It has recently been suggested that delusions be conceived of as symptoms on the harmful dysfunction account of disorder: delusions sometimes arise from dysfunction, but can also arise through normal cognition. Much attention has thus been payed to the question of how we can determine whether a delusion arises from dysfunction as opposed to normal cognition. In this paper, we consider another question, one that remains under-explored: which delusions warrant treatment? On the harmful dysfunction account, this question dissociates from the (...) question about dysfunction—there are a broad range of “treatable conditions” beyond mere harmful dysfunctions. As such, many conditions that arise from normal cognition are also eligible for medical intervention. We argue that some delusions that arise from normal cognition may well fall under the banner of treatable conditions. We examine the practical and ethical questions surrounding such treatment, including the issue of coercive and deceptive treatment options. (shrink)

This paper discusses J.S. Mill’s distinction between higher and lower pleasures, and suggests that recent neuroscientific evidence counts against it.

Despite growing evidence that a significant number of patients living with Parkison’s disease experience neuropsychiatric changes following Deep Brain Stimulation treatment, the phenomenon remains poorly understood and largely unexplored in the literature. To shed new light on this phenomenon, we used qualitative methods grounded in phenomenology to conduct in-depth, semi-structured interviews with 17 patients living with Parkinson’s Disease who had undergone DBS. Our study found that patients appear to experience postoperative DBS-induced changes in the form of self-estrangement. Using the insights (...) from patients’ subjective perceptions of postoperative self-change provides a potent explanation of potential DBS-induced self-estrangement. (shrink)

This paper critically discusses the argument from objectification – as recently presented by Elizabeth Shaw – against mandatory direct brain interventions targeting criminal offenders’ values as part of rehabilitative or reformative schemes. Shaw contends that such DBIs would objectify offenders because a DBI “excludes offenders by portraying them as a group to whom we need not listen” and “implies that offenders are radically defective with regard to one of the most fundamental aspects of their agency”. To ensure that offenders are (...) not objectified, Shaw first maintains that we should restrict rehabilitative/reformative schemes to attempts at rational dialogue because such an approach respects the offender’s personhood. Second, Shaw claims that we should not portray offenders as radically defective because such treatment would only negatively impact offenders’ already tenuous relationship with society. Third, Shaw contends that we should not confer the state the power to change an offender’s values because the state lacks insight into what constitutes the right values. I contend that none of these arguments should prevent the use of value-targeting DBIs. First, I show that the dialogue requirement for rehabilitative schemes is insufficient ground from which to oppose the use of these DBIs. Second, I show that it is doubtful that the use of DBIs as proposed would damage the relationship between offenders and society. Finally, although the state may often lack insight into what constitutes the correct values, this lack of insight should not by itself prevent value-targeting DBIs from being employed on certain groups of offenders. (shrink)

According to the dual-process account of moral judgment, deontological and utilitarian judgments stem from two different cognitive systems. Deontological judgments are effortless, intuitive and emotion-driven, whereas utilitarian judgments are effortful, reasoned and dispassionate. The most notable evidence for dual-process theory comes from neuroimaging studies by Joshua Greene and colleagues. Greene has suggested that these empirical findings undermine deontology and support utilitarianism. It has been pointed out, however, that the most promising interpretation of his argument does not make use of the (...) empirical findings. In this paper, I engage with recent attempts by Greene to vindicate the moral significance of dual-process theory and the supporting neuroscientific findings. I consider their potential moral significance with regard to three aspects of Greene’s case against deontology: the argument from morally irrelevant factors, the functionalist argument and the argument from confabulation. I conclude that Greene fails to demonstrate how neuroscience and dual-process theory in general can advance moral theorizing. (shrink)

