Trust is central to the therapeutic relationship, but the epistemic asymmetries between the expert healthcare provider and the patient make the patient, the trustor, vulnerable to the provider, the trustee. The narratives of pain sufferers provide helpful insights into the experience of pain at the juncture of trust, expert knowledge, and the therapeutic relationship. While stories of pain sufferers having their testimonies dismissed are well documented, pain sufferers continue to experience their testimonies as being epistemically downgraded. This kind of epistemic (...) injustice has received limited treatment in bioethics. In this paper, we examine how a climate of distrust in pain management may facilitate what Fricker calls epistemic injustice. We critically interrogate the processes through which pain sufferers are vulnerable to specific kinds of epistemic injustice, such as testimonial injustice. We also examine how healthcare institutions and practices privilege some kinds of evidence and ways of knowing while excluding certain patient testimonies from epistemic consideration. We argue that providers ought to avoid epistemic injustice in pain management by striving toward epistemic humility. Epistemic humility, as a form of epistemic justice, may be the kind disposition required to correct the harmful prejudices that may arise through testimonial exchange in chronic pain management. (shrink)

Background Our objective was to evaluate whether the description of a machine learning (ML) app or brain imaging technology to predict the onset of schizophrenia or alcohol use disorder (AUD) influences healthcare professionals’ judgments of stigma, empathy, and compassion.Methods We randomized healthcare professionals (N = 310) to one vignette about a person whose clinician seeks to predict schizophrenia or an AUD, using a ML app, brain imaging, or a psychosocial assessment. Participants used scales to measure their judgments of stigma, empathy, (...) and compassion.Results Participants randomized to the ML vignette endorsed less anger and more fear relative to the psychosocial vignette, and the brain imaging vignette elicited higher pity ratings. The brain imaging and ML vignettes evoked lower personal responsibility judgments compared to the psychosocial vignette. Physicians and nurses reported less empathy than clinical psychologists.Conclusions The use of predictive technologies may reinforce essentialist views about mental health and substance use that may increase specific aspects of stigma and reduce others. (shrink)

In this paper, we claim that we can only seek to eradicate the stigma associated with the contemporary opioid overdose epidemic when we understand how opioid stigma and the epidemic have co-evolved. Rather than conceptualizing stigma as a parallel social process alongside the epidemiologically and physiologically defined harms of the epidemic, we argue that the stigmatized history of opioids and their use defines the epidemic. We conclude by offering recommendations for disrupting the burden of opioid stigma.

Prescription opioid abuse (POA) is an escalating clinical and public health problem. Physician worries about iatrogenic addiction and whether patients are ‘drug seeking’, ‘abusing’ and ‘diverting’ prescription opioids exist against a backdrop of professional and legal consequences of prescribing that have created a climate of distrust in chronic pain management. One attempt to circumvent these worries is the use of opioid contracts that outline conditions patients must agree to in order to receive opioids. Opioid contracts have received some scholarly attention, (...) with trust and trustworthiness identified as key values and virtues. However, few articles have provided a critical account of trust and trustworthiness in this context, particularly when there exists disagreement about their role in terms of enhancing or detracting from the patient–physician relationship. This paper argues that opioid contracts represent a misleading appeal to patient–physician trust. Assuming the patient is untrustworthy may wrongfully undermine the credibility of the patient's testimony, which may exacerbate certain vulnerabilities of the person in pain. However, misplaced trust in certain patients may render the physician vulnerable to the potential harms of POA. If patients distrust their physician, or feel distrusted by them, this may destabilise the therapeutic relationship and compromise care. A process of epistemic humility may help cultivate mutual patient–physician trust. Epistemic humility is a collaborative effort between physicians and patients that recognises the role of patients’ subjective knowledge in enhancing physicians’ self-understanding of their theoretical and practice frameworks, values and assumptions about the motivations of certain patients who report chronic pain. (shrink)

