Empirical research has discovered that experimental subjects in ultimatum bargaining situations generally fail to play the decision-theoretic optimum strategy, and instead play something between that strategy and a fair split. In evolutionary dynamics, fair division and nearly fair division strategies often go to fixation and weakly dominated strategies can do quite well. Computer simulations were done using three different ultimatum bargaining games as determinates of fitness. (1) No tendency toward the elimination of weakly dominated strategies was observed, with or without (...) mutation. (2) Strategies making fair demands had sizable basins of attraction. (3) In a system where five different demands can be made, demands closest to (approximately) 91% had the largest basins of attraction. (4) If the strategies have thresholds for acceptable demands, rather than individuated responses to each demand, the apparent optimum demand may be quite low: 64% for one set of trials. (shrink)

Has the time come to put to bed the concept of a harm threshold when discussing the ethics of reproductive decision making and the legal limits that should be placed upon it? In this commentary, we defend the claim that there exist good moral reasons, despite the conclusions of the non-identity problem, based on the interests of those we might create, to refrain from bringing to birth individuals whose lives are often described in the philosophical literature as ‘less than (...) worth living’. (shrink)

In an earlier paper entitled _Harm is all you need?_, I used an analysis of English law to claim that the harm threshold was an unsuitable mediator of the best interests test when deciding if parental decisions should be overruled. In this paper I respond to a number of commentaries of that paper, and extend my discussion to consider the claim that the harm threshold gives appropriate normative weight to the interests of parents. While I accept that parents (...) have some rights over their children, I argue these are dependent on parents’ duties to benefit their children. While many such benefits are understood pluralistically, and are thus within parents’ ambit to decide, I claim that health benefits are ordinally different, because they play a foundational role in the flourishing of an individual. In the light of this, clinicians have the moral authority to override parental refusals, although in some cases abstaining from exercising this authority may be a pragmatic way to maintain parental engagement and ensure our ability to benefit the child in future. (shrink)

We applaud Notini and colleagues for highlighting the clinical and ethical complexities of a case in which a non-binary individual desires indefinite treatment with puberty blockers.1 While we agree discontinuing treatment may cause psychological distress, we believe there are potential physical and neurocognitive harms caused by prolonged treatment that have been underestimated given the limited research conducted to date. Specifically, the impact of permanent pubertal suppression on the brain and decision-making capacity should be considered. In this context, we outline (...) the potential risks of ongoing pubertal suppression on bone and cardiovascular health, sexual and reproductive function, and brain development—all noted in the article but perhaps in an overly simplistic manner.1 First, the authors’ note OPS will almost certainly result in reduced bone density.1 Although we agree the absolute fracture risk is low in studies among older adults, there is less clarity about implications during adolescence and young adulthood when peak bone accrual occurs.2 Further, the authors propose ongoing monitoring with bone density scans, but no clear guidelines for clinicians if bone density becomes critically low—so we ask, at what point would a potential fracture risk outweigh the proposed benefits …. (shrink)

We applaud Notini and colleagues for highlighting the clinical and ethical complexities of a case in which a non-binary individual desires indefinite treatment with puberty blockers. 1 While we agree discontinuing treatment may cause psychological distress, we believe there are potential physical and neurocognitive harms caused by prolonged treatment that have been underestimated given the limited research conducted to date. Specifically, the impact of permanent pubertal suppression on the brain and decision-making capacity should be considered. In this context, we (...) outline the potential risks of ongoing pubertal suppression on bone and cardiovascular health, sexual and reproductive function, and brain development—all noted in the article but perhaps in an overly simplistic manner. 1 First, the authors’ note OPS will almost certainly result in reduced bone density. 1 Although we agree the absolute fracture risk is low in studies among older adults, there is less clarity about... (shrink)

