Accounts of the value of patient choice in contemporary medical ethics typically focus on the act of choosing. Being the one to choose, it is argued, can be valuable either because it enables one to bring about desired outcomes, or because it is a way of enacting one’s autonomy. This paper argues that all such accounts miss something important. In some circumstances, it is having the opportunity to choose, not the act of choosing, that is valuable. That is because in (...) many situations whether one has, or is denied, that opportunity conveys how one is seen. In particular, it conveys whether or not one is seen as an equal and competent member of society. Adequately recognising this fact has implications for what healthcare professionals should do, ones that require a move away from the current focus on autonomy. The paper draws out these implications by focusing on patients who may struggle to be recognised as competent and equal members of society, and whose autonomy may thus itself sometimes be in question. (shrink)

John Dewey developed a pragmatic theory of inquiry to provide intelligent methods for social progress. He believed that the logic and attitude of successful scientific inquiries, properly conceived, could be fruitfully applied to morals and politics. Unfortunately, his project has been poorly understood and his logic of inquiry neglected as a resource. Contemporary pragmatists, like Richard Rorty, for example, dismiss his emphasis on method and avoid judgments of moral progress that are in any way independent of the biases of particular (...) cultures. In this article, I argue that Dewey’s theory of inquiry indeed provides intelligent methods and intellectual criteria for engaging moral and political matters. Inquiry, as Dewey conceives it, issues in judgments that are increasingly objective, reliable and refined in application. These judgments are rooted in particular times and places, in actual ‘situations’, but are not entirely hostage to specific cultures. I then apply Dewey’s theory to two standard moral problems to demonstrate how it works. The conclusion is that Dewey’s theory of inquiry gets it just right: it provides solid ground for criticism and moral progress while remaining acutely sensitive to cultural differences and changing circumstances. (shrink)

The task of aligning the philosophical and clinical perspectives on ethics is a challenging one. Clinical practice informs philosophy, not merely by supplying cases, but through shaping and testing philosophical concepts in the reality of the clinical world. In this paper we explore several aspects of the relationship between the philosophical and the clinical within a framework of palliative care for people living with Alzheimer's disease. We suggest that health professionals have a moral obligation to question previous assumptions concerning the (...) quality of life among people with Alzheimer's, and to address the question: does the concept of palliative care properly embrace people with severe dementia? We propose an ethic of palliative care for people with Alzheimer's that is based, not on the traditionally understood principle of autonomy, but on the need to listen to those living with the disease, acknowledging their profound loss of cognitive abilities, with a focus on preventing and relieving suffering, and improving the individual's quality of life. (shrink)

Technological developments in the sphere of artificial intelligence (AI) inspire debates about the implications of autonomous weapon systems (AWS), which can select and engage targets without human intervention. While increasingly more systems which could qualify as AWS, such as loitering munitions, are reportedly used in armed conflicts, the global discussion about a system of governance and international legal norms on AWS at the United Nations Convention on Certain Conventional Weapons (UN CCW) has stalled. In this article we argue for the (...) necessity to adopt legal norms on the use and development of AWS. Without a framework for global regulation, state practices in using weapon systems with AI-based and autonomous features will continue to shape the norms of warfare and affect the level and quality of human control in the use of force. By examining the practices of China, Russia, and the United States in their pursuit of AWS-related technologies and participation at the UN CCW debate, we acknowledge that their differing approaches make it challenging for states parties to reach an agreement on regulation, especially in a forum based on consensus. Nevertheless, we argue that global governance on AWS is not impossible. It will depend on the extent to which an actor or group of actors would be ready to take the lead on an alternative process outside of the CCW, inspired by the direction of travel given by previous arms control and weapons ban initiatives. (shrink)

