We examine a set of debates in Practical Ethics commonly labeled “the ethics of human enhancement.” Our essay focuses on (1) conceptual concerns about the limits of legitimate health care—the treatment vs. enhancement distinction, (2) moral considerations about fairness, authenticity, and human nature that are common in discussing the use of medical technologies in competitive institutions like sports and academia, and (3) broader issues that pertain to science policy and the distribution and regulation of medical technologies.

I present Lockean considerations that count in favor of a global basic income program. This paper articulates a conception of equal-share left-libertarianism that is supported by the moral rights of full self-ownership and world-ownership. It is argued that, according to this view, an appropriately constructed global basic income program would be a key institution for promoting the rights of full self-ownership and world-ownership.

In their stimulating article, “What do psychiatrists think about caring for patients who have extremely treatment-refractory illness?,” Dorfman et al. (2024) survey 212 U.S. psychiatrists to gauge...

Decisional capacity evaluations (DCEs) occur in clinical settings where it is unclear whether a consumer of medical services has the capacity to make an informed decision about the relevant medical options. DCEs are localized interventions, not the global loss of competence, that assign a surrogate decision maker to make the decision on behalf of the medical consumer. We maintain that one important necessary condition for a DCE to be morally justified, in cases of medical necessity, is that the health care (...) consumer under evaluation is incapable of expressing a preference for a certain outcome. (shrink)

I reconstruct Bernard Williams’ integrity-based critique of Act-Utilitarianism (AU). I contend that Williams presents a compelling argument against AU, but the argument does not generalize to all impartial moral theories. I argue that Williams’ conception of personal integrity as the pursuit of one’s projects presents a strong objection to AU and it reveals the importance of widening the scope of morality to include considerations of partial inter-personal relations. I also contend that Williams’ conception of integrity can withstand the scrutiny brought (...) upon it by the self-indulgence objection. However, defenders of his conception of integrity must admit that personal integrity does place one in the danger of having evil projects. (shrink)

Following Kahneman and Tversky, I examine the term ‘bias’ as it is used to refer to systematic errors. Given the central role of error in this understanding of bias, it is helpful to consider what it is to err and to distinguish different kinds of error. I identify two main kinds of error, examine ethical issues that pertain to the relation of these types of error, and explain their moral significance. Next, I provide a four-level explanatory framework for understanding biases: (...) personal, sub-personal, situational, and systemic levels. Finally, I examine some of the ethical complexities involved in attributing biases to oneself and to others. (shrink)

This groundbreaking volume of original essays presents fresh avenues of inquiry at the intersection of philosophy and psychiatry. Contributors draw from a variety of fields, including evolutionary psychiatry, phenomenology, biopsychosocial models, psychoanalysis, neuroscience, neuroethics, behavioral economics, and virtue theory. Philosophy and Psychiatry’s unique structure consists of two parts: in the first, philosophers write five lead essays with replies from psychiatrists. In the second part, this arrangement is reversed. The result is an interdisciplinary exchange that allows for direct discourse, and a (...) volume at the forefront of defining an emerging discipline. Philosophy and Psychiatry will be of interest to professionals in philosophy and psychiatry, as well as mental health researchers and clinicians. (shrink)

This essay explores philosophical questions about practical identity that emerge in David Cronenberg's films, "A History of Violence" and "Eastern Promises." I distinguish the metaphysical problems of personal identity from the practical problems and contend that the latter are of central importance to the topic of authenticity. Central scenes from both films are examined with an eye to their engagement with the issues of authenticity and self-creation.

Psychiatric disorders usually do not have characteristic physical exam findings, imaging, or lab values. Psychiatrists therefore diagnose and treat patients largely based on reported or observed behavior, which makes collateral information from a patient’s close contacts especially pertinent to an accurate diagnosis. The American Psychiatric Association considers communication with patients’ supports a best practice when the patient provides informed consent or does not object to the communication. However, situations arise in which a patient’s objection to such communication is the product (...) of impaired decision-making and the benefits of obtaining collateral information represent best practice. In this article a framework for addressing these situations is proposed using a full decisional capacity evaluation, followed by an alternate decision-making process by concurrence from a second physician. It is recommended that a patient’s refusal to allow the gathering of collateral information should be addressed exactly like refusals for other diagnostic or treatment interventions. (shrink)

This essay is the introduction to a special debate issue of the journal "Basic Income Studies" on the topic of whether libertarians should endorse a universal basic income. The essay attempts to clarify some common uses of the term 'libertarianism" as it is used by moral and political philosophers. It identifies some important common features of libertarian normative theories.

