Background: The use of therapeutic untruths raises a number of ethical issues, which have begun to be explored to some extent, particularly in dementia care services, where their use has been found to be high. Little is known, however, about their use by health professionals working in learning disability services. Research question: The study aimed to explore the frequency of use of therapeutic untruths by student learning disability nurses, and by their colleagues; how effective the students perceived them (...) to be as a means of responding to behaviours that challenge; and their level of comfort with using them. Research design: A correlational design was used to gather data from an online version of the Best Interest Scale, adapted for a learning disability context. Participants were 30 learning disability student nurses studying at a university in the North-East of England. Ethical considerations: The study was reviewed and received ethical approval from the first author’s university ethics committee. Findings: Overall, 96% of participants reported using therapeutic untruths. ‘Omission’ was the most frequently used type of therapeutic untruths, the most effective and the type that the students felt most comfortable using. Frequency of use of therapeutic untruths correlated significantly and positively with perceived effectiveness and the level of comfort that the students felt when using them, for all types of therapeutic untruths. Conclusion: The use of therapeutic untruths by the student nurses was consistent with that found in research in dementia care services in the United Kingdom and abroad. Further research to explore the generalisability of the results to the wider context of learning disability services is needed. The study highlights that there may be a need for more formal guidance and educational input to student nurses in the use of therapeutic untruths with people with a learning disability. (shrink)

In this study of advertisements appearing in medical periodicals and by direct mail advertising to general practitioners, Dr. Stimson, a sociologist, concludes that from what is intended to provide therapeutic information hardly any therapeutic information is provided. He reminds the reader of the safeguards which surround all drug advertising by law and by the code of practice of the Association of the British Pharmaceutical Industry but these safeguards do not appear to control real or potential sins of (...) class='Hi'>omission. Frequently in these advertisements the literature relating to the drug is quoted but Dr. Stimson found that it was difficult to trace all the papers quoted in different types of medical library. (Some references quoted were to unpublished papers but surely the blame should be shared in this situation?) Dr. Stimson also gives a vivid and fascinating glimpse of what he calls the 'images and stereotypes' of the patients who, it is claimed, would benefit from the drug being advertised. Certainly most general practitioners must be aware that when they prescribe that image is displaced by an individual but the portrait gallery is indeed depressing. However, to balance these advertisements drug companies issue data sheets which must be more informative than advertisements and conform to regulations in their format. Unfortunately data sheets are only issued every 15 months whereas the 'average general practitioner is potentially exposed to 1,300 advertisements every month'. In other words, the data sheet and not the advertisement should be the guideline but it arrives too infrequently to offset the lack of therapeutic information contained in advertisements. (shrink)

The principle of the child's right to an open future was first proposed by the legal philosopher Joel Feinberg and developed further by bioethicist Dena Davis. The principle holds that children possess a unique class of rights called rights in trust—rights that they cannot yet exercise, but which they will be able to exercise when they reach maturity. Parents should not, therefore, take actions that permanently foreclose on or pre-empt the future options of their children, but leave them the greatest (...) possible scope for exercising personal life choices in adulthood. Davis particularly applies the principle to genetic counselling, arguing that parents should not take deliberate steps to create physically abnormal children, and to religion, arguing that while parents are entitled to bring their children up in accordance with their own values, they are not entitled to inflict physical or mental harm, neither by omission nor commission. In this paper, I aim to elucidate the open future principle, and consider whether it is applicable to non-therapeutic circumcision of boys, whether performed for cultural/religious or for prophylactic/health reasons. I argue that the principle is highly applicable to non-therapeutic circumcision, and conclude that non-therapeutic circumcision would be a violation of the child's right to an open future, and thus objectionable from both an ethical and a human rights perspective. (shrink)

Many people have moral qualms about embryo research, feeling that embryos must deserve some kind of protection, if not so much as is afforded to persons. This paper will show that these qualms serve to camouflage motives that are really prudential, at the cost of also obscuring the real ethical issues at play in the debate concerning embryo research and therapeutic cloning. This in turn leads to fallacious use of the Actions/Omissions Distinction and ultimately neglects the duties that we (...) have towards future persons. (shrink)

