This chapter examines an evidentialist ethics of belief, and W. K. Clifford’s proposal in particular. It argues that regardless of how one understands the notion of evidence, it is implausible that we could have a moral obligation to refrain from believing something whenever we lack sufficient evidence. Alternatively, this chapter argues that there are wide-scope conditional requirements on beliefs but that these requirements can be met without having sufficient evidence for the belief in question. It then (...) argues that we are epistemically, though not morally, required to form epistemically valuable beliefs. However, these beliefs, too, need not be beliefs for which we have sufficient evidence—epistemically good beliefs need not be based on sufficient evidence. (shrink)

I argue that given standard deontic logic, wide-scope rational requirements entail narrow-scope rational requirements. In particular, the widely-embraced Enkratic Principle entails that if a particular combination of attitudes is rationally forbidden, it is also rationally forbidden to believe that that combination of attitudes is required.

Deontological evidentialism is the claim that we ought to form and maintain our beliefs in accordance with our evidence. In this paper, I criticize two arguments in its defense. I begin by discussing Berit Broogard’s use of the distinction between narrow-scope and wide-scope requirements against W.K. Clifford’s moral defense of. I then use this very distinction against a defense of inspired by Stephen Grimm’s more recent claims about the moral source of epistemic normativity. I use this (...) distinction once again to argue that Hilary Kornblith’s criticism of Richard Feldman’s defense of is incomplete. Finally, I argue that Feldman’s defense is insensitive to the relation between normative requirements and privileged values: values that have normative authority over us. (shrink)

The Wide-Scope approach to instrumental reason holds that the requirement to intend the necessary means to your ends should be understood as a requirement to either intend the means, or else not intend the end. In this paper I explain and defend a neglected version of this approach. I argue that three serious objections to Wide-Scope accounts turn on a certain assumption about the nature of the reasons that ground the Wide-Scope requirement. The version (...) of the Wide-Scope approach defended here allows us to reject this assumption, and so defuse the objections. (shrink)

I make the observation that English sentences such as “You have reason to take the bus or to take the train” do not have the logical form that they superficially appear to have. I find in these sentences a conjunctive use of “or,” as found in sentences like “You can have milk or lemon in your tea,” which gives you a permission to have milk, and a permission to have lemon, though no permission to have both. I argue that a (...) confusion of genuine disjunctions with sentences of the above form has motivated the mistaken acceptance by some philosophers of principles like the one I call “Liberal Transmission.” This is the principle that if you have a reason to do something, then you have a reason to do it in each of the possible ways in which it can be done (though not more than one of them). I argue that Liberal Transmission and its close relatives are false. Wide-scope reasons are defined as reasons that have a conditional or other logical connective within the scope of the reason operator. For example, a wide-scope instrumental reason might be: reason(if you have an end, take the means). By refuting Liberal Transmission, I show that you could have wide-scope instrumental reasons like this while nevertheless lacking any narrow-scope reason to take the means, or narrow-scope reason to not have the end. This enables me to respond to two major objections to the wide-scope approach to the instrumental principle that have been developed by Joseph Raz and by Niko Kolodny. (shrink)

This paper argues, on the basis of data from St'át'imcets (Lillooet Salish), for a theory of wide-scope indefinites which is similar, though not identical, to that proposed by Kratzer (1998). I show that a subset of S'át'imcets indefinites takes obligatory wide scope with respect to if-clauses, negation, and modals, and is unable to be distributed over by quantificational phrases. These wide-scope effects cannot be accounted for by movement, but require an analysis involving choice functions (...) (Reinhart 1995, 1997). However, Reinhart's particular choice function analysis is unable to account for the St'át'imcets data. A Kratzer-style theory, on the other hand, accounts not only for the wide-scope effects, but also for the emergence of narrower-than-widest interpretations for indefinites which contain bound variables. I depart from Kratzer's analysis in claiming that St'át'imcets choice function indefinites are not 'specific'; the discourse context does not provide a value for the function variable. Therefore, I utilize wide- scope existential closure over choice functions rather than leaving the variables free. However, my analysis provides support for Kratzer's claim that English indefinites are ambiguous between a choice function interpretation and a quantificational interpretation, since St'át'imcets determiners overtly encode the English ambiguity. I conclude by suggesting that the proposed analysis of wide-scope indefinites may be universally valid. (shrink)

You are irrational when you are akratic. On this point most agree. Despite this agreement, there is a tremendous amount of disagreement about what the correct explanation of this data is. Narrow-scopers think that the correct explanation is that you are violating a narrow-scope conditional requirement. You lack an intention to x that you are required to have given the fact that you believe you ought to x. Wide-scopers disagree. They think that a conditional you are required to (...) make true is false. You aren’t required to have any particular attitudes. You’re just required to intend to x or not believe you ought to x. Wide-scope accounts are symmetrical insofar as they predict that you are complying with the relevant requirement just so long as the relevant conditional is true. Some narrow-scopers object to this symmetry. However, there is disagreement about why the symmetry is objectionable. This has led wide-scopers to defend their view against a number of different symmetry objections. I think their defenses in the face of these objections are, on the whole, plausible. Unfortunately for them, they aren’t defending their view against the best version of the objection. In this paper I will show that there is a symmetry objection to wide-scope accounts that both hasn’t been responded to and is a serious problem for wide-scope accounts. Moreover, my version of the objection will allow us to see that there is at least one narrow-scope view that has been seriously underappreciated in the literature. (shrink)

