Patients in a minimally conscious state (MCS) fall into a different diagnostic category than patients in the more familiar vegetative states (VS). Not only are MCS patients conscious in some sense, they have a higher chance for recovery than VS patients. Because of these differences, we ostensibly have reason to provide MCS patients with care that goes beyond what we provide to patients with some VS patients. But how to justify this differential treatment? I argue we can’t justify it solely (...) by looking to MCS patients’ actual levels of consciousness. We must look also to the ways in which these patients are potentially conscious. Specifically, I argue that certain sensible and well-regarded policy recommendations cannot be justified by looking solely to patients’ actual levels of consciousness, but that they can be justified by looking to patients’ potential for consciousness. Insofar then as we have prima facie reason to follow the recommendations, we also have prima facie reason to view the potential for consciousness as morally salient. If that is true, however, several important implications follow: first, if the potential for consciousness is morally salient, this translates into actual and pressing obligations to patients with disorders of consciousness generally. Second, if the potential for consciousness is morally salient, this has implications that go beyond our obligations to patients with disorders of consciousness. Indeed, if the potential for consciousness is morally salient, this adds an important layer of complexity to the normative landscape, a layer we may not have sufficiently noticed before. (shrink)

Lockean accounts of personhood propose that an individual is a person just in case that individual is characterized by some advanced cognitive capacity. On these accounts, human beings with severe cognitive impairment are not persons. Some accept this result—I do not. In this paper, I therefore advance and defend an account of personhood that secures personhood for human beings who are cognitively impaired. On the account for which I argue, an individual is a person just in case that individual belongs (...) to a natural kind that is normally characterized by advanced cognitive capacities. Since “human being” is just such a natural kind, individual human beings can be persons even when they do not themselves have advanced cognitive capacities. I argue, furthermore, that we have good reason to accept this account of personhood over rival accounts since it is uniquely able to accommodate the intuitive concept of an impaired person. (shrink)

Dickert et al. (2020) effectively address how factors such as time limitations, stress, and illness severity in acute conditions warrant a deeper evaluation of how current consent processes serve patients. While data suggests that patients “prefer to be asked for permission upfront rather than waiving consent” (2), consent forms themselves “are frequently long and technical, follow rigid templates, and contain language that appears to prioritize institutional protection” (1). Such findings elucidate patients’ valuation of personal agency over settling for the “benefit (...) of the doubt” that physicians and the consent forms they provide are acting in the patients’ best interests. In response, the authors recommend revisions to consent forms in terms of content, structure, and tone to better facilitate patient understanding beyond the mere conveyance of information. We aim to build Dickert et al.’s discussion of how “consent processes serve functions beyond facilitating an informed, autonomous decision” (2), but with a broader focus on an underrecognized purpose of the consent process: namely, reaffirming a patient’s status as a capable, rational agent. Specifically, we argue that patients can exercise this agency when they thoroughly understand the consent process, per Grimm’s (2012) conception of understanding. (shrink)

Cultural psychologists often describe the relationship between mind and culture as ‘dynamic.’ In light of this, we provide two desiderata that a theory about encultured minds ought to meet: the theory ought to reflect how cultural psychologists describe their own findings and it ought to be thoroughly naturalistic. We show that a realist theory of causal powers—which holds that powers are causally-efficacious and empirically-discoverable—fits the bill. After an introduction to the major concepts in cultural psychology and describing causal power realism, (...) we use a case study—the effects of pathogen prevalence on culture and cognition—to show the explanatory capacities of the powers framework. (shrink)

Volume 20, Issue 8, August 2020, Page 107-109.

Goering and colleagues (2017) acknowledge closed-loop neural devices have the potential to undermine agency. Indeed, the authors observe that “the agent using the device may . . . sometimes doubt whether she is the author of her action, given that the device may operate in ways that are not transparent to her” (65). Still, the authors ultimately argue that closed-loop neural devices may be construed as supporting agency, especially when we view agency from a relational perspective. The reason? We often (...) manifest our agency in relation with others. For example, family and close friends sometimes step in to support us in setting and achieving our aims. In a similar way, then, the authors argue that “we can imagine [a closed-loop] device stepping in to support the user in achieving her aim” (67). Closed-loop neural devices, in other words, can be construed as supporting one’s agency in much the same way as other people can be seen as supporting one’s agency. The authors thus conclude that when we view agents from a relational perspective, closed-loop neural devices may be viewed as supporting rather than undermining agency. I largely agree with the authors’ conclusion. I also believe, however, that their discussion can be clarified by distinguishing three kinds of agency and viewing closed-loop neural devices from the perspective of each. By thinking carefully about agency, we can see more clearly the ways in which it is undermined by closed-loop neural devices, as well as the way in which these devices may support agency. (shrink)