Advances in neuroscience are changing how mental health issues such as addiction are understood and addressed as a brain disease. Although a brain disease model legitimizes addiction as a medical condition, it promotes neuro-essentialist thinking and categorical ideas of responsibility and free choice, and undermines the complexity involved in its emergence. We propose a “biopsychosocial systems” model where psychosocial factors complement and interact with neurogenetics. A systems approach addresses the complexity of addiction and approaches free choice and moral responsibility within (...) the biological, lived experience and sociohistorical context of the individual. We examine heroin-assisted treatment as an applied case example within our framework. We conclude with a discussion of the model and its implications for drug policy, research, addiction health care systems and delivery, and treatment of substance use problems. (shrink)

While solid organ transplantation for patients with substance use issues has attracted ethical discussion, a typology of the ethics themes has not been articulated in the literature. We conducted a scoping review of peer-reviewed literature on solid organ transplantation and substance use published between January 1997 and April 2016. We aimed to identify and develop a typology of the main ethical themes discussed in this literature and to identify gaps worthy of future research. Seventy articles met inclusion criteria and underwent (...) inductive content analysis. Four main ethical themes were identified: (1) personal responsibility; (2) utility; (3) moral character; and (4) fairness. Each theme had multiple sub-themes and there was substantial overlap between themes. This scoping review identified a disproportionate emphasis in the literature regarding personal responsibility, which was referenced by each of the other themes, and a narrow focus on alcohol and liver. We recommend future research further investigate these connections between ethical themes and focus on ethical issues associated with transplants from organ groups other than liver for patients who use substances other than alcohol. (shrink)

Since its introduction in the 1980s, futility as a concept has held contested meaning and applications throughout medicine. There has been little discussion within the psychiatric literature about the use of futility in the care of individuals experiencing severe and persistent mental illness, despite some tacit acceptance that futility may apply in certain cases of psychiatric illness. In this paper, we explore the literature surrounding futility and argue that its connotation within medicine is to describe situations where patients believe that (...) interventions will almost certainly provide no meaningful benefit. We then provide two arguments in support of the use of futility within the care of individuals experiencing SPMI: that some SPMI can be considered a terminal illness, and that the risk-benefit ratio is a dynamic entity such that futility can help describe what Gillett calls the ‘risk of unacceptable badness’ when it comes to considering how an intervention might impact a patient’s quality of life. We posit that capacity should not pose an obstacle to declaring futility when caring for individuals experiencing SPMI and explain how futility is not antithetical to recovery in mental health. Finally, we describe how using futility within psychiatric practice can allow for a reorientation of care by signalling the need to shift to a palliative approach. (shrink)

North America is in the grips of an epidemic of opioid-related poisonings. Overdose education and naloxone distribution programmes emerged as an option for structurally vulnerable populations who could not or would not access mainstream emergency medical services in the event of an overdose. These task shifting programmes utilize lay persons to deliver opioid resuscitation in the context of longstanding stigmatization and marginalization from mainstream healthcare services. OEND programmes exist at the intersection of harm reduction and emergency services. One goal of (...) OEND programmes is to help redress the health-related inequities common among people who use drugs, which include minimizing the gap between people who use drugs and the formal healthcare system. However, if this goal is not achieved these inequities may be entrenched. In this article, we consider the ethical promises and perils associated with OEND as task shifting. We argue that public health practitioners must consider the ethical aspects of task shifting programmes that may inadvertently harm already structurally vulnerable populations. We believe that even if OEND programmes reduce opioid-related deaths, we nevertheless question if, by virtue of its existence, OEND programmes might also unintentionally disenfranchise structurally vulnerable populations from comprehensive healthcare services, including mainstream emergency care. (shrink)

A main strength of neuroimaging and neuroscience is its reductionist focus on the brain. A limitation is that it runs the possibility of ignoring larger social factors. The brain image may not necessarily indicate the brain’s neuroplastic ‘rewiring’ over time from genomic, epigenetic, environmental and social conditions. These factors are all necessary to understand the diverse nature of our brains, especially complex concerns such as addiction. For addiction to emerge it requires an intersection of genetic, environmental and social influences. It (...) is foreseeable to ignore this multi-factorial interaction in the clinical setting when interpreting predictive brain imaging scans. This paper argues that relying too heavily on clinical neuroimaging in the treatment of patients who present a vulnerability to addiction can lead to cases of biological reductionism ignoring the influence social systems have on brain responses. (shrink)

Bioethics has received important criticisms for its perceived privileging of biomedical authority with longstanding calls for greater recognition of the social, political, economic, historical, and...

