Among medical researchers and clinicians the dominant view is that it is unethical to deceive patients by prescribing a placebo. This opinion is formalized in a recent policy issued by the American Medical Association (AMA [Chicago, IL]). Although placebos can be shown to be always safe, often effective, and sometimes necessary, doctors are now effectively prohibited from using them in clinical practice. I argue that the deceptive administration of placebos is not subject to the same moral objections that face other (...) forms of deception in clinical practice and medical research. Although deception is normally objectionable on the grounds that it limits autonomy and breaches trust, these grounds do not apply to placebos when they are prescribed within appropriate ethical limits. Patients have reason to prefer that doctors can prescribe placebos in ethically responsible ways. Hence, the AMA has an obligation to endorse and to promote the responsible use of deceptive placebos in clinical practice. (shrink)

It is often claimed that the autonomy of heroin addicts is compromised when they are choosing between taking their drug of addiction and abstaining. This is the basis of claims that they are incompetent to give consent to be prescribed heroin. We reject these claims on a number of empirical and theoretical grounds. First we argue that addicts are likely to be sober, and thus capable of rational thought, when approaching researchers to participate in research. We reject behavioural evidence purported (...) to establish that addicts lack autonomy. We present an argument that extrinsic forces must be irresistible in order to make a choice non-autonomous. We argue that heroin does not present such an irresistible force. We make a case that drug-oriented desires are strong regular appetitive desires, which do not compromise consent. Finally we argue that an addict’s apparent desire to engage in a harmful act cannot be construed as evidence of irrational or compulsive thought. On these arguments, a sober heroin addict must be considered competent, autonomous and capable of giving consent. More generally, any argument against legalisation of drugs or supporting infringement of the liberty of those desiring to take drugs of addiction must be based on considerations of harm and paternalism, and not on false claims that addicts lack freedom of the will. (shrink)

The author comments on the article “The neurobiology of addiction: Implications for voluntary control of behavior,‘ by S. E. Hyman. Hyman presents that addiction is a brain disease or a moral condition. The authors present that addiction is a strong preference, similar to appetitive preferences. They state that addiction is merely a form of pleasure-seeking. The authors conclude that the problem of addiction is the problem of the management of pleasure, not treatment of a disease. Accession Number: 24077914; Authors: (...) class='Hi'>Foddy, Bennett 1; Email Address: bennett@foddy.net Savulescu, Julian 2; Affiliations: 1: University of Melbourne, Monash University, Australia; 2: University of Oxford; Subject: EDITORIALS; Subject: ADDICTIONS; Subject: HYMAN, S. E.; Subject: BRAIN -- Diseases; Subject: PLEASURE; Subject: NEUROBIOLOGY; Subject: BEHAVIOR; Number of Pages: 4p. (shrink)

Philosophers and psychologists have been attracted to two differing accounts of addictive motivation. In this paper, we investigate these two accounts and challenge their mutual claim that addictions compromise a person’s self-control. First, we identify some incompatibilities between this claim of reduced self-control and the available evidence from various disciplines. A critical assessment of the evidence weakens the empirical argument for reduced autonomy. Second, we identify sources of unwarranted normative bias in the popular theories of addiction that introduce systematic errors (...) in interpreting the evidence. By eliminating these errors, we are able to generate a minimal, but correct account, of addiction that presumes addicts to be autonomous in their addictive behavior, absent further evidence to the contrary. Finally, we explore some of the implications of this minimal, correct view. (shrink)

2007 will be remembered as the year in which the Tour de France died. Race leader and likely eventual winner, Michael Rasmussen, was eliminated near the end on an allegation of doping. Since the 1960s, the idealistic drug crusaders have been on a mission to reverse the course of history, and eliminate drugs from the sport. But this “zero tolerance” strategy to drugs has failed, as 2007's Tour spectacularly showed. Only around 10–15% of professional athletes are drug tested. Currently, it (...) is illegal to use erythropoietin (EPO) or blood doping to move your haematocrit from 48 to 49% even though some people will have a normal level of 49%. A regulated permissive policy would paradoxically reduce risk to athletes. The present system creates an environment of risk to the athlete. A rational policy on doping would allow safe performance‐enhancing interventions which are consistent with the spirit of a particular sport. (shrink)

