How research studies should use social media to recruit research participants is a timely question. Importantly, the question is how, not if, studies should use...

While experience often affords important knowledge and insight that is difficult to garner through observation or testimony alone, it also has the potential to generate conflicts of interest and unrepresentative perspectives. We call this tension the paradox of experience. In this paper, we first outline appeals to experience made in debates about access to unproven medical products and disability bioethics, as examples of how experience claims arise in bioethics and some of the challenges raised by these claims. We then motivate (...) the idea that experience can be an asset by appealing to themes in feminist and moral epistemology, distinguishing between epistemic and justice-based appeals. Next, we explain the concern that experience may be a liability by appealing to empirical work on cognitive biases and theoretical work about the problem of partial representation. We conclude with preliminary recommendations for addressing the paradox and offer several questions for future discussion. (shrink)

Abstract“Suffering” is a central concept within bioethics and often a crucial consideration in medical decision making. As used in practice, however, the concept risks being uninformative, ambiguous, or even misleading. In this paper, we consider a series of cases in which “suffering” is invoked and analyze them in light of prominent theories of suffering. We then outline ethical hazards that arise as a result of imprecise usage of the concept and offer practical recommendations for avoiding them. Appeals to suffering are (...) often getting at something ethically important. But this is where the work of ethics begins, not where it ends. (shrink)

The neurodiversity view makes both a conceptual and a political claim. Conceptually, the neurodiversity view holds that certain neurocognitive differences currently classified as disorders—autism, most notably—are best understood as forms of diversity. Politically, it holds that, rather than being medicalized and ‘treated’, neurodiversity ought to be respected in the way other human differences—such as differences in race and sexual orientation—are respected. In this article, I challenge the arguments given in support of neurodiversity’s conceptual claim, while defending its political aims of (...) respect, inclusion, and accommodation. Although neurodiversity provides a compelling challenge to the status quo, I conclude that its most prominent arguments fall short of establishing that autism is not a disorder. As I go on to argue, however, the fact that autism is a disorder does not entail that medicalization is the only course. My view is ultimately that social change and medical intervention need not be considered mutually exclusive. (shrink)

Work done within the realm of what is sometimes called ‘descriptive ethics’ brings two questions readily to mind: How can empirical findings, in general, inform normative debates? and How can these empirical findings, in particular, inform the normative debate at hand? Brick et al 1 confront these questions in their novel investigation of public views about lives worth living and the permissibility of withdrawing life-sustaining treatment from critically ill infants. Mindful of the is-ought gap, the authors suggest modestly that their (...) data ‘may be useful when constructing guidelines for clinical practice’. In this commentary, I consider some potential limitations on the generalisability of these data in the context of policy and clinical practice, limitations which may in turn serve as directions for future empirical research. The authors’ study presented participants six case scenarios, five of which involved the possibility of withdrawing life-sustaining treatment from critically ill infants. The results revealed that “[a]lmost all respondents agreed that at some level of quality of life, life may be of no benefit or worse than death for an infant” and that “participants significantly favoured withdrawal of treatment for the most severe cases.” One salient detail in these scenarios …. (shrink)

Volume 20, Issue 4, May 2020, Page 48-50.

Volume 20, Issue 7, July 2020, Page 190-192.

Volume 20, Issue 2, February 2020, Page 66-68.

Hastings Center Report, Volume 52, Issue 1, Page 42-50, January/February 2022.

How should clinical ethicists be trained? Scholars have stated that clinical ethics fellowships create well-trained, competent ethicists. While this appears intuitive, few features of fellowship programs have been publicly discussed, let alone debated. In this paper, we examine how fellowships can foster effective mentoring relationships. These relationships provide the foundation for the fellow’s transition from novice to competent professional. In this essay, we begin by discussing our pedagogical commitments. Next, we describe the structures our program has created to assist our (...) fellows in becoming competent ethicists. We then outline the kinds of knowledge, skills, and professional attributes mentors should possess. Following this, we focus on the knowledge, skills, and professional attributes that fellows develop as they co-create effective mentoring relationships. We will not prescribe a single approach to fellowship training; instead, our perspective will, we hope, become a catalyst for further conversation on training and mentoring clinical ethics fellows. (shrink)

Patients who experience difficulty making medical decisions are often referred to as “ambivalent.” However, the current lack of attention to the nuances between a cluster of phenomena that resemble...