For the majority of scholars concerned with the ethics of living organ donation, inflicting moderate harms on competent volunteers in order to save the lives or increase the life chances of others is held to be justifiable provided certain conditions are met. These conditions tend to include one, or more commonly, some combination of the following: The living donor provides valid consent to donation. Living donation produces an overall positive balance of harm–benefit for donors and recipients which cannot be (...) obtained in a less harmful manner. Donation is not liable to cause significant and long-term morbidity to, or the death of, the donor. This paper critically examines the suggestion that these criteria are not sufficient to offer a general account of justified living organ donation in the context of competent volunteers and that key to justified living organ donation is that donors receive sufficient benefits from their donation that these outweigh the harms they suffer. However, although this view—termed here ‘The Donor Benefit Standard’—directs welcome attention to the many and complex motives which may underlie living organ donation, this paper ultimately concludes that given the threats this position poses to individual autonomy and the lives of those in need of organ transplants ‘The Donor Benefit Standard’ should ultimately be rejected. (shrink)

The Harm Threshold (HT) holds that the state may interfere in medical decisions parents make on their children’s behalf only when those decisions are likely to cause serious harm to the child. Such a high bar for intervention seems incompatible with both parental obligations and the state’s role in protecting children’s well-being. In this paper, I assess the theoretical underpinnings for the HT, focusing on John Stuart Mill’s Harm Principle as its most plausible conceptual foundation. I offer (i) a (...) novel, text-based argument showing that Mill’s Harm Principle does not give justificatory force to the HT; and (ii) a positive account of some considerations which, beyond significant harm, would comprise an intervention principle normatively grounded in Mill’s ethical theory. I find that substantive recommendations derived from Mill’s socio-political texts are less _laissez-faire_ than they have been interpreted by HT proponents. Justification for state intervention owes not to the severity of a harm, but to whether that harm arises from the failure to satisfy one’s duty. Thus, a pediatric intervention principle derived from Mill ought not to be oriented around the _degree_ of harm caused by a parent’s healthcare decision, but rather, the _kind_ of harm—specifically, whether the harm arises from violation of parental obligation. These findings challenge the interpretation of Mill adopted by HT proponents, eliminating a critical source of justification for a protected domain of parental liberty and reorienting the debate to focus on parental duties. (shrink)

This article critically examines the legal arguments presented on behalf of Charlie Gard’s parents, Connie Yates and Chris Gard, based on a threshold test of significant harm for intervention into the decisions made jointly by holders of parental responsibility. It argues that the legal basis of the argument, from the case of Ashya King, was tenuous. It sought to introduce different categories of cases concerning children’s medical treatment when, despite the inevitable factual distinctions between individual cases, the duty of (...) the judge in all cases to determine the best interests of the child is firmly established by the case law. It argues that the focus should not have been on a threshold for intervention but on whether his parents had established that the therapy they wanted was a viable alternative therapeutic option. In the April hearing, Charlie’s parents relied on the offer of treatment from a US doctor; by July they had an independent panel of international experts supporting their case although by this time the medical evidence was that it was too late for Charlie. One of Charlie’s legacies for future disputes may be that his case highlighted the need for evidence as to whether the treatment parents want for their child is a viable alternative therapeutic option before a court can determine which therapeutic option is in the best interests of the child. (shrink)

Minors are generally considered incompetent to provide legally binding decisions regarding their health care, and parents or guardians are empowered to make those decisions on their behalf. Parental authority is not absolute, however, and when a parent acts contrary to the best interests of a child, the state may intervene. The best interests standard is the threshold most frequently employed in challenging a parent''s refusal to provide consent for a child''s medical care. In this paper, I will argue that (...) the best interest standard provides insufficient guidance for decision-making regarding children and does not reflect the actual standard used by medical providers and courts. Rather, I will suggest that the Harm Principle provides a more appropriate threshold for state intervention than the Best Interest standard. Finally, I will suggest a series of criteria that can be used in deciding whether the state should intervene in a parent''s decision to refuse medical care on behalf of a child. (shrink)

Douglas Diekema influentially argues that interference with parental decisions is not in fact guided by the child’s best interests, but rather by a more permissive standard, which he calls the harm principle. This article first seeks to clarify this alternative position and defend it against certain existing criticisms, before offering a new criticism and alternative. This ‘harm principle’ has been criticized for (i) lack of adequate moral grounding, and (ii) being as indeterminate as the best interest standard that it seeks (...) to replace. I argue that these are not serious problems. I take Diekema’s negative point to be right—our actual standard for intervention is not literally the best interests of the child—but I disagree with his proposed replacement. First, Diekema’s proposed harm threshold should be more carefully distinguished from Mill’s harm principle. Second, there is no reason to assume that the standard for permissible intervention coincides with the threshold for harm (or serious harm). Thus, I propose that the best alternative to the best interests standard is not a harm principle, but rather a sufficiency threshold between adequate (or ‘good enough’) and inadequate (or ‘substandard’) parenting. (shrink)