Double Effect Donation claims it is permissible for a person meeting brain death criteria to donate vital organs, even though such a person may be alive. The reason this act is permissible is that it does not aim at one’s own death but rather at saving the lives of others, and because saving the lives of others constitutes a proportionately serious reason for engaging in a behavior in which one foresees one’s death as the outcome. Double Effect Donation, we argue, (...) opens a novel position in debates surrounding brain death and organ donation, and does so without compromising the sacredness and fundamental equality of human life. (shrink)

Prolonged survival after the declaration of death by neurologic criteria creates ambiguity regarding the validity of this methodology. This ambiguity has perpetuated the debate among secular and nondissenting Catholic authors who question whether the neurologic standards are sufficient for the declaration of death of organ donors. Cardiopulmonary criteria are being increasingly used for organ donors who do not meet brain death standards. However, cardiopulmonary criteria are plagued by conflict of interest issues, arbitrary standards for candidacy, and the lack of standardized (...) protocols for organ procurement. Combining the neurological and cardiopulmonary standards into a single protocol would mitigate the weaknesses of both and provide greater biologic and moral certainty that a donor of unpaired vital organs is indeed dead. (shrink)

A review of Eric Schwitzgebel's book "A Theory of Jerks and Other Philosophical Misadventures" (2020).

Understanding the difference between conscious and unconscious states is important for making sense of human cognition. Consider: your perception of these words is currently conscious while the feeling of the floor beneath your left foot presumably is not. But what does the difference between these states consist in? Contemporary philosophers disagree about how to answer this kind of question. Extrinsic theorists claim states are conscious because of how they are related to other states, entities, or processes. Intrinsic theorists deny this (...) by claiming that consciousness is internal to states. As it stands, debates about consciousness are thus stuck at an impasse.^ So I approach things differently. In this dissertation, I argue there is a way to overcome the gridlock that plagues contemporary debates about consciousness, and to accommodate the considerations that motivate both intrinsic and extrinsic theorists. The way forward lies in developing a robust account of causal powers. Causal powers, on my view, correspond to dispositions things have. For example, salt’s disposition to dissolve in water corresponds to a power salt has: its solubility. Causal powers, moreover, can help us account for how things behave, for how and why things interact with each other in the ways they do. For example, we can account for salt’s dissolving in water by studying when and why salt manifests its power of solubility. ^ And we can also account for our conscious experiences in reference to causal powers. Indeed, I argue that just as salt manifests one of its powers when it dissolves in water, so too humans manifest one of their powers when they have conscious experiences—our conscious experiences can be understood in reference to the causal powers we have, and in reference to how and why we manifest these powers. Just as importantly, if we use causal powers as a basis for a theory of consciousness, we can overcome the current opposition between extrinsic and intrinsic theories, and in doing so, open up avenues for theorizing about consciousness anew. (shrink)

Some psychologists and philosophers have argued that neuroscience is importantly relevant to our moral responsibility practices, especially to our practices of praise and blame. For consider: on an unprecedented scale, contemporary neuroscience presents us with a mechanistic account of human action. Furthermore, in uential studies – most notoriously, Libet et al. (1983) – seem to show that the brain decides to do things (so to speak) before we consciously make a decision. In light of these ndings, then – or so (...) some have argued – we ought to revise our practices of praise and blame. In the current paper, I argue that this conclusion is unwarranted. The reason is that the argument for it depends on controversial non-empirical premises, premises we need not accept. I suggest, however, that neuroscience does bear on our moral responsibility practices in one important, if less revisionary, way. In particular, neuroscience o ers a new kind of evidence for determining when agents should be held exempt from our normal moral responsibility practices. (shrink)