This month's issue of the Journal of Medical Ethics is a special issue devoted entirely to the ethics of infant male circumcision—an elective surgical practice that is currently performed on around a third of the world's male population.1The last time the Journal ran a symposium on this issue was in 2004, and there has been relatively scant discussion of the practice in the ethical literature since then. Three events that took place in the past year have brought the ethics of (...) infant male circumcision back into the global spotlight.First, in April of 2012, controversy erupted after it was reported that a baby had died in New York City after contracting Herpes Simplex virus during the Orthodox Jewish variant of circumcision known as metzitzah b'peh, which involves the oral suction of blood from the infant's penis following the circumcision procedure.2Later that year, the American Academy of Pediatrics released a policy statement which suggested that the health benefits of ordinary forms of male circumcision outweigh the risks and …. (shrink)

One argument which is frequently levelled against the enhancement of human biology is that we do not understand the evolved function of our bodies well enough to meddle in our biology without producing unintended and potentially catastrophic effects. In particular, this argument is levelled against attempts to slow or eliminate the processes of human ageing, or ‘senescence’, which cause us to grow decrepit before we die. In this article, I claim that even if this argument could usefully be applied against (...) attempts to enhance other human traits, it cannot be valid in the case of attempts to enhance the various processes that constitute senescence. I begin by reviewing the biology of ageing to show how it consists of a number of unrelated traits. Then, following the arguments of a number of evolutionary biologists, I explain that every one of these traits is a product of evolutionary ‘neglect’ rather than ‘intent’. Finally, I consider the strongest version of the argument against enhancing senescence, which acknowledges these facts about the evolution of ageing but insists that we have nevertheless have prudential reasons to avoid enhancement wherever there is some uncertainty about the genetics or evolutionary function of a trait. I provide two reasons for rejecting this version of the argument as well, even in the case of human senescence, where such uncertainty is currently significant. (shrink)

There is a growing consensus among neuroscientists that people can become addicted to food, and that at least some cases of obesity have addiction as their cause. By contrast, the rest of the world continues to see obesity as either a disease of the metabolism, or as a reckless case of self-harm. Among obesity researchers, there has been a lively debate on the issue of whether obesity ought to be considered a disease. Few researchers, however, have suggested that obesity is (...) a disease in the same sense as addiction is usually claimed to be a disease—that is, a disease of behaviour with a neurological cause. In this piece, I review what is now a compelling body of evidence for food addiction, to establish that many or most cases of obesity have addiction at their foundation. I then argue that in spite of this, obesity ought not to be considered a neurobehavioural disease in the sense usually attributed to drug addiction. Given the link between addiction and obesity, this implies that the disease conception of addiction must be abandoned. I conclude by assessing some of the implications this move has for policy and ethics, with regard to both obesity and drug addiction. (shrink)

A category of enhancement technologies target neural systems as a means of improving physical performance. The author calls these as neurophysical enhancements. This chapter demonstrates why neurophysical enhancements deserve an ethical assessment which is independent of those relating to physical and cognitive enhancements. It focuses almost exclusively on the use of neurophysical enhancements in the sporting arena, where they are for the most part prohibited. World Anti‐Doping Agency (WADA) does permit some drugs which are effective enhancements. Caffeine is permitted on (...) the rationale that it is ineffective at unsafe doses (and hence safe at an effective dose). It makes little sense to ban every performance enhancer from sporting competition, no matter what it is used for, and what the risks are, since sport is essentially a project of performance enhancement. If every form of enhancement is to be considered unethical, competitive sport must be abandoned. (shrink)

Concepts We thank all three commentators for extremely constructive, insightful, and gracious commentaries. We cannot address all their valuable points. In this response, we elucidate and relate the concepts of addiction, disease, disability, autonomy, and well-being. We examine some of the implications of these relationships in the context of the helpful responses made by our commentators. We begin with the definitions of the relevant concepts which we employ: ¥? ? ? Addiction (Liberal Concept): An addiction is a strong appetite. ¥? (...) ? ? Appetites: An appetite is a disposition that generates desires that are urgent, oriented toward some rewarding behavior, periodically recurring, often in predictable circumstances, sated temporarily by their fulfillment, and generally provide pleasure. ¥? ? ? Disease (Naturalistic Concept): A disease is some biological or psychological state that results in subfunctioning of the organism in a given set of environmental and social circumstances, C. The reference class is a natural class of organisms of uniform functional design; specifically, an age group of a sex of a species. A normal function is a part or process within members of the reference class and is a statistically typical contribution by it to their individual survival and reproduction (Boorse 1977, 1997). ¥? ? ? Disability (Welfarist Concept): A disability is a relatively stable biological or psychological state that tends to reduce the amount of well-being that this person will enjoy in a given set of environmental and social circumstances (Savulescu and Kahane 2009; Kahane and Savulescu, 2009). ¥? ? ? Autonomy (Rationalist Concept): A person rationally desires or values some state of affairs if and only if he or she desires that state of affairs while (1) being in possession of all relevant. (shrink)

