Given the long-standing controversy about whether the brain-dead should be considered alive in an irreversible coma or dead despite displaying apparent signs of life, the ethical and policy issues posed when family members insist on continued treatment are not as simple as commentators have claimed. In this article, we consider the kind of policy that should be adopted to manage a family's insistence that their brain-dead loved one continues to receive supportive care. We argue that while it would be ethically (...) inappropriate to continue to devote scarce acute care resources to such patients in a hospital setting, it may not be ethically inappropriate for patients to receive these resources in certain other settings. Thus, if a family insists on continuing to care for their brain-dead loved at their home, we should not, from a policy perspective, interfere with the family's wishes. We also argue that healthcare professionals should make some effort to facilitate the transfer of brain-dead patients to these other settings when families insist on continued treatment despite being informed about the lack of any potential for recovery of consciousness. Our arguments are strengthened by the fact that patients in a persistent vegetative state, who, when correctly diagnosed, also have no potential for recovery of consciousness, are routinely transferred from hospitals to nursing homes or long-term care facilities where they continue to be ventilated, tube fed and to receive other supportive care. We also briefly explore the question of who should be responsible for the costs of such treatment at the long-term care facility. (shrink)

Given the long‐standing controversy about whether the brain‐dead should be considered alive in an irreversible coma or dead despite displaying apparent signs of life, the ethical and policy issues posed when family members insist on continued treatment are not as simple as commentators have claimed. In this article, we consider the kind of policy that should be adopted to manage a family's insistence that their brain‐dead loved one continues to receive supportive care. We argue that while it would be ethically (...) inappropriate to continue to devote scarce acute care resources to such patients in a hospital setting, it may not be ethically inappropriate for patients to receive these resources in certain other settings. Thus, if a family insists on continuing to care for their brain‐dead loved at their home, we should not, from a policy perspective, interfere with the family's wishes. We also argue that healthcare professionals should make some effort to facilitate the transfer of brain‐dead patients to these other settings when families insist on continued treatment despite being informed about the lack of any potential for recovery of consciousness. Our arguments are strengthened by the fact that patients in a persistent vegetative state, who, when correctly diagnosed, also have no potential for recovery of consciousness, are routinely transferred from hospitals to nursing homes or long‐term care facilities where they continue to be ventilated, tube fed and to receive other supportive care. We also briefly explore the question of who should be responsible for the costs of such treatment at the long‐term care facility. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Virtual GalleryJessica Evett-Miller (bio) Click for larger view View full resolutionImage 1. Click for larger view View full resolutionImage 2. Click for larger view View full resolutionImage 3. Click for larger view View full resolutionImage 4. Click for larger view View full resolutionImage 5. Click for larger view View full resolutionImage 6. Click for larger view View full resolutionImage 7. Click for larger view View full resolutionImage 8. (...) Click for larger view View full resolutionImage 9. Click for larger view View full resolutionImage 10. Click for larger view View full resolutionImage 11. Click for larger view View full resolutionImage 12. Click for larger view View full resolutionImage 13. Click for larger view View full resolutionImage 14. Click for larger view View full resolutionImage 15. Click for larger view View full resolutionImage 16.Jessica Evett-Miller Jessica Evett-Miller took these photographs during a trip to Italy and Sicily and assembled them for her senior project at the Alternative Community School in Ithaca’ New York. Now a freshman at Cornell University, she is planning to design an independent major in visual studies. She would like to dedicate thesephotographs toherfather, John Miller, and to thank him for his inspiration.She paired the front and back cover images (the first and the last) to create an interplay between the two. They function together rather than separately.Copyright © 1996 The Johns Hopkins University Press... (shrink)

ABSTRACT Defining a nonpaternalistic yet achievable form of trust in medicine in an era of simultaneous patient empowerment and institutional control has been and remains an important task of bioethics. The ‘crisis of trust’ in medicine has been viewed mainly as the problem of getting patients to trust their health care providers, especially physicians. However, since paradigmatic cases of trust are mutual, bioethicists must pay more attention to physician trust in patients. A physician’s view of the reasonableness of trust in (...) a particular patient is affected not just by his or her relationship with that patient, but also by what is going on institutionally, professionally, legally, and politically with regard to a given treatment or intervention. Since general moral principles are insufficient in determining the moral value and reasonableness of trust in particular instances, I discuss in detail the role of trust and distrust in the specific case of treating patients with medications implicated in drug abuse. I conclude that it is important to become aware, first, of the clinical significance of physician trust and distrust in patients, and second, of the many factors which inform both of these moral attitudes. These two claims together suggest that a central, but overlooked, virtue of medical practice is reflective, context‐responsive trust in patients. (shrink)