Many people have moral qualms about embryo research, feeling that embryos must deserve some kind of protection, if not so much as is afforded to persons. This paper will show that these qualms serve to camouflage motives that are really prudential, at the cost of also obscuring the real ethical issues at play in the debate concerning embryo research and therapeutic cloning. This in turn leads to fallacious use of the Actions/Omissions Distinction and ultimately neglects the duties that we (...) have towards future persons. (shrink)

My first experience as a clinician was in a Therapeutic Community for service users with personality disorder. As well as having personality disorder, many of the Community members also suffered from related conditions, such as addiction and eating disorders. Broadly speaking, these conditions are what we might call ‘disorders of agency’. Core diagnostic symptoms or maintaining factors of disorders of agency are actions and omissions: patterns of behaviour central to the nature or maintenance of the condition. For instance, borderline (...) personality disorder is diagnosed in part via deliberate self-harm and attempted suicide, reckless and impulsive behaviour, substance use, violence, and outbursts of anger; addiction is diagnosed via maladaptive patterns of drug consumption; eating disorders involve eating too much or too little. If a service user is to improve let alone recover from these disorders, they must change the diagnostic or maintaining pattern of behaviour (cf. Pearce and Pickard, 2010). For instance, service users with borderline personality disorder must stop self-harming; addicts need to quit using drugs or alcohol; anorexics must eat. (shrink)

The foreskin is a complex structure that protects and moisturizes the head of the penis, and, being the most densely innervated and sensitive portion of the penis, is essential to providing the complete sexual response. Circumcision—the removal of this structure—is non-therapeutic, painful, irreversible surgery that also risks serious physical injury, psychological sequelae, and death. Men rarely volunteer for it, and increasingly circumcised men are expressing their resentment about it.Circumcision is usually performed for religious, cultural and personal reasons. Early claims (...) about its medical benefits have been proven false. The American Academy of Pediatrics and the Centers for Disease Prevention and Control have made many scientifically untenable claims promoting circumcision that run counter to the consensus of Western medical organizations.Circumcision violates the cardinal principles of medical ethics, to respect autonomy, to do good, to do no harm, and to be just. Without a clear medical indication, circumcision must be deferred until the child can provide his own fully informed consent.In 2012, a German court held that circumcision constitutes criminal assault. Under existing United States law and international human rights declarations as well, circumcision already violates boys› absolute rights to equal protection, bodily integrity, autonomy, and freedom to choose their own religion. A physician has a legal duty to protect children from unnecessary interventions. Physicians who obtain parental permission through spurious claims or omissions, or rely on the American Academy of Pediatrics' position, also risk liability for misleading parents about circumcision. (shrink)

Although the positive outcomes achieved in home‐visiting interventions targeting young, disadvantaged mothers are partly credited to therapeutic relationships, researchers rarely offer philosophical or theoretical explanations for these relationships. This omission is a conspicuous oversight as nurse–family relationships have figured prominently in public health nursing practice since its inception. In this study, I suggest that the contribution of therapeutic relationships to positive outcomes will remain theoretically undeveloped as long as clinical trials and nursing practice models follow the logic (...) of techne. After describing how a scientific–clinical gaze misrepresents teen mothers and contributes to a rational–technical model of clinical practice, I draw on contemporary hermeneutics to describe how dialog and understanding are indispensable for clinical judgment and the judicious use of scientific knowledge. This hermeneutic corrective calls attention to the dialogical nature of truth and the relational skills that disclose meaning, preserve personhood, and support possibilities available in the life‐world. Dialogical understanding also disrupts the scientific–clinical gaze by disclosing the social disparities that are implicated in early childbearing and teen mothers’ long‐term prospects. The implications of this thought for legitimating and supporting the flexibility and clinical know‐how that ‘strays’ from protocol‐driven care is addressed. (shrink)

