So called “shapes of opposition”—like the classical square of opposition and its extensions—can be seen as graphical representations of the ways in which types of statements constrain each other in their possible truth values. As such, they can be used as a novel way of analysing the subject matter of disputes. While there have been great refinements and extensions of this logico-topological tool in the last years, the broad range of shapes of opposition are not widely known outside of a (...) circle of specialists. This ignorance may lead to the presumption that the classical square of opposition fits all disputes. A broader view, which takes expanded shapes of opposition into account, may come to a more nuanced appraisal of possible disputes. Once we take other shapes of opposition into account, some alleged disputes may turn out to be Scheindisputes. In order to do the wide range of linguistic expressions justice and to differentiate Scheindisputes from real ones, a broader view is advised. To illustrate this point, I discuss the notion of “introspective disputes”. These are commonly reconstructed as obeying the square, but are more aptly reconstructed with a more complex octagon. If we reconstruct these disputes based on Buridan’s octagon, it becomes obvious that “introspective disputes” are likely Scheindisputes. (shrink)

How to model non-egoic experiences – mental events with phenomenal aspects that lack a felt self – has become an interesting research question. The main source of evidence for the existence of such non-egoic experiences are self-ascriptions of non-egoic experiences. In these, a person says about herself that she underwent an episode where she was conscious but lacked a feeling of self. Some interpret these as accurate reports, but this is questionable. Thomas Metzinger, Rocco Gennaro, and Charles Foster have hinted (...) at the self-defeating nature of such statements if we take them to be genuine reports: Apparently, the reporter explicitly denies her existence during the selfless experience, but implicitly affirms her existence as a witness to that selfless experience in order to give a first-person report about it. So the content of such a report conflicts with the pragmatics of reporting. If all self-ascriptions of non-egoic experiences are self-defeating in this way, then they cannot count as evidence for the existence of non-egoic experiences. Here, I map out why such strong conclusions do not directly follow: What look like self-ascriptions of non-egoic experiences may occur for a number of reasons. Only some explanations for such utterances rely on a change in consciousness. Of those that do rely on a change in consciousness, only one is incoherent. But its alternatives do not lead to contradictions. I argue that the most likely change in phenomenality that leads to self-ascriptions of non-egoic experiences is not one where a felt self disappears, but where it expands. (shrink)

A main goal of the neuroscience of consciousness is: find the neural correlate to conscious experiences (NCC). When have we achieved this goal? The answer depends on our operationalization of “NCC.” Chalmers (2000) shaped the widely accepted operationalization according to which an NCC is a neural system with a state which is minimally sufficient (but not necessary) for an experience. A deeper look at this operationalization reveals why it might be unsatisfactory: (i) it is not an operationalization of a correlate (...) for occurring experiences, but of the capacity to experience; (ii) it is unhelpful for certain cases which are used to motivate a search for neural correlates of consciousness; (iii) it does not mirror the usage of “NCC” by scientists who seek for unique correlates; (iv) it hardly allows for a form of comparative testing of hypotheses, namely experimenta crucis. Because of these problems (i–iv), we ought to amend or improve on Chalmers's operationalization. Here, I present an alternative which avoids these problems. This “NCC2.0” also retains some benefits of Chalmers's operationalization, namely being compatible with contributions from extended, embedded, enacted, or embodied accounts (4E-accounts) and allowing for the possibility of non-biological or artificial experiencers. (shrink)

Chris Letheby argues in Philosophy of Psychedelics that psychedelics and knowledge are compatible. Psychedelics may cause new mental states, some of which can be states of knowledge. But the influence of psychedelics is largely psychological, and not all psychological processes are epistemic. So I want to build on the distinction between processes of discovery and processes of justification to criticise some aspects of Letheby’s epistemology of psychedelics. Unarguably, psychedelics can elicit processes of discovery. Yet, I hold, they can hardly contribute (...) either to the epistemic success of a mental state or to processes of justification. As these are central for a mental state to be a state of knowledge and are largely uninfluenced by psychedelics, the contributions of psychedelics to knowledge are rather indirect than direct: The heavy epistemic lifting—what turns a mental state into a state of knowledge—is, in its epistemic aspects, independent of any influence of psychedelics on our psyche. Positively, while the mechanisms that Letheby points to need not be associated with knowledge, they do provide crucial epistemic benefits if they are associated with understanding. Reading them as facilitating understanding covers also those cases where truth or justification is missing and thereby provides a broader picture of the epistemic contributions of psychedelics. (shrink)