Should the development of pharmacological cognitive enhancers raise worries about doping in cognitively demanding activities? In this paper, we argue against using current evidence relating to enhancement to justify a ban on cognitive enhancers using the example of chess. It is a mistake to assume that enhanced cognitive functioning on psychometric testing is transferable to chess performance because cognitive expertise is highly complex and in large part not merely a function of the sum specific sub-processes. A deeper reason to doubt (...) that pharmacological cognitive enhancers would be as significant in mind sports is the misleading parallel with physical enhancement. We will make the case that cognitive performance is less mechanical in nature than physical performance. We draw lessons from this case example of chess for the regulation of cognitive enhancement more generally in education and the professions. Premature regulation runs the risk of creating a detrimental culture of suspicion that ascribes unwarranted blame. (shrink)

In a recent article, Sabine Müller, Merlin Bittlinger, and Henrik Walter launch a sweeping attack against what they call the "personal identity debate" as it relates to patients treated with deep brain stimulation (DBS). In this critique offered by Müller et al., the so-called personal identity debate is said to: (a) be metaphysical in a problematic way, (b) constitute a threat to patients, and (c) use "vague" and "contradictory" statements from patients and their families as direct evidence for metaphysical theories. (...) In this response, I critically evaluate Müller et al.'s argument, with a special focus on these three just-mentioned aspects of their discussion. My conclusion is that Müller et al.'s overall argument is problematic. It overgeneralizes criticisms that may apply to some, but certainly not to all, contributions to what they call the personal identity-debate. Moreover, it rests on a problematic conception of what much of this debate is about. Nor is Müller et al.'s overall argument fair in its assessment of the methodology used by most participants in the debate. For these reasons, we should be skeptical of Müller et al.'s claim that the "personal identity debate" is a "threat to neurosurgical patients". (shrink)

This is a reply to Jesse Prinz and Paul Bloom’s skepticism about the moral importance of empathy. It concedes that empathy is spontaneously biased to individuals who are spatio-temporally close, as well as discriminatory in other ways, and incapable of accommodating large numbers of individuals. But it is argued that we could partly correct these shortcomings of empathy by a guidance of reason because empathy for others consists in imagining what they feel, and, importantly, such acts of imagination can be (...) voluntary – and, thus, under the influence of reflection – as well as automatic. Since empathizing with others motivates concern for their welfare, a reflectively justified empathy will lead to a likewise justified altruistic concern. In addition, we argue that such concern supports another central moral attitude, namely a sense of justice or fairness. (shrink)

Women are diagnosed with clinical depression at twice the rates as men. Treating depression through psychotherapy or medication both focus on changing an individual, rather than addressing socioecological influences or social roles. In the current study, participants read of systemic inequality contributing to differential rates of depression in either American men or women, or in two fictitious Australian First Nation groups. Participants then considered the acceptability and efficacy of treating depression through psychotherapy, medication, or social change. When socioecological inequities and (...) unequal social roles were presented through an unfamiliar foreign lens, participants were more likely to recognize the systemic unfairness, and endorsed social change more than psychotherapy or medication as a treatment strategy. However, when identical social inequities and social roles were presented through descriptions of American men and women, social intervention was less likely to be endorsed, and psychotherapy or medication gained in acceptability. Participants of color were also more likely to recognize and endorse social change as a strategy for treating depression, while those reporting a history of psychotropic medication for affective disorders rated medication as more effective and acceptable. (shrink)

IntroductionTourette Syndrome is a childhood onset disorder characterized by vocal and motor tics and often remits spontaneously during adolescence. For treatment refractory patients, Deep Brain Stimulation may be considered.Methods and ResultsWe discuss ethical problems encountered in two adolescent TS patients treated with DBS and systematically review the literature on the topic. Following surgery one patient experienced side effects without sufficient therapeutic effects and the stimulator was turned off. After a second series of behavioural treatment, he experienced a tic reduction of (...) more than 50%. The second patient went through a period of behavioural disturbances that interfered with optimal programming, but eventually experienced a 70% tic reduction. Sixteen DBS surgeries in adolescent TS patients have been reported, none of which pays attention to ethical aspects.DiscussionSpecific ethical issues arise in adolescent TS patients undergoing DBS relating both to clinical practice as well as to research. Attention should be paid to selecting patients fairly, thorough examination and weighing of risks and benefits, protecting the health of children and adolescents receiving DBS, special issues concerning patient’s autonomy, and the normative impact of quality of life. In research, registration of all TS cases in a central database covering a range of standardized information will facilitate further development of DBS for this indication.ConclusionClinical practice should be accompanied by ongoing ethical reflection, preferably covering not only theoretical thought but providing also insights in the views and perspectives of those concerned, that is patients, family members and professionals. (shrink)