Although widely recognized as founder and key figure in the current re-emergence of pragmatism, Charles Peirce is rarely brought into contemporary dialogue. In this book, Kory Sorrell shows that Peirce has much to offer contemporary debate and deepens the value of Peirce’s view of representation in light of feminist epistemology, philosophy of science, and cultural anthropology. Drawing also on William James and John Dewey, Sorrell identifies ways in which bias, authority, and purpose are ineluctable constituents of shared representation. (...) He nevertheless defends Peirce’s realistic account of representation, showing how the independently real world both constrains social representation and informs its content. Most importantly, Sorrell shows how members of a given community not only represent but transform a shared world—and how those practices of representation may, and should, be improved. (shrink)

How wrong is it to deceive someone into sex by lying, say, about one's profession? The answer is seriously wrong when the liar's actual profession would be a deal breaker for the victim of the deception: this deception vitiates the victim's sexual consent, and it is seriously wrong to have sex with someone while lacking his or her consent.

Empathy is the ability to infer and share the feelings, intentions, and goals of other persons.1 It provides the basis for our extraordinary capacity to help others, including strangers we may never meet, without interest in personal benefit. Its extent has been controversial, but recent studies in neuroscience, empirical psychology, and primatology support a highly empathic understanding of human nature. This view overturns the so-called “Darwinian” paradigm prevalent both in popular imagination and academic disciplines.2 The “Darwinian” account—in quotes because distant (...) from Darwin’s own express views3—holds that “man is a wolf to man” (homo homini lupus); that individuals are self-maximizing and manipulative .. (shrink)

There is widespread agreement that it would be both morally and legally wrong to treat a competent patient, or to carry out research with a competent participant, without the voluntary consent of that patient or research participant. Furthermore, in medical ethics it is generally taken that that consent must be informed. The most widely given reason for this has been that informed consent is needed to respect the patient’s or research participant’s autonomy. In this article I set out to challenge (...) this claim by considering in detail each of the three most prominent ways in which ‘autonomy’ has been conceptualized in the medical ethics literature. I will argue that whilst these accounts support the claim that consent is needed if the treatment of competent patients, or research on competent individuals, is to respect their autonomy, they do not support the claim that informed consent is needed for this purpose. (shrink)

It is generally held that doctors and researchers have an obligation to obtain informed consent. Over time there has been a move in relation to this obligation from a requirement to disclose information to a requirement to ensure that that information is understood. Whilst this change has been resisted, in this article I argue that both sides on this matter are mistaken. When investigating what information is needed for consent to be informed we might be trying to determine what information (...) a person would need in order to consent at all, or we might be trying to determine what information a person needs in order to make an informed choice about whether or not to consent. I argue that the obligation to ensure understanding only applies to information generated by the first type of enquiry; but that much of the information generally thought necessary in order for consent to be informed is only required if our concern is with the second type of enquiry. For this reason it is neither the case that doctors and researchers should ensure all the information they provide is understood, nor is it the case that their only obligation is to disclose it. (shrink)

This essay focuses on the role relationships of authority play in the communal production of knowledge. The author draws on recent developments in feminist epistemology and the pragmatism of John Dewey to show that not only is authority representation ineluctable, but is desirable if held properly accountable.

This article argues that philosophy instructors in general, and critical thinking instructors in particular, profit from developing concise preparatory remarks for introductory classes. To this end, it argues for two simple, but effective, introductory descriptions of philosophy: talking about how we do what we do and why we do what we do, and critical thinking applied to writing. Of particular interest with respect to the second formulation is an introductory treatment of the concept of thinking, emphasizing critical thinking as a (...) synthetic as well as analytic activity. The article also includes a suggested application of its thesis, namely, “the index-card exercise,” in which students engage in philosophical writing from day one of an introductory course, and use the results to structure and write philosophical papers. (shrink)

ABSTRACT This article defends Charles Peirce's “doctrine of immediate perception.” This realistic view holds that conscious agents, due to the work of unconscious mind, directly perceive the world and often know objects, events, and persons as they truly are, independently of how we might prefer to think of them. The doctrine provides a promising alternative to more recent views insisting that all experience of the world and other persons is ineluctably mediated by language, along with the categories and biases language (...) inevitably imposes. Peirce's view is further explicated in terms of what neuroscientists now call the “new” unconscious and supported by recent work in both neuroscience and empirical psychology, especially experiments involving infants. The article supports the conclusion that, while much experience is mediated by language, direct access to a world that informs and often surprises us persists throughout conscious experience. (shrink)