John Haugeland aimed throughout his career to determine what it is for an entity to count as having intelligence or thought, and at each stage he developed the idea from the phenomenological tradition that genuine thought requires intentionality. His most mature essay to do this, “Authentic Intentionality,” shows how the intentional directedness of thought requires that thinkers understand themselves as responsive to entities they think about, that they be committed to maintaining the socially shared forms of understanding of those entities, (...) and yet that they be self-critically open to the possibility of needing to revise or reject those forms of understanding. In this essay I argue that, while Haugeland’s account of intentionality sheds much light on empirical thought (thought directed at different kinds of things in the world), it doesn’t address what it takes for thought to intend or think its own form—and so it fails to describe the kind of transcendental thought of which the account itself is an instance. Building on Haugeland’s own rich picture of self-understanding, I show how we can remedy this omission, and that when we do, we see that transcendental thought is performed by each of us as concrete individuals and yet takes place from a perspective outside of, and thus free from, the normative demands and existential situations of our empirical lives. It is thus of at most therapeutic use in them, even as it is valuable for its own sake as an exercise of our finite freedom. (shrink)

Philosophers have already recognized the importance of causal preemption involving “positive” events. First, preemption with positive events raises problems for counterfactual theories of causation. Second, theories of moral and legal responsibility rely heavily on the concept of causation, so accurately assessing responsibility in preemption cases requires correctly assessing their causal structure. However, philosophers have not discussed preemption involving “negative” events or omissions. This paper argues that cases of preemptive omissions exist and have important implications for theories of causation and for (...) moral and legal responsibility. Of theoretical importance, the alterations made to counterfactual theories of causation to address preemption with positive events do not seem to work for accommodating preemptive omissions. Of practical importance, there have been actual legal cases involving preemptive omissions, and at least one such case was, this paper contends, decided incorrectly on erroneous causal grounds. This paper identifies what must happen for preemptive omissions to obtain. It then argues for the existence of preemptive omissions by constructing a series of cases and drawing structural parallels between preemption cases with positive events and cases with omissions. It ultimately presents a formula for generating preemptive omissions and examines both why “traditional” methods of generating preemption fail for omissions and why the proposed method avoids such concerns. (shrink)

This paper gives a framework for understanding causal counterpossibles, counterfactuals imbued with causal content whose antecedents appeal to metaphysically impossible worlds. Such statements are generated by omissive causal claims that appeal to metaphysically impossible events, such as “If the mathematician had not failed to prove that 2+2=5, the math textbooks would not have remained intact.” After providing an account of impossible omissions, the paper argues for three claims: (i) impossible omissions play a causal role in the actual world, (ii) causal (...) counterpossibles have broad applications in philosophy, and (iii) the truth of causal counterpossibles provides evidence for the nonvacuity of counterpossibles more generally. (shrink)

Philosophical theories of agency have focused primarily on actions and activities. But, besides acting, we often omit to do or refrain from doing certain things. How is this aspect of our agency to be conceived? This book offers a comprehensive account of omitting and refraining, addressing issues ranging from the nature of agency and moral responsibility to the metaphysics of absences and causation. Topics addressed include the role of intention in intentional omission, the connection between negligence and omission, (...) the distinction between doing and allowing, and the distinction in law between act and omission. (shrink)

I present and develop the view that omissions are de re possibilities of actual events. Omissions do not literally fail to occur; rather, they possibly occur. An omission is a tripartite metaphysical entity composed of an actual event, a possible event, and a contextually specified counterpart relation between them. This view resolves ontological, causal, and semantic puzzles about omissions, and also accounts for important data about moral responsibility for outcomes resulting from omissions.

In previous work I have argued that talk about negative events should not be taken at face value: typically, what we are inclined to think of as a negative event (John’s failure to go jogging) is just an ordinary, positive event (his going to the movie instead); it is a positive event under a negative description. Here I consider more closely the difficulties that arise in those cases where no positive event seems available to do the job, as with putative (...) cases of causation by omission. In particular, I elaborate on Helen Beebee’s idea that not all causal explanations are reports of causation. When we mention John’s failure to turn off the gas as an explanans of why there was an explosion, we do not say what caused the explosion. We do not mention any of the relevant causes. We just remark that one sort of event that was supposed to occur, and whose occurrence would have prevented the explosion, did not in fact occur. (shrink)