Mental health care providers increasingly confront challenges posed by the introduction of new neurotechnology into the clinic, but little is known about the impact of such capabilities on practice patterns and relationships with patients. To address this important gap, we sought providers’ perspectives on the potential clinical translation of functional neuroimaging for prediction and diagnosis of mental illness. We conducted 32 semi-structured telephone interviews with mental health care providers representing psychiatry, psychology, family medicine, and allied mental health. Our results suggest (...) that mental health providers have begun to re-conceptualize mental illness with a neuroscience gaze. They report an epistemic commitment to the value of a brain scan to provide a meaningful explanation of mental illness for their clients. If functional neuroimaging continues along its projected trajectory to translation, providers will ultimately have to negotiate its role in mental health. Their perspectives, therefore, enrich bioethical discourse surrounding neurotechnology and inform the translational pathway. (shrink)

We read Marshall et al.’s paper with great interest but were left with many questions and concerns (Marshall et al., in press). As a group of public health researchers and practitioners (nursing, s...

Bianchi et al. argue that for some patients with severe and enduring anorexia nervosa approaches that do not aim for complete clinical recovery are ethically warranted. We believe tha...

A recent article in this journal described practical and conceptual difficulties faced by public health researchers studying scabies outbreaks in British residential care facilities. Their study population was elderly, decisionally incapacitated residents, many of whom lacked a legally appropriate decision-maker for healthcare decisions. The researchers reported difficulties securing Research Ethics Committee approval. As practicing healthcare ethicists working in a large Canadian research hospital, we are familiar with this challenge and welcomed the authors’ invitation to join the discussion of the ‘outstanding (...) ambiguities and further questions’ that their experience uncovered. We propose a Power of Attorney for Research as one substantive solution to help address the problems they identified. Although we acknowledge the familiar shortcomings associated with Advance Directives in the clinical context, we believe that Powers of Attorney for Research Participation, accompanied by Advance Research Directives, may increase the likelihood of gaining deeper understandings of potential participant’s values and priorities and how they might apply to foreseeable research opportunities. (shrink)

Researchers are studying how artificial intelligence (AI) can be used to better detect, prognosticate and subgroup diseases. The idea that AI might advance medicine’s understanding of biological categories of psychiatric disorders, as well as provide better treatments, is appealing given the historical challenges with prediction, diagnosis and treatment in psychiatry. Given the power of AI to analyse vast amounts of information, some clinicians may feel obligated to align their clinical judgements with the outputs of the AI system. However, a potential (...) epistemic privileging of AI in clinical judgements may lead to unintended consequences that could negatively affect patient treatment, well-being and rights. The implications are also relevant to precision medicine, digital twin technologies and predictive analytics generally. We propose that a commitment to epistemic humility can help promote judicious clinical decision-making at the interface of big data and AI in psychiatry. (shrink)

Trust is central to the therapeutic relationship, but the epistemic asymmetries between the expert healthcare provider and the patient make the patient, the trustor, vulnerable to the provider, the trustee. The narratives of pain sufferers provide helpful insights into the experience of pain at the juncture of trust, expert knowledge, and the therapeutic relationship. While stories of pain sufferers having their testimonies dismissed are well documented, pain sufferers continue to experience their testimonies as being epistemically downgraded. This kind of epistemic (...) injustice has received limited treatment in bioethics. In this paper, we examine how a climate of distrust in pain management may facilitate what Fricker calls epistemic injustice. We critically interrogate the processes through which pain sufferers are vulnerable to specific kinds of epistemic injustice, such as testimonial injustice. We also examine how healthcare institutions and practices privilege some kinds of evidence and ways of knowing while excluding certain patient testimonies from epistemic consideration. We argue that providers ought to avoid epistemic injustice in pain management by striving toward epistemic humility. Epistemic humility, as a form of epistemic justice, may be the kind disposition required to correct the harmful prejudices that may arise through testimonial exchange in chronic pain management. (shrink)