Children are presumptively regarded as incompetent to make their own medical decisions, and the responsibility for making such decisions typically falls to parents. Parental authority is not unlimited, however, and ethical guidelines identifying appropriate bounds on this authority are needed. One proposal currently gaining support is the Harm Threshold (HT), which asserts that the state may only legitimately intervene in parental decision-making when serious and preventable harm to children is likely. This paper considers two questions: in virtue of what (...) underlying principle or property does the HT gain its purported justification?; and does this underlying principle or property ground the HT as its proponents conceive of it? I identify two separate grounds represented in the literature: (i) J.S. Mill’s Harm Principle; and (ii) the liberty interests of parents. I find that the HT is not sufficiently grounded in either of these, revealing a substantial conceptual difficulty for its advocates. (shrink)

Birchley9s critique of the harm threshold for overriding parental decisions is successful in demonstrating that the harm threshold, like the best interests standard, suffers from the problem of indeterminacy. However, his focus on critiquing empirical rather than normative arguments for the harm threshold means that his broad conclusion that it is ‘ill-judged’ is not justified. Advocates of the harm threshold can accept that the concept of harm to a child is indeterminate, yet still invoke strong normative (...) arguments for this way of responding to parental decisions that conflict with medical recommendations. I suggest that Birchley9s discussion, rather than showing that the harm threshold is mistaken, instead highlights the importance of developing a comprehensive account of children9s interests, for proponents of a best interests approach and for advocates of the harm threshold. (shrink)

In his book Reasons and Persons, Derek Parfit suggests that people are not harmed by being conceived with a disease or disability if they could not have existed without suffering that particular condition. He nevertheless contends that entities can be harmed if the suffering they experience is sufficiently severe. By implication, there is a threshold which divides harmful from non-harmful conceptions. The assumption that such a threshold exists has come to play a part in UK policy making. I (...) argue that Parfit’s distinction between harmful and non-harmful conceptions is untenable. Drawing on Kant’s refutation of the ontological argument for God’s existence, I suggest that the act of creation cannot be identical with the act of harming—nor indeed of benefiting—however great the offspring’s suffering may be. I suggest that Parfit is right that bringing children into existence does not usually harm them, but I argue that this must be applied to all conceptions, since Parfit cannot show how the harm threshold can be operationalised. If we think certain conceptions are unethical or should be illegal, this must be on other grounds than that the child is harmed by them. I show that a Millian approach in this context fails to exemplify the empirical and epistemological advantages which are commonly associated with it, and that harm-based legislation would need to be based on broader harm considerations than those relating to the child who is conceived. (shrink)

BackgroundThe complexity of decision-making in the paediatric context is well recognised. In the majority of cases, parents and healthcare professionals work together to decide which treatments the paediatric patient should receive. On occasions, however, parental wishes conflict with what clinicians think is best for the paediatric patient. Where persistent disagreement between clinicians and parents exists, clinicians must ascertain if they have a moral, professional, and legal obligation to overrule the parents' decision and implement their preferred option.PurposeFew decision-making frameworks to assist (...) in addressing the ethical issues that arise in clinical decision-making relate specifically to the paediatric context. Diekema's Harm Threshold Framework and the Zone of Parental Discretion Framework assist in determining whether parental decisions should or should not be overridden. This paper examines the similarities and differences between these frameworks.MethodsThe frameworks are analysed i... (shrink)

One of the primary views on our supposed obligation towards our descendants in the context of environmental problems invokes the idea of the rights of future generations. A growing number of authors also hold that the descendants of those victimized by historical injustices, including colonialism and slavery, have the right to demand financial reparations for the sufferings of their distant ancestors. However, these claims of intergenerational rights face theoretical difficulties, notably the non-identity problem. To circumvent this problem in a relationship (...) between present and future generations, some rights theorists replace future individual rights with such collective rights. Others advance the threshold conception of harm in discussing intergenerational relationships in general. Despite the significant implications these revisionist views might have, few efforts have been made to scrutinize their solidity. To plug such a gap in the literature, this paper examines to what extent the collective understanding of intergenerational rights is pertinent. I also explore the virtues and drawbacks of the threshold interpretation of harm. The paper concludes by suggesting that the motivation behind these and other versions of the rights theory suffers from the ambiguity of a traditional dichotomy between perfect and imperfect duties. (shrink)