Ground Representationism is the position that for each phenomenal feature there is a representational feature that accounts for it. Against this thesis, Ned Block (The Puzzle of Phenomenal Precision, 2015) has provided an intricate argument that rests on the notion of “phenomenal precision”: the phenomenal precision of a percept may change at a different rate from its representational counterpart. If so, there is then no representational feature that accounts for a specific change of this phenomenal feature. Therefore, Ground Representationism cannot (...) be generally true. -/- Although the notion of phenomenal precision is intuitive, it is admittedly in need of clarification. Here I reconstruct Block’s argument by suggesting a way of estimating phenomenal precision that is based on the assumption that parts of perceptual wholes can share phenomenal features independently of their place in the whole. Understood like this, the overall argument shows what it is supposed to show. -/- A more thorough look at the notion of phenomenal precision suggests tension with Block’s other work: in order to be non-trivial, we have to accept that some of our phenomenality is not concrete, but only generic. Such “solely generic phenomenology”, however, is a position mainly held by opponents to Block’s Access- vs. Phenomenal Consciousness-distinction. Interpreting phenomenal imprecision as constituted by introspective imprecision does not suffice as a way out. It seems that phenomenal precision is either trivial, self-contradictory, or incompatible with Block’s position elsewhere. So some additional elucidation on this crucial notion is needed. (shrink)

Sceptics vis-à-vis introspection often base their scepticism on ‘phenomenological disputes’, ‘introspective disagreement’, or ‘introspective disputes’ (Kriegel, 2007; Bayne and Spener, 2010; Schwitzgebel, 2011): introspectors massively diverge in their opinions about experiences, and there seems to be no method to resolve these issues. Sceptics take this to show that introspection lacks any epistemic merit. Here, I provide a list of paradigmatic examples, distill necessary and sufficient conditions for IDs, present the sceptical argument encouraged by IDs, and review the two main strategies (...) to reject such a scepticism. However, both types of strategies are unsatisfactory. In order to save introspection from the looming sceptical threat, I advocate a deflationary strategy, based on either an ‘Argument from Perceptual Kinship’ or an ‘Argument from Ownership’. In the end, there cannot be any genuine IDs, for nothing can fulfil the reasonable conditions for IDs. What looks like IDs may instead be indicators of phenomenal variation. Debates that look like IDs may then arise even if introspection were a perfect method to know one’s mind. Thus, scepticism vis-à-vis introspection based on IDs rests on shaky grounds. (shrink)

Thomas Metzinger has diagnosed the need for a Bewusstseinskultur, a ‘consciousness culture’: a culturally implemented way in which a society as a whole engages with the dawning natural science of consciousness, with phenomenal experiences themselves, and with our increasing capability to manipulate them. A Bewusstseinskultur is an achievement, built by a society-wide orientation on empirical evidence, thorough scientific theorizing and rational deliberation. It affects a broad range of issues from animal ethics, drug policy, end-of-life-care, and robo-ethics to post-humanism. However, this (...) notion has not yet been presented in English, and is so far unconnected to other discussions in philosophy. Here, I remedy this: I present Metzinger's notion of a Bewusstseinskultur and connect it to discussion on transformative experiences, Parfit's meta-hedonic states, and the Access vs. Phenomenal Consciousness distinction. (shrink)

At least two distinct modeling frameworks contribute to the view that mind and brain are Bayesian: Bayesian Rational Analysis (BRA) and Hierarchical Predictive Coding (HPC). What is the relative contribution of each, and how exactly do they relate? In order to answer this question, we compare the way in which these two modeling frameworks address different levels of analysis within Marr’s tripartite conception of explanation in cognitive science. Whereas BRA answers questions at the computational level only, many HPC-theorists answer questions (...) at the computational, algorithmic, and implementational levels simultaneously. Given that all three levels of analysis need to be addressed in order to explain a behavioral or cognitive phenomenon, HPC seems to deliver more complete explanations. Nevertheless, BRA is well-suited for providing a solution to the dark room problem, a major theoretical obstacle for HPC. A combination of the two approaches also combines the benefits of an embodied-externalistic approach to resolving the dark room problem with the idea of a persisting evidentiary border beyond which matters are out of cognitive reach. For this reason, the development of explanations spanning all three Marrian levels within the general Bayesian approach may require combining the BRA and HPC modeling frameworks. (shrink)

This special issue focuses on the Philosophy of Psychedelics by Chris Letheby in the form of a book symposium. Introduced by Matthew Johnson, Letheby presents the main claims of this book that explores the apparent conflict between psychedelic therapy and naturalism in a préci​s.​​ Seven contributions criticize, expand or comment on Letheby's arguments, focusing either on his proposed mechanism for psychedelic therapy or on the epistemic implications. The symposium concludes with Letheby’s replies to these commentaries.