BackgroundClinical ethics consultations can be complex interventions, involving multiple methods, stakeholders, and competing ethical values. Despite longstanding calls for rigorous evaluation in the field, progress has been limited. The Medical Research Council proposed guidelines for evaluating the effectiveness of complex interventions. The evaluation of CEC may benefit from application of the MRC framework to advance the transparency and methodological rigor of this field. A first step is to understand the outcomes measured in evaluations of CEC in healthcare settings. ObjectiveThe primary (...) objective of this review was to identify and map the outcomes reported in primary studies of CEC. The secondary objective was to provide a comprehensive overview of CEC structures, processes, and roles to enhance understanding and to inform standardization.MethodsWe searched electronic databases to identify primary studies of CEC involving patients, substitute decision-makers and/or family members, clinicians, healthcare staff and leaders. Outcomes were mapped across five conceptual domains as identified a priori based on our clinical ethics experience and preliminary literature searches and revised based on our emerging interpretation of the data. These domains included personal factors, process factors, clinical factors, quality, and resource factors. ResultsForty-eight studies were included in the review. Studies were highly heterogeneous and varied considerably regarding format and process of ethical intervention, credentials of interventionist, population of study, outcomes reported, and measures employed. In addition, few studies used validated measurement tools. The top three outcome domains that studies reported on were quality, process factors, and clinical factors. The majority of studies examined multiple outcome domains. All five outcome domains were multidimensional and included a variety of subthemes.ConclusionsThis scoping review represents the initial phase of mapping the outcomes reported in primary studies of CEC and identifying gaps in the evidence. The confirmed lack of standardization represents a hindrance to the provision of high quality intervention and CEC scientific progress. Insights gained can inform the development of a core outcome set to standardize outcome measures in CEC evaluation research and enable scientifically rigorous efficacy trials of CEC. (shrink)

Background: After over 4 years since medical assistance in dying legalization in Canada, there is still much uncertainty about how this ruling has affected Canadian society. Objective: To describe the positive aspects of medical assistance in dying legalization from the perspectives of hospice palliative care providers engaging in medical assistance in dying. Design: In this qualitative descriptive study, we conducted an inductive thematic analysis of semi-structured interviews with hospice palliative care providers. Participants and setting: Multi-disciplinary hospice palliative care providers in (...) acute, community, residential, and hospice care in Vancouver and Toronto, Canada, who have engaged in end-of-life care planning with patients who have inquired about and/or requested medical assistance in dying. Ethical considerations: The research proposal was approved by University of British Columbia Research Ethics Board in Vancouver and University Health Network in Toronto. Participants were informed regarding the research goals, signed a written consent, and were assigned pseudonyms. Results: The 48 participants included hospice palliative care physicians, nurses, social workers, and allied health providers. The average interview length was 50 min. Positive aspects of medical assistance in dying legalization were identified at the individual level: a new end-of-life option, patients’ last chance to express control over their lives, patient and family comfort and relief, and a unique learning experience for hospice palliative care providers; the team level: supportive collegial relationships, broadened discussions about end-of-life and palliative care, and team debriefs provide opportunities for education and support; and the institutional level: improved processes to facilitate the implementation logistics. Conclusion: While being involved in the medical assistance in dying process is complex and challenging, this study sheds light on the positive aspects of medical assistance in dying legalization from the hospice palliative care provider’s perspectives. Medical Assistance in Dying legalization has resulted in improved end-of-life conversations between hospice palliative care providers, patients, and their families. Improved communication leads to a better understanding of patients’ end-of-life care plans and bridges some of the existing gaps between hospice palliative care and medical assistance in dying. (shrink)

Peterson et al. (2023) identify important ethical issues that are relevant to psychedelic therapy and research in various clinical populations and contexts. This is certainly the case in palliative...