We describe the legal practice of using civil court orders to mandate outpatient mental health treatment for adults with serious mental illness. After briefly placing the practice in historical context, we discuss the traditional clinical rationale and assumptions underlying outpatient commitment and its legal variants, as well as how the predominant and controversial preventive form of outpatient commitment emerged in the U.S. to address limitations of earlier versions of these laws, such as "conditional release." We then consider whether, and under (...) what conditions, outpatient commitment may be ethical, and we provide a conceptual framework for deciding such questions at the policy and individual-case levels. (shrink)

We identify three points of intersection between economics and ethics: the ethics of economics, ethics in economics and ethics out of economics. These points of intersection reveal three types of conversation between economists and moral philosophers that have produced, and may continue to produce, fruitful exchange between the disciplines.

John Harris's influential work on human enhancement has advocated the development, use, and exchange of human enhancement technologies. The types of enhancements that are of interest are biomedical interventions that are used to improve human capacities beyond what is necessary to achieve or maintain health or "normal functioning". This new book is unique in Harris's body of work in that it takes a more cautious stance regarding moral enhancements than he has taken toward other forms of human enhancement, such as (...) cognitive enhancements. I examine and evaluate Harris's main arguments for this cautious stance. Two of the main issues that are discussed are: (1) whether it would be unethical for someone to use biomedical technologies to become less racist and (2) whether it would be unethical for someone to use biomedical technologies to reduce impulsive violent aggression. (shrink)

Kane's ambitious and bold book presents a sustained argument for an ethical theory that gives an account of right action and the good life. The general structure of the main argument is presented and specific points are critically discussed.

Abstract This article outlines Locke's theory of war as found in his political writings and seeks to redress a perceived imbalance in John Locke's morality of war. Locke's strident rejection of any sense of proportionality in warfare against unjust aggression, as read in the Second Treatise of Government, has to be tempered with his general philosophical programme against extremism of any sort. Arguably, Locke's war ethic when read alone is strict, objective, and emphatic, but when compared with his epistemological work, (...) its righteousness is reduced to extreme circumstances. (shrink)

A pioneering work in the philosophy of mind, Content and Consciousness brings together the approaches of philosophers and scientists to the mind--a connection that must occur if genuine analysis of the mind is to be made. This unified approach permits the most forbiddingly mysterious mental phenomenon--consciousness--to be broken down into several distinct phenomena, and these are each given a foundation in the physical activity of the brain. This paperback edition contains a preface placing the book in the context of recent (...) work in the area. (shrink)

In this book by the award-winning author of Just Healthcare, Norman Daniels develops a comprehensive theory of justice for health that answers three key questions: what is the special moral importance of health? When are health inequalities unjust? How can we meet health needs fairly when we cannot meet them all? Daniels' theory has implications for national and global health policy: can we meet health needs fairly in ageing societies? Or protect health in the workplace while respecting individual liberty? Or (...) meet professional obligations and obligations of justice without conflict? When is an effort to reduce health disparities, or to set priorities in realising a human right to health, fair? What do richer, healthier societies owe poorer, sicker societies? Just Health: Meeting Health Needs Fairly explores the many ways that social justice is good for the health of populations in developed and developing countries. (shrink)

In this book Daniel Wegner offers a novel understanding of the relation of consciousness, the will, and our intentional and voluntary actions. Wegner claims that our experience and common sense view according to which we can influence our behavior roughly the way we experience that we do it is an illusion.

Rowan Williams's theological-moral reasoning regarding the formation of personal identities in relation to gender, familial and communal ties is analysed in an article review of his book Lost Icons. This is his most sustained essay in theological social criticism, and was intended for the general public beyond academic theology. Williams exposes Christian moral reasoning on these issues to forms of secular critique whilst simultaneously using theological and historical strategies from liberal Anglo-Catholicism. His argumentation is subjected to theological and social-scientific scrutiny. (...) The article calls for closer attention to debates within secular feminism and social research concerning the formation of adult men and women in relation to the wider post-Christian society. Links are made from Williams's thought in Lost Icons to underlying patterns in his academic theological output. (shrink)