Death and morality connect in interesting ways in Disney movies. In some Disney films, heroes are defined partly by their willingness to take risks that might result in death, as long as these risks are to protect or obtain good things that make human life worth living. A related ethical issue that Disney films address with regard to death is appropriate grief. Disney films, on balance, show an awareness and respect for the cycle of human life. Perhaps that is why (...) Disney reserves some of its worst deaths for evil characters who refuse to accept the fact of their own mortality. In all of the examples, Disney illustrates the connection many philosophers maintain between courage, cowardice, and death. Disney and Pixar films are so rich and popular that people should use them to engage in difficult conversations about death and other subjects. (shrink)

Recent literature on trust commonly contains the claim that the trust which characterizes intimate relationships is a different phenomenon altogether from the trust that characterizes professional and other sorts of non-intimate relationships. In this paper I argue that while there are important differences among kinds of trust, an invidious distinction between trust in strangers and trust infriends is not only unwarranted but it obscures the fundamentally affective and relational base of all forms of interpersonal trust. In this essay I construct (...) an account of interpersonal trust, which recognizes the similarities that pervade its different forms. Without such a complex approach, we lose theoretical sight not only of key features of trust, but of the relationship of trust to significant dimensions of human existence. (shrink)

This paper explores the ways in which trust and distrust, especially among relative strangers, are connected to social identities and locations. It begins by sketching an account of interpersonal trust, emphasizing the role that socially salient identities, based in part upon cultural figurations, play in their development. It then contends that these cultural figurations both foster and result from distrust of specific social groups, including African Americans, the poor, and (some) women. Treating social roles and relations as central to moral (...) analysis enables an understanding of the injustice of some forms of social distrust which does not imply that one individual’s distrust of another is culpable in a straightforward way. The paper then develops the claim that one’s social location can affect the moral desirability of trust and distrust, concluding that social distrust can sometimes function as a kind of dissident attitude, a political stance with emancipatory potential. (shrink)

Robert Baker (2005) has urged that bioethicists develop a code of ethics on several related but distinct grounds: that, based on his analysis of the history of development of other professions, the...

In the early 2000s, several states legalized marijuana for medicinal uses. Since then, more and more states have either decriminalized or legalized marijuana use for medical or recreational purposes. Federal law has remained unchanged. The state-level decriminalization of marijuana and the concomitant de-stigmatizing and mainstreaming is likely to lead to greater use among the general population, including among nursing mothers. Marijuana is already one of the most widely used illicit substances among lactating women. There exist few studies demonstrating the effects (...) of marijuana in breast milk on nursing babies. In the present context of a changing legal landscape, shifting cultural beliefs, and the absence of clear professional guidelines, healthcare professionals are faced with ethical questions around how best to support nursing mothers and their babies when marijuana use is a factor. This paper first presents an overview of the law, science, and professional guidelines as they relate to marijuana and breastfeeding. Then, I offer an assessment of the relevant ethical issues providers and their patients may need to navigate. (shrink)

ABSTRACTWe investigated the impact of emotions on learning vocabulary in an unfamiliar language to better understand affective influences in foreign language acquisition. Seventy native English speakers learned new vocabulary in either a negative or a neutral emotional state. Participants also completed two sets of working memory tasks to examine the potential mediating role of working memory. Results revealed that participants exposed to negative stimuli exhibited difficulty in retrieving and correctly pairing English words with Indonesian words, as reflected in a lower (...) performance on the prompted recall tests and the free recall measure. Emotional induction did not change working memory scores from pre to post manipulation. This suggests working memory could not explain the reduced vocabulary learning in the negative group. We argue that negative mood can adversely affect language learning by suppressing aspects of native-language processing and impeding form-meaning mapping with second language words. (shrink)

This paper explores the ways in which trust and distrust, especially among relative strangers, are connected to social identities and locations. It begins by sketching an account of interpersonal trust, emphasizing the role that socially salient identities, based in part upon cultural figurations, play in their development. It then contends that these cultural figurations both foster and result from distrust of specific social groups, including African Americans, the poor, and (some) women. Treating social roles and relations as central to moral (...) analysis enables an understanding of the injustice of some forms of social distrust which does not imply that one individual’s distrust of another is culpable in a straightforward way. The paper then develops the claim that one’s social location can affect the moral desirability of trust and distrust, concluding that social distrust can sometimes function as a kind of dissident attitude, a political stance with emancipatory potential. (shrink)