This symposium focuses on Thinking and Perceiving by Dustin Stokes (2021), published by Routledge. In his précis, Stokes (2023a) provides an overview of the key arguments of his book, which lead to a new descriptive and normative account of the relationship between cognition and perception. Four commentaries examine the scope and implications of this account. Zoe Drayson (2023) and Christopher Mole (2023) examine the epistemological force of Stokes’s claims about the organisation of the human mind. Furthermore, the implications of philosophical (...) and empirical research on object recognition are discussed by Aleksandra Mroczko-Wasowicz (2023) and on perceptual learning by Zed Adams (2023). The symposium concludes with a reply by Stokes to these commentaries (Stokes, 2023b). (shrink)

Unter einigenWissenschaftlern ist die Vorstellung verbreitet, dass Paradoxien Anzeichen von Fortschritt sein können. Es ist jedoch unklar, wie dies zu deuten ist. Dieser Essay stellt ein subjekt-relatives Verständnis von Paradoxikalität vor, das Paradoxien als »Dissonanzen der Zustimmung« (Rescher 2001) charakterisiert und dadurch erlaubt, sie als Katalysator wissenschaftlichen Fortschritts zu rekonstruieren: Durch ihre Struktur haben Problemstellungen in Form von Paradoxien wenigstens fünf fortschrittsfördernde Eigenschaften, die sie Problemstellungen in Form von Fragen voraushaben. Dadurch können Paradoxien als Angelpunkte theoretischen Fortschritts gesehen werden. Dies (...) legt eine Forderung nahe: Wenn wir theoretischen Fortschritt in den Wissenschaften fördern wollen, so sollten wir den Bau von Paradoxien aktiv verfolgen, gemäß dem Credo: Progress by Paradox! (shrink)

In recent years, the science and the philosophy of consciousness has seen growing interest in structural questions about consciousness. This is the Editorial Introduction for a special volume for Philosophy and the Mind Sciences on “Structuralism in Consciousness Studies.”.

There is tension between commonly held views concerning phenomenal imagery on the one hand and our first-person epistemic access to it on the other. This tension is evident in many individual issues and experiments in philosophy and psychology (e.g. inattentional and change blindness, the speckled hen, dream coloration, visual periphery). To dissolve it, we can give up either (i) that we lack full introspective access to the phenomenal properties of our imagistic experiences, or (ii) that phenomenal imagery is fully determined, (...) or (iii) that phenomenal imagery does not exist. Which option is preferable? I explore the feasibility of option (ii) in more details by distinguishing between di erent kinds of indeterminacy. One of the most often proclaimed versions of indeterminacy is tied to Representationalism. However, I argue that in this context, Representationalism appears to be the least satisfying option, for which I give ten reasons. By abduction, we should reject Representationalism in favour of (i) or (iii)—the most parsimonious option being eliminativism, and the most conservative being the rejection of privileged access. The decision between these two, however, should be made on a case-by-case basis, depending on which is most adequate given the data. I illustrate this with the comparison between visual agnosia and Charles-Bonnet-Syndrome. (shrink)

In this consensus report by a diverse group of academics who conduct and/or are concerned about social and behavioral genomics (SBG) research, the authors recount the often‐ugly history of scientific attempts to understand the genetic contributions to human behaviors and social outcomes. They then describe what the current science—including genomewide association studies and polygenic indexes—can and cannot tell us, as well as its risks and potential benefits. They conclude with a discussion of responsible behavior in the context of SBG research. (...) SBG research that compares individuals within a group according to a “sensitive” phenotype requires extra attention to responsible conduct and to responsible communication about the research and its findings. SBG research (1) on sensitive phenotypes that (2) compares two or more groups defined by (a) race, (b) ethnicity, or (c) genetic ancestry (where genetic ancestry could easily be misunderstood as race or ethnicity) requires a compelling justification to be conducted, funded, or published. All authors agree that this justification at least requires a convincing argument that a study's design could yield scientifically valid results; some authors would additionally require the study to have a socially favorable risk‐benefit profile. (shrink)