In the first thirty years after World War II, the US economy performed very well. The rate of growth averaged 4—5%, the rate of unemployment was seldom above 5%, inflation was almost non-existent, and the living standards of workers improved steadily. These were the ‘good old days'. However, this long period of expansion and prosperity ended in the 1970s. Since then, both the rate of unemployment and the rate of inflation have been much higher than before, and the average real (...) wages of workers have declined some 20%. Productivity growth has also slowed down and the debt burden of both capitalist enterprises and the Federal government has increased dramatically. It is in this sense that we may refer to the ‘economic crisis’ of the US economy over the last two decades. This crisis has certainly not been as severe as the Great Depression of the 1930s, but the economic performance has been significantly worse than in the early post-war period. (shrink)

The _Physics_ is a foundational work of western philosophy, and the crucial one for understanding Aristotle's views on matter, form, essence, causation, movement, space, and time. This richly annotated, scrupulously accurate, and consistent translation makes it available to a contemporary English reader as no other does—in part because it fits together seamlessly with other closely associated works in the New Hackett Aristotle series, such as the _Metaphysics_, _De Anima_, and forthcoming _De Caelo_ and _On Coming to Be and Passing Away_. (...) Eventually the series will include all of Aristotle's works. Sequentially numbered endnotes provide the information most needed at each juncture, while a detailed Index of Terms indicates places where focused discussion of key notions occurs. An illuminating general Introduction describes the book that lies ahead, explaining what sort of work it is and what sorts of evidence it relies on. (shrink)

How should medical services be distributed within society? Who should pay for them? Is it right that large amounts should be spent on sophisticated technology and expensive operations, or would the resources be better employed in, for instance, less costly preventive measures? These and others are the questions addreses in this book. Norman Daniels examines some of the dilemmas thrown up by conflicting demands for medical attention, and goes on to advance a theory of justice in the distribution of health (...) care. The central argument is that health care, both preventive and acute, has a crucial effect on equality of opportunity, and that a principle guaranteeing equality of opportunity must underly the distribution of health-care services. Access to care, preventive measures, treatment of the elderly, and the obligations of doctors and medical administrations are fully discussed, and the theory is shown to underwrite various practical policies in the area. (shrink)

Précis for a book symposium, with contributions from Meg Wallace, Louis deRosset, and Chris Tillman and Joshua Spencer.

Our ability to locate moral responsibility is often thought to be a necessary condition for conducting morally permissible medical practice, engaging in a just war, and other high-stakes endeavors. Yet, with increasing reliance upon artificially intelligent systems, we may be facing a wideningresponsibility gap, which, some argue, cannot be bridged by traditional concepts of responsibility. How then, if at all, can we make use of crucial emerging technologies? According to Colin Allen and Wendell Wallach, the advent of so-called ‘artificial moral (...) agents’ (AMAs) is inevitable. Still, this notion may seem to push back the problem, leaving those who have an interest in developing autonomous technology with a dilemma. We may need to scale-back our efforts at deploying AMAs (or at least maintain human oversight); otherwise, we must rapidly and drastically update our moral and legal norms in a way that ensures responsibility for potentially avoidable harms. This paper invokes contemporary accounts of responsibility in order to show how artificially intelligent systems might be held responsible. Although many theorists are concerned enough to develop artificial conceptions ofagencyor to exploit our present inability to regulate valuable innovations, the proposal here highlights the importance of—and outlines a plausible foundation for—a workable notion ofartificial moral responsibility. (shrink)

In this paper I will present a puzzle about epistemic akrasia, and I will use that puzzle to motivate accepting some non-standard views about the nature of epistemological judgment. The puzzle is that while it seems obvious that epistemic akrasia must be irrational, the claim that epistemic akrasia is always irrational amounts to the claim that a certain sort of justified false belief—a justified false belief about what one ought to believe—is impossible. But justified false beliefs seem to be possible (...) in any domain, and it’s hard to see why beliefs about what one ought to believe should be an exception. I will argue that when we get clearer about what sort of psychological state epistemic akrasia is, we can resolve the puzzle in favor of the intuitive view that epistemic akrasia is always irrational. (shrink)