We thank Carrie Jenkins and Neil Levy for their thoughtful comments on our article about love and addiction. Although we do not have room for a comprehensive reply, we will touch on a few main issues.Jenkins points out, correctly in our view, that the word ‘addiction’ can trigger “connotations of reduced autonomy.” It may therefore be used, she argues, to “excuse” violent or otherwise harmful behaviors—disproportionately carried out by men—within the context of romantic relationships. Debates about love addiction, therefore, “are (...) best addressed with an eye to the more general issue of how we as a society apportion responsibility for things like date rape and intimate partner violence” (Jenkins... (shrink)

abstract Criminal behaviour is but one behavioural tendency for which a genetic influence has been suggested. Whilst this research certainly raises difficult ethical questions and is subject to scientific criticism, one recent research project suggests that for some families, criminal tendency might be predicted by genetics. In this paper, supposing this research is valid, we consider whether intervening in the criminal tendency of future children is ethically justifiable. We argue that, if avoidance of harm is a paramount consideration, such an (...) intervention is acceptable when genetic selection is employed instead of genetic enhancement. Moreover, other moral problems in avoiding having children with a tendency to criminal behaviour, such as the prospect of social discrimination, can also be overcome. (shrink)

By nature we are all addicted to love... meaning we want it, seek it and have a hard time not thinking about it. We need attachment to survive and we instinctively seek connection, especially romantic connection. [But] there is nothing dysfunctional about wanting love.Throughout the ages, love has been rendered as an excruciating passion. Ovid was the first to proclaim: “I can’t live with or without you”—a locution made famous to modern ears by the Irish band U2. Contemporary film expresses (...) a similar sentiment: as Jake Gyllenhaal’s character famously says in Brokeback Mountain, “I wish I knew how to quit you.” And everyday speech, too, is rife with such expressions as “I need you” and “I’m addicted to you.”... (shrink)

A brief introduction to and commentary on the life of the Chinese philosopher Laozi is followed by an interpretative text of his teachings.

In this paper I consider whether traditional behaviors of animals, like traditions of humans, are transmitted by imitation learning. Review of the literature on problem solving by captive primates, and detailed consideration of two widely cited instances of purported learning by imitation and of culture in free-living primates (sweet-potato washing by Japanese macaques and termite fishing by chimpanzees), suggests that nonhuman primates do not learn to solve problems by imitation. It may, therefore, be misleading to treat animal traditions and human (...) culture as homologous (rather than analogous) and to refer to animal traditions as cultural. (shrink)

How can we motivate ourselves to do what we think we ought? How can we deliberate about personal values and priorities? Bennett Helm argues that standard philosophical answers to these questions presuppose a sharp distinction between cognition and conation that undermines an adequate understanding of values and their connection to motivation and deliberation. Rejecting this distinction, Helm argues that emotions are fundamental to any account of value and motivation, and he develops a detailed alternative theory both of emotions, desires (...) and evaluative judgements and of their rational interconnections. The result is an innovative theory of practical rationality and of how we can control not only what we do but also what we value and who we are as persons. (shrink)

Recently there has been a resurgence of philosophical interest in love, resulting in a wide variety of accounts. Central to most accounts of love is the notion of caring about your beloved for his sake. Yet such a notion needs to be carefully articulated in the context of providing an account of love, for it is clear that the kind of caring involved in love must be carefully distinguished from impersonal modes of concern for particular others for their sakes, such (...) as moral concern or concern grounded in compassion. That is, we might say, the kind of caring that is central to love must be somehow distinctly intimate. The trouble is to cash out these firm intuitions in a satisfactory way. (shrink)

There is now a general consensus amongst philosophers in the values in science literature that values necessarily play a role in core areas of scientific inquiry. We argue that attention should now be turned from debating the value-free ideal to delineating legitimate from illegitimate influences of values in science, a project we dub “The New Demarcation Problem.” First, we review past attempts to demarcate the uses of values and propose a categorization of the strategies by where they seek to draw (...) legitimacy from. Next, we propose a set of desiderata for what we take to be a satisfactory solution and present a case study where conflicting sets of values clearly impinge on science, but where the legitimacy of their influence is ambiguous. We use these desiderata and the case study to illustrate what we take to be the strengths and weaknesses of current strategies. To be clear, our goal is not to answer the question we pose, but to articulate a framework within which a solution can be judged. (shrink)