You are irrational when you are akratic. On this point most agree. Despite this agreement, there is a tremendous amount of disagreement about what the correct explanation of this data is. Narrow-scopers think that the correct explanation is that you are violating a narrow-scope conditional requirement. You lack an intention to x that you are required to have given the fact that you believe you ought to x. Wide-scopers disagree. They think that a conditional you are required to (...) make true is false. You aren’t required to have any particular attitudes. You’re just required to intend to x or not believe you ought to x. Wide-scope accounts are symmetrical insofar as they predict that you are complying with the relevant requirement just so long as the relevant conditional is true. Some narrow-scopers object to this symmetry. However, there is disagreement about why the symmetry is objectionable. This has led wide-scopers to defend their view against a number of different symmetry objections. I think their defenses in the face of these objections are, on the whole, plausible. Unfortunately for them, they aren’t defending their view against the best version of the objection. In this paper I will show that there is a symmetry objection to wide-scope accounts that both hasn’t been responded to and is a serious problem for wide-scope accounts. Moreover, my version of the objection will allow us to see that there is at least one narrow-scope view that has been seriously underappreciated in the literature. (shrink)

This chapter distinguishes between several senses of “normativity”. For example, that we ought to abstain from causing unnecessary suffering is a normative, not descriptive, claim. And so is the claim that we have good reason, and ought to drive on the right, or left, side of the road because the law requires us to do that. Reasons and oughts are normative, by definition. Indeed, it may be that “[t]he normativity of all that is normative consists in the way it is, (...) or provides, or is otherwise related to reasons” (Raz 1999, 67) . That is what the “reasons-first” view holds, but there are also other views, and what is by definition a normative statement, or a normative fact if you like, depends on how we define normativity. -/- It may seem that requirements are also by definition normative. But it seems that there can also be requirements that one has no reason to meet: it is less clear whether such requirements are normative in the same sense that reasons and oughts are normative. This paper will go through various further phenomena, which are candidates for being normative in some other sense than normative reasons and oughts, defending however the view that not all of them are. But arguably four or so different senses of normativity can be distinguished. -/- The paper will accept the view that the normativity of reasons and oughts, which is here called normativity1, is central. It is an open question whether all requirements or expectations or socially constructed norms are normative in that sense. Arguably it depends on the contents and content-independent authority of the legislators, whether we have good reasons, or ought, to meet the requirements, obey the law, or to follow the etiquette, or to conform to others’ interpersonal expectations, requests, demands or prescriptions. Whether and when we do have such reasons is a difficult and important substantive question, which concerns the normativity1 of requirements of law. -/- In another sense, norms (intended to guide behavior) are trivially or by definition normative, and constitute normativity: some forms of behavior are ruled as acceptable (e.g. driving on the right) and others as unacceptable (e.g. driving on the left) in light of the norm. Even in the case of a bad norm (that we have no reason to follow, and which ought to be changed, and ought not prevail) classifies behaviours as acceptable or unacceptable in light of the norm. Surely norms are by definition normative? Call this conformity to social norms and actual expectations normativity2. It is not an open question whether social norms are normative in that sense – they are by definition normative2. But importantly, it is an open question whether one has good reasons, or sufficient reason, or ought, to follow any social norm – that is, whether the norm in question is normative1. -/- The first section of the article characterizes further the difference between these two senses of normativity, and additionally introduces various other candidate senses of “normativity”. These possible senses of “normativity” may be at stake in the debates about normative requirements of rationality , about so called ought-to-be -rules , about normativity of linguistic meaning , about “directions of fit” of beliefs and desires , about subjective authority of intentions and decisions and interpersonal authority or co-authority of concrete others. -/- In later sections these cases are discussed. Do they constitute separate senses of normativity? And are the later phenomena such that they give agents good reasons: do they include normativity1 – the core sense? A “normative power -model” is suggested as a framework for examining whether actual social norms, laws, expectations provide good reasons and oughts or not. Once we understand the relation between the first two senses of normativity, do the later phenomena follow the same pattern – is the “normative powers – model” relevant for them as well? (shrink)

Many philosophers think that requirements of rationality are “wide-scope”. That is to say: they are requirements to satisfy some material conditional, such that one counts as satisfying the requirement iff one either makes the conditional’s antecedent false or makes its consequent true. These contrast with narrow-scope requirements, where the requirement takes scope only over the consequent of the conditional. Many of the philosophers who have preferred wide-scope requirements to narrow-scope (...) requirements have also endorsed a corresponding semantic claim, namely that ordinary talk about rationality, despite appearances to the contrary, expresses wide-scope claims. In doing so, they seek to avoid attributing massive error to ordinary speakers. However, it is becoming increasingly clear that the wide-scope semantics inadequately captures the meaning of ordinary talk about rationality. It seems, then, that we are left with a dilemma: either give up the view that requirements of rationality are wide-scope, or accept an implausible semantics for ordinary talk about rationality, or attribute massive error to speakers. In this paper, I argue that this dilemma is only apparent, since we can appeal to a standard kind of contextualist semantics for modals to explain why narrow-scope talk comes out true in virtue of the wide-scope requirements. My view, then, combines wide-scoping about the explanatorily fundamental requirements of rationality with a contextualist variant of a narrow-scope semantics. I argue that this view gives us the best of both worlds, as well as solving related puzzles and challenges for the extant views in the literature. (shrink)

This paper is a response to ‘Why Be Rational?’ by Niko Kolodny. Kolodny argues that we have no reason to satisfy the requirements of rationality. His argument assumes that these requirements have a logically narrow scope. To see what the question of scope turns on, this comment provides a semantics for ‘requirement’. It shows that requirements of rationality have a wide scope, at least under one sense of ‘requirement’. Consequently Kolodny's conclusion cannot be (...) derived. (shrink)

Offers a conciliatory solution to one of the central contemporary debates in the theory of rationality, the debate about the proper formulation of rational requirements. Introduces a novel conception of the “symmetry problem” for wide scope rational requirements, and sketches a theory of rational commitment as a response.

