A large slice of contemporary phenomenology of medicine has been devoted to developing an account of health and illness that proceeds from the first-person perspective when attempting to understand the ill person in contrast and connection to the third-person perspective on his/her diseased body. A proof that this phenomenological account of health and illness, represented by philosophers, such as Drew Leder, Kay Toombs, Havi Carel, Hans-Georg Gadamer, Kevin Aho, and Fredrik Svenaeus, is becoming increasingly influential in philosophy of medicine and (...) medical ethics is the criticism of it that has been voiced in some recent studies. In this article, two such critical contributions, proceeding from radically different premises and backgrounds, are discussed: Jonathan Sholl’s naturalistic critique and Talia Welsh’s Nietzschean critique. The aim is to defend the phenomenological account and clear up misunderstandings about what it amounts to and what we should be able to expect from it. (shrink)

Ethical analyses of the effects of neural interventions commonly focus on changes to personality and behavior, interpreting these changes in terms of authenticity and identity. These phenomena have led to debate among ethicists about the meaning of these terms for ethical analysis of such interventions. While these theoretical approaches have different criteria for ethical significance, they agree that patients’ reports are concerning because a sense of self is valuable. In this paper, I question this assumption. I propose that the Buddhist (...) theory of no‐self offers a novel approach to making ethical sense of patients’ claims following deep brain stimulation. This alternative approach is based on the value of insight into patterns of cause and effect among mental states and actions. (shrink)

In this paper, the moral person is understood through the lens of identity theory in sociological social psychology. Identity theory helps identify the internal dynamics of individuals as moral persons by apprehending their self-views’, behavior, and emotions within and across situations. When the identity process is activated, the cognitive, behavioral, and affective dimensions of individuals inter-relate through a self-regulated control system. When this control system is laced with moral meanings, we see how moral persons emerge and are maintained or challenged (...) in situations. I review studies that I carried out over 2 years that sampled over 3,000 individuals using survey and laboratory research. A series of hypothesis consistent with identity theory were tested to examine individuals’ moral identity, moral behavior, and moral emotions. The findings confirm the predictive power of identity theory in explaining the moral person. Future avenues for research are briefly discussed. (shrink)

Applied ethics is relatively new on the philosophical scene, having grown out of the various civil rights movements of the 1950s and 1960s, as well as the student demand that college courses be relevant. Even today, there are those who think that there are no philosophically interesting practical ethical questions, and that applied ethics is not a branch of philosophy at all. This article rejects that view, both because some of the most interesting and respectable philosophers in the world have (...) worked in applied ethics and because applied ethics has been the source of many difficult conceptual questions in theoretical ethics and even metaphysics. These include the grounds for moral status, human identity, how to conceive rights in general and the right to life in particular, the question whether existence itself can be a harm (the nonidentity problem), and the nature of moral principles. (shrink)

Since certain temporal aspects of the relation between duties, rights, and the interests that rights protect have not been fully theorized, a puzzle arises when we come to consider whether and how entities such as members of future generations, fetuses, deceased persons, and unconscious persons are able to possess rights. This paper evolves a unified structure for attributing the ability to possess rights to such entities. It demonstrates that while, under any cogent theory of rights-attributions, rights and duties must be (...) strictly contemporaneous, the interests that rights protect need not temporally coincide with those rights. (shrink)

Many find it intuitive that those who use enhancements like steroids and Adderall in Olympic weightlifting and education are due less praise than those who perform equally well without using these enhancements. Nonetheless, it is not easy to coherently explain why one might be justifiably due less praise for using these technologies to enhance one’s performance. Justifications for this intuition which rely on concerns regarding authenticity, cheating, or shifts in who is responsible for the performance face serious problems. Santoni de (...) Sio et al., however, have recently defended a justification for this intuition which avoids the problems competing justifications face; the nature-of-activities justification. This justification relies on a conceptual analysis of the nature of activities and does not require the defense of any particular ethical stance concerning the use of enhancements. Santoni de Sio et al. claim that the success of the nature-of-activities account requires distinguishing between practice-oriented activities and goal-directed activities. I, however, show that this distinction is both deeply problematic and unnecessary. After exposing the weaknesses of Santoni de Sio et al.’s original account, I defend a simpler and less problematic version of the nature-of-activities account. The revised account is capable of both justifying this intuition of less praise and allowing one to determine when enhancements should be deemed permissible, impermissible, or obligatory for a given activity. (shrink)

A persistent question in discussions of the ethics of advance directives for euthanasia is whether patients who go through deep psychological changes retain their identity. Rather than seek an account of identity that answers this question, I argue that responsible policy should directly address indeterminacy about identity directly. Three sorts of indeterminacy are distinguished. Two of these—epistemic indeterminacy and metaphysical indeterminacy—should be addressed in laws/policies regarding advance directives for euthanasia.