This collection of essays explores the metaphysical thesis that the living world is not made up of substantial particles or things, as has often been assumed, but is rather constituted by processes. The biological domain is organised as an interdependent hierarchy of processes, which are stabilised and actively maintained at different timescales. Even entities that intuitively appear to be paradigms of things, such as organisms, are actually better understood as processes. Unlike previous attempts to articulate processual views of biology, which (...) have tended to use Alfred North Whitehead’s panpsychist metaphysics as a foundation, this book takes a naturalistic approach to metaphysics. It submits that the main motivations for replacing an ontology of substances with one of processes are to be found in the empirical findings of science. Biology provides compelling reasons for thinking that the living realm is fundamentally dynamic, and that the existence of things is always conditional on the existence of processes. The phenomenon of life cries out for theories that prioritise processes over things, and it suggests that the central explanandum of biology is not change but rather stability, or more precisely, stability attained through constant change. This edited volume brings together philosophers of science and metaphysicians interested in exploring the consequences of a processual philosophy of biology. The contributors draw on an extremely wide range of biological case studies, and employ a process perspective to cast new light on a number of traditional philosophical problems, such as identity, persistence, and individuality. (shrink)

Supporters of open borders sometimes argue that the state has no pro tanto right to restrict immigration, because such a right would also entail a right to exclude existing citizens for whatever reasons justify excluding immigrants. These arguments can be defeated by suggesting that people have a right to stay put. I present a new form of the exclusion argument against closed borders which escapes this “right to stay put” reply. I do this by describing a kind of exclusion that (...) has not been discussed in depth, which I call “territorial exclusion.” Territorial exclusion is the process according to which the group that wishes to exclude current citizens secedes from the territory in which those citizens reside. I argue that the wrongness of territorial exclusion explains why there is no pro tanto right for a state to exclude immigrants, because otherwise there would be a pro tanto right for the state to kick people out by seceding from the territory they inhabit. Because kicking people out like this is typically wrong, borders cannot be closed. (shrink)

I defend the cosmopolitan instrumentalist theory of secession, according to which a group has a right to secede only if this would promote cosmopolitan justice. I argue that the theory is preferable to other theories of secession because it is an entailment of cosmopolitanism, which is independently attractive, and because, unlike other theories of secession, it allows us to give the answers we want to give in cases like secession of the rich or secession that would make things worse for (...) minorities. I defend the view against the objections that it allows for colonialism and annexation, that it is not a distinct theory, and that it is impractical. (shrink)

This chapter introduces readers to the view that praise is a form of address, or is communicative in the sense of seeking uptake from its target. The proposal that praise is communicative will seem counterintuitive if we take blame to be our paradigm of what it is for a responsibility-response to be communicative. This is because blame is communicative in a manner that intuitively presupposes some normative failure; it involves calling its target to account (or answer) for some wrongdoing. But, (...) the ‘rightdoer’ already properly regarded the relevant reasons in acting praiseworthily. So, there is nothing for which the praiseworthy agent must similarly account or answer for. How then could praise be communicative in sense of seeking uptake from its target? This chapter develops the view that praise is communicative in that it invites the praiseworthy agent to accept credit by co-valuing their action in the evaluative terms supplied by the praiser. This proposal is defended against three objections, namely that it is descriptively inadequate regarding our actual practices, that it is morally mistaken about when we owe others a response, and that it implies redundant communication. (shrink)

Advances in understanding genetic disorders have been rapid in the last few years and with them the need and desire for genetic counselling have grown. Almost simultaneously, particularly in the USA, several large screening programmes have been initiated to screen large numbers of people who may be carriers of such deleterious genes as those of Tay-Sachs disease and sickle cell anaemia. The authors of this paper, clinical medical students at University College Hospital, London, spent some time studying the ethical issues (...) raised. The first part of their study, which is not published here, relates to the biochemistry of certain genetic disorders, so leading up to the aspect of the subject which must concern readers of this journal, genetic counselling. At present genetic counselling is generally the province of the medical practitioner working with clinical biochemists, and in this paper their function is described and how programmes of screening for carriers are designed. Whether the subjects of the screening tests are found to be 'innocent' or 'guilty' psychological problems confront them, and of these the genetic counsellor must be aware. In fact the range of ethical problems raised by such counselling is wide and can only be sketched in this article. (shrink)

This volume provides a detailed account of the syntax of expressive language, that is, utterances that express, rather than describe, the emotions and attitudes of the speaker... Daniel Gutzmann demonstrates that expressivity has strong syntactic reflexes that interact with the semantic and pragmatic interpretation of these utterances, and argues that expressivity is in fact a syntactic feature on a par with other established features such as tense and gender. Evidence for this claim is drawn from three detailed case studies (...) of expressive adjectives, intensifiers, and vocatives; their puzzling properties are accounted for through a minimalist approach to syntactic features and agreement, which shows that expressivity can partake in agreement operations, trigger movement, and be selected for syntactically. The analysis not only supports the hypothesis of expressive syntax, but also highlights the hidden role that grammar may play in phenomena that are traditionally considered to be solely semantic in nature" -- Publisher. (shrink)