It is natural to think that at root, agents are beings that act. Agents do more than this, however – agents omit to act. Sometimes agents do so intentionally. How should we understand intentional omission? Recent accounts of intentional omission have given causation a central theoretical role. The move is well-motivated. If some form of causalism about intentional omission can successfully exploit similarities between action and omission, it might inherit the broad support causalism about intentional action (...) enjoys. In this paper I consider the prospects for causalism about intentional omission. I examine two recent proposals: one Carolina Sartorio (2009) defends, and one Randolph Clarke (2010a) defends. I argue these versions fail, and for a similar reason. Reflection on the function of intention for agency brings this reason to light, and motivates a novel causalism about intentional omission. On the account I go on to defend necessarily, an agent J intentionally omits to A only if an intention of J’s with relevant content (or the intention’s acquisition) causes in J a disposition not to A. Though the causal work done by intentions to omit differs in some cases from the causal work done by intentions to act, it turns out that causalism about intentional behavior (i.e., about action and omission) is viable. (shrink)

Analyses of factual causation face perennial problems, including preemption, overdetermination, and omissions. Arguably, the thorniest, are cases of omissive overdetermination, involving two independent omissions, each sufficient for the harm, and neither, independently, making a difference. A famous example is Saunders, where pedestrian was hit by a driver of a rental car who never pressed on the (unbeknownst to the driver) defective (and, negligently, never inspected) brakes. Causal intuitions in such cases are messy, reflected in disagreement about which omission mattered. (...) What these analyses mistakenly take for granted, is that at issue is the 'efficacy' of each omission. I argue, on the contrary, the puzzle of omissive overdetermination favors taking the act/omission distinction seriously. Factual causation, properly understood precludes omissions (i.e. omissions are not causal). Of course, the law also attaches liability to omissions, but this works differently from liability for real causes (e.g. omissions have a duty requirement, they also respond differentially to difference-making considerations). The manner in which liability attaches for omissions differs from that of straightforward causal liability, and is entirely dependent on the underlying causal structure. Attention to that structure (e.g. that the driver's hitting the pedestrian with his car is what actually caused the injury) sheds light on which omissions matter (e.g. driver's failure to press on the brakes) and why (because that failure removes a defense the driver would have to liability for the accident he caused). Other cases, where the parties' connection is entirely omissive (e.g. two physicians fail to detect independently lethal conditions), come out differently (tracking moralized elements). The analysis offered makes better sense of both why omissive determination cases are puzzling and how to resolve them. (shrink)

We take ourselves to be able to omit to perform certain actions and to be at times responsible for these omissions. Moreover, omissions seem to have effects and to be manifestations of our agency. So, it is natural to think that omissions must be events. However, very few people writing on this topic have been willing to argue that omissions are events. Such a view is taken to face three significant challenges: (i) omissions are thought to be somehow problematically negative, (...) (ii) it is unclear where the event of an omission would be located, and (iii) if we accept any omissions as events, it seems like there would be far too much causation involving them. In this paper, I develop a novel view of omissions as events and as actions that provides answers to these challenges. (shrink)

Some omissions seem to be causes. For example, suppose Barry promises to water Alice’s plant, doesn’t water it, and that the plant then dries up and dies. Barry’s not watering the plant – his omitting to water the plant – caused its death. But there is reason to believe that if omissions are ever causes, then there is far more causation by omission than we ordinarily think. In other words, there is reason to think the following thesis true.

It is argued that intentionally omitting requires having an intention with relevant content. And the intention must play a causal role with respect to one’s subsequent thought and conduct. Even if omissions cannot be caused, an account of intentional omission must be causal. There is a causal role for one’s reasons as well when one intentionally omits to do something.