While it is not explicitly included in capacity assessment tools, “consistency” has come to feature as a central concern when assessing patients’ capacity. In order to determine whether inconsistency indicates incapacity, clinicians must determine the source of the inconsistency with respect to the process or content of a patient’s decision-making. In this paper, we outline common types of inconsistency and analyze them against widely accepted elements of capacity. We explore the question of whether inconsistency necessarily entails a deficiency in a (...) patient’s capacity. While inconsistency may count as _prima_ _facie_ evidence of incapacity—enough evidence to justify a closer look—when making such determinations, it is important for clinicians to slow down, inquire about the reasons underlying the inconsistency and clearly show which of the elements of capacity the patient fails to satisfy. (shrink)

Volume 19, Issue 11, November 2019, Page 82-84.

If the COVID-19 crisis has brought any benefits, one is the increased attention paid to persons with disabilities in the contexts of clinical medicine and public health. There has been a great deal of insightful discussion since the outbreak about controversial disability issues the pandemic has brought to light. For a population often overlooked in both academic circles and the public square, mere visibility is a victory. There are at least two important respects in which the discussion remains underdeveloped, however.First, (...) much of the work being done has focused on disability considerations in policies governing triage and the rationing of critical care resources under crisis conditions. This is undoubtedly an... (shrink)

While it is not explicitly included in capacity assessment tools, “consistency” has come to feature as a central concern when assessing patients’ capacity. In order to determine whether inconsistency indicates incapacity, clinicians must determine the source of the inconsistency with respect to the process or content of a patient’s decision-making. In this paper, we outline common types of inconsistency and analyze them against widely accepted elements of capacity. We explore the question of whether inconsistency necessarily entails a deficiency in a (...) patient’s capacity. While inconsistency may count as prima facie evidence of incapacity—enough evidence to justify a closer look—when making such determinations, it is important for clinicians to slow down, inquire about the reasons underlying the inconsistency and clearly show which of the elements of capacity the patient fails to satisfy. (shrink)

Extracorporeal membrane oxygenation (ECMO) is typically viewed as a time-limited intervention—a bridge to recovery or transplant—not a destination therapy. However, some patients with decision-making capacity request continued ECMO support despite a poor prognosis for recovery and lack of viability as a transplant candidate. In response, critical care teams have asked for guidance regarding the ethical permissibility of unilateral withdrawal over the objections of a capacitated patient. In this article, we evaluate several ethical arguments that have been made in favor of (...) withdrawal, including distributive justice, quality of life, patients’ rights, professional integrity, and the Equivalence Thesis. We find that existing justifications for unilateral withdrawal of ECMO support in capacitated patients are problematic, which leads us to conclude that either: (1) additional ethical arguments are necessary to defend this approach or (2) the claim that it is not appropriate to use ECMO as a destination therapy should be questioned. (shrink)

Questions about when to limit unhelpful treatments are often raised in general medicine but are less commonly considered in psychiatry. Here we describe a survey of U.S. psychiatrists intended to characterize their attitudes about the management of suicidal ideation in patients with severely treatment-refractory illness. Respondents (n = 212) received one of two cases describing a patient with suicidal ideation due to either borderline personality disorder or major depressive disorder. Both patients were described as receiving all guideline-based and plausible emerging (...) treatments. Respondents rated the expected helpfulness and likelihood of recommending each of four types of intervention: hospitalization, additional medication changes, additional neurostimulation, and additional psychotherapy. Across both cases, most respondents said they were likely to provide each intervention, except for additional neurostimulation in borderline personality disorder, while fewer thought each intervention would be helpful. Substantial minorities of respondents indicated that they would provide an intervention they did not think was likely to be helpful. Our results suggest that while most psychiatrists recognize the possibility that some patients are unlikely to be helped by available treatments, many would continue to offer such treatments. (shrink)

This volume concerns the status and ambitions of metaphysics as a discipline.

In his postapocalyptic novel, Those Who Remain, G. Michael Hopf (2016) makes an important observation about the effect crises can have on human psychology by noting that "hard times create strong [humans]" (loc. 200). While the catastrophic effects of the recent COVID-19 outbreak are incontestable, there are arguments to be made that the situation itself could be materia prima of a more grounded, and authentic generation of humanity, at least in theory. In this article I draw on Heidegger's early, implicit (...) ethic of finitude as well as his later work surrounding the nature of technology, and place them into dialogue with a global milieu contextualized by worldwide pandemic. I approach this discussion from two different angles: in the first part, I explicate the ethic of finitude, and use it as a framework to describe the observable behavior of communities worldwide in order to better understand how global crises impact the psychical welfare of individual human beings. In the second part, I apply lessons given to us by the later Heidegger, specifically those oriented around the movement away from calculative thinking, in an effort to define a loose, albeit fundamentally ennobling prescriptive aimed at easing the existential strain of the situation we have found ourselves in. *This is a pre-print of an article published in Human Arenas. The final authenticated version is available at DOI: 10.1007/s42087-020-00142-6. (shrink)