The case of Charlie Gard sparked an ongoing public and academic debate whether in court decisions about medical treatment for children in England & Wales the best interests test should be replaced by a harm threshold. However, the literature has scantly considered (1) what the impact of such a replacement would be on future litigation and (2) how a harm threshold should be introduced: for triage or as standard for decision-making. This article directly addresses these gaps, by first (...) analysing reported cases in England & Wales about medical treatment in the context of a S31 order, thus using a harm threshold for triage and second comparing court decisions about medical treatment for children in England & Wales based on the best interest test with Dutch and German case law using a harm threshold. The investigation found that whilst no substantial increase of parental discretion can be expected an introduction of a harm threshold for triage would change litigation. In particular, cases in which harm is limited, currently only heard when there are concerns about parental decision-making, may be denied a court hearing as might cases in which the child has lost their capacity to suffer. Applying a harm threshold for triage in decisions about withholding or withdrawing life-sustaining treatment might lead to a continuation of medical treatment that could be considered futile. (shrink)

The risks of harm to nonhuman primates, and the absence of benefits for them, are critically important to decisions about nonhuman primate research. Current guidelines for review and practice tend to be permissive for nonhuman primate research as long as minimal welfare requirements are fulfilled and human medical advances are anticipated. This situation is substantially different from human research, in which risks of harms to the individual subject are typically reduced to the extent feasible. A risk threshold is (...) needed for the justification of research on nonhuman primates, comparable to the way risk thresholds are set for vulnerable human subjects who cannot provide informed consent. Much of the laboratory research conducted today has inadequate standards, leading to common physical, psychological, and social harms. (shrink)

It is common practice in intergenerational justice to set fixed thresholds determining what qualifies as justice. Static definitions of how much and what to save for future generations, however, overestimate human epistemological limits and predictive capacity in regard to uncertainty in social- and ecosystems. Long-term predictions cannot account for the inherent range of contingent variables at play, especially according to contemporary theories of punctuated equilibrium. It is argued that policies deliberately testing ecological limits as currently conceived must be excluded from (...) political calculations to minimize current actions from foreclosing future life quality and options. To better reduce harms to present and future generations and support the stability of just institutions (and the stable environments they depend on) as Rawls and others demand, polities can overcompensate resource allocation to environmental sustainability. Focus on reducing environmental harms benefits both current and future generations, reconciling distributive versus intergenerational justice trade-offs. (shrink)

In this paper, I argue that Threshold-Hell Christianity conflicts with the pro-life position on abortion. The specific type of Christianity is that which also accepts threshold deontology and the existence of hell. Threshold deontology is the view that ordinarily moral duties consist of non-consequentialist side-constraints on the pursuit of the good but that in some cases these side-constraints are overridden. My strategy is to establish that a person who brings about an abortion guarantees that the aborted individual (...) goes to heaven and that it is morally permissible to guarantee someone goes to heaven. It follows that if Threshold-Hell Christianity is true, then abortion is morally permissible. (shrink)

ABSTRACT This commentary shows how Dormandy’s ‘Partiality Norm of Belief for Faith’ can be made compatible with ‘Evidentialism about Faith’. Dormandy takes partiality to involve disrespect toward evidence—where evidence we are partial toward is given undue weight. I propose an alternative where partiality is to require more or less evidence for believing a proposition given the benefits or harms of holding the belief. Rather than disrespecting evidence, this partiality is simply to have variable ‘evidence thresholds’ that are partly set (...) by pragmatic considerations. Evidence is not disrespected; an agent just requires more or less of it on pragmatic grounds. (shrink)