Niko Kolodny has argued that some (local) rational requirements are narrow-scope requirements. Against this, I argue here that all (local) rational requirements are wide-scope requirements. I present a new objection to the narrow-scope interpretations of the four specific rational requirements which Kolodny considers. His argument for the narrow-scope interpretations of these four requirements rests on a false assumption, that an attitude which puts in place a narrow-scope rational requirement (...) somewhere thereby puts in place a narrow-scope rational requirement everywhere. My argument against Kolodny is analogous to arguments which use holism about reasons to defend moral particularism. (shrink)

It is generally agreed that many types of attitudinal incoherence are irrational, but there is controversy about why they are. Some think incoherence is irrational because it violates certain wide-scope conditional requirements, others (‘narrow-scopers’) that it violates narrow-scope conditional requirements. In his paper ‘The Scope of Rational Requirements’, John Brunero has offered a putative counter-example to narrow-scope views. But a narrow-scoper should reject a crucial assumption which Brunero makes, namely, the claim that (...) we always violate conditional narrow-scope requirements when we do not comply with them. I show how Brunero's objection can be met by denying this claim, and I provide independent arguments in favour of denying it. (shrink)

A significant part of the debate concerning the nature of rational requirements centers on disambiguating ordinary articulations of conditional requirements of rationality. Particular focus has been put on the question of whether conditional requirements of rationality take a wide or a narrow logical scope. However, this paper shows that this focus is misguided and harmful to the debate. I argue that concentrating on syntactic scope renders us more likely to arrive at incorrect formulations of (...) rational requirements and to overlook questions of greater philosophical importance. (shrink)

Instrumental rationality prohibits one from being in the following state: intending to pass a test, not intending to study, and believing one must intend to study if one is to pass. One could escape from this incoherent state in three ways: by intending to study, by not intending to pass, or by giving up one’s instrumental belief. However, not all of these ways of proceeding seem equally rational: giving up one’s instrumental belief seems less rational than giving up an end, (...) which itself seems less rational than intending the means. I consider whether, as some philosophers allege, these “asymmetries” pose a problem for the wide-scope formulation of instrumental rationality. I argue that they do not. I also present an argument in favor of the wide-scope formulation. The arguments employed here in defense of the wide-scope formulation of instrumental rationality can also be employed in defense of the wide-scope formulations of other rational requirements. (shrink)

According to the democratic borders argument, the democratic legitimacy of a state's regime of border control requires granting foreigners a right to participate in the procedures determining it. This argument appeals to the All-Subjected Principle, which implies that democratic legitimacy requires that all those subject to political power have a right to participate in determining the laws governing its exercise. The scope objection claims that this argument presupposes an implausible account of subjection and hence of the All-Subjected Principle, which (...) absurdly implies that all domestic laws subject foreigners to their requirements. I argue that this objection misconstrues the logical structure of the legal requirements enshrined in domestic laws: domestic laws typically enshrine narrow-scope, not wide-scope, legal requirements. To be sure, some state laws do subject foreigners to their requirements, and the All-Subjected Principle conditions democratic legitimacy on granting foreigners some say in determining them. But the best reading of the Principle does not have such general expansionary implications. (shrink)

Some irrational states can be avoided in more than one way. For example, if you believe that you ought to A you can avoid akrasia by intending to A or by dropping the belief that you ought to A. This supports the claim that some rational requirements are wide-scope. For instance, the requirement against akrasia is a requirement to intend to A or not believe that you ought to A. But some writers object that this Wide- (...) class='Hi'>Scope view ignores asymmetries between the different ways of avoiding irrationality. In this paper I defend the Wide-Scope view against recent objections of this sort from Mark Schroeder and Niko Kolodny. I argue that once we are clear about what the Wide-Scope view is committed to—and, importantly, what it is not—we can see that Schroeder and Kolodny’s objections fail. (shrink)

This paper looks at the question of what form the requirements of practical rationality take. One common view is that the requirements of rationality are wide-scope, and another is that they are narrow-scope. I argue that the resolution to the question of wide-scope versus narrow-scope depends to a significant degree on what one expects a theory of rationality to do. In examining these expectations, I consider whether there might be a way to (...) unify requirements of both forms into a single theory of rationality, and what the difficulties involved in doing so can teach us about the foundations of practical rationality. (shrink)

This paper considers the formulation of the moral requirement against hypocrisy, paying particular attention to the logical scope of ‘requires’ in that formulation. The paper argues (i) that we should prefer a wide-scope formulation to a narrow-scope formulation, and (ii) this result has some advantages for our normative theorizing about hypocrisy – in particular, it allows us to resist several of Daniela Dover’s (2019) recent arguments against the anti-hypocrisy requirement.