Modern medical technology has made it possible for babies to survive with conditions that would have ended their lives only half a century ago. But complex health care interventions and regimens are not enough. These children require support, caregiving, and constant vigilance from their families, especially their parents. Sometimes referred to as children with "special needs," their dependency and vulnerability may stem from genetic disorders, premature births, serious accidents, or illness. This includes conditions such as severe autism spectrum disorder, Down (...) syndrome, hypoxic ischemic encephalopathy, Trisomy 13, Trisomy 18, Fragile X Syndrome, spina bifida, and brain damage... (shrink)

In this paper, we move toward offering psychological benchmarks to measure success in building increasingly humanlike robots. By psychological benchmarks we mean categories of interaction that capture conceptually fundamental aspects of human life, specified abstractly enough to resist their identity as a mere psychological instrument, but capable of being translated into testable empirical propositions. Nine possible benchmarks are considered: autonomy, imitation, intrinsic moral value, moral accountability, privacy, reciprocity, conventionality, creativity, and authenticity of relation. Finally, we discuss how getting the right (...) group of benchmarks in human–robot interaction will, in future years, help inform on the foundational question of what constitutes essential features of being human. (shrink)

ABSTRACTEmotion knowledge, the ability to accurately perceive and label emotions, predicts higher quality peer relations, higher social competence, higher academic achievement, and fewer behaviour...

In this paper, we move toward offering psychological benchmarks to measure success in building increasingly humanlike robots. By psychological benchmarks we mean categories of interaction that capture conceptually fundamental aspects of human life, specified abstractly enough to resist their identity as a mere psychological instrument, but capable of being translated into testable empirical propositions. Nine possible benchmarks are considered: autonomy, imitation, intrinsic moral value, moral accountability, privacy, reciprocity, conventionality, creativity, and authenticity of relation. Finally, we discuss how getting the right (...) group of benchmarks in human–robot interaction will, in future years, help inform on the foundational question of what constitutes essential features of being human. (shrink)

In 1959, Neal Miller made the bold claim that the Stimulus–Response, Behaviorist models of that era were describing the way in which stimuli lead to the entry of contents into consciousness. Today, researchers have begun to investigate the link between external stimuli and involuntary entry, using paradigms such as the reflexive imagery task, the focus of our review. The RIT has revealed that stimuli can elicit insuppressible entry of high-level cognitions. Knowledge of the boundary conditions of the RIT effect (...) illuminates the limitations of involuntary processes and the role of consciousness in the regulation of behavior. We review the boundary conditions of this paradigm as well as its systematic effects. Systematic effects are unlikely to be due to experimental demand. While reviewing each effect, we consider its theoretical implications. In addition, throughout our review, we discuss future directions for the study of insuppressible entry using the RIT. Last, we discuss a theoretical development that stems from the RIT and illuminates how involuntary entry and encapsulation, though at times disadvantageous for the actor, are essential for adaptive action selection during the course of ontogeny. (shrink)

How should physical entities be characterized? Physicalists, who have most to do with the notion, usually characterize the physical by reference to two components: 1. The physical entities are the entities treated by fundamental physics with the proviso that 2. Physical entities are not fundamentally mental (that is, do not individually possess or bestow mentality) Here I explore the extent to which the appeals to fundamental physics and to the NFM (“no fundamental mentality”) constraint are appropriate for characterizing the physical, (...) especially for purposes of formulating physicalism. Ultimately, I motivate and defend a version of an account incorporating both components: The physics-based NFM account: An entity existing at a world w is physical iff (i) it is treated, approximately accurately, by current or future (in the limit of inquiry, ideal) versions of fundamental physics at w, and (ii) it is not fundamentally mental (that is, does not individually either possess or bestow mentality). (shrink)

Fallibilists claim that one can know a proposition on the basis of evidence that supports it even if the evidence doesn't guarantee its truth. Jessica Brown offers a compelling defence of this view against infallibilists, who claim that it is contradictory to claim to know and yet to admit the possibility of error.