Three common ethical principles for establishing the limits of parental authority in pediatric treatment decision making are the harm principle, the principle of best interest, and the threshold view. This paper consider how these principles apply to a case of a premature neonate with multiple significant comorbidities whose mother wanted all possible treatments, and whose health care providers wondered whether it would be ethically permissible to allow him to die comfortably despite her wishes. Whether and how these principles help (...) to understand what was morally right for the child is questioned. The paper concludes that the principles were of some value in understanding the moral geography of the case, but that the case reveals common bioethical principles for medical decision making are problematically value-laden because they are inconsistent with the widespread moral value of medical vitalism. (shrink)

A growing number of bioethics papers endorse the harm threshold when judging whether to override parental decisions. Among other claims, these papers argue that the harm threshold is easily understood by lay and professional audiences and correctly conforms to societal expectations of parents in regard to their children. English law contains a harm threshold which mediates the use of the best interests test in cases where a child may be removed from her parents. Using Diekema9s seminal paper (...) as an example, this paper explores the proposed workings of the harm threshold. I use examples from the practical use of the harm threshold in English law to argue that the harm threshold is an inadequate answer to the indeterminacy of the best interests test. I detail two criticisms: First, the harm standard has evaluative overtones and judges are loath to employ it where parental behaviour is misguided but they wish to treat parents sympathetically. Thus, by focusing only on ‘substandard’ parenting, harm is problematic where the parental attempts to benefit their child are misguided or wrong, such as in disputes about withdrawal of medical treatment. Second, when harm is used in genuine dilemmas, court judgments offer different answers to similar cases. This level of indeterminacy suggests that, in practice, the operation of the harm threshold would be indistinguishable from best interests. Since indeterminacy appears to be the greatest problem in elucidating what is best, bioethicists should concentrate on discovering the values that inform best interests. (shrink)

Does the decision to relax by taking a drive rather than by taking a walk cause harm? In particular, do the additional carbon emissions caused by such a decision make anyone worse off? Recently several philosophers have argued that the answer is no, and on this basis have gone on to claim that act-consequentialism cannot provide a moral reason for individuals to voluntarily reduce their emissions. The reasoning typically consists of two steps. First, the effect of individual emissions on the (...) weather is miniscule: the planet’s meteorological system is so large, and the size of individual emissions so tiny, that whatever impact an individual emission has on the weather must be vanishingly small. Second, vanishingly small impacts aren’t morally relevant because no one could possibly tell the difference between such an impact occurring and it not occurring. In this paper, we show why both steps are mistaken, and hence why act-consequentialism implies that each of us has an individual obligation to do what we can to stop damaging the climate, including by refraining from, or perhaps by purchasing offsets against, our own individual luxury carbon emissions. (shrink)

This paper outlines an account of the ethics of lying, which accommodates two main ideas about lying. The first of these, Anti-Deceptionalism, is the view that lying does not necessarily involve intentions to deceive. The second, Anti-Absolutism, is the view that lying is not always morally wrong. It is argued that lying is not wrong in itself, but rather the wrong in lying is explained by different factors in different cases. In some cases such factors may include deceptive intentions on (...) the part of the liar. In other cases, where such intentions are not found, the wrong in lying may be explained by other factors. Moreover, it is argued that the interaction between considerations against lying and considerations against telling the truth are sensitive to the practical interests of those lied to. When the topic of the lie in question matters little to the victim's rational decision making, the threshold for when considerations against telling the truth can outweigh considerations against lying are lowered. This account is seen to explain why lying to avoid little harm is sometimes permissible, and sometimes not. (shrink)

On the standard view we assess a person’s competence by considering her relevant abilities without reference to the actual decision she is about to make. If she is deemed to satisfy certain threshold conditions of competence, it is still an open question whether her decision could ever be overruled on account of its harmful consequences for her (‘hard paternalism’). In practice, however, one normally uses a variable, risk dependent conception of competence, which really means that in considering whether or (...) not to respect a person’s decision-making authority we weigh her decision on several relevant dimensions at the same time: its harmful consequences, its importance in terms of the person’s own relevant values, the infringement of her autonomy involved in overruling it, and her decision-making abilities. I argue that we should openly recognize the multi-dimensional nature of this judgment. This implies rejecting both the threshold conception of competence and the categorical distinction between hard and soft paternalism. (shrink)