Background Chronic pain is a pervasive and invisible condition which affects people in a myriad of ways including but not limited to their quality of life, autonomy, mental and physical health, social mobility, and productivity. There are many ethical implications of neuroscience research on chronic pain, given its potential to reduce suffering and improve the lived experience of people in pain. While a growing body of research studies the etiology, neurophysiology, and management of chronic pain, it is unknown to what (...) degree neuroscience research in this area engages with relevant ethics concepts. Aim To explore the presence of ethics concepts in empirical chronic pain neuroscience literature to advance knowledge regarding the ethics of chronic pain management. Methods We conducted a hybrid bibliometric analysis and scoping review of chronic pain neuroscience articles published between 1999 and 2021 to identify the presence of ethics concepts. We selected articles from the top, middle, and bottom 20 neuroscience journals ranked by Impact Factor. We conducted a database search of Web of Science and a hand-search using PubMed, Google Scholar, and the reference lists of included articles. Findings Our database search yielded 2779 results from which 46 articles met inclusion criteria. An additional 13 articles were hand-retrieved using PubMed and Google Scholar in accordance with the inclusion criteria, totaling 59 articles. We identified four main ethics themes in our analysis: 1) Quality of Life (n = 46), 2) Autonomy (n = 5), 3) Transparency (n = 4), and 4) Beneficence and Non-Maleficence (n = 4). Conclusion Most neuroscience papers do not include a discussion of ethics related to chronic pain conditions. Those that do tend to merely state rather than define or contextualize a particular ethics concept. Given the potential ethical implications of neuroscience research for people living with chronic pain, we argue that to maximize its public health benefit, neuroscience researchers should consider the ethical relevance of their work within their scientific publications. This may generate further ethical reflection within the field, to improve pain management. (shrink)

Dorfman et al. (2024) make a significant empirical contribution to a growing body of literature pertaining to issues of futility in psychiatry. The authors acknowledge that their survey methodologi...

A brain-computer interface technology that can decode the neural signals associated with attempted but unarticulated speech could offer a future efficient means of communication for people with severe motor impairments. Recent demonstrations have validated this approach. Here we assume that it will be possible in future to decode imagined (i.e., attempted but unarticulated) speech in people with severe motor impairments, and we consider the characteristics that could maximize the social utility of a BCI for communication. As a social interaction, communication (...) involves the needs and goals of both speaker and listener, particularly in contexts that have significant potential consequences. We explore three high-consequence legal situations in which neurally-decoded speech could have implications:Testimony, where decoded speech is used as evidence;Consent and Capacity, where it may be used as a means of agency and participation such as consent to medical treatment; andHarm, where such communications may be networked or may cause harm to others. We then illustrate how design choices might impact the social and legal acceptability of these technologies. (shrink)

Bluhm et al.’s (2023) qualitative study on psychiatric electroceutical interventions describes several types and characteristics of invasiveness identified by psychiatrists and people living with a...

One of the central questions of material-object metaphysics is which highly visible objects there are right before our eyes. Daniel Z. Korman defends a conservative view, according to which our ordinary, natural judgments about which objects there are are more or less correct. He begins with an overview of the arguments that have led people away from the conservative view, into revisionary views according to which there are far more objects than we ordinarily take there to be or far (...) fewer. Korman criticizes a variety of compatibilist strategies, according to which these revisionary views are actually compatible with our ordinary beliefs. He goes on to respond to debunking arguments; objections that the conservative's verdicts about which objects that are and aren't are objectionably arbitrary; the argument from vagueness; the overdetermination argument; the argument from material constitution; and the problem of the many. (shrink)