Can we employ the property of rationality in establishing what rationality requires? According to a central and formal thesis of John Broome’s work on rational requirements, the answer is ‘no’ – at least if we expect a precise answer. In particular, Broome argues that (i) the property of full rationality (i.e. whether or not you are fully rational) is independent of whether we formulate conditional requirements of rationality as having a wide or a narrow logical scope. (...) That is, (ii) by replacing a wide-scope requirement with a corresponding narrow-scope requirement (or vice versa), we do not alter the situations in which a person is fully rational. As a consequence, (iii) the property of full rationality is unable to guide us in determining whether a rational requirement has a wide or a narrow logical scope. We cannot resolve the wide/narrow scope debate by appealing to a theory of fully rational attitudes. This paper argues that (i), (ii) and (iii) are incorrect. Replacing a wide- with a corresponding narrow-scope requirement (or vice versa) can alter the set of circumstances in which a person is fully rational. The property of full rationality is therefore not independent of whether we formulate conditional requirements of rationality as having a wide or a narrow logical scope. As a consequence, the property of full rationality can guide us in determining what rationality requires – even in cases where we expect a precise answer. (shrink)

rational requirements are narrow scope. The source of our disagreement, I suspect, is that Broome believes that the relevant rational requirements govern states, whereas I believe that they govern processes. If they govern states, then the debate over scope is sterile. The difference between narrow- and wide-scope state requirements is only as important as the difference between not violating a requirement and satisfying one. Broome's observations about conflicting narrow-scope state requirements only (...) corroborate this. Why, then, have we thought that there was an important difference? Perhaps, I conjecture, because there is an important difference between narrow- and wide-scope process requirements, and we have implicitly taken process requirements as our topic. I clarify and try to defend my argument that some process requirements are narrow scope, so that if there were reasons to conform to rational requirements, there would be implausible bootstrapping. I then reformulate Broome's observations about conflicting narrow-scope state requirements as an argument against narrow-scope process requirements, and suggest a reply. (shrink)

This article shows that the democratic borders argument is defensible, albeit not in the way Arash Abizadeh proposes. The democratic borders argument depends on the All-Subjected Principle, according to which the exercise of political power is justified only insofar as everyone who is subjected to that power is guaranteed a right to vote. According to the so-called “scope objection,” the scope of the All-Subjected Principle is too broad, however, and therefore, the argument can be refuted by reductio ad (...) absurdum. Here I argue that Abizadeh’s appeal to the narrow-scope interpretation of jurisdictionally circumscribed legal requirements is not a plausible way of defusing this reductio. Instead, I show that the democratic borders argument is successful if the All-Subjected Principle consists of two individually sufficient conditions corresponding to narrow-scope and qualified wide-scope interpretations. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Managed Health Care: New Ethical Issues for All*Martina Darragh (bio) and Pat Milmoe McCarrick (bio)Changes in the way that health care is perceived, delivered, and financed have occurred rapidly in a relatively short time span. The 50-year period since World War II encompasses enormous growth in medical technology, soaring health care costs, and significant fragmentation of the two-party patient- physician relationship. This relationship first grew to include the third-party (...) payer, the health insurance industry, and now “with great speed and relatively little public awareness, a significant change has occurred in the way some decisions are made about a patient’s medical care” (III, Institute of Medicine 1989).The new means of providing health care bring an increasing number of parties into clinical decision-making processes. With this change, ethical issues that once concerned only health care professionals, the physician or the nurse, have expanded to include the patient and the groups who “manage” care—e.g., health maintenance organizations (HMOs), preferred provider organizations (PPOs), point of service groups (POSs), independent practice associations (IPAs), insurance reviewers, hospital administrators, institutional managers, and, the most recent players, purchasers of group health care who base their decisions on competitive pricing.The term “managed care” refers to a variety of continually adapting and developing arrangements that involve four groups. These groups, which have been labeled by the world of business, not health, are the “consumer” (once the patient), the “provider” (the physician and other health care professionals), the “insurer” (the reimburser for any care), and the “purchaser of care” or the primary buyer of health services (the large employer organization). Capitation is a common way to pay for health services in managed care systems. A certain dollar amount is negotiated for health services for a specified number of patients whether the care is delivered or not; the provider shares with the [End Page 189] insurer any financial risk for the actual cost of care (III, Centers for Disease Control 1995).When the Clinton administration’s health care reform movement failed to gain support in the U.S. Congress, the use of managed care to control rising health care costs accelerated. The literature on managed care and its effect on the patient-physician relationship reflects this shift. During the era of health care reform, “debate centered on how managed care could control costs, on the use of technology and patient satisfaction, [and] on access and barriers to care” (IV, Emanuel and Dubler 1995). When managed care organizations began contracting with physicians to provide health care services subject to the plans’ provisions, these plans became agents in clinical decision making on a wide-spread basis. HMO enrollment grew to 51 million persons by 1994 (III, Centers for Disease Control 1995). This “corporatization” of health care has sparked a plethora of articles about the effects of the marketplace on the physician’s ability to do what is best for the patient, and on the patient’s ability to trust the physician to do so.Many authors make it clear that managed care itself is not the problem, but rather the development of for-profit managed care plans by “corporate conglomerates with billions of dollars in assets that compensate their executives as grandly as basketball players” (V, Kassirer 1995) “in a marketplace that is largely unregulated” (I, Zoloth-Dorfman and Rubin 1995). “Some, mostly older plans that were created when cost containment was an unexpected benefit rather than their central purpose, deliver high-quality care economically. Unfortunately, others cut costs by recruiting the healthiest patients, excluding the sickest, rationing care by making it inconvenient to obtain, and denying care by a variety of mechanisms” (V, Kassirer 1995).These cost-containment features now play an intimate role in clinical practice. When a managed care plan contracts with a physician, the doctor becomes a “double agent” with contractual obligations to the plan to provide a preset amount of services and professional responsibilities to each patient to authorize necessary treatment (V, Angell 1993). This duality can undermine the physician’s fiduciary responsibility to the patient wherein the physician “has power over the affairs of [the patient]...and is required by law to act on that person’s... (shrink)