Embodied, embedded, enactive, and extended theorists do not typically focus on the ontological frameworks in which they develop their theories. One exception is 4E theories that embrace New Mechanism. In this paper, we endorse the New Mechanist’s general turn to ontology, but argue that their ontology is not the best on the market for 4E theories. Instead, we advocate for a different ontology: causal powers realism. Causal powers realism posits that psychological manifestations are the product of mental powers, and that (...) mental powers are empirically-discoverable features of individuals that account for the causal work those individuals do. We contend that causal powers realism provides a unifying framework for the central commitments of 4E theories, as well as additional resources for theorizing in a 4E framework. And while New Mechanism offers some of these resources as well, we argue that causal powers realism is ultimately the better of the two. (shrink)

Fabiano argues that virtue theory offers the best “safety framework” for mitigating the risks of moral enhancement (1). He advances five desiderata for an ideal safety framework and then explains how virtue theory satisfies each. Among these desiderata is the “preservation of identity” (1). Fabiano argues that moral enhancement can safely preserve personal identity when carried out within the framework of virtue theory. We suggest Fabiano's argument for this conclusion falls short, since contra Fabiano’s claim, enhancing virtues may not preserve—and (...) could even damage—personal identity. We draw on three sources of evidence: 1) virtue theory scholarship that argues for the importance of habituation for virtue formation, 2) Focquaert and Schermer’s (2015) distinction between active and passive enhancement and attendant endorsement of more active paths to virtue enhancement, and 3) empirical research suggesting that technologies which support moral enhancements may have damaging effects on personal identity. (shrink)

Berger (2019) argues effectively that “representativeness is more aptly understood as a variable that is multidimensional and continuous based on relational moral authority,” and also makes some useful suggestions about how taking this observation seriously might require changes in current patterns of practice regarding surrogates. But the essay raises additional important questions about how the Best Interest Standard (BIS) should be used among unrepresented patients and other patients as well because many surrogates besides those who “have no actionable knowledge of (...) a patient’s preferences” find themselves in positions in which they need to determine, with the physician, what is in the patient’s best interests. In this commentary, we therefore provide support for the ethical superiority of BIS judgments made by a multi-stakeholder process (rather than solo decision-makers), and sketch a process by which such judgments might be made. (shrink)

Conversation is a foundational aspect of philosophical pedagogy. Too often, however, philosophical research becomes disconnected from this dialogue, and is instead conducted as a solitary endeavor. We aim to bridge the disconnect between philosophical pedagogy and research by proposing a novel framework. Philosophy labs, we propose, can function as both a pedagogical tool and a model for conducting group research. Our review of collaborative learning literature suggests that philosophy labs, like traditional STEM labs, can harness group learning models such as (...) Positive Interdependence Theory (PIT) to engage in meaningful discussion and execute projects and research. This article distills PIT into four essential tenets which we argue support student success at both the individual and group levels. Our argument is grounded in two case studies detailing our experiences facilitating different philosophy labs, and demonstrations of how they can foster the continued evolution of philosophical research and pedagogy beyond the single-occupancy armchair. (shrink)

Rainey et al. (forthcoming) discuss the complications that arise with assigning responsibility for brain computer interface (BCI)-mediated actions. Because BCI-mediated actions can differ from non-BCI-mediated actions in terms of control and foreseeability, the authors suggest that our ethical and legal evaluation of these actions may differ in important ways. While we take no issue with the authors’ discussion or conclusion, we also recognize the difficulty of grappling with the relationship between control, foreseeability, and moral responsibility practices, even without the additional (...) complications introduced by BCI-mediation. In this commentary, we therefore consider BCI-mediated action against the backdrop of a different--perhaps less murky--normative framework: blame. (shrink)

Memory blunting is a pharmacological intervention that decreases the emotional salience of memories. The technique promises a brighter future for those suffering from memory-related disorders such as PTSD, but it also raises normative questions about the limits of its permissibility. So far, neuroethicists have staked out two primary camps in response to these questions. In this paper, I argue both are problematic. I then argue for an alternative approach to memory blunting, one that can accommodate the considerations that motivate rival (...) approaches even while avoiding the problems these rivals face. In addition to arguing for this primary thesis, the paper also aims to suggest something about neuroethics generally: despite what some neuroethicists claim, new discoveries in neuroscience may not typically upend traditional views of morality. Rather, discoveries in neuroscience often provide us with new occasions to reflect on enduring questions about what it means to be human. (shrink)