Ryan Wasserman explores a range of fascinating puzzles raised by the possibility of time travel, with entertaining examples from physics, science fiction, and popular culture, and he draws out their implications for our understanding of time, tense, freedom, fatalism, causation, counterfactuals, laws of nature, persistence, change, and mereology.

Including significant passages from The Prince, The Discourses, The Art of War and History of Florence, this illuminating book explores the influence of Machiavelli, who was often reviled as a teacher of evil, on the modern state.

This book is the first comprehensive study of Schopenhauer's philosophy of religion. It develops a contextual account of Schopenhauer's relation to the religions of India by placing his interpretation of their main doctrines within the perspective of his diagnosis of the religious situation in nineteenth-century Europe, and his revised conception of the proper content and methods of metaphysical philosophy in the wake of Kant. It shows that Schopenhauer's encounter with the religions of India was the stimulus for his formulation of (...) a novel theory of a revitalised modern Christianity. The possibility of an oriental renaissance prompted Schopenhauer to argue that Christianity's immanent or ethical teachings needed to be severed from its supernatural or metaphysical doctrines, so that European culture could continue to satisfy the human need for a metaphysical interpretation of the world and life. This book will be of interest to philosophers, theologians, students of religion and modern intellectual history. (shrink)

Essays discuss cognition, perception, art, science, truth, metaphor, education, philosophy, and cognitive psychology.

AI and people do not compete on a level-playing field. Self-driving vehicles may be safer than human drivers, but laws often penalize such technology. People may provide superior customer service, but businesses are automating to reduce their taxes. AI may innovate more effectively, but an antiquated legal framework constrains inventive AI. In The Reasonable Robot, Ryan Abbott argues that the law should not discriminate between AI and human behavior and proposes a new legal principle that will ultimately improve human (...) well-being. This work should be read by anyone interested in the rapidly evolving relationship between AI and the law. (shrink)

The author reviews the work of select theologians, ethicists, and biblical scholars who suggest that the difference between humans and animals should serve not solely as an ascription of a special status to humans but also as the foundation for a responsibility that humans bear toward animals. As an added reflection, the author explores common categorical differentiations in systematic theology: God and creation, human and nonhuman, elect and non-elect. In the first and last of these categorical differentiations, unique identity entails (...) both a special status and a responsibility. The latter is normatively directed to those who are categorically different. As such, the categorical difference between humans and animals establishes a foundation for moral concern. (shrink)

When are morally good actions beautiful, when indeed they are? In this paper, it is argued that morally good actions are beautiful when they appear to express the deep or true self, and in turn tend to give rise to an emotion which is characterised by feelings of being moved, unity, inspiration, and meaningfulness, inter alia. In advancing the case for this claim, it is revealed that there are additional sources of well-formedness in play in the context of moral beauty (...) in addition to those that have tended to be focused on to date: one which is connected to imagining a deep location for the goodness concerned, and another which is connected to imagining that the goodness stems from capacities which are essential to the person. (shrink)

In this paper I assess the labour ward admission policies introduced by some National Health Service trusts during the COVID-19 pandemic, arguing that these intersected with other policies in a manner which may have coerced birthing people into consenting to vaginal examinations they might have otherwise refused. In order to fully understand the potential severity of these policies, I situate this critique in the historical and contemporary context of the problematic relationship between consent and vaginal examinations. Identifying the legal wrongs (...) associated with performing coerced vaginal examinations, I highlight that the law is inadequately equipped to provide appropriate redress. Further, I illustrate that the issue explored in this paper reflects broader problems which exist with regard to the focus of, and the investment in, the maternity services. (shrink)

How Classification Works attempts to bridge the gap between philosophy and the social sciences using as a focus some of the work of Nelson Goodman. Throughout his long career Goodman has addressed the question: are some ways of conceptualizing more natural than others? This book looks at the rightness of categories, assessing Goodman's role in modern philosophy and explaining some of his ideas on the relation between aesthetics and cognitive theory. Two papers by Nelson Goodman are included in (...) the collection and there are analyses of his work by seven leading academics in anthropology, philosophy, sociology and musicology. (shrink)