A particularly strong reason to vaccinate against transmittable diseases, based on considerations of harm, is to contribute to the realization of population-level herd immunity. We argue, however, that herd immunity alone is insufficient for deriving a strong harm-based moral obligation to vaccinate in all circumstances, since the obligation significantly weakens well above and well below the herd immunity threshold. The paper offers two additional harm-based arguments that, together with the herd immunity argument, consolidates our moral obligation. First, we argue (...) that individuals should themselves aim not to expose others to risk of harm, and that this consideration becomes stronger the more non-vaccinated people there are, i.e., the further we are below herd immunity. Second, we elaborate on two pragmatic reasons to vaccinate beyond the realization of herd immunity, pertaining to instability of vaccination rates and population heterogeneity, and argue that vaccinating above the threshold should serve as a precautionary measure for buttressing herd immunity. We also show that considerations of harm have normative primacy in establishing this obligation over considerations of fairness. Although perfectly sound, considerations of fairness are, at worst secondary, or at best complementary to considerations of harm. (shrink)

In intensive care, disputes sometimes arise when patients or surrogates strongly desire treatment, yet health professionals regard it as potentially inappropriate. While professional guidelines confirm that physicians are not always obliged to provide requested treatment, determining when treatment would be inappropriate is extremely challenging. One potential reason for refusing to provide a desired and potentially beneficial treatment is because (within the setting of limited resources) this would harm other patients. Elsewhere in public health systems, cost effectiveness analysis is sometimes used (...) to decide between different priorities for funding. In this paper, we explore whether cost-effectiveness could be used to determine the appropriateness of providing intensive care. We explore a set of treatment thresholds: the probability threshold (a minimum probability of survival for providing treatment), the cost threshold (a maximum cost of treatment), the duration threshold (the maximum duration of intensive care), and the quality threshold (a minimum quality of life). One common objection to cost-effectiveness analysis is that it might lead to rationing of life-saving treatment. The analysis in this paper might be used to inform debate about the implications of applying cost-effectiveness thresholds to clinical decisions around potentially inappropriate treatment. (shrink)

The ‘no-difference problem’ challenges us to explain in which way the occurrence of an aggregate effect gives us reason to act in a specific way, although our individual actions make no difference to the effect’s occurrence. When discussing this problem, philosophers usually distinguish between so-called ‘triggering cases’, where the aggregate effect in question is brought about upon reaching a precise threshold, and ‘non-triggering cases’, in which no such precise threshold exists. However, despite their relevant differences, it is widely (...) assumed not only that both categories of cases confront us with the same moral problem, but also that this problem should be solved in the same way no matter which category we are considering. In this paper, I argue that this assumption is mistaken by showing that non-triggering cases pose very different moral problems than triggering cases unless very specific and, arguably, unlikely assumptions in neighbouring debates about causation and decision-making under indeterminacy hold. (shrink)

In April 2018, the International Association of Athletics Federations released new regulations placing a ceiling on women athletes’ natural testosterone levels to “ensure fair and meaningful competition.” The regulations revise previous ones with the same intent. They require women with higher natural levels of testosterone and androgen sensitivity who compete in a set of “restricted” events to lower their testosterone levels to below a designated threshold. If they do not lower their testosterone, women may compete in the male category, (...) in an intersex category, at the national level, or in unrestricted events. Women may also challenge the regulation, whether or not they have lowered their testosterone, or quit sport. Irrespective of IAAF’s stated aims, the options forced by the new regulations are impossible choices. They violate dignity, threaten privacy, and mete out both suspicion and judgement on the sex and gender identity of the athletes regulated. (shrink)

Much research in the philosophy of psychiatry has been devoted to the characterization of the normal and the pathological. In this article, we identify and deconstruct two postulates that have held sway in the philosophy of psychiatry. The first postulate concerns the belief that clinicians would benefit from conceiving of psychiatric disorders as stable entities with clear boundaries. By relying on a symptom-based approach, we support a conception of psychiatric disorders whose symptoms are the products of many activated mechanisms in (...) mutual interactions. The second postulate concerns the way in which the philosophy of psychiatry has approached the question of harm. We posit that clinicians perceive harms primarily through networks of clinical manifestations. The identification and deconstruction of these two postulates leads us to propose a practical definition of a psychiatric disorder that is useful for the clinician, while adopting a principle of prudential conservatism that does not exclude other theoretical definitions of psychiatric disorder that are useful as an epistemic hub. Thus, we propose the following definition of a psychiatric disorder that is relevant to clinical practice: “a set of clinical manifestations belonging to the prototypical central core of psychiatry, organized in a causal network, involving at least one harm, and whose set of harms exceeds the traditional threshold of significance for a given psychiatric disorder, directly related to an activated mechanism. Such a network composed of clinical manifestations is frozen in a state that is unable to allow the deactivation of these manifestations spontaneously without a therapeutic intervention”. (shrink)

