requires us to have imprecise credal states (i.e. credal states representable only by sets of credence functions) rather than precise ones (i.e. credal states representable by single credence functions). Some writers have recently argued that this claim conflicts with accuracy-centered epistemology, i.e., the project of justifying epistemic norms by appealing solely to the overall accuracy of the doxastic states they recommend. But these arguments are far from decisive. In this essay, we prove some (...) new results, which show that there is little hope for reconciling the rationality of credal imprecision with accuracy-centered epistemology. (shrink)

The United States may justifiably exclude unvaccinated aliens, perhaps even under the assumption of Open Borders, according to which people should generally be permitted to settle in countries of their choosing. Furthermore, there are good reasons to endorse the Centers for Disease Control and Prevention’s (CDC’s) current vaccination-related exclusion criteria, which were last revised in 2009. I frame my discussion around CDC’s 2008 decision to permit immigrant girls and women to be excluded if they were not vaccinated against human papillomavirus (...) (HPV)—a decision that was quickly reversed and that led to the 2009 revisions to CDC’s vaccination-related immigrant exclusion criteria. (shrink)

Davis called for “extreme caution” in the use of non-invasive brain stimulation to treat neurological disorders in children, due to gaps in scientific knowledge. We are sympathetic to his position. However, we must also address the ethical implications of applying this technology to minors. Compensatory trade-offs associated with NIBS present a challenge to its use in children, insofar as these trade-offs have the effect of limiting the child’s future options. The distinction between treatment and enhancement has some normative force here. (...) As the intervention moves away from being a treatment toward being an enhancement—and thus toward a more uncertain weighing of the benefits, risks, and costs—considerations of the child’s best interests diminish, and the need to protect the child’s autonomy looms larger. NIBS for enhancement involving trade-offs should therefore be delayed, if possible, until the child reaches a state of maturity and can make an informed, personal decision. NIBS for treatment, by contrast, is permissible insofar as it can be shown to be at least as safe and effective as currently approved treatments, which are themselves justified on a best interests standard. (shrink)

This essay argues, through conceptual analysis, against an objection to reproaches addressed to financiers after the Crisis of 2007-8: the idea that they could not have acted otherwise (at least, not rationally) and that no one should be blamed for a fact one could not have avoided. If correct, this would threaten the justifiability of corporate social responsibility and legal responsibility of directors. Identified as the “thesis of inevitability”, this objection is illustrated by an analysis of the film Margin Call (...) (2011) and associated with other investigations on ethics and responsibility. This target-thesis follows from a confusion between different notions of responsibility (for an assignment, for a judgment, and causal and liability responsibility) and leads to an inconsistent form of fatalism. It is suggested, finally, that invoking the “inevitability” can be a way to rationalize the decision, obscuring reasons against it. (shrink)

Criminal courts make decisions that can remove the liberty and even life of those accused. Civil trials can cause the bankruptcy of companies employing thousands of people, asylum seekers being deported, or children being placed into state care. Selecting the right standards when deciding legal cases is of utmost importance in giving those affected a fair deal. This Element is an introduction to the philosophy of legal proof. It is organised around five questions. First, it introduces the standards of (...) proof and considers what justifies them. Second, it discusses whether we should use different standards in different cases. Third, it asks whether trials should end only in binary outcomes (e.g. guilty or not guilty) or rather use more fine-grained or precise verdicts. Fourth, it considers whether proof is simply about probability, concentrating on the famous 'Proof Paradox'. Finally, it examines who should be trusted with deciding trials, focusing on the jury system. (shrink)

Standard theories of rational decision making and rational preference embrace the idea that there is something special about the present. Standard decision theory, for example, demands that agents privilege the perspective of the present (i.e., the time of decision) in evaluating what to do. When forming preferences, most philosophers believe that a similar focus on the present is justified, at least in the sense that rationality requires or permits future experiences to be given more weight than past ones. In (...) this dissertation, I examine such theories in light of the expected success of the agents who follow them. In Chapters 2 and 3, I show that this bias toward the present is a liability: it tends to make agents less successful than they might otherwise be. I also show how these problems can be avoided: In the case of rational decision making, we must privilege the beginning rather than the present (what I call “inceptive maximization”). In the case of rational preferences, we must be completely temporally neutral. -/- In chapters 4 and 5 I introduce a larger framework in which to interpret these results. My core thesis is that practical rationality is a form of conditional reliability. Practically rational decisions, preferences, intentions, or other relevant factors reliably produce whatever we take to be of value, conditional on an agent’s beliefs. This focus on value-conduciveness is thus the analog of the focus on truth-conduciveness in reliability theories of epistemic norms. Like reliabilism in epistemology, I show that practical reliabilism is supported by a methodologically naturalistic approach to normativity. In this way and others, I argue that epistemic and practical reliabilism interconnect to create an overarching theory of normativity. (shrink)