Self-control is integral to successful human agency. Without it we cannot extend our agency across time and secure central social, moral, and personal goods. But self-control is not a unitary capacity. In the first part of this paper we provide a taxonomy of self-control and trace its connections to agency and the self. In part two, we turn our attention to the external conditions that support successful agency and the exercise of self-control. We argue that what we call moral security (...) is a critical foundation for agency. Parts three and four explore what happens to agency when moral security is lacking, as in the case of those subject to racism, and those living in poverty. The disadvantages suffered by those who are poor, in a racial minority or other oppressed group, or suffering mental illness or addiction, are often attributed to a lack of individual self-control or personal responsibility. In particular, members of these groups are often seen as irresponsibly focused on short-term pleasures over long-term good, a view underwritten by particular psychological theories of self-control. We explore how narratives about racism and poverty undermine moral security, and limit and distort the possibility of synchronic and diachronic self-control. Where moral security is undermined, the connection between self-control and diachronic goods often fails to obtain and agency contracts accordingly. We close with some preliminary reflections on the implications for responsibility. (shrink)

In the Critique of Judgment, Kant claims that genius is a talent for art, but not for science. Despite his restriction of genius to the domain of fine art, several recent interpreters have suggested that genius has a role to play in Kant’s account of cognition in general and scientific practice in particular. In this paper, I explore Kant’s reasons for excluding genius from science as well as the reasons that one might nevertheless be tempted to think that his account (...) allows room for the scientific genius. I then argue that Kant’s concerns are not only epistemic, but also moral, and together, they give us good reason for resisting the veneration of genius. (shrink)

Amie Thomasson’s work provides numerous ways to rethink and improve our approach to metaphysics. This chapter is my attempt to begin to sketch why I still think the easy approach leaves room for substantive metaphysical work, and why I do not think that metaphysics need rely on any ‘epistemically metaphysical’ knowledge. After distinguishing two possible forms of deflationism, I argue that the easy ontologist needs to accept (implicitly or explicitly) that there are worldly constraints on what sorts of entities could (...) exist, and could co-exist. I argue this leaves room for a substantive role for metaphysics if (following the work of E.J. Lowe) we take metaphysics to be concerned with the possible ways that reality could be. I explain how this conception does not need to appeal to any ‘epistemically metaphysical’ knowledge, and need only make use of conceptual and/or empirical means to arrive at views on what could exist (and co-exist). Thus, the answer I propose to the question posed in the title, at least in my view, is no-one. Or, at least, no-one should be afraid of conceptual analysis. Not even metaphysicians. (shrink)

Hume's Dictum (HD) says, roughly and typically, that there are no metaphysically necessary connections between distinct, intrinsically typed, entities. HD plays an influential role in metaphysical debate, both in constructing theories and in assessing them. One should ask of such an influential thesis: why believe it? Proponents do not accept Hume's arguments for his dictum, nor do they provide their own; however, some have suggested either that HD is analytic or that it is synthetic a priori (that is: motivated by (...) intuitions we have no good reason to question). Here I explore whether belief in HD is directly justified on either grounds. I motivate and present more formal characterizations of HD; I show that there are good prima facie cases to be made for HD's being analytic and for its being synthetic a priori; I argue that each of the prima facie cases fails, some things considered. I close by offering two suggestions for how belief in HD might be indirectly justified on argumentative grounds. (shrink)

Some claim that Non-reductive Physicalism is an unstable position, on grounds that NRP either collapses into reductive physicalism, or expands into emergentism of a robust or ‘strong’ variety. I argue that this claim is unfounded, by attention to the notion of a degree of freedom—roughly, an independent parameter needed to characterize an entity as being in a state functionally relevant to its law-governed properties and behavior. I start by distinguishing three relations that may hold between the degrees of freedom needed (...) to characterize certain special science entities, and those needed to characterize their composing physical entities; these correspond to what I call ‘reductions’, ‘restrictions’, and ‘eliminations’ in degrees of freedom. I then argue that eliminations in degrees of freedom, in particular—when strictly fewer degrees of freedom are required to characterize certain special science entities than are required to characterize their composing physical entities—provide a basis for making sense of how certain special science entities can be both physically acceptable and ontologically irreducible to physical entities. (shrink)

Arguably no concept is more fundamental to science than that of causality, for investigations into cases of existence, persistence, and change in the natural world are largely investigations into the causes of these phenomena. Yet the metaphysics and epistemology of causality remain unclear. For example, the ontological categories of the causal relata have been taken to be objects (Hume 1739), events (Davidson 1967), properties (Armstrong 1978), processes (Salmon 1984), variables (Hitchcock 1993), and facts (Mellor 1995). (For convenience, causes and effects (...) will usually be understood as events in what follows.) Complicating matters, causal relations may be singular (Socrates’s drinking hemlock caused Socrates’s death) or general (Drinking hemlock causes death); hence the relata might be tokens (e.g., instances of properties) or types (e.g., types of events) of the category in question. Other questions up for grabs are: Are singular causes metaphysically and/or epistemologically prior to general causes or vice versa (or neither)? What grounds the intuitive asymmetry of the causal relation? Are macro-causal relations reducible to micro-causal relations? And perhaps most importantly: Are causal facts (e.g., the holding of causal relations) reducible to non-causal facts (e.g., the holding of certain spatiotemporal relations)? (shrink)