This article develops an unconventional perspective on the utilitarianism of Bentham and Mill in at least four areas. First, it is shown that both authors conceived of utility as irreducibly multi-dimensional, and that Bentham in particular was very much aware of the ambiguity that multi-dimensionality imposes upon optimal choice under the greatest happiness principle. Secondly, I argue that any attribution of intrinsic worth to any form of human behaviour violates the first principles of Bentham's and Mill's utilitarianism, and that this (...) renders both authors immune to the claim by G. E. Moore that they committed a ‘naturalistic fallacy’. Thirdly, in light of these contentions, I find no flaw in Mill's ‘proof of utility’. Fourthly, I use the notion of intrapersonal utility weights to provide an interpretation of Mill's qualitative hedonism that is entirely consistent with his value monism. (shrink)

In a health service with limited resources we must make decisions about who to treat first. In this paper I develop a version of the restoration argument according to which those whose need for resources is a consequence of their voluntary choices should receive lower priority when it comes to health care. I then consider three possible problems for this argument based on those that have been raised against other theories of this type: that we don't know in a particular (...) case that the illness is self-inflicted, that it seems that all illness is self-inflicted in the sense used in my argument, and finally that this type of approach incorporates an unacceptable moralising element if it is to avoid giving those like fire-fighters a lower priority for treatment. I argue that the position outlined here has the resources to respond to each of these objections. (shrink)

Physicians in rural settings confront many of the same ethical dilemmas as their urban counterparts: confidentiality, quality‐of‐life decisions, resource allocation, and their moral responsibility for bettering the life of the community. However, the courses of action they choose as morally justifiable are influenced by distance from other professional facilities, the interrelationship of private and professional roles in a small community, and the non‐specialized orientation of their practices.

The frequency of death from miscarriage is very high, greater than the number of deaths from induced abortion or major diseases.Berg (2017, Philosophical Studies 174:1217–26) argues that, given this, those who contend that personhood begins at conception (PAC) are obliged to reorient their resources accordingly—towards stopping miscarriage, in preference to stopping abortion or diseases. This argument depends on there being a basic moral similarity between these deaths. I argue that, for those that hold to PAC, there are good reasons to (...) think that there is no such similarity. There is a morally relevant difference between preventing killing and letting die, giving PAC supporters reasons to prioritize reducing abortion over reducing miscarriage. And the time-relative interest account provides a morally relevant difference in the badness of death of miscarriages and deaths of born adults, justifying attempts to combat major diseases over attempts to combat miscarriage. I consider recent developments in the literature and contend that these new arguments are unsuccessful in establishing moral similarities between deaths from miscarriage and abortion, and deaths from miscarriage and disease. (shrink)

Nearly everyone prefers pain to be in the past rather than the future. This seems like a rationally permissible preference. But I argue that appearances are misleading, and that future-biased preferences are in fact irrational. My argument appeals to trade-offs between hedonic experiences and other goods. I argue that we are rationally required to adopt an exchange rate between a hedonic experience and another type of good that stays fixed, regardless of whether the hedonic experience is in the past or (...) future. (shrink)

First Published in 2004. Routledge is an imprint of Taylor & Francis, an informa company.

The scope of someone's consent is the range of actions that they permit by giving consent. The Scope of Consent investigates the under-explored question of which normative principle governs the scope of consent. To answer this question, the book's investigation involves taking a stance on what constitutes consent. By appealing to the idea that someone can justify their behaviour by appealing to another person's consent, Dougherty defends the view that consent consists in behaviour that expresses a consent-giver's will for how (...) a consent-receiver behaves. The ultimate conclusion of the book is that the scope of consent is determined by certain evidence that bears on the appropriate interpretation of the consent. (shrink)

First Published in 2004. Routledge is an imprint of Taylor & Francis, an informa company.