IntroductionTourette Syndrome is a childhood onset disorder characterized by vocal and motor tics and often remits spontaneously during adolescence. For treatment refractory patients, Deep Brain Stimulation may be considered.Methods and ResultsWe discuss ethical problems encountered in two adolescent TS patients treated with DBS and systematically review the literature on the topic. Following surgery one patient experienced side effects without sufficient therapeutic effects and the stimulator was turned off. After a second series of behavioural treatment, he experienced a tic reduction of (...) more than 50%. The second patient went through a period of behavioural disturbances that interfered with optimal programming, but eventually experienced a 70% tic reduction. Sixteen DBS surgeries in adolescent TS patients have been reported, none of which pays attention to ethical aspects.DiscussionSpecific ethical issues arise in adolescent TS patients undergoing DBS relating both to clinical practice as well as to research. Attention should be paid to selecting patients fairly, thorough examination and weighing of risks and benefits, protecting the health of children and adolescents receiving DBS, special issues concerning patient’s autonomy, and the normative impact of quality of life. In research, registration of all TS cases in a central database covering a range of standardized information will facilitate further development of DBS for this indication.ConclusionClinical practice should be accompanied by ongoing ethical reflection, preferably covering not only theoretical thought but providing also insights in the views and perspectives of those concerned, that is patients, family members and professionals. (shrink)

We argue that many modern marketing techniques are morally problematic because they take advantage of a phenomenon known as ‘ego-depletion’ according to which willpower is, similar to physical strength, a limited resource that can be depleted by predictable factors. We argue that this is impermissible for the same reason that spiking someone’s drink to impair their judgment is impermissible.

David Shoemaker has claimed that a binary approach to moral responsibility leaves out something important, namely instances of marginal agency, cases where agents seem to be eligible for some responsibility responses but not others. In this paper we endorse and extend Shoemaker’s approach by presenting and discussing one more case of marginal agency not yet covered by Shoemaker or in the other literature on moral responsibility. Our case is that of Kenneth Parks, a Canadian man who drove a long way (...) to his mother-in-law’s and killed her in a state of somnambulism. We support our claim about Parks’ marginal responsibility in three steps: we first deny that Parks acts involuntarily as traditionally claimed in the legal literature; we then propose to extend Shoemaker’s analysis of marginal responsibility based on quality of will so as to include two other dimensions: the moral status of the agent and the actual causal effects of their actions; finally, we distinguish Parks’ marginal responsibility from four other existing concepts: “tracing”, diminished responsibility, causal responsibility, and moral disapproval without responsibility. (shrink)

There might be value in examining the phenomenon of free will, without attempting to solve the debate surrounding its existence. Studies have suggested that diminishing belief in free will increases cheating behavior and that basic physiological states such as appetite diminish free will. These findings, if robust, could have important philosophical and ethical implications. Accordingly, we aimed to critically review methodologies and results in the body of literature that speaks to the two following questions: whether certain factors can change belief (...) in free will or not and whether changes in belief in free will impact different attitudinal or behavioral factors or not. Searching the PubMed and PsycInfo databases with different keyword strategies supplemented with reference section searches, we found 52 relevant papers for review. For each distinct study, we extracted information regarding: sample characteristics and related analyses, procedures and methodology, factors investigated, results, and effect sizes. Overall, we found that the samples were heavily constituted of women, of students and younger participants, with little information about representation of ethnic minorities. Procedures and methodology relied strongly on the use of experimental manipulations and a wide array of scales, including scales created by researchers. Several studies suggest the static and consequential properties of belief in free will. However, these conclusions are restrained by numerous limitations of the supporting body of evidence and the absence of replication studies. (shrink)