In healthcare ethics there is a discussion regarding whether autonomy of personal preferences, what sometimes is referred to as authenticity, is necessary for autonomous decision-making. It has been argued that patients’ decisions that lack sufficient authenticity could be deemed as non-autonomous and be justifiably overruled by healthcare staff. The present paper discusses this issue in relation certain psychiatric disorders. It takes its starting point in recent qualitative studies of the experiences and thoughts of patients’ with anorexia nervosa where issues related (...) to authenticity seem particularly relevant. The paper examines different interpretations of authenticity relevant for autonomy and concludes that the concept, as it has been elaborated in recent debate, is highly problematic to use as a criterion for autonomous decision-making in healthcare. (shrink)

In this article, I examine children's reported experiences with stimulant drug treatments for attention deficit hyperactivity disorder in light of bioethical arguments about the potential threats of psychotropic drugs to authenticity and moral agency. Drawing on a study that involved over 150 families in the USA and the UK, I show that children are able to report threats to authenticity, but that the majority of children are not concerned with such threats. On balance, children report that stimulants improve their capacity (...) for moral agency, and they associate this capacity with an ability to meet normative expectations. I argue that although under certain conditions stimulant drug treatment may increase the risk of a threat to authenticity, there are ways to minimise this risk and to maximise the benefits of stimulant drug treatment. Medical professionals in particular should help children to flourish with stimulant drug treatments, in good and in bad conditions. (shrink)

Are embryos deserving of moral consideration in our actions? A standard view suggests that embryos are considerable only if they have interests. One argument for embryonic interests contends that embryos are harmed by death because they are deprived of valuable future lives as adult persons. Some have challenged this argument on the grounds that embryos aren’t identical to adults: either due to the potential for embryos to twin or because we do not exist until the fetus develops consciousness. These arguments (...) fail to show that embryos do not have future adult lives. There is a better reason to think that embryos cannot have interests; namely, because they are not capable of having desires. Others have held this view but have not sufficiently justified it. The justification lies in the fact that the capacity for desires is necessary to make sense of the normativity of interests. (shrink)

Many people believe that for someone to now be responsible for some past action, the agent of that action and the responsible agent now must be one and the same person. In other words, many people that moral responsibility presupposes numerical personal identity. In this paper, I show why this platitude is false. I then suggest an account of what actual metaphysical relationship moral responsibility presupposes instead.

Many philosophers have taken there to be an important relation between personal identity and several of our practical concerns (among them moral responsibility, compensation, and self-concern). I articulate four natural methodological assumptions made by those wanting to construct a theory of the relation between identity and practical concerns, and I point out powerful objections to each assumption, objections constituting serious methodological obstacles to the overall project. I then attempt to offer replies to each general objection in a way that leaves (...) the project intact, albeit significantly changed. Perhaps the most important change stems from the recognition that the practical concerns motivating investigation into personal identity turn out to be not univocal, as is typically thought, such that each of the different practical concerns may actually be related to personal identity in very different ways. (shrink)

“Philosophy as a way of life” has its roots in ancient ethics and has attracted renewed interest in recent decades. The aim in this paper is to construct a contemporized image of Socrates, consistent with the textual evidence. The account defers concern over analytical/theoretical inquiry into virtue, in favor of a neo-existentialist process of self-examination informed by the virtue of what is called “moral seriousness.” This process is modeled on Frankfurt’s hierarchical account of self-identification, and the paper suggests an expansion (...) of Frankfurt’s concept of a person to include “full” personhood, in which the apprehended “meaning” of one’s “whole life” is taken as a necessary condition for eudaimonia (meaning of life) and is characterized by phenomenological transcendence. In addition, the importance of the informed scrutiny of a community of philosophers to the self-examination process is discussed. (shrink)