Cognitivists about practical reason hold that we can explain why certain wide-scope requirements of practical rationality are true by appealing to certain epistemic requirements. Extant discussions of cognitivism focus solely on two claims. The first is the claim that intentions involve beliefs. The second is that whenever your intentions are incoherent in certain ways, you will be epistemically irrational. Even if the cognitivist successfully defends these claims, she still needs to show that they entail certain practical (...) requirements. That is, she has to show that the epistemic requirements explain the practical requirements. In this paper I argue that it is not plausible that the epistemic requirements explain the practical requirements. This shows that the cognitivists' project will fail even if we grant their controversial views about the relationship between the practical and epistemic. (shrink)

BackgroundChronic kidney disease is a significant cause of global deaths. Those who progress to end-stage kidney disease often commence dialysis as a life-extending treatment. For cognitively impaired patients, the decision as to whether they commence dialysis will fall to someone else. This scoping review was conducted to map existing literature pertaining to how decisions about dialysis are and should be made with, for, and on behalf of adult patients who lack decision-making capacity. In doing so, it forms the basis of (...) a larger body of work that is exploring how these decisions ought to be made.MethodsTo identify relevant papers, searches were conducted on Ovid MEDLINE(R), Embase, PsychINFO, The Cochrane Library, and Web of Science. Inclusion criteria were then applied, requiring that papers: report on empirical studies about how decisions about dialysis are made and/or discuss how decisions about dialysis should be made with, for, and on behalf of adult patients who lack decision-making capacity; be published from 1961 onwards; and be published in English. This resulted in 27 papers eligible for inclusion.ResultsOf note, the majority of papers originated in the United States. There was wide variation across the included papers. Extracted data were grouped under the following themes: involving various parties (patient involvement, family dominance, and wider communication); objectivity about care options (including difficulties with family detachment); cultural sensitivity; medical versus non-medical factors; managing nonadherent patients; and the role and prevalence of substituted judgement. The literature shows that there is inconsistency in the principles and processes surrounding decisions made about dialysis with, for, and on behalf of adult patients who lack decision-making capacity.ConclusionsThis scoping review demonstrates that there is significant variation in both the practice and theory of dialysis decision making with, for, and on behalf of cognitively impaired adult patients. Complexity arises in considering who should get a say, how influential their say should be in a decision, and what factors are most relevant to the decision. A lack of up-to-date literature exploring this issue is highlighted, with this scoping review providing a useful groundwork from which further research can be undertaken. (shrink)

Background Conventional consent practices face ethical challenges in continuously evolving digital health environments due to their static, one-time nature. Dynamic consent offers a promising solution, providing adaptability and flexibility to address these ethical concerns. However, due to the immaturity of the concept and accompanying technology, dynamic consent has not yet been widely used in practice. This study aims to identify the facilitators of and barriers to adopting dynamic consent in real-world scenarios. Methods This scoping review, conducted in December 2022, adhered (...) to the PRISMA Extension for Scoping Reviews guidelines, focusing on dynamic consent within the health domain. A comprehensive search across Web of Science, PubMed, and Scopus yielded 22 selected articles based on predefined inclusion and exclusion criteria. Results The facilitators for the adoption of dynamic consent in digital health ecosystems were the provision of multiple consent modalities, personalized alternatives, continuous communication, and the dissemination of up-to-date information. Nevertheless, several barriers, such as consent fatigue, the digital divide, complexities in system implementation, and privacy and security concerns, needed to be addressed. This study also investigated current technological advancements and suggested considerations for further research aimed at resolving the remaining challenges surrounding dynamic consent. Conclusions Dynamic consent emerges as an ethically advantageous method for digital health ecosystems, driven by its adaptability and support for continuous, two-way communication between data subjects and consumers. Ethical implementation in real-world settings requires the development of a robust technical framework capable of accommodating the diverse needs of stakeholders, thereby ensuring ethical integrity and data privacy in the evolving digital health landscape. (shrink)

The paper proposes a novel account to the problem of exceptional scope (ES) of (in)definites, e.g. the widest and intermediate scope readings of the sentence Every student of mine read every poem that a famous Romanian poet wrote before World War II. We propose that ES readings are available when the sentence is interpreted as anaphoric to quantificational domains and quantificational dependencies introduced in the previous discourse. For example, the two every quantifiers and the indefinite elaborate on the (...) sets of individuals and the correlations between them introduced by a previous sentence like Every student chose a poet and read every poem written by him (for the intermediate scope reading) or a sentence like Every student chose a poet - the same poet - and read every poem written by him (for the widest scope reading). Our account, formulated within a compositional dynamic system couched in classical type logic, relies on two independently motivated assumptions: (a) the discourse context stores not only (sets of) individuals, but also quantificational dependencies between them, and (b) quantifier domains are always contextually restricted. Under this analysis, (in)definites are unambiguous and we do not resort to movement or special storage mechanisms, nor do weposit special choice-functional variables. (shrink)