The consequences of restricting or not restricting the right to freedom of assembly are potentially magnified in transitional societies. Yet determining whether such consequences are indeed ‘harmful’, and whether their cost should be borne despite the harms caused, requires the elaboration of criteria which define what are valid and relevant harms. While a human rights framework can perform this task, open-textured rights standards prescribe neither the threshold of legal intervention nor the goals of transition. By extension, the (...) rule of law—underpinned by this rights discourse—is silent about whether liberal or communitarian ideals should inform the reconstruction of public space in conflicted or nascent democracies. Illustrated by analysis of legal interventions in parade disputes in Northern Ireland, this article argues that the rule of law is necessarily orientated by ethical consensus about its scope. Furthermore, this consensus operates as a restraint upon the degree of normative discontinuity permitted during transitional compromises. The article frames the ethical options in terms of three liberty-limiting principles—the argument from democracy, the argument for toleration, and the argument for recognition. Each suggests different parameters for the transitional project and for the role of law within it. (shrink)

This article revisits a principle of distributive justice accepted by most, if not all, scholars of climate justice. The principle at stake, the limit, protects those who are very badly off from bearing the costs of climate change mitigation. The persistent noncompliance of developed states with their obligations toward burden sharing, however, means that this principle is increasingly in tension with successful climate change mitigation, given it seems to require that those in poverty have continued access to emissions in cases (...) where alternative forms of energy are not provided. In the first half of the paper I outline this tension and show how the dominant expression of the limit in the literature, advanced by Henry Shue, must be abandoned. I argue that any attempt to articulate the limit in current circumstance, where the carbon budget is very scarce, must consider the climate harm associated with continued subsistence emissions. The second half of the article defends a principle, the exemption, which is best able to maintain the strong commitment to shielding those below the minimal threshold from the costs of mitigation, even in light of the potential harm that will result if they require emissions to fuel their energy needs. (shrink)

Are the state’s obligations to victims of its own wrongdoing greater than to persons who have suffered from bad luck? Many people endorse an affirmative answer to this question. Call this the Difference View. This view can seem arbitrary from the perspective of the victims in question; why should a victim of bad luck, who is just as badly off through no fault of her own, be entitled to less assistance from the state than a victim of state-caused wrongful harm? (...) This paper defends a qualified version of the Difference View, the Threshold Version of the Difference View. According to this view, all disadvantaged persons, no matter what the cause of their disadvantage, must be compensated until they reach a minimum threshold of wellbeing; however, among disadvantaged persons above this threshold, full compensation is owed for those who are victims of state wrongdoing, whereas full compensation is not necessarily owed to those who are disadvantaged due to bad luck. (shrink)

The World Professional Association for Transgender Health’s Standards of Care, now in its seventh edition, is a frequently cited, internationally recognized, evidence-based document that details a comprehensive framework for gender-related care of trans people. However, the WPATH SOC still relies heavily in some cases on gatekeeping practices, dubbed “triadic therapy,” or a process where a trans patient is encouraged to seek out psychotherapy, and hormone therapy, and only then be able to engage in surgical options for transitioning. I use G. (...) Alan Marlatt’s harm reduction framework to argue that the triadic process creates its own set of harms that trans people have to contend with, especially insofar as it focuses on resolving gender dysphoria in a demanding, moralizing, and top-down way as opposed to enriching trans lives by reducing harms that prevent us from flourishing. Using Marlatt’s criterion that harm reduction ought to be bottom-up, low threshold, and not moralizing, I develop a list of suggestions for what ought to be centrally considered in treating trans patients. (shrink)