According to Macklin & Natanson (2019), one reason unusual practices can be misidentified as usual care is that “instead of using pertinent, accurate information describing usual care, investigators may rely on the opinion of ‘experts’ in the field, whose information may be out of date or otherwise inaccurate." We find Macklin & Natanson’s insights about misattributed expertise crucial, and suggest their discussion can be elucidated further by characterizing it in the context of Ballantyne (2018)’s recent exploration of what he calls (...) epistemic trespassing. What insights can be drawn from this characterization? In this commentary, we highlight two. First, the characterization elucidates the serious consequences that can result from epistemic trespassing. Second, the characterization of Macklin & Natanson’s cases as instances of epistemic trespassing offers us a potential roadmap for overcoming some of the problems the authors identify. (shrink)

The BRAIN 2.0 Neuroethics Report reflects on the ways in which neuroscientific research may inform our understanding of concepts such as consciousness and empathy, and how advances in this understanding might in turn affect practices such as research on non-human animal primates. Generally, the Report calls for “the integration of neuroscience and neuroethics during the remaining years of the BRAIN initiative and beyond” (NIH 2019). In responding to the Report, the articles in this issue grapple with theoretical questions about what (...) the integration of neuroscience and neuroethics might look like, as well as how specific practices might be affected. In this commentary, we don’t grapple with these questions ourselves. Instead, we propose a framework for debates about them. Specifically, we introduce the idea of ‘morally-salient features,’ suggesting that the concept may be helpful in providing a framework for the kinds of questions addressed by the BRAIN 2.0 Neuroethics Report as well as those tackled by the authors of this issue. (shrink)

Discussion of the ethics of memory modification technologies (MMTs) has often focused on questions about the limits of their permissibility. In the current paper, I focus primarily on a different issue: when (if ever) is it rational to prefer MMTs to alternative interventions? The question is crucial. Unless those who condone the use of MMTs offer guidance for navigating among various interventions, their account risks becoming a moral endorsement that says little about what one faced with the option of using (...) an MMT should do. In this paper, I therefore consider questions about the conditions in which MMTs are rationally preferable to alternative interventions. My conclusion is that these conditions are rare. The reason stems from considerations of autonomy. When compared with other interventions, MMTs do a particularly poor job at promoting of their users. Insofar as a decision-maker values autonomy, this therefore counts against choosing MMTs over alternative interventions. If that is true, moreover, this provides a fresh perspective on debates about the permissibility MMTs. For those who would limit the use of MMTs to a narrow range of circumstances, the conclusion that MMTs are rarely preferable gives them further reason to eye MMTs with suspicion. For those who view MMTs as permissible in a wide range of circumstances, the conclusion may deflate their endorsement. By approaching MMTs from the perspective offered by questions about preferability, I therefore ultimately aim to focus discussions about MMTs on the subjective rationality rather than the moral permissibility of their usage. (shrink)

A review of J.P. Moreland's SCIENTISM AND SECULARISM: Learning to Respond to a Dangerous Ideology.

Jecker & Ko (2017) argue that numerical identity is not the only aspect of identity that matters to patients faced with certain neurosurgical interventions. Put differently: surviving an intervention in the numerical sense—being numerically the same person before and after the intervention—is not enough. It also matters whether an intervention preserves a patient’s narrative identity, that is, whether an intervention allows the patient’s “inner story” to continue. I agree with the authors’ conclusion. I believe, however, that further work can be (...) done to show precisely why narrative identity matters. We can accept Jecker & Ko’s conclusion, but still wonder: why should it matter to us that our inner story continues? In this response, I suggest that the reason rests on a more basic concern we have with living authentic lives. We are concerned with preserving our narrative identities because we want to live authentic lives rather than inauthentic ones. If that’s the case, however, those considering neurosurgical interventions such as deep brain stimulation and temporal lobectomy should not only pay attention to ways the interventions may support or undermine narrative identity, but also to broader considerations about the ways these interventions may support or undermine one’s living an authentic life. (shrink)