Imagine you and your friend Pierre agreed on meeting each other at a café, but he does not show up. What is the difference between a friend’s not showing up meeting? and any other person not coming? In some sense, all people who did not come show the same kind of behaviour, but most people would be willing to say that the absence of a friend who you expected to see is different in kind. In this paper, I will spell (...) out this difference by investigating laypeople’s conceptualisation of absences of actions in four experiments. In languages such as German, French, Italian, or Polish, people consider a friend’s not coming an omission. Any other person’s not coming, in contrast, is not considered an omission at all, but just a mere nothing. This use of the term omission differs from the usage in English, where ‘omission’ refers to all kinds of absences. In addition, ‘omission’ is not even an everyday term, but invented by philosophers for the sake of philosophical investigation. In other languages, ‘omission’ is part of an everyday vocabulary. Finally, I will discuss how this folk concept of omission could be made fruitful for philosophical questions. (shrink)

Neuropragmatism offers a non-dualistic conception of experience from which scientific inquiries can provide resources for sociocultural critique. This reconstructive effort addresses what Emma Dowling calls the care crisis without succumbing to what Mike W. Martin calls therapeutic tyranny. This tyranny relies on problematic dualisms, between mind/body, mind/world, and fact/value, that are also found in neuropsychoanalysis. While pragmatism and psychoanalysis more generally share an evolutionary perspective and can overlap in therapeutic approaches, neuropsychoanalysis diverges from this effort in its dual-aspect (...) monism and positivistic conception of science. Where neuropsychoanalysis seeks to reconcile the first-person subjectivity of lived experience with the third-person objectivity of science, neuropragmatism offers reconstruction. In taking the neuropragmatic turn, neuropsychoanalysts can better utilize Freudian therapies in conjunction with active inference principles, such as the free-energy principle and allostasis. Along with neuropragmatism’s conception of experience as organism-environment dynamic engagement, neuropsychoanalysis can benefit from allostatic approaches to experience and inquiry without reducing experience to brute mechanism or denying the utility of such mechanisms for prediction and intervention. Understanding the value-ladenness of experience, primary and secondary, in everyday waking life and in reflective inquiry, empowers people to better care for themselves without succumbing to merely coping with neoliberal oppression. (shrink)

It is widely held that one can be responsible for doing something that one was unable to avoid doing. This paper focuses primarily on the question of whether one can be responsible for not doing something that one was unable to do. The paper begins with an examination of the account of responsibility for omissions offered by John Martin Fischer and Mark Ravizza, arguing that in many cases it yields mistaken verdicts. An alternative account is sketched that jibes with and (...) explains judgments about a variety of omissions cases, including intentional omissions as well as simple failures to act. (shrink)

The Counterfactual Comparative Account of Harm says that an event is overall harmful for someone if and only if it makes her worse off than she otherwise would have been. I defend this account from two common objections.

Omissions are puzzling, and theyraise myriad questions for many areas of philosophy. In contrast, omissions ofomissions are not usually taken to be very puzzling since they are oftenthought to just be a fancy way of describing ordinary “positive” events, statesof affairs, or actions. This paper contends that – as far as agency isconcerned – at least some omissions of omissions are omissions, not actions. First,this paper highlights how our actions are accompanied by many first-orderomissions - i.e., omissions to act – (...) and that there already are many strongreasons to think that at least some of these first-order omissions are agentiallydistinct from simultaneous actions and from other first-order omissions. Itthen argues that our actions and first-order omissions are also accompanied byhigher-order omissions – i.e., omissions to omit to act – and that higher-orderomissions are distinct from actions and first-order omissions for similarreasons. Higher-order omissions also illuminate a more holistic picture of agency,which involves recognizing that our exercises of agency at a moment in timeinclude all of our overlapping behaviors – our actions, first-order omissions,and higher-order omissions. This paper concludes by exploring the impacts ofhigher-order omissions. (shrink)

Omissions are metaphysically puzzling: Are they something or are they nothing? This paper develops and defends the constitution view of omissions, according to which a correct analysis of a person’s omission has the form “S omitted to X by Y-ing,” where her Y-ing is what constitutes her not-X-ing. The paper explains why the constitution view should be preferred to other views of omissions and defends the view against objections.