You are morally permitted to save your friend at the expense of a few strangers, but not at the expense of very many. However, there seems no number of strangers that marks a precise upper bound here. Consequently, there are borderline cases of groups at the expense of which you are permitted to save your friend. This essay discusses the question of what explains ethical vagueness like this, arguing that there are interesting metaethical consequences of various explanations.

In an influential paper, L. A. Paul argues that one cannot rationally decide whether to have children. In particular, she argues that such a decision is intractable for standard decision theory. Paul's central argument in this paper rests on the claim that becoming a parent is ``epistemically transformative''---prior to becoming a parent, it is impossible to know what being a parent is like. Paul argues that because parenting is epistemically transformative, one cannot estimate the values of the various outcomes of (...) a decision whether to become a parent. In response, we argue that it is possible to estimate the value of epistemically transformative experiences. Therefore, there is no special difficulty involved in deciding whether to undergo epistemically transformative experiences. Insofar as major life decisions do pose a challenge to decision theory, we suggest that this is because they often involve separate, familiar problems. (shrink)

The anglophone philosophy profession has a well-known problem with gender equity. A sig-nificant aspect of the problem is the fact that there are simply so many more male philoso-phers than female philosophers among students and faculty alike. The problem is at its stark-est at the faculty level, where only 22% - 24% of philosophers are female in the United States (Van Camp 2014), the United Kingdom (Beebee & Saul 2011) and Australia (Goddard 2008).<1> While this is a result of the (...) percentage of women declining at each point through-out the standard career trajectory, recent large-scale studies in the United States (Paxton et al. 2012) and Australia (Goddard et al. 2008) have identified a key drop-off point as the transi-tion between taking introductory classes and majoring in philosophy. So why do dispropor-tionately few female students choose to major in philosophy? (shrink)

Ulysses contracts are a method by which one person binds himself by agreeing to be bound by others. In medicine such contracts have primarily been discussed as ways of treating people with episodic mental illnesses, where the features of the illness are such that they now judge that they will refuse treatment at the time it is needed. Enforcing Ulysses contracts in these circumstances would require medical professionals to override the express refusal of the patient at the time treatment is (...) required, something that is generally problematic both ethically and legally. In this paper I will argue that despite appearances Ulysses contracts can make it the case that treating a patient in such circumstances is an instance of treating him with his consent, although safeguards are needed to ensure that this is the case. Given the potential benefits to patients I further argue that modified Ulysses contracts should be made legally enforceable. (shrink)

Most of us are “time-biased” in preferring pains to be past rather than future and pleasures to be future rather than past. However, it turns out that if you are risk averse and time-biased, then you can be turned into a “pain pump”—in order to insure yourself against misfortune, you will take a series of pills which leaves you with more pain and better off in no respect. Since this vulnerability seems rationally impermissible, while time-bias and risk aversion seem rationally (...) permissible, we are left with a puzzle. (shrink)

Why is there female under-representation among philosophy majors? We survey the hypotheses that have been proposed so far, grouping similar hypotheses together. We then propose a chronological taxonomy that distinguishes hypotheses according to the stage in undergraduates’ careers at which the hypotheses predict an increase in female under-representation. We then survey the empirical evidence for and against various hypotheses. We end by suggesting future avenues for research.

The author proposes a dimensional model of our emotion concepts that is intended to be largely independent of one’s theory of emotions and applicable to the different ways in which emotions are measured. He outlines some conditions for selecting the dimensions based on these motivations and general conceptual grounds. Given these conditions he then advances an 8-dimensional model that is shown to effectively differentiate emotion labels both within and across cultures, as well as more obscure expressive language. The 8 dimensions (...) are: (1) attracted—repulsed, (2) powerful—weak, (3) free—constrained, (4) certain—uncertain, (5) generalized—focused, (6) future directed—past directed, (7) enduring—sudden, (8) socially connected—disconnected. (shrink)