Capital punishment—the legally authorized killing of a criminal offender by an agent of the state for the commission of a crime—stands in special need of moral justification. This is because execution is a particularly severe punishment. Execution is different in kind from monetary and custodial penalties in an obvious way: execution causes the death of an offender. While fines and incarceration set back some of one’s interests, death eliminates the possibility of setting and pursuing ends. While fines and incarceration narrow (...) one’s routes to happiness, death eliminates its possibility. Not surprisingly, there is much debate about the moral permissibility of capital punishment. This entry maps the terrain of this debate. The first section discusses justifications of the death penalty as they appear in major theories of punishment. The second section surveys moral objections to execution that apply to most justifications. The third addresses procedural criticisms, which do not target the morality of execution so much as the justice of its implementation. (shrink)

Kant famously insists that free will is a condition of morality. The difficulty of providing a demonstration of freedom has left him vulnerable to devastating criticism: critics charge that Kant's post-Groundwork justification of morality amounts to a dogmatic assertion of morality's authority. My paper rebuts this objection, showing that Kant offers a cogent demonstration of freedom. My central claim is that the demonstration must be understood in practical rather than theoretical terms. A practical demonstration of x works by bringing x (...) into existence, and what the demonstration of freedom brings into existence is a moral will, a will regulated by the moral law and capable of acting in accordance with it. Since to act morally is to act freely, bringing a moral will into existence actualizes our capacity for freedom and demonstrates that we possess it. To confirm the viability of such a demonstration, Kant must establish that agents can regulate their wills by practical principles, and that practical judgments are efficacious of themselves (i.e., that non-Humean motivational internalism is true). Kant, I argue, is successful on both counts. (shrink)

While Hume has often been held to have been an agnostic or atheist, several contemporary scholars have argued that Hume was a theist. These interpretations depend chiefly on several passages in which Hume allegedly confesses to theism. In this paper, I argue against this position by giving a threshold characterization of theism and using it to show that Hume does not confess. His most important confession does not cross this threshold and the ones that do are often expressive rather than (...) assertive. I then argue that Hume is best interpreted as an atheist. Instead of interpreting Hume as a proto-logical positivist and arguing on the basis of Hume’s theories of meaning and method, I show that textually he appears to align himself with atheism, that his arguments in the Dialogues on Natural Religion support atheism, and that this position is most consistent with Hume’s naturalism. But, I hold that his atheism is soft and therefore distinct from that of his peers like Baron d’Holbach—while Hume really does reject theism, he neither embraces a dogmatically materialist position nor takes up a purely polemical stance towards theism. I conclude by suggesting several ways in which Hume’s atheistic philosophy of religion is relevant to contemporary discussions. (shrink)

There at least three ways of thinking about rationality: instrumental, substantive, and intentional. By far, the instrumental account is most influential. This essay proposes that intentional rationality can provide substantive accounts with room to breathe, and in a way that is facially distinct from instrumental accounts. I suggest that the intentionality of a judgment is made up of what it is about and the orientation through which it is judged, while irrationality is the subversion of a strict supporting connection between (...) the judgment and its corresponding set of coordinated attitudes (reasons). It follows that irrational intentionality is made up of episodic states where a judgment is subverted because of a misalignment between what it is about and the way the judge is oriented towards its contents. Four examples of irrational intentionality are considered: passivity towards ends, constitutive ignorance towards facts, delirious paranoia towards objects, and a disjunctive orientation towards categorizations. (shrink)

In this paper I argue that textualism is far less attractive as a theory of written law than some of its modern proponents think. For it is not usually sensible to expect the grammatical meaning of a provision to determine its appropriate legal meaning. Factors that are unrelated to grammar in the identification of law (e.g., legal theory, context) do too much of the work. **Draft -- acknowledgments welcome, but please do not cite.**.