Free will skepticism is the view that people never truly deserve to be praised, blamed, or punished for what they do. One challenge free will skeptics face is to explain how criminality could be dealt with given their skepticism. This paper critically examines the prospects of implementing legal changes concerning crime and punishment derived from the free will skeptical views developed by Derk Pereboom and Gregg Caruso. One central aspect of the changes their views require is a concern for reducing (...) the severity of current forms of punishment. The paper considers two strategies for pursuing such a reduction. By taking into account evidence from the psychology of belief in free will and desire to punish, it is argued that a strategy aiming at a reduction of people’s natural desire to punish criminals can be successful if capable of providing alternatives to current forms of punishment satisfying three properties: they must be less harmful than current forms of punishment, more effective in preventing crime, and incompatible with current forms of punishment. (shrink)

Neuroethics is a dynamic and still rather young interdisciplinary field involving neuroscience, philosophy, or bioethics, among other academic specialties. It is under a process of institutionalization on a global scale, although not at the same pace in every country. Much literature has been devoted to the discussion of the purpose and relevance of neuroethics as a field, but few attempts have been made to analyze its local conditions of development. This paper describes the advancement of neuroethics in Japan as a (...) case study on the ups and downs of the institutionalization of a new academic field. As one of the peculiarities of neuroethics is the diversity of its constituent subject areas, which range from ethics of neuroscience to neuroscience of ethics, the analysis relies on a framework delineating its different aspects. The discussion of the Japanese case study is embedded in several interpretations of the significance of the field proposed by various actors, proponents, or detractors of neuroethics. The history of neuroethics in Japan can be read as a contribution to meta-neuroethics by those interested in definitions of neuroethics, and as a study in science policy by those interested in the Japanese system of research. (shrink)

Psychopathy, executive functions, and neuropsychological data: a response to Sifferd and Hirstein.

Does having a mental disorder, in general, affect whether someone is morally responsible for an action? Many people seem to think so, holding that mental disorders nearly always mitigate responsibility. Against this Naïve view, we argue for a Nuanced account. The problem is not just that different theories of responsibility yield different verdicts about particular cases. Even when all reasonable theories agree about what's relevant to responsibility, the ways mental illness can affect behavior are so varied that a more nuanced (...) approach is needed. (shrink)

As a neurodevelopmental condition that affects cognitive functioning, autism has been used as a test case for theories of moral responsibility. Most of the relevant literature focuses on autism’s impact on theory of mind and empathy. Here I examine aspects of autism related to executive function. I apply an account of how we might fail to be reasons responsive to argue that autism can increase the frequency of excuses for transgressive behavior, but will rarely make anyone completely exempt from moral (...) responsibility in general. On this account, although excuses may apply more often to autists than to others, the excuses that apply to autists are just the same excuses that can apply to anyone. (shrink)

In the present manuscript, we comment upon a paper that strongly criticized an expert report written by the consultants of the defense in a case of pedophilia, in which clinical and neuro-scientific data were used to establish the causal link between brain alterations and onset of criminal behavior. These critiques appear to be based mainly on wrong pieces of information and on a misinterpretation of the logical reasoning adopted by defense consultants. Here we provide a point-by-point reply to the issues (...) raised in the above paper and also discuss the potential role that neuroscience may contribute in the forensic context. Did the forensic neuroscience defense consultants claim the existence of a deterministic relationship between brain structure or function and behavior? How did the neuroscientific logic work in this specific case? How may the classic psychiatric/neurologic examination and neuroscientific evidence work side by side? Does the rarity of a disease impact on the causal relationship between the disease and the crime? Do neuroscientific data need to be interpreted? We address the above questions and conclude that neuroscience may strengthen the results of psychiatric evaluations, thus reducing uncertainty in the forensic settings. (shrink)