The Ethics of Need: Agency, Dignity, and Obligation argues for the philosophical importance of the notion of need and for an ethical framework through which we can determine which needs have moral significance. In the volume, Sarah Clark Miller synthesizes insights from Kantian and feminist care ethics to establish that our mutual and inevitable interdependence gives rise to a duty to care for the needs of others. Further, she argues that we are obligated not merely to meet others’ needs (...) but to do so in a manner that expresses "dignifying care," a concept that captures how human interactions can grant or deny equal moral standing and inclusion in a moral community. She illuminates these theoretical developments by examining two cases where urgent needs require a caring and dignifying response: the needs of the elderly and the needs of global strangers. Those working in the areas of feminist theory, women’s studies, aging studies, bioethics, and global studies should find this volume of interest. (shrink)

(Note: the posted version of this paper is undergoing non-trivial revision; an updated version will be posted in June 2024.) Is there a need for a distinctively diachronic conception of metaphysical emergence? Here I argue to the contrary. In the main, my strategy consists in considering a representative sample of accounts of purportedly diachronic metaphysical emergence, and arguing that in each case, the purportedly diachronic emergence at issue either can (and should) be subsumed under a broadly synchronic account of metaphysical (...) emergence, or else is better seen as simply a case of causation. In addition, I consider and argue against the suggestion that 'in-principle unpredictability' accounts of diachronic emergence support there being distinctively diachronic metaphysical emergence. (shrink)

In this lucid, deep, and entertaining book, John Perry supposes that type-identity physicalism is antecedently plausible, and that rejecting this thesis requires good reason. He aims to show that experience gap arguments, as given by Jackson, Kripke, and Chalmers, fail to provide such reason, and moreover that each failure stems from an overly restrictive conception of the content of thought.

Liberal democracies who perpetrate torture represent an apparent paradox: a flagrant violation of human rights by states supposedly dedicated to protecting human rights. In liberal democracies, the political, social, and legal narratives used to justify torture portray torture as an individual act motivated by important moral values. This individualized torture narrative then shapes the moral framework through which the public, policy-makers, and individual torturers view torture, and masks the institutional nature of torture perpetration. It is this interaction between an individualized (...) torture narrative and the moral framework of torture that distinguishes democratic perpetrators (Critchell et al. 2017, 9-10) from nondemocratic perpetrators of torture. Yet, the implementation of a torture program in a democratic state is remarkably similar to the implementation of a torture program in a nondemocratic state. In both cases, torture is an institutionalized practice given moral and political meaning through broad social and political narratives. This chapter uses the post-9/11 US torture program as a case study of a democratic perpetrator in order to explore the interaction between democratic narratives of torture, state implementation of torture, and the moral psychology of individual torturers. This permits a way of thinking about torture perpetration that goes beyond a myopic focus on torture as individual act to understand the interaction and mutual reinforcement of different forms of torture perpetration. This analysis also offers a starting point from which to consider how to resist and oppose torture narratives that sustain democratic tortue, a question I explore in the conclusion of this chapter. (shrink)

A number of examples of studies from the field ‘The Philosophy of Mathematical Practice’ (PMP) are given. To characterise this new field, three different strands are identified: an agent-based, a historical, and an epistemological PMP. These differ in how they understand ‘practice’ and which assumptions lie at the core of their investigations. In the last part a general framework, capturing some overall structure of the field, is proposed.

(Note: this is the lead article in a forthcoming issue of _Australasian Philosophical Review_ edited by Dana Goswick, with invited comments by Karen Bennett, Ricki Bliss, Jonathan Schaffer, Alexander Skiles. In June 2024 there will be an open call for other commentators; please contact Dana or Jessica if you are interested.) A wide range of scientific, religious/cosmological, and philosophical views presuppose that there is what I call `metaphysical structure', whereby (i) some goings-on in a given domain D are (absolutely (...) or comparatively) fundamental; and (ii) (comparatively) non-fundamental goings-on in D metaphysically depend on (absolutely or comparatively) fundamental goings-on in D. Such presuppositions motivate two broadly metametaphysical questions: (i) what makes it the case that some goings-on in a domain D are (absolutely or comparatively) fundamental? and (ii) what makes it the case that (comparatively) non-fundamental goings-on in a domain D metaphysically depend on (absolutely or comparatively) fundamental goings-on in D? Here I advance my preferred 'Fundamentality First' package deal approach to metaphysical structure, which couples a primitivist approach to fundamentality with a pluralist approach to metaphysical dependence. (shrink)