This paper argues that Immanuel Kant’s practical philosophy contains a coherent, albeit implicit, defense of the legitimacy of capital punishment, one that refutes the most important objections leveled against it. I first show that Kant is consistent in his application of the ius talionis. I then explain how Kant can respond to the claim that death penalty violates the inviolable right to life. To address the most significant objection – the claim that execution violates human dignity – I argue that (...) motives of honor, as Kant conceives it, require a rational person to will her own execution, were she to commit murder. (shrink)

In this paper I argue that Poston and Dougherty's attempt to undermine the problem of divine hiddenness by using the notion of belief de re is problematic at best. They hold that individuals who appear to be unbelievers (because they are de dicto unbelievers) may actually be de re believers. I construct a set of conditions on ascribing belief de re to show that it is prima facie implausible to claim that seemingly inculpable and apparent unbelievers are really de re (...) believers. Thus, while it is indeed possible that a de dicto unbeliever is a de re believer, it is unlikely that this has sufficiently general application to actual individuals to alleviate the problem of divine hiddenness. (shrink)

Many philosophers and legal theorists worry about punishing the socially disadvantaged as severely as their advantaged counterparts. One philosophically popular explanation of this concern is couched in terms of moral standing: seriously unjust states are said to lack standing to condemn disadvantaged offenders. If this is the case, institutional condemnation of disadvantaged offenders (especially via hard treatment) will often be unjust. I describe two problems with canonical versions of this view. First, its proponents groundlessly claim that disadvantaged offenders may be (...) punished as severely as advantaged ones, even though such punishment is unjust in light of the state’s loss of standing. Second, and more importantly, moral standing arguments prohibit states from blaming advantaged as well as disadvantaged offenders. This unwelcome outcome suggests that standing approaches incorrectly analyze the source of moral misgivings about punishing the disadvantaged. I conclude that those who share such concerns should put standing accounts aside. (shrink)

This chapter offers a proceduralist argument against capital punishment. More specifically, it contends that the possibility of irrevocable mistakes precludes the just administration of the death penalty. At stake is a principle of political morality: legal institutions must strive to remedy their mistakes and to compensate those who suffer from wrongful sanctions. The incompatibility of remedy and execution is the crux of the irrevocability argument: because the wrongly executed cannot enjoy the morally required compensation, execution is impermissible. Along with defending (...) his key premises, Yost explains the complicated role that sentencing uncertainty plays in the argument. He concludes by noting some of the flaws in substantive consequentialist and retributivist justifications of capital punishment. (shrink)

In response to the racial disparities that plague the American criminal justice system, the Movement for Black Lives calls for an end to policing and punishment “as we know it.” But refusing to punish violent offenses leaves unprotected those most vulnerable to crime, and outright abolition thus appears to undermine black rights and liberties. I call this the decarceration dilemma. After discussing Tommie Shelby and Christopher Lewis’s attempts to resolve the dilemma, I offer my own, which employs a procedural rather (...) than a substantive solution. I lean on the principle of expanded asymmetry (EA), which holds that it is better to underpunish than overpunish. After defending EA, I note that it obtains only under conditions of uncertainty. I then show that because virtually all trials of black offenders meet the uncertainty condition, sentencing authorities are obliged to treat black offenders leniently. I conclude by noting the advantages of my proceduralist approach. (shrink)

Many philosophers and legal theorists worry about punishing the socially disadvantaged as severely as their advantaged counterparts. One philosophically popular explanation of this concern is couched in terms of moral standing: seriously unjust states are said to lack standing to condemn disadvantaged offenders. If this is the case, institutional condemnation of disadvantaged offenders (especially via hard treatment) will often be unjust. I describe two problems with canonical versions of this view. First, its proponents groundlessly claim that disadvantaged offenders may be (...) punished as severely as advantaged ones, even though such punishment is unjust in light of the state’s loss of standing. Second, and more importantly, moral standing arguments prohibit states from blaming advantaged as well as disadvantaged offenders. This unwelcome outcome suggests that standing approaches incorrectly analyze the source of moral misgivings about punishing the disadvantaged. I conclude that those who share such concerns should put standing accounts aside. (shrink)

This paper advocates for a general policy of penal leniency: judges should often sentence offenders to a punishment less severe than initially preferred. The argument’s keystone is the relatively uncontroversial Minimal Invasion Principle (MIP). MIP says that when more than one course of action satisfies a state’s legitimate aim, only the least invasive is permissibly pursued. I contend that MIP applies in two common sentencing situations. In the first, all sentences within a statutorily specified range are equally proportionate. Here MIP (...) applies directly. In the second, judges reasonably believe that one of the sentences within the range is the most proportionate, but can’t identify it with any certainty. In these cases of sentencing uncertainty, judges must be indifferent between their preferred sentence and a softer one, and this indifference triggers MIP. MIP thus frequently mandates some degree of leniency. I conclude with some comments on statistical uncertainty. (shrink)

Andrew Eshleman has argued that atheists can believe in God by being fully engaged members of religious communities and using religious discourse in a non-realist way. He calls this position 'fictionalism' because the atheist takes up religion as a useful fiction. In this paper I critique fictionalism along two lines: that it is problematic to successfully be a fictionalist and that fictionalism is unjustified. Reflection on fictionalism will point to some wider problems with religious anti-realism.