This paper warns of two threats to moral responsibility that arise when accounting for omissions, given some plausible assumptions about how abilities are related to responsibility. The first problem threatens the legitimacy of our being responsible by expanding the preexisting tension that luck famously raises for moral responsibility. The second threat to moral responsibility challenges the legitimacy of our practices of holding responsible. Holding others responsible for their omissions requires us to bridge an epistemic gap that does not arise when (...) holding others responsible for their actions—one that we might often fail to cross. (shrink)

Unwitting omissions pose a challenge for theories of moral responsibility. For commonsense morality holds many unwitting omitters morally responsible for their omissions (and for the consequences thereof), even though they appear to lack both awareness and control. For example, some people who leave dogs trapped in their cars outside on a hot day (see Sher 2009), or who forget to pick something up from the store as they promised (see Clarke 2014) seem to be blameworthy for their omissions. And yet, (...) if moral responsibility requires awareness of one’s omission and of its moral significance, as well as control, then it would appear that the unwitting protagonists of these cases are not, in fact, morally responsible for their omissions. In this paper, we consider, and ultimately reject, a number of influential views that try to solve this problem, including skepticism about responsibility for such omissions, a view we call the “decision tracing” view that grounds responsibility for such omissions in previous exercises of conscious agency, and “attributionist” views that ground responsibility for such omissions in the value judgments or other aspects of the agents’ selves. We propose instead a new tracing view that grounds responsibility for unwitting omissions in past opportunities to avoid them, where having such opportunities requires general awareness of the risk of such an omission, but not an exercise of agency, in contrast to the decision tracing view. We argue that the view can better accommodate cases, and fits well with the most plausible conception of the kind of control required for responsibility. (shrink)

Sometimes it seems intuitively plausible to hold loosely structured sets of individuals morally responsible for failing to act collectively. Virginia Held, Larry May, and Torbj rn T nnsj have all drawn this conclusion from thought experiments concerning small groups, although they apply the conclusion to large-scale omissions as well. On the other hand it is commonly assumed that (collective) agency is a necessary condition for (collective) responsibility. If that is true, then how can we hold sets of people responsible for (...) not having acted collectively? This paper argues that that loosely structured inactive groups sometimes meet this requirement if we employ a weak (but nonetheless non-reductionist) notion of collective agency. This notion can be defended on independent grounds. The resulting position on distribution of responsibility is more restrictive than Held's, May's or T nnsj 's, and this consequence seems intuitively attractive. (shrink)

Literature on testimonial injustice and ways that perpetrators might combat it have flourished since Miranda Fricker’s ground-breaking work on testimonial injustice. Less attention has been given, however, to the role of bystanders. In this paper, I examine the accountability that bystanders may have for their omissions to redress testimonial injustice. I argue that bystander accountability applies in cases where it is opportune for bystanders to intervene, and if they are also sufficiently equipped and able to redress the testimonial injustice. Moreover, (...) I recommend that we move beyond virtue responsibilism for ameliorative thinking about testimonial injustice. (shrink)

The characteristic asymmetry in intentionality attributions that is known as the Knobe effect can be explained by conjoining an orthodox theory of intentional action with a normative account of intentional omission. On the latter view: omissions presuppose some normative context; there are good reasons why the intentionality of omissions requires agents' knowledge rather than intention. The asymmetry in intentionality attributions in Knobe's cases can be seen to be derivative from an asymmetry in intentional omissions. The omissions account further explains (...) the Butler problem and some related puzzles. It also safeguards the simple view of intentional action from the asymmetry challenge. (shrink)

In some contexts, not saying S generates a conversational implicature: that the speaker didn’t have sufficient reason, all things considered, to say S. I call this an omissive implicature. Standard ways of thinking about conversational implicature make the importance and even the existence of omissive implicatures somewhat surprising. But I argue that there is no principled reason to deny that there are such implicatures, and that they help explain a range of important phenomena. This paper focuses on the roles omissive (...) implicatures play in Quantity implicatures—in particular, in solving the symmetry problem for scalar implicatures—and on the political and social importance of omissions where apologies, objections, or other communicative acts are expected or warranted. (shrink)