What is the nature of the concept BEAUTY? Does it differ fundamentally from nearby concepts such as PRETTINESS? It is argued that BEAUTY, but not PRETTINESS, is a dual-character concept. Across a number of contexts, it is proposed that BEAUTY has a descriptive sense that is characterised by, inter alia, having intrinsically pleasing appearances; and a normative sense associated with deeply-held values. This account is supported across two, pre-registered, studies (N=500), and by drawing on analysis of corpus data. It is (...) suggested that this can help to explain why beauty, unlike prettiness, is thought to be deep in both the sense of being important, and in the sense of being less closely tied to sensory surfaces. (shrink)

According to the most important objection to the existence of moral beauty, true judgements of moral beauty are not possible as moral judgements require being motivated to act in line with the moral judgement made, and judgements of beauty require not being motivated to act in any way. Here, I clarify the argument underlying the objection, and show that it does not show that moral beauty does not exist. I present two responses: namely, that the beauty of moral beauty does (...) not lie in the moral goodness per se (the “adjacent properties” response); and that only a dispositional motivation to act is required for the moral judgements that are typically made as part of judgements of moral beauty, whereas aesthetic judgements only rule out state motivations to act (the “equivocation of motivation required” response). In addressing the objection, I show how moral beauty is consistent with disinterestedness, and so should be accepted more widely; and also clarify where the beauty in moral beauty resides, and how the moral-aesthetic distinction should be drawn. (shrink)

Miller (1956) summarized evidence that people can remember about seven chunks in short-term memory (STM) tasks. However, that number was meant more as a rough estimate and a rhetorical device than as a real capacity limit. Others have since suggested that there is a more precise capacity limit, but that it is only three to five chunks. The present target article brings together a wide variety of data on capacity limits suggesting that the smaller capacity limit is real. Capacity limits (...) will be useful in analyses of information processing only if the boundary conditions for observing them can be carefully described. Four basic conditions in which chunks can be identified and capacity limits can accordingly be observed are: (1) when information overload limits chunks to individual stimulus items, (2) when other steps are taken specifically to block the recoding of stimulus items into larger chunks, (3) in performance discontinuities caused by the capacity limit, and (4) in various indirect effects of the capacity limit. Under these conditions, rehearsal and long-term memory cannot be used to combine stimulus items into chunks of an unknown size; nor can storage mechanisms that are not capacity-limited, such as sensory memory, allow the capacity-limited storage mechanism to be refilled during recall. A single, central capacity limit averaging about four chunks is implicated along with other, noncapacity-limited sources. The pure STM capacity limit expressed in chunks is distinguished from compound STM limits obtained when the number of separately held chunks is unclear. Reasons why pure capacity estimates fall within a narrow range are discussed and a capacity limit for the focus of attention is proposed. Key Words: attention; enumeration; information chunks; memory capacity; processing capacity; processing channels; serial recall; short-term memory; storage capacity; verbal recall; working memory capacity. (shrink)

Very diverse societies pose real problems for Rawlsian models of public reason. This is for two reasons: first, public reason is unable accommodate diverse perspectives in determining a regulative ideal. Second, regulative ideals are unable to respond to social change. While models based on public reason focus on the justification of principles, this book suggests that we need to orient our normative theories more toward discovery and experimentation. The book develops a unique approach to social contract theory that focuses on (...) diverse perspectives. It offers a new moral stance that author Ryan Muldoon calls, "The View From Everywhere," which allows for substantive, fundamental moral disagreement. This stance is used to develop a bargaining model in which agents can cooperate despite seeing different perspectives. Rather than arguing for an ideal contract or particular principles of justice, Muldoon outlines a procedure for iterated revisions to the rules of a social contract. It expands Mill's conception of experiments in living to help form a foundational principle for social contract theory. By embracing this kind of experimentation, we move away from a conception of justice as an end state, and toward a conception of justice as a trajectory. (shrink)

Why are moral actions beautiful, when indeed they are? This paper assesses the view, found most notably in Schiller, that moral actions are beautiful just when they present the appearance of freedom by appearing to be the result of internal harmony (the Schillerian Internal Harmony Thesis). I argue that while this thesis can accommodate some of the beauty involved in contrasts of the ‘continent’ and the ‘fully’ virtuous, it cannot account for all of the beauty in such contrasts, and so (...) needs to be weakened considerably (to the Internal Harmony Thesis). To account for the remaining beauty that cannot be fully accommodated even by this revised thesis, as well as the beauty contained in contrasts that involve agents who experience internal conflict as a result of being sensitive to different sources of moral value to an appropriate extent, a number of further theses need to be posited: namely, that the beauty of some moral actions is to be accommodated in terms of internal disharmony (the Internal Disharmony Thesis), and in terms of a felt harmony between the appreciator of the action and the executor of the action (the Affective Harmony Thesis). As such, in contrast to Schiller, I suggest that we need to take a pluralist and context-sensitive approach to accommodating the beauty of moral actions. (shrink)