Introduction The bioethics literature reflects significant interest in and concern with the use of genetic and genomic information in various settings. Because psychiatric treatment and research raises unique ethical, legal, and social issues, we conducted a scoping review of the biomedical, bioethics, and psychology literature regarding the application of genetic and genomic tools to psychiatric disorders (as listed in the DSM-5) and two associated behaviors or symptoms to provide a more detailed overview of the state of the field. Objectives The (...) primary objective was to examine the available bioethics, biomedical, and psychology literature on applying genetic and genomic tools to psychiatric disorders (other than neurodevelopmental disorders) and two behaviors or symptoms sometimes associated with them (aggression or violence and suicidality) to identify the disorders to which these tools have been applied, the contexts in or purposes for which they have been applied, the ethical, legal, or social concerns associated with those uses, and proposed recommendations for mitigating those concerns. Methods We used Arksey and O’Malley’s scoping review framework: (1) identify the research question; (2) identify relevant studies; (3) select studies; (4) chart the data; and (5) collate, summarize, and report results (2005). We relied on Levac et al. to inform our application of the framework (2010). The PRISMA extension for scoping reviews checklist informed our reporting (2018). We searched three electronic databases MEDLINE (PubMed), Embase, and PsycInfo (EbscoHost) for peer-reviewed journal articles in English to identify relevant literature. One author screened the initial results and additional screening was done in consultation with other authors. A data extraction form using DSM-5 diagnostic categories (excluding neurodevelopmental disorders) was developed and two authors independently each reviewed approximately half of the articles. Inter-rater reliability was ensured by double-coding approximately 10% of the papers. An additional author independently coded 10% of the articles to audit the data. Results In 365 coded publications, we identified 15 DSM-5 diagnostic categories in addition to the two pre-selected behaviors or symptoms (aggression or violence and suicidality) to which genetic or genomic tools have been applied. We identified 11 settings in or purposes for which these tools were applied. Twenty-two types of ethical, legal, or social concerns associated with the application of genetic or genomic tools to these disorders or behaviors/symptoms were identified along with 13 practices or policies that could mitigate these concerns. Conclusion Genetic and genomic tools have been applied to a wide range of psychiatric disorders. These raise a range of ethical, legal, and social concerns. Additional research is warranted to better understand the concerns and effective ways to address them. Advancing the literature to identify relevant ethical, legal, or social concerns and solutions to those problems likely requires greater attention to specific applications of genetic or genomic tools to particular psychiatric disorders and associated behaviors/symptoms as well as broad stakeholder engagement. (shrink)

Mind 116:462 (2007): 371–85. (A reply to John Broome’s comment, “Wide or Narrow Scope?”).

Genomic research can reveal ‘unsolicited’ or ‘incidental’ findings that are of potential health or reproductive significance to participants. It is widely thought that researchers have a moral obligation, grounded in the duty of easy rescue, to return certain kinds of unsolicited findings to research participants. It is less widely thought that researchers have a moral obligation to actively look for health-related findings. This paper examines whether there is a moral obligation, grounded in the duty of easy rescue, to actively hunt (...) for genomic secondary findings. We begin by showing how the duty to disclose individual research findings can be grounded in the duty of easy rescue. Next, we describe a parallel moral duty, also grounded in the duty of easy rescue, to actively hunt for such information. We then consider six possible objections to our argument, each of which we find unsuccessful. Some of these objections provide reason to limit the scope of the duty to look for secondary findings, but none provide reason to reject this duty outright. We argue that under a certain range of circumstances, researchers are morally required to hunt for these kinds of secondary findings. Although these circumstances may not currently obtain, genomic researchers will likely acquire an obligation to hunt for secondary findings as the field of genomics continues to evolve. (shrink)

Roberto Frega’s Pragmatism and the Wide View of Democracy marks an ambitious attempt to construct a comprehensive and critical vision of democratic theory, a vision that draws together elements from pragmatism, from sociological theory, and from critical theory. Responding to the pervasive sense of crisis that surrounds democracy, Frega persuasively argues, requires broadening our understanding of the concept’s scope. Frega seeks to move beyond two prominent conceptions of democracy in contem...

BackgroundDespite its ubiquity, it is often not clear what organizations and services mean by well-being. Visual impairment has been associated with poorer well-being and well-being has become a key outcome for support and services for adults living with VI. A shared understanding of what well-being means is therefore essential to enable assessment of well-being and cross-service provision of well-being support.ObjectivesTo provide an overview of the ways in which well-being has been conceptualized in research relating to adults living with VI.Eligibility criteriaArticles (...) were included in the review if the article discussed well-being in the context of adults living with VI, was available in English and as a full text.Data sourcesA systematic search using search terms relating to VI and well-being was conducted in EBSCOHost and Ovid.ChartingA team of three reviewers screened titles, abstracts and full-texts articles and extracted data. Ambiguous articles were referred to the research group and discussed.ResultsOf 10,662 articles identified in the search, 249 were included in the review. These referred to 38 types of well-being. The most common types were general well-being emotional well-being and psychological well-being. Most articles referred to one type only, with a maximum of 9 listed in one article. A large number of articles did not clearly define well-being. A wide range of indicators of well-being related to the domains of hedonia, mood, positive and negative affect, quality of life, mental health, eudaimonia, self/identity, health, psychological reactions to disability and health problems, functioning, social functioning and environment, were extracted, many of which were used just once.ConclusionsThere remains a lack of consensus on how well-being is conceptualized and assessed in the context of adult VI. A standardized multi-domain approach derived with input from adults with VI and practitioners working with them is required to enable comparison of findings and cross-organizational provision of support. (shrink)