Abstract:This article brings together considerations from philosophical work on standpoint epistemology, feminist philosophy of science, and epistemic injustice to examine a particular problem facing contemporary psychiatry: the conflict between the conceptual resources of psychiatric medicine and alternative conceptualizations like those of the neurodiversity movement and psychiatric abolitionism. I argue that resistance to fully considering such alternative conceptualizations in processes such as the revision of the Diagnostic and Statistical Manual of Mental Disorders emerges in part from a particular form of epistemic (...) injustice (hermeneutical ignorance) leveled against a particular social group (which I call the "psychopathologized"). Further, insofar as the objectivity which psychiatry should aspire to is a kind of "social objectivity" which requires incorporation of various normative perspectives, this particular form of epistemic injustice threatens to undermine its scientific objectivity. Although many questions regarding implementation remain, this implies that psychiatry must grapple substantively with radical reconceptualizations of its domain if it is to achieve legitimate scientific objectivity. (shrink)

Privacy is defined within a symbolic interaction framework in terms of identity definition and maintenance processes. It is argued that defining privacy within a symbolic interaction framework both generates a number of hypotheses involving the concept of privacy and allows the theorist to draw together several social psychological concepts within the one conceptual schema.

Sedlakova and Trachsel (2023) identify a major benefit of conversational artificial intelligence (CAI) in psychotherapy as its ability to expand access to mental healthcare for vulnerable populatio...

First published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.

Industry is a major source of funding for scientific research. There is also a growing concern for how it corrupts researchers faced with conflicts of interest. As such, the debate has focused on whether researchers have maintained their integrity. In this article we draw on both the history of medicine and formal modeling to argue that given methodological diversity and a merit-based system, industry funding can bias a community without corrupting any particular individual. We close by considering a policy solution (...) that may seem to promote unbiased inquiry but that actually exacerbates the problem without additional restrictions. (shrink)

The phenomenology of emotions has traditionally been understood in terms of bodily sensations they involve. This is a mistake. We should instead understand their phenomenology in terms of their distinctively evaluative intentionality. Emotions are essentially affective modes of response to the ways our circumstances come to matter to us, and so they are ways of being pleased or pained by those circumstances. Making sense of the intentionality and phenomenology of emotions in this way requires rejecting traditional understandings of intentionality and (...) so coming to see emotions as a distinctive and irreducible class of mental states lying at the intersection of intentionality, phenomenology, and motivation. (shrink)

History of Cognitive Neuroscience documents the major neuroscientific experiments and theories over the last century and a half in the domain of cognitive neuroscience, and evaluates the cogency of the conclusions that have been drawn from them. Provides a companion work to the highly acclaimed Philosophical Foundations of Neuroscience – combining scientific detail with philosophical insights Views the evolution of brain science through the lens of its principal figures and experiments Addresses philosophical criticism of Bennett and Hacker?s previous book (...) Accompanied by more than 100 illustrations. (shrink)

In recent years the social nature of scientific inquiry has generated considerable interest. We examine the effect of an epistemically impure agent on a community of honest truth seekers. Extending a formal model of network epistemology pioneered by Zollman, we conclude that an intransigently biased agent prevents the community from ever converging to the truth. We explore two solutions to this problem, including a novel procedure for endogenous network formation in which agents choose whom to trust. We contend that our (...) model nicely captures aspects of current problems in medical research and gesture at some morals for medical epistemology more generally. (shrink)

This paper argues that pleasure and pains are not qualia and they are not to be analyzed in terms of supposedly antecedently intelligible mental states like bodily sensation or desire. Rather, pleasure and pain are char- acteristic of a distinctive kind of evaluation that is common to emotions, desires, and (some) bodily sensations. These are felt evaluations: pas- sive responses to attend to and be motivated by the import of something impressing itself on us, responses that are nonetheless simultaneously con- (...) stitutive of that import by virtue of the broader rational patterns of which they are a part and that they serve to de?ne. This account of felt eval- uations makes sense of the way in which pleasures and pains grab our attention and motivate us to act and of the peculiar dual objectivity and subjectivity of their implicit evaluations, while o?ering a phenomenology adequate to both emotional and bodily pleasures and pains. (shrink)

We consider whether intervening in the criminal tendency of future children is ethically justifiable. We argue that, if avoidance of.