In this paper I discuss a recent exchange of articles between Hugh McLachlan and John Coggon on the relationship between omissions, causation, and moral responsibility. My aim is to contribute to their debate by isolating a presupposition I believe they both share and by questioning that presupposition. The presupposition is that, at any given moment, there are countless things that I am omitting to do. This leads both McLachlan and Coggon to give a distorted account of the relationship between causation (...) and moral or (as the case may be) legal responsibility and, in the case of Coggon, to claim that the law’s conception of causation is a fiction based on policy. Once it is seen that this presupposition is faulty, we can attain a more accurate view of the logical relationship between causation and moral responsibility in the case of omissions. This is important because it will enable us, in turn, to understand why the law continues to regard omissions as different, both logically and morally, from acts, and why the law seeks to track that logical and moral difference in the legal distinction it draws between withholding life-sustaining measures and euthanasia. (shrink)

In their thought-provoking article, Sedlakova and Trachsel (2023) defend the view that the status—both epistemic and ethical—of Conversational Artificial Intelligence (CAI) used in psychotherapy is complicated. While therapeutic CAI seems to be more than a mere tool implementing particular therapeutic techniques, it falls short of being a “digital therapist.” One of the main arguments supporting the latter claim is that even though “the interaction with CAI happens in the course of conversation… the conversation is profoundly different from a (...) conversation with a human therapist” (Sedlakova and Trachsel 2023, 8). In particular, unlike a human therapist, CAI cannot help its users gain new insight and self-understanding (Sedlakova and Trachsel 2023). We agree that currently available therapeutic CAI cannot be considered a “digital therapist,” however, we think that the issue surrounding the acquisition of new self-understanding in the interaction with therapeutic CAI is more complicated than Sedlakova and Trachsel suggest. (shrink)

The criminal law presently distinguishes between actions and omissions, and only rarely proscribes failures to avert consequences that it would be an offense to bring about. Why? In recent years it has been persuasively argued by both Glover and Bennett that, celeris paribus, omissions to prevent a harm are just as culpable as are actions which bring that harm about. On the other hand, and acknowledging that hitherto “lawyers have not been very successful in finding a rationale for it,” Tony (...) Honoré has sought to defend the law's differential treatment. He proposes a “distinct-duties theory” that in addition to the general duties we owe to everyone, we also owe distinct duties to a more limited collection of people and associations, specified by features of our relationship with them. Where a distinct duty holds, breach by omission may well be no better than breach by positive action. But absent a distinct duty, omissions, per Honoré, are less culpable. They are mere failures to intervene and improve or rectify things, whereas actions are positive interventions which make things worse. And, thus, the law has good reason to differentiate between them. (shrink)

Moore is one of the many law theorists who doubt that omissions can operate as factors in the causation of events and that in cases in which potential agents remain passive in spite of an obligation to intervene ascriptions of responsibility are justified exclusively by non-causal factors. The paper argues that this is an uneasy and essentially unstable position. It also shows that Moore himself, in Causation and Responsibility, does not consistently follow his exclusion of a causal role of (...) class='Hi'>omission in the context of casuistic analysis. Though Moore is to be praised for the clear stance he takes on the issue of negative causality, an analysis of the reasons given for the negation of causality by omission shows that these do not carry enough weight to compensate the sacrifice in theoretical coherence made by the special treatment of negative responsibility in cases in special obligations. It is proposed, instead, that the fact that responsibility for omissions is, as a rule, weaker than that for positive acts is better explained by non-causal factors such as the significant, though incomplete, correlation of the active-passive distinction with a number of normatively relevant factors and the greater social significance of moral and legal rules against active over against passive forms of wrongdoing. (shrink)

This paper develops and defends a new account of therapeutic trust, its nature and its constitutive norms. Central to the view advanced is a distinction between two kinds of therapeutic trust – default therapeutic trust and overriding therapeutic trust – each which derives from a distinct kind of trusting competence. The new view is shown to have advantages over extant accounts of therapeutic trust, and its relation to standard (non-therapeutic) trust, as defended by Hieronymi, (...) Frost-Arnold, and Jones. (shrink)

People generally accept that there is causation by omission—that the omission of some events cause some related events. But this acceptance elicits the selection problem, or the difficulty of explaining the selection of a particular omissive cause or class of causes from the causal conditions. Some theorists contend that dependence theories of causation cannot resolve this problem. In this paper, we argue that the appeal to norms adequately resolves the selection problem for dependence theories, and we provide novel (...) experimental evidence for it. (shrink)