One of the many arguments against capital punishment is that execution is irrevocable. At its most simple, the argument has three premises. First, legal institutions should abolish penalties that do not admit correction of error, unless there are no alternative penalties. Second, irrevocable penalties are those that do not admit of correction. Third, execution is irrevocable. It follows that capital punishment should be abolished. This paper argues for the third premise. One might think that the truth of this premise is (...) self-evident. But in his paper “Is the Death Penalty Irrevocable?” Mike Davis argues that it is false: the death penalty is not irrevocable. While Davis’ argument is itself somewhat compelling, it receives additional support from work in the metaphysics of death, specifically the literature on posthumous harm. Strengthened in this way, the argument deserves careful consideration. I begin with a quick sketch of Davis’ argument, then show how the Pitcher-Feinberg theory of posthumous harm enables a more robust argument against the irrevocability of capital punishment, defending their theory of harm against standard objections in the literature. Having established the coherency of the robust argument, I conclude that it nevertheless fails to make the case against irrevocability. This is because it ignores the full set of practical requirements incumbent on legal institutions that wrongly punish someone. (shrink)

To vindicate morality against skeptical doubts, Kant must show that agents can be moved to act independently of their sensible desires. Kant must therefore answer a motivational question: how does an agent get from the cognition that she ought to act morally to acting morally? Affectivist interpretations of Kant hold that agents are moved to act by feelings, while intellectualists appeal to cognition alone. To overcome the significant shortcomings of each view, I develop a hybrid theory of motivation. My central (...) interpretive claim is that Kant is a special kind of motivational internalist: on his view, agents are moved to act by a feeling of intellectual pleasure at the prospect of accomplishing a task they have set for themselves, a feeling that originates in free choice. The resulting theory is immune to the challenges facing intellectualism and affectivism, thus strengthening the prospects of Kant’s justification of morality. (shrink)

The rapid development of COVID-19 vaccines in 2020 involved an unprecedented clinical research initiative. The case here involves a Phase I clinical trial of “second-generation” COVID-19 vaccines d...

Half of the drug offenders incarcerated in the United States are black, even though whites and blacks use and sell drugs at the same rate, and blacks make up only 13 percent of the population. Noncomparativists about retributive justice see nothing wrong with this picture; for them, an offender’s desert is insensitive to facts about other offenders. By contrast, comparativists about retributive justice assert that facts about others can partially determine an offender’s desert. Not surprisingly, comparativists, especially comparative egalitarians, contend (...) that differential punishment is retributively unjust. I agree with this assessment, but take issue with the reasons egalitarians cite in its favor. In this paper, I argue that differential punishment violates retributive justice because it contributes to structural racial oppression. Over the course of developing and defending this claim, I identify the shortcomings of both comparative egalitarianism and respectarianism, which is the most popular and plausible brand of noncomparativism. (shrink)

Medical practice should evolve alongside medical ethics. As our understanding of the ethical implications of physician-patient interactions becomes more nuanced, physicians should integrate those lessons into practice. As early as the 1930s, epidemiological studies began to identify that the rates of medical procedures varied significantly along geographic and socioeconomic lines. Dr. J. Alison Glover recognized that tonsillectomy rates in school children in certain school districts in England and Wales were in some cases eight times the rates of children in other (...) districts, with the only significant predictive factors being the current chief medical officer in the area and the socioeconomic well-being of the child's parents. Unfortunately, Dr. Glover's work revealed that the increase in tonsillectomies did not improve the health of adolescent patients and appeared to be performed “as a routine prophylactic ritual for no particular reason and with no particular result.”. (shrink)

Clinical evidence suggests that many patients undergo surgery that they would decline if fully informed. Failure to communicate the relevant risks, benefits, and alternatives of a procedure violates medical ethics and wastes medical resources. Integrating shared decision-making, a method of communication between provider and patient, into medical decisions can satisfy physicians' ethical obligations and reduce unwanted procedures. This article proposes a three-step process for implementing a nationwide practice of shared decision-making: create model integration programs; provide legal incentives to ease the (...) transition; and incorporate shared decision-making into medical necessity determinations. (shrink)