BackgroundLiterature on issues relating to comprehension during the process of obtaining informed consent (IC) has largely focused on the challenges potential participants can face in understanding the IC documents, and the strategies used to enhance comprehension of those documents. In this review, we set out to describe the factors that have an impact on comprehension and the strategies used to enhance the IC process in sub-Saharan African countries.MethodsFrom November 2021 to January 2022, we conducted a literature search using a PRISMA (...) tool. We searched electronic databases (PubMed, EMBASE, EBSCOHOST) to identify relevant peer reviewed studies. We then reviewed the references of these articles to find additional literature that might have been missed through the initial search. We were particularly interested in full text articles in English that focused on the IC process in SSA published between 2006 and 2020. We included systematic reviews, and studies from Western and Asian countries that included data about SSA. We excluded articles that focused on medical interventions and studies that did not require IC.ResultsOut of the 50 studies included most were multi-country (n = 13) followed by single country studies in South Africa (n = 12); Kenya, Tanzania, Uganda (n = 5) each; Gambia, Ghana and Nigeria (n = 2)each ; and one each for Botswana, Malawi, Mali, Mozambique. We identified three areas of focus: (1) socio-cultural factors affecting IC; (2) gaps in the ethical and legal frameworks guiding the IC process; and (3) strategies used to improve participants’ understanding of IC.ConclusionOur review showed wide recognition that the process of achieving IC in SSA is inherently challenging, and there are limitations in the strategies aimed at improving comprehension in IC. We suggest that there is a need for greater flexibility and negotiation with communities to ensure that the approach to IC is suited to the diverse socio-cultural contexts. We propose moving beyond the literal translations and technical language to understanding IC comprehension from the participants’ perspectives and the researchers’ views, while examining contextual factors that impact the IC process. (shrink)

Wide-scopers argue that the detachment of intuitively false ‘ought’ claims from hypothetical imperatives is blocked because ‘ought’ takes wide, as opposed to narrow, scope. I present two arguments against this view. The first questions the premise that natural language conditionals are true just in case the antecedent is false. The second shows that intuitively false ‘ought’s can still be detached even WITH wide-scope readings. This weakens the motivation for wide-scoping.

A deterrence theory of punishment holds that the institution of criminal punishment is morally justified because it serves to deter crime. Because the fear of external sanction is an important incentive in crime deterrence, the deterrence theory is often associated with the idea of severe, disproportionate punishment. An objection to this theory holds that hope of escape renders even the severest punishment inapt and irrelevant. -/- This article revisits the concept of deterrence and defend a more plausible deterrence theory of (...) punishment—the wide-scope deterrence theory. The wide-scope theory holds that we must make the best use of all the deterrence tools available, including both external and internal sanctions. Drawing on insights from the early Confucian tradition, the article develops a deep deterrence theory, which holds that the most important deterrence tool involves internal, not external, sanction. It describes how internal sanctions deter potential offenses and why relevant policies need not conflict with liberalism’s respect for neutrality. (shrink)

This paper responds to the Radical Behavioral Challenge to normative business ethics. According to RBC, recent research on bounded ethicality shows that it is psychologically impossible for people to follow the prescriptions of normative business ethics. Thus, said prescriptions run afoul of the principle that nobody has an obligation to do something that they cannot do. I show that the only explicit response to this challenge in the business ethics literature is flawed because it limits normative business ethics to condemning (...) practitioners’ behavior without providing usable suggestions for how to do better. I argue that a more satisfying response is to, first, recognize that most obligations in business are wide-scope which, second, implies that there are multiple ways of fulfilling them. This provides a solid theoretical grounding for the increasingly popular view that we have obligations to erect institutional safeguards when bounded ethicality is likely to interfere with our ability to do what is right. I conclude with examples of such safeguards and some advice on how to use the research findings on bounded ethicality in designing ethical business organizations. (shrink)

I defend the claim that Kant held a wide-scope view of hypothetical imperatives, against objections raised by Mark Schroeder [2005]. There is an important objection, now commonly known as the ‘bootstrapping’ problem, to the alternative, narrow-scope, view which Schroeder attributes to Kant. Schroeder argues that Kant has sufficient resources to reply to the bootstrapping problem, and claims that this leaves us with no good reason to attribute to Kant the wide-scope view. I show that Schroeder's (...) Kantian reply to the bootstrapping problem cannot fully answer it. Schroeder also offers three main textual arguments for attributing to Kant the narrow-scope view: from Kant's claim that the moral imperative is unique in virtue of its categoricity, from Kant's distinction between ‘problematic’ and ‘assertoric’ hypothetical imperatives, and from Kant's conception of analyticity together with his claim that hypothetical imperatives are analytic. I argue that each of these views can be understood as cohering with the.. (shrink)

The Wide-Scope view of instrumental reason holds that you should not intend an end without also intending what you believe to be the necessary means. This, the Wide-Scoper claims, provides the best account of why failing to intend the believed means to your end is a rational failing. But Wide-Scopers have struggled to meet a simple Explanatory Challenge: why shouldn't you intend an end without intending the necessary means? What reason is there not to do so? (...) In the first half of this paper, I argue that the Wide-Scope view struggles to meet this challenge because it takes the principles of instrumental reason to have unlimited application—to apply to all agents, in all circumstances. I then go on to offer a new account of these principles. The new account is very much in the spirit of the Wide-Scope view, and shares its central advantages, but lacks its unlimited application. This view should, therefore, find the Explanatory Challenge more tractable. In the second half of the paper, I argue that this prediction is confirmed. If the requirements of instrumental reason apply only when a means is, or is believed to be, necessary for your end, then plausible independent claims, about reasons, rationality, and intentions, explain why failing to intend the necessary means to your ends is a rational failing. (shrink)