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

Debunking arguments—also known as etiological arguments, genealogical arguments, access problems, isolation objec- tions, and reliability challenges—arise in philosophical debates about a diverse range of topics, including causation, chance, color, consciousness, epistemic reasons, free will, grounding, laws of nature, logic, mathematics, modality, morality, natural kinds, ordinary objects, religion, and time. What unifies the arguments is the transition from a premise about what does or doesn't explain why we have certain mental states to a negative assessment of their epistemic status. I examine (...) the common, underlying structure of the arguments and the different strategies for motivating and resisting the premises of debunking arguments. (shrink)

Moral debunking arguments are meant to show that, by realist lights, moral beliefs are not explained by moral facts, which in turn is meant to show that they lack some significant counterfactual connection to the moral facts (e.g., safety, sensitivity, reliability). The dominant, “minimalist” response to the arguments—sometimes defended under the heading of “third-factors” or “pre-established harmonies”—involves affirming that moral beliefs enjoy the relevant counterfactual connection while granting that these beliefs are not explained by the moral facts. We show that (...) the minimalist gambit rests on a controversial thesis about epistemic priority: that explanatory concessions derive their epistemic import from what they reveal about counterfactual connections. We then challenge this epistemic priority thesis, which undermines the minimalist response to debunking arguments (in ethics and elsewhere). (shrink)

Rose and Schaffer (forthcoming) argue that teleological thinking has a substantial influence on folk intuitions about composition. They take this to show (i) that we should not rely on folk intuitions about composition and (ii) that we therefore should not reject theories of composition on the basis of intuitions about composition. We cast doubt on the teleological interpretation of folk judgments about composition; we show how their debunking argument can be resisted, even on the assumption that folk intuitions have a (...) teleological source; and we argue that, even if folk intuitions about composition carry no weight, theories of composition can still be rejected on the basis of the intuitions of metaphysicians. (shrink)

Sometimes, learning about the origins of a belief can make it irrational to continue to hold that belief—a phenomenon we call ‘genealogical defeat’. According to explanationist accounts, genealogical defeat occurs when one learns that there is no appropriate explanatory connection between one’s belief and the truth. Flatfooted versions of explanationism have been widely and rightly rejected on the grounds that they would disallow beliefs about the future and other inductively-formed beliefs. After motivating the need for some explanationist account, we raise (...) some problems for recent versions of explanationism. Learning from their failures, we then produce and defend a more resilient explanationism. (shrink)

An encyclopedia entry which covers various revisionary conceptions of which macroscopic objects there are, and the puzzles and arguments that motivate these conceptions: sorites arguments, the argument from vagueness, the puzzles of material constitution, arguments against indeterminate identity, arguments from arbitrariness, debunking arguments, the overdetermination argument, and the problem of the many.

Nihilism is the thesis that no composite objects exist. Some ontologists have advocated abandoning nihilism in favor of deep nihilism, the thesis that composites do not existO, where to existO is to be in the domain of the most fundamental quantifier. By shifting from an existential to an existentialO thesis, the deep nihilist seems to secure all the benefits of a composite-free ontology without running afoul of ordinary belief in the existence of composites. I argue that, while there are well-known (...) reasons for accepting nihilism, there appears to be no reason at all to accept deep nihilism. In particular, deep nihilism draws no support either from the usual arguments for nihilism or from considerations of parsimony. (shrink)

Evolutionary debunking arguments abound, but it is widely assumed that they do not arise for our perceptual beliefs about midsized objects, insofar as the adaptive value of our object beliefs cannot be explained without reference to the objects themselves. I argue that this is a mistake. Just as with moral beliefs, the adaptive value of our object beliefs can be explained without assuming that the beliefs are accurate. I then explore the prospects for other sorts of vindications of our object (...) beliefs—which involve “bootstrapping” from our experiences as of midsized objects—and I defend bootstrapping maneuvers against a variety of objections. Finally, I argue for an explanatory constraint on legitimate bootstrapping and show how some attempts to respond to debunking arguments run afoul of the constraint. (shrink)

I present two puzzles about the metaphysics of stores, restaurants, and other such establishments. I defend a solution to the puzzles, according to which establishments are not material objects and are not constituted by the buildings that they occupy.