Given the pervasiveness of habit in human life, the distinctive problems posed by habitual acts for accounts of moral responsibility deserve more attention than they have hitherto received. But whereas it is hard to find a systematic treatment habitual acts within current accounts of moral responsibility, proponents of such accounts have turned their attention to a topic which, I suggest, is a closely related one: unwitting omissions. Habitual acts and unwitting omissions raise similar issues for a theory of responsibility because (...) they likewise invite us to rethink the assumption that moral responsibility requires awareness of the relevant features of one’s conduct. And given the increasing interest in the problem of responsibility for unwitting omissions, it is reasonable to expect that the theoretical moves made in response to this problem might be used to make sense of judgments of responsibility regarding habitual acts. I substantiate these points by inquiring into whether some well-known accounts of unwitting omissions can be used to explain how we can be responsible for things we do out of habit. (shrink)

According to what I call theidentity view, omissions are actual events. For example, the nominal ‘Ali's non-jogging’ denotes whatever Ali is doing at the time she is said not to be jogging. Some have objected that omissions (and more generally absences) cannot be events, since the two do not have the same causal relations. I show how advocates of the identity view can offer a pragmatic account of the data the objection relies on.

But if there aren’t, then ‘they’ are not caused by anything and do not cause anything. That certainly appears to be false, however. John’s absence from our party might have been caused by his having fallen ill, and might cause a commotion. Dick’s not eating his soup might have been caused by his having fallen ill, and might cause a commotion.

What requirements does morality impose on us in relation to climate change? This question can be asked of individuals, of the entire global population, and of groups of various sizes in between. Given the case for accepting that we all collectively ought to be causing less climate-affecting pollution than we do, what follows from that about the moral status of the actions of members of the larger group? I examine two main ways in which moral requirements on group members can (...) derive from requirements that apply to the larger group. But neither of them seems to apply to the case of climate-affecting pollution. Perhaps this is a case where we together act wrongly, although no-one’s contribution to our doing so is wrong. (shrink)

The practical aspect of ancient philosophy has been recently made a focus of renewed metaphilosophical investigation. After a brief presentation of three accounts of this kind developed by Martha Nussbaum, Pierre Hadot, and Michel Foucault, the model of the therapeutic argument developed by Nussbaum is called into question from the perspectives offered by her French colleagues, who emphasize spiritual exercise (Hadot) or the care of the self (Foucault). The ways in which the account of Nussbaum can be defended are (...) then discussed, including both a ‘negative’ defense, i.e. the indication of the weaknesses of Hadot and Foucault’s proposals, and a ‘positive’ one focused on the points in which Nussbaum can convincingly address doubts about her metaphilosophical account. In response to these analyses, some further remarks made by Hadot and Foucault are discussed in order to demonstrate that their accounts are not as distant from Nussbaum after all. Finally, a recent metaphilosophical study by John Sellars together with a therapeutic (medical) model developed by the author of the present article are suggested as providing a framework for potential reconciliation between all three accounts discussed and a resource for further metaphilosophical studies. (shrink)

But if there aren’t, then ‘they’ are not caused by anything and do not cause anything. That certainly appears to be false, however. John’s absence from our party might have been caused by his having fallen ill, and might cause a commotion. Dick’s not eating his soup might have been caused by his having fallen ill, and might cause a commotion.

Therapeutic touch, a healing technique based upon the laying‐on of hands, has found wide acceptance in the nursing profession despite its lack of scientific plausibility. Its acceptance is indicative of a broad antiscientific trend in nursing. Adherents of this movement use the jargon of postmodern philosophy to justify their enthusiasm for a variety of mystically based techniques, citing such postmodern critics of science as Derrida and Michel Foucault as well as philosophical forerunners Heidegger and Husserl. Between 1997 and 1999, (...) 94 articles in nursing journals referred to postmodernism, according to a database search. This paper criticizes the postmodern movement for abandoning the biological underpinnings of nursing and for misreading philosophy in the service of an antiscientific world‐view. It is also suggested that nursing can retain its tradition of ‘caring’ without abandoning the scientific method. (shrink)