This book explores the constraints which justice imposes on immigration policy. Like liberal nationalists, Ryan Pevnick argues that citizens have special claims to the institutions of their states. However, the source of these special claims is located in the citizenry's ownership of state institutions rather than in a shared national identity. Citizens contribute to the construction and maintenance of institutions, and as a result they have special claims to these institutions and a limited right to exclude outsiders. Pevnick shows (...) that the resulting view justifies a set of policies - including support for certain types of guest worker programs - which is distinct from those supported by either liberal nationalists or advocates of open borders. His book provides a framework for considering a number of connected topics including issues related to self-determination, the scope of distributive justice and the significance of shared national identity. (shrink)

In The Conditions for Ethical Chemical Restraint, Crutchfield and Redinger (2024) propose ethical standards for the use of chemical restraints, which they consider normatively distinct from physica...

INTRODUCTION Reopening a Discussion The empiricist-derived epistemology that has directed most social and natural scientific inquiry for the last three ...

Those giving birth within modern maternity systems are recognised as facing a number of barriers to person-centred care. In this paper, I argue that in order to best facilitate the conditions for positive change, work needs to be done to provide a more granular articulation of the specific barriers. I then offer a nuanced and contextually aware articulation of one key component of the overall failure to ensure person-centred care: medical authority and the expectation of conformity. Articulating these barriers with (...) increased specificity is valuable, as it creates a stronger foundation from which to challenge existing problems which serve to constrain the autonomy of birthing individuals. The analysis offered in this paper also underscores the need for change at an institutional, rather than individual, level. (shrink)

Coronavirus disease 2019 can lead to respiratory failure. Some patients require extracorporeal membrane oxygenation support. During the current pandemic, health care resources in some cities have been overwhelmed, and doctors have faced complex decisions about resource allocation. We present a case in which a pediatric hospital caring for both children and adults seeks to establish guidelines for the use of extracorporeal membrane oxygenation if there are not enough resources to treat every patient. Experts in critical care, end-of-life care, bioethics, and (...) health policy discuss if age should guide rationing decisions. (shrink)

In this article, I examine A. John Simmons’s philosophical anarchism, and specifically, the problems that result from the combination of its three foundational principles: the strong correlativity of legitimacy rights and political obligations; the strict distinction between justified existence and legitimate authority; and the doctrine of personal consent, more precisely, its supporting assumptions about the natural freedom of individuals and the non-natural states into which individuals are born. As I argue, these assumptions, when combined with the strong correlativity and strict (...) distinction theses, undermine Simmons’s claim, which is central to his philosophical anarchism, that a state may be justified in enforcing the law, even if illegitimate or unjustified in existing. (shrink)

Most accounts of cognitive scaffolding focus on ways that external structure can support or augment an agent’s cognitive capacities. We call cases where the interests of the user are served benign scaffolding and argue for the possibility and reality of hostile scaffolding. This is scaffolding which depends on the same capacities of an agent to make cognitive use of external structure as in benign cases, but that undermines or exploits the user while serving the interests of another agent. We develop (...) criteria for scaffolding being hostile and show by reference to examples including the design features of electronic gambling machines and casino management systems that hostile scaffolding exists and can be highly effective. In cases where the scaffolding is deep and permits the offloading of significant cognitive work, hostile scaffolding exploitatively manipulates cognitive processing itself. Given the extent of human reliance on scaffolding this is an important and neglected vulnerability. [This is an updated version of the paper, added in February 2023.]. (shrink)

Diese Schriften kennzeichnen den Weg, auf dem Nelson - Kant folgend - sein Ziel einer "kritischen Philosophie" angestrebt hat. Es geht ihm darum, durch Kritik der Vernunft unmittelbare Erkenntnisse aus reiner Vernunft aufzusuchen, ihnen die Maßstäbe für wissenschaftliches Philosophieren zu entnehmen und so, im Selbstvertrauen der Vernunft, Ausblicke auf pädagogische Aufgaben und Weltanschauungsfragen zu gewinnen.