A presentation of the Lewis-Sider argument from vagueness for unrestricted composition and possible responses.

Virtually everyone agrees that, even after having presented the arguments for their positions, proponents of revisionary philosophical theories are required to provide some sort of account of the conflict between their theories and what the folk believe. I examine various strategies for answering the challenge from folk belief. The examination proceeds as a case study, whose focus is eliminativism about ordinary material objects. I critically assess eliminativist attempts to explain folk belief by appeal to paraphrase, experience, and intuition.

Particularists in material-object metaphysics hold that our intuitive judgments about which kinds of things there are and are not are largely correct. One common argument against particularism is the argument from arbitrariness, which turns on the claim that there is no ontologically significant difference between certain of the familiar kinds that we intuitively judge to exist (snowballs, islands, statues, solar systems) and certain of the strange kinds that we intuitively judge not to exist (snowdiscalls, incars, gollyswoggles, the fusion of the (...) my nose and the Eiffel Tower). Particularists frequently respond by conceding that there is no ontologically significant difference and embracing some sort of deflationary metaontology (relativism, constructivism, quantifier variance). I show -- by identifying ontologically significant differences -- that the argument can be resisted without retreating to any sort of deflationary metaontology. (shrink)

When some objects are the parts of another object, they compose that object and that object is composite. This article is intended as an introduction to the central questions about composition and a highly selective overview of various answers to those questions. In §1, we review some formal features of parthood that are important for understanding the nature of composition. In §2, we consider some answers to the question: which pluralities of objects together compose something? As we will see, the (...) dominant answers are all of them and none of them. In §§3-4, we examine one of the main arguments that has driven philosophers to these extreme answers: the argument from vagueness. In §5, we turn to the question of whether composition is unique: is it sometimes the case that some things compose more than one thing? Finally, in §6, we turn from the question of which composites exist to the question of which composites exist fundamentally. (shrink)

This is a contribution to a symposium on Amie Thomasson’s Ontology Made Easy (2015). Thomasson defends two deflationary theses: that philosophical questions about the existence of numbers, tables, properties, and other disputed entities can all easily be answered, and that there is something wrong with prolonged debates about whether such objects exist. I argue that the first thesis (properly understood) does not by itself entail the second. Rather, the case for deflationary metaontology rests largely on a controversial doctrine about the (...) possible meanings of ‘object’. I challenge Thomasson's argument for that doctrine, and I make a positive case for the availability of the contested, unrestricted use of ‘object’. (shrink)

Debunking arguments are arguments that aim to undermine some range of beliefs by showing that those beliefs are not appropriately connected to their subject matter. Arguments of this sort rear their heads in a wide variety of domains, threatening beliefs about morality, mathematics, logic, color, and the existence of God. Perceptual beliefs about ordinary objects, however, are widely thought to be invulnerable to such arguments. I will show that this is a mistake. I articulate a debunking argument that purports to (...) undermine our most basic perceptual beliefs. I then challenge a number of responses to the argument, including the “permissivist” response that there are a plenitude of objects before us, virtually guaranteeing the accuracy of our object beliefs. (shrink)

Dry earth seems to its inhabitants (our intrinsic duplicates) just as earth seems to us, that is, it seems to them as though there are rivers and lakes and a clear, odorless liquid flowing from their faucets. But, in fact, this is an illusion; there is no such liquid anywhere on the planet. I address two objections to externalism concerning the nature of the concept that is expressed by the word 'water' in the mouths of the inhabitants of dry earth. (...) Gabriel Segal presents a dilemma for the externalist concerning the application conditions of the concept, and Paul Boghossian presents a dilemma for the externalist concerning the complexity of the concept. I show that, in both cases, the externalist may occupy the horn of his choice without departing from either the letter or spirit of externalism. (shrink)