Traditionally, it has been assumed that metaphysical and practical questions about personhood and personal identity are inherently linked. Neo-Lockean views that draw such a link have been problematic, leading to an opposing view that metaphysical and ethical questions about persons should be sharply distinguished. This paper argues that consideration of this issue suffers from an overly narrow conception of the practical concerns associated with persons that focuses on higher-order capacities and fails to appreciate basic practical concerns more directly connected to (...) our animality. A more inclusive alternative is proposed. (shrink)

Deep Brain Stimulation (DBS) is a treatment involving the implantation of electrodes into the brain. Presently, it is used for neurological disorders like Parkinson’s disease, but indications are expanding to psychiatric disorders such as depression, addiction and Obsessive Compulsive Disorder (OCD). Theoretically, it may be possible to use DBS for the enhancement of various mental functions. This article discusses a case of an OCD patient who felt very happy with the DBS treatment, even though her symptoms were not reduced. First, (...) it is explored if the argument that ‘doctors are not in the business of trading happiness’, as used by her psychiatrist to justify his discontinuation of the DBS treatment, holds. The relationship between enhancement and the goals of medicine is discussed and it is concluded that even though the goals of medicine do not set strict limits and may even include certain types of enhancement, there are some good reasons for limiting the kind of things doctors are required or allowed to do. Next, the case is discussed from the perspective of beneficence and autonomy. It is argued that making people feel good is not the same as enhancing their well-being and that it is unlikely—though not absolutely impossible—that the well-being of the happy OCD patient is really improved. Finally, some concerns regarding the autonomy of a request made under the influence of DBS treatment are considered. (shrink)

A popular “Reductionist” account of personal identity unifies person stages into persons in virtue of their psychological continuity with one another. One objection to psychological continuity accounts is that there is more to our personal identity than just mere psychological continuity: there is also an active process of self-interpretation and self-creation. This criticism can be used to motivate a rival account of personal identity that appeals to the notion of a narrative. To the extent that they comment upon the issue, (...) proponents of narrative accounts typically reject Reductionist metaphysics that (ontologically) reduce persons to aggregates of person stages. In contrast to this trend, we seek to develop a narrative account of personal identity from within Reductionist metaphysics: we think person stages are unified into persons in virtue of their narrative continuity with one another. We argue that this Reductionist version of the narrative account avoids some serious problems facing non-Reductionist versions of the narrative account. (shrink)

Narrative ethics taps into an inherent human need to tell our own stories centred on our own moral values and to have those stories heard and acknowledged. However, not everyone’s words are afforded equal power. The use of narrative ethics in bioethical decision-making is problematized by a disparity in whose stories are told, whose stories are heard, and whose stories are believed. Here, I conduct an analysis of narrative ethics through a critical theory lens to show how entrenched patterns of (...) narrative neglect in medicine are harming not only our capacity to make use of narrative ethics but also our capacity to deliver effective healthcare. To illustrate this point, I use three examples where the patient’s gender affects how their stories unfold: autism, weight, and pain management. From these, I argue that the use of narrative ethics without the application of a critical theory lens risks the exacerbation of what Miranda Fricker refers to as “testimonial injustice,” the prima facie harm experienced by individuals whose credibility is undermined by others’ prejudices. Finally, I suggest that narrative ethics can be a powerful tool for mitigating oppressive practices in medicine if we couple it with critical analysis that enables us to understand the power dynamics at play in storytelling. (shrink)

I argue that a form of animalism that does not include the belief that ‘human animal’ is a substance-sortal has a dialectical advantage over other versions of animalism. The main reason for this advantage is that Phase Animalism, the version of animalism described here, has the theoretical resources to provide convincing descriptions of the outcomes of scenarios problematic for other forms of animalism. Although Phase Animalism rejects the claim that ‘human animal’ is a substance-sortal, it is still appealing to those (...) who believe that our nature is continuous or of a similar kind to that of other physical entities. (shrink)