There are some philosophical questions that can be answered without attention to the social context in which evidence is produced and distributed.ing away from social context is an excellent way to ignore messy details and lay bare the underlying structure of the limits of inference. Idealization is entirely appropriate when one is essentially asking: In the best of all possible worlds, what am I entitled to infer? Yet, philosophers’ concerns often go beyond this domain. As an example I examine the (...) debate on mechanistic evidence and then reevaluate a canonical case study in this debate. I show that for the assessment of actual evidence, produced in a world that is far from ideal, omission of the social aspects of medical epistemology leads philosophers to draw the wrong lessons from cases they take as paradigmatic cases for their views. I close by arguing that social epistemology provides an avenue to incorporate these complications and provides the necessary framework to understand medical evidence. (shrink)

Communities of respect are communities of people sharing common practices or a (partial) way of life; they include families, clubs, religious groups, and political parties. This book develops a detailed account of such communities in terms of the rational structure of their members' reactive attitudes, arguing that they are fundamental in three interrelated ways to understanding what it is to be a person. First, it is only by being a member of a community of respect that one can be a (...) responsible agent having dignity; such an agent therefore has certain rights as well as the authority to demand that fellow members recognize her dignity and follow the norms of the community, norms compliance with which they likewise have the authority to demand from her. Second, by prescribing or proscribing both actions and values, communities of respect can shape the identities of its members in ways that others have the authority to enforce, thereby revealing an important interpersonal dimension of the identities of persons. Finally, all of this is grounded in a distinctively interpersonal form of practical rationality in virtue of which we jointly have reasons to recognize the dignity and authority of fellow members and so to comply with their authoritative demands, as well as to respect (and so comply with) the norms of the community. Hence we persons are essentially social creatures. (shrink)

Private companies provide by far the most funding for scientific research and development. Nevertheless, relatively little attention has been paid to the dynamics of industry‐funded research by philosophers of science. This paper addresses this gap by providing an overview of the major strengths and weaknesses of industry research funding, together with the existing recommendations for addressing the weaknesses. It is designed to provide a starting point for future philosophical work that explores the features of industry‐funded research, avenues for addressing concerns, (...) and strategies for making research funded by the private sector as fruitful as possible. (shrink)

This essay focuses on personal love, or the love of particular persons as such. Part of the philosophical task in understanding personal love is to distinguish the various kinds of personal love. For example, the way in which I love my wife is seemingly very different from the way I love my mother, my child, and my friend. This task has typically proceeded hand-in-hand with philosophical analyses of these kinds of personal love, analyses that in part respond to various puzzles (...) about love. Can love be justified? If so, how? What is the value of personal love? What impact does love have on the autonomy of both the lover and the beloved? (shrink)

Genuine agents are able to engage in activity because they find it worth pursuing—because they care about it. In this respect, they differ from what might be called “mere intentional systems”: systems like chess-playing computers that exhibit merely goal-directed behavior mediated by instrumental rationality, without caring. A parallel distinction can be made in the domain of social activity: plural agents must be distinguished from plural intentional systems in that plural agents have cares and engage in activity because of those cares. (...) In this paper, I sketch an account of what it is for an individual to care about things in terms of her exhibiting a certain pattern of emotions. After extending this account to make sense of an individual's caring about other agents, I then show how a certain sort of emotional connectedness among a group of people can make intelligible the group's having cares and thereby constitute that group as a plural agent. Alternative accounts of social action, by ignoring the difference between mere intentional systems and genuine agents, and so by leaving out these emotional entanglements from their accounts of social action, thereby fail to capture a whole range of social phenomena involving plural agents. (shrink)

One central argument in favor of perceptual accounts of emotions concerns recalcitrant emotions: emotions that persist in the face of repudiating judgments. For, it is argued, to understand how the conflict between recalcitrant emotions and judgment falls short of incoherence in judgment, we need to understand recalcitrant emotions to be something like perceptual illusions of value, so that in normal, non-recalcitrant cases emotions are non-illusory perceptions of value. I argue that these arguments fail and that a closer examination of recalcitrant (...) emotions reveals important disanalogies with perception that undermine the perceptual model of emotions. (shrink)

Using William Shakespeare’s Hamlet and the play-within-the play, The Murder of Gonzago, as a case study, this essay argues that theatrical utterances constitute a special case of language usage not previously elucidated: the utterance of a statement with propositional content in theatre functions as an event. In short, the propositional content of a particular p (e.g. p1, p2, p3 …), whether or not it is true, is only understood—and understood to be true—if p1 is uttered in a particular time, place, (...) and situation (i.e. during a theatrical event); otherwise, the propositional content in those theatrical utterances can either be false or contingently true. (shrink)

It is well known that Berkeley had two arguments for the existence of God. A while ago, in trying to discover what these arguments are and how they fit into Berkeley's scheme of things, I encountered certain problems which are hardly raised, let alone solved, in the standard commentaries. I think that I have now solved these problems, and in this paper I present my results.