Analgesia and amnesia represent two complimentary pillars of anesthesia directed, respectively, at mitigating the experience of pain and the processes of encoding that experience into memory. These elements are typically combined in modern anesthetic techniques, but some circumstances exist – such as conscious sedation – in which the conditions of amnesia are satisfied while analgesia plays an auxiliary and often incomplete role. These activities reflect a widely held yet underrecognized belief in clinical practice that although pain experiences may be short-lived, (...) their representation in memory and its subsequent effects on thought and emotion can have enduring consequences for patients. In this exploratory article, we delineate phenomenal and abstract ontological categories of pain experience; advance a claim that they are treated by analgesic and amnestic agents, respectively; and describe how each class of experience is uniquely able to bring about individual harm. Beginning with the question of how it can be permissible to allow any preventable experiences or memories of pain, we identify that both phenomenal and abstract pain manifest on a spectrum of severity, each with an enigmatic threshold – unique to circumstance and individual – that determines whether or not pain will translate into harm, and what permissions therefore surround its treatment. Ultimately, we find that there are compelling physiological reasons for the concurrent use of analgesics and amnestics when pain experience exceeds these thresholds, while the treatment of “sub-threshold” experience in either class is a purely ethical imperative to be balanced with considerations of the potential harms posed by the treatments themselves. (shrink)

This book is intended to help transform epistemology - the traditional study of knowledge - into a rigorous discipline by removing conceptual roadblocks and developing formal tools required for a fully naturalized epistemology. The evolutionary approach which Harms favours begins with the common observation that if our senses and reasoning were not reliable, then natural selection would have eliminated them long ago. The challenge for some time has been how to transform these informal musings about evolutionary epistemology into a (...) rigorous theoretical discipline capable of complementing current scientific studies of the evolution of cognition with a philosophically defensible account of meaning and justification. (shrink)

Ten years ago, researchers using event-related brain potentials to study language comprehension were puzzled by what looked like a Semantic Illusion: Semantically anomalous, but structurally well-formed sentences did not affect the N400 component—traditionally taken to reflect semantic integration—but instead produced a P600 effect, which is generally linked to syntactic processing. This finding led to a considerable amount of debate, and a number of complex processing models have been proposed as an explanation. What these models have in common is that they (...) postulate two or more separate processing streams, in order to reconcile the Semantic Illusion and other semantically induced P600 effects with the traditional interpretations of the N400 and the P600. Recently, however, these multi-stream models have been called into question, and a simpler single-stream model has been proposed. According to this alternative model, the N400 component reflects the retrieval of word meaning from semantic memory, and the P600 component indexes the integration of this meaning into the unfolding utterance interpretation. In the present paper, we provide support for this “Retrieval–Integration ” account by instantiating it as a neurocomputational model. This neurocomputational model is the first to successfully simulate the N400 and P600 amplitude in language comprehension, and simulations with this model provide a proof of concept of the single-stream RI account of semantically induced patterns of N400 and P600 modulations. (shrink)

Conventional wisdom has it that evolution makes a sham of morality, even if morality is an adaptation. I disagree. I argue that our best current adaptationist theory of meaning offers objective truth conditionsfor signaling systems of all sorts. The objectivity is, however, relative to species – specifically to the adaptive history of the signaling system in question. While evolution may not provide the kind of species independent objective standards that (e.g.) Kantians desire, this should be enough for the practical work (...) of justifying our confidence in the objectivity of moral standards. If you believe morality is an adaptation, you should be a moral realist. (shrink)

The concept of information tempts us as a theoretical primitive, partly because of the respectability lent to it by highly successful applications of Shannon’s information theory, partly because of its broad range of applicability in various domains, partly because of its neutrality with respect to what basic sorts of things there are. This versatility, however, is the very reason why information cannot be the theoretical primitive we might like it to be. “Information,” as it is variously used, is systematically ambiguous (...) between whether it involves continuous or discrete quantities, causal or noncausal relationships, and intrinsic or relational properties. Many uses can be firmly grounded in existing theory, however. Continuous quantities of information involving probabilities can be related to information theory proper. Information defined relative to systems of rules or conventions can be understood relative to the theory of meaning . A number of causal notions may possibly be located relative to standard notions in physics. Precise specification of these distinct properties involved in the common notion of information can allow us to map the relationships between them. Consequently, while information is not in itself the kind of single thing that can play a significant unifying role, analyzing its ambiguities may facilitate headway toward that goal. (shrink)