Choices confront us with questions. How we act depends on our answers to those questions. So the way our beliefs guide our choices is not just a function of their informational content, but also depends systematically on the questions those beliefs address. This paper gives a precise account of the interplay between choices, questions and beliefs, and harnesses this account to obtain a principled approach to the problem of deduction. The result is a novel theory of belief-guided action that explains (...) and predicts the decisions of agents who, like ourselves, fail to be logically omniscient: that is, of agents whose beliefs may not be deductively closed, or even consistent. (Winner of the 2021 Isaac Levi Prize.). (shrink)

After 50 years of debate, the ethics of aggregation has reached a curious stalemate, with both sides arguing that only their theory treats people as equals. I argue that, on the issue of equality, both sides are wrong. From the premise that “each counts for one,” we cannot derive the conclusion that “more count for more”—or its negation. The familiar arguments from equality to aggregation presuppose more than equality: the Kamm/Scanlon “Balancing Argument” rests on what social choice theorists call “(Positive) (...) Responsiveness,” Kamm’s “Aggregation Argument” assumes that “equal” lives are fungible, and Hsieh et al. have it that spreading goods broadly best approximates equality. In each case, the crucial premise is not equality itself but a further idea that Taurek, I argue, can safely reject. I conclude with a conjecture: there is no theory-neutral argument that settles the question of whether the numbers count. (shrink)

This paper presents a new interpretation of Michel Foucault’s critical project. It is well known that Foucault’s genealogical critique does not focus on issues of justification, but instead tackles “aspectival captivity,” that is, apparently inevitable limits of thought that constrain the agent’s freedom but that, in fact, can be transformed. However, it has not been recognized that, according to Foucault, critique can proceed along two distinct paths. In a key passage of “What Is Critique?,” Foucault states that critique is tasked (...) with questioning truth about its effects of power and with questioning power about its discourses of truth. We show that this “double movement” organizes Foucault’s critical project as a whole, giving it a significantly wider scope and a more complex structure than has been previously acknowledged. At the heart of the above-mentioned bifurcation lies an apparent tension between two contrastive roles Foucault assigns to truth-telling in the context of critique: on the one hand, truth-telling (as avowal) is a target of critique; on the other, truth-telling (as parrhesia) is one of critique’s methods. We argue that combining these two dimensions in a unified account is crucial for understanding and re-evaluating Foucault’s critical project as a whole. By showing that truth-telling remains an essential element of Foucauldian critique, this paper also rectifies some influential misinterpretations according to which Foucault’s critical project seeks to eliminate truth from the picture. (shrink)

The American Journal of Bioethics, Volume 12, Issue 8, Page 19-20, August 2012.

This chapter draws on insights from non-equilibrium thermodynamics to demonstrate the ontological inadequacy of the machine conception of the organism. The thermodynamic character of living systems underlies the importance of metabolism and calls for the adoption of a processual view, exemplified by the Heraclitean metaphor of the stream of life. This alternative conception is explored in its various historical formulations and the extent to which it captures the nature of living systems is examined. Following this, the chapter considers the metaphysical (...) implications of reconceptualizing the organism from complex machine to flowing stream. What do we learn when we reject the mechanical and embrace the processual? Three key lessons for biological ontology are identified. The first is that activity is a necessary condition for existence. The second is that persistence is grounded in the continuous self-maintenance of form. And the third is that order does not entail design. (shrink)

I argue that the phenomenon underlying Bernard Williams’ (1976) “agent-regret” is considerably broader than appreciated by Williams and others. Agent-regret— an anguished response that agents have for harms they have caused, even if faultlessly— I maintain, is a species of a more general response to harms that need not be one’s fault, but which nonetheless impact one’s practical identity in a special way. This broader genus includes as a species what I call “relation-regret”, a pained response to harm caused by (...) a person to whom one is intimately related, as a co-member of a group partly constitutive of one’s practical identity (e.g. one’s family). After providing an account of the moral psychology of relation-regret, I attend to its normative significance, proposing in particular that acceptance of relation-regret provides us with reasons for accepting a novel form of moral luck, namely associative luck: the luck of being vulnerable to responsibility-responses in virtue of one’s attachments to others, despite one’s personal faultlessness. (shrink)