The paper proposes a novel analysis of quantificational subordination, e.g. Harvey courts a woman at every convention. {She is very pretty. vs. She always comes to the banquet with him.} (Karttunen 1976), in particular of the fact that the indefinite in the initial sentence can have wide or narrow scope, but the first discourse as a whole allows only for the wide scope reading, while the second discourse allows for both readings. The cross-sentential interaction between (...) class='Hi'>scope and anaphora is captured in terms of structured anaphora to quantifier domains, formalized in a new dynamic system couched in classical type logic; given the underlying type logic, Montague-style compositionality at sub-clausal level follows automatically. Modal subordination (Roberts 1987) is analyzed in a parallel way, thereby capturing the parallels between the individual and modal domains argued for in Stone (1999). Several other phenomena are analyzed in terms of structured anaphora: exceptional wide scope, weak / strong donkey readings, anaphoric / uniqueness-implying definite descriptions and interactions between same / different and quantifier scope. (shrink)

The paper investigates the scope properties of indefinites.

It is widely held that instrumental reasoning to a practical conclusion is parasitic on non-instrumental practical reasoning. This conclusion is based on the claim that when there is no reason to adopt a certain end, there is no reason to take the means (qua means) to that end. But, as will be argued, while there is a sense of reason according to which the previous statement is true, there is another sense according to which it is false. Furthermore, in both (...) of the relevant senses of reason, it is true that reasons are considerations that ground correct conclusions of practical deliberation and correct advice. It follows that instrumental reasoning to a practical conclusion is not invariably parasitic on non-instrumental practical reasoning. The view that it is results from combining the idea that when there is no reason to adopt a certain end, there is no reason to take the means (qua means) to that end, with the common but faulty assumption that considerations that ground correct conclusions of practical deliberation and correct advice are all reasons in a single sense (sometimes referred to as the normative sense of reason). The assumption in question is implicit in, for example, the work of John Broome, T. M. Scanlon, Christine Korsgaard, and Stephen Darwall.1 Given the common identification of normative reasons with considerations that ground correct conclusions of practical deliberation and correct advice, the position that will be defended in this paper can be expressed by saying that there is not one but two senses of reason for which it is true that reasons are normative.. (shrink)

Normativity involves two kinds of relation. On the one hand, there is the relation of being a reason for. This is a relation between a fact and an attitude. On the other hand, there are relations specified by requirements of rationality. These are relations among a person's attitudes, viewed in abstraction from the reasons for them. I ask how the normativity of rationality—the sense in which we ‘ought’ to comply with requirements of rationality—is related to the normativity of (...) reasons—the sense in which we ‘ought’ to have the attitudes what we have conclusive reason to have. The normativity of rationality is not straightforwardly that of reasons, I argue; there are no reasons to comply with rational requirements in general. First, this would lead to ‘bootstrapping’, because, contrary to the claims of John Broome, not all rational requirements have ‘wide scope’. Second, it is unclear what such reasons to be rational might be. Finally, we typically do not, and in many cases could not, treat rational requirements as reasons. Instead, I suggest, rationality is only apparently normative, and the normativity that it appears to have is that of reasons. According to this ‘Transparency Account’, rational requirements govern our responses to our beliefs about reasons. The normative ‘pressure’ that we feel, when rational requirements apply to us, derives from these beliefs: from the reasons that, as it seems to us, we have. (shrink)

A cognitive pragmatic approach is taken to some long-standing problem cases of negation, the so-called presupposition denial cases. It is argued that a full account of the processes and levels of representation involved in their interpretation typically requires the sequential pragmatic derivation of two different propositions expressed. The first is one in which the presupposition is preserved and, following the rejection of this, the second involves the echoic (metalinguistic) use of material falling in the scope of the negation. The (...) semantic base for these processes is the standard anti-presuppositionalist wide-scope negation. A different view, developed by Burton-Roberts (1989a, 1989b), takes presupposition to be a semantic relation encoded in natural language and so argues for a negation operator that does not cancel presuppositions. This view is shown to be flawed, in that it makes the false prediction that presupposition denial cases are semantic contradictions and it is based on too narrow a view of the role of pragmatic inferencing. (shrink)

Niko Kolodny It is often said that there is a special class of norms, ‘rational requirements’, that demand that our attitudes be related one another in certain ways, whatever else may be the case.1 In recent work, a special class of these rational requirements has attracted particular attention: what I will call ‘requirements of formal coherence as such’, which require just that our attitudes be formally coherent.2 For example, we are rationally required, if we believe something, to (...) believe what it entails. And we are rationally required, if we intend an end, to intend what we take to be necessary means to it. The intuitive idea is that formally incoherent attitudes give rise to a certain normative tension, or exert a kind of rational pressure on each another, and this tension, or pressure, is relieved just when one of the attitudes is revised. As John Broome observes, these requirements are, by their nature, ‘wide scope’, which is to say that there is no particular attitude that one must have or lack in order to satisfy them. This is because they require just formal coherence, and there is no particular attitude that one must have or lack in order to be formally coherent. (shrink)

Kiesewetter defends the normativity of rationality by presenting a new solution to the problems that arise from the common assumption that we ought to be rational. He provides a defence of a reason-response conception of rationality, an evidence-relative account of reason, and an explanation of structural irrationality in relation to these accounts.