A symposium on my *Objects: Nothing Out of the Ordinary* (2015). In response to Wallace, I attempt to clarify the dialectical and epistemic role that my arguments from counterexamples were meant to play, I provide a limited defense of the comparison to the Gettier examples, and I embrace the comparison to Moorean anti-skeptical arguments. In response to deRosset, I provide a clearer formulation of conservatism, explain how a conservative should think about the interaction between intuition and science, and discuss what (...) conservatives should say about scattered territories, clonal colonies, and arbitrary systems. In response to Tillman and Spencer, I fortify my original presentation of the debunking arguments by clarifying why, even while trees (if they exist) are paradigmatically causal, conservatives are meant to be rationally obstructed from believing that it is trees that are causing our tree beliefs. (shrink)

Words, languages, symphonies, fictional characters, games, and recipes are plausibly abstract artifacts— entities that have no spatial location and that are deliberately brought into existence as a result of creative acts. Many accept that composition is unrestricted: for every plurality of material objects, there is a material object that is the sum of those objects. These two views may seem entirely unrelated. I will argue that the most influential argument against restricted composition—the vagueness argument—doubles as an argument that there can (...) be no abstract artifacts. There is no way to resist the vagueness argument against abstract artifacts that does not also undermine the vagueness argument against restricted composition. (shrink)

You see a cherry and you experience it as red. A textbook explanation for why you have this sort of experience is going to cite such things as the cherry’s chemical surface properties and the distinctive mixture wavelengths of light it is disposed to reflect. What does not show up in this explanation is the redness of the cherry. Many allege that the availability of color-free explanations of color experience somehow calls into question our beliefs about the colors of objects (...) around us. We explore how such explanations are supposed to undermine color beliefs, and in particular whether evolutionary considerations have any special role to play. (shrink)

Many of those who accept the universalist thesis that mereological composition is unrestricted also maintain that the folk typically restrict their quantifiers in such a way as to exclude strange fusions when they say things that appear to conflict with universalism. Despite its prima facie implausibility, there are powerful arguments for universalism. By contrast, there is remarkably little evidence for the thesis that strange fusions are excluded from the ordinary domain of quantification. Furthermore, this reconciliatory strategy seems hopeless when applied (...) to the more fundamental conflict between universalism and the intuitions that tell against it. (shrink)

I defend an interpretation of Locke’s remarks on substratum according to which substrata not only have sensible qualities but are just familiar things and stuffs: horses, stones, gold, wax, and snow. The supporting relation that holds between substrata and the qualities that they support is simply the familiar relation of having, or instantiating, which holds between a particular substance and its qualities. I address the obvious objection to the interpretation -- namely, that it cannot be reconciled with Locke’s claim that (...) the idea substratum is an obscure, confused idea of we know not what -- and I identify numerous textual parallels between Locke's discussions of substrata and particular substances which strongly support the deflationary interpretation. (shrink)

According to principles of modal security, evidence undermines a belief only when it calls into question certain purportedly important modal connections between one’s beliefs and the truth (e.g., safety or sensitivity). Justin Clarke-Doane and Dan Baras have advanced such principles with the aim of blocking evolutionary moral debunking arguments. We examine a variety of different principles of modal security, showing that some of these are too strong, failing to accommodate clear cases of undermining, while others are too weak, failing to (...) do their advertised work of blocking evolutionary moral debunking arguments. If there is a security principle that slips between the horns of this dilemma—one that is both viable and debunker-blocking—it remains to be formulated. (shrink)

There’s the question of what there is, and then there’s the question of what ultimately exists. Many contend that, once we have this distinction clearly in mind, we can see that there is no sensible debate to be had about whether there are such things as properties or tables or numbers, and that the only ontological question worth debating is whether such things are ultimate (in one or another sense). I argue that this is a mistake. Taking debates about ordinary (...) objects as a case study, I show that the arguments that animate these debates bear directly on the question of which objects there are and cannot plausibly be recast as arguments about what’s ultimate. I then address the objection that, because they are easy answerable, questions about what there is cannot be a proper subject of ontological debate. (shrink)