Women are diagnosed with clinical depression at twice the rates as men. Treating depression through psychotherapy or medication both focus on changing an individual, rather than addressing socioecological influences or social roles. In the current study, participants read of systemic inequality contributing to differential rates of depression in either American men or women, or in two fictitious Australian First Nation groups. Participants then considered the acceptability and efficacy of treating depression through psychotherapy, medication, or social change. When socioecological inequities and (...) unequal social roles were presented through an unfamiliar foreign lens, participants were more likely to recognize the systemic unfairness, and endorsed social change more than psychotherapy or medication as a treatment strategy. However, when identical social inequities and social roles were presented through descriptions of American men and women, social intervention was less likely to be endorsed, and psychotherapy or medication gained in acceptability. Participants of color were also more likely to recognize and endorse social change as a strategy for treating depression, while those reporting a history of psychotropic medication for affective disorders rated medication as more effective and acceptable. (shrink)

Philosophers concerned with the question of personal identity have typically been asking the so-called re-identification question: what are the conditions under which a person at one point in time is properly re-identified at another point in time? This is a rather technical question. In our everyday interactions, however, we do raise a number of personal identity questions that are quite distinct from it. In order to explore the variety of ways in which the Internet may affect personal identity, I propose (...) in this study to broaden the typical philosophical horizon to other more mundane senses of the question. In Section 2, I describe a number of possible meanings of personal identity observed in everyday contexts and more philosophical ones. With some caveats, I argue that it is the specific context in which the question arises that disambiguates the meaning of the question. Online contexts are novel and peculiar insofar as they afford prolonged disembodied and anonymous interaction with others. In line with our previous conclusion, then, there is reason to suspect that such contexts generate new and sui generis answers to the personal identity question. In Section 3, I examine this question and, contrary to expectations, largely dispel this suspicion. Finally, in Section 4, I discuss the often-heard claim to the effect that disembodiment and anonymity foster the creation of distinct and incompatible online and offline identities. (shrink)

Nicht nur in der Demenzethik, sondern auch in grundlegenden Fragen zum Personen-Status von Demenzbetroffenen sind Verweise auf narrative Modelle, die die personale Identität Demenzkranker aufzeigen sollen, populär. Ziel des Beitrages ist eine kritische Auseinandersetzung mit den Voraussetzungen und argumentativen Problemen, die sich im Anschluss an diese ‚narrativen Demenztheorien‘ ergeben. Nach einer Einführung in die Begrifflichkeiten philosophischer Identitätskonzeptionen und einem exemplarischen Einblick in Modelle narrativer Demenztheorien werden Einwände gegen diese Positionen diskutiert. So ist zunächst unklar, welches Verständnis von ‚Narration‘ und ‚narrativer (...) Identität‘ in narrativen Demenztheorien vorausgesetzt wird. Beim Versuch der Klärung des Begriffs einer ‚narrativen Identität‘ zeigt sich anschließend, dass sich narrative Demenztheorien nicht nur in Widersprüche verwickeln, sondern sich zudem Probleme ergeben, die aus der relationalen Struktur narrativer Demenztheorien resultieren und die u.a. in den von Peter Lamarque geäußerten Trivialitätseinwand münden. Soll die personale Identität Demenzbetroffener rekonstruiert werden, so empfiehlt es sich vielmehr, auf holistische Konzeptionen, die die gesamte Biographie einer Person narrativ aufarbeiten, zu verzichten und stattdessen episodische Artikulationen zu berücksichtigen, die die auch von Vertretern narrativer Ansätze geforderte Aufwertung des aktualen Erlebenszustandes der Betroffenen leisten können. Eine solche alternative Herangehensweise wird am Ende des Beitrags durch Einbezug der Ansätze Galen Strawsons und Jeff McMahans vorgestellt. (shrink)

It seems plausible that (i) how much punishment a person deserves cannot be affected by the mere existence or nonexistence of another person. We might have also thought that (ii) how much punishment is deserved cannot increase merely in virtue of personal division. I argue that (i) and (ii) are inconsistent with the popular belief that, other things being equal, when people culpably do very wrong or bad acts, they ought to be punished for this—even if they have repented, are (...) now virtuous, and punishing them would benefit no one. Insofar as we cannot deny (i), we are either forced to abandon the popular belief in desert, or else allow that personal division could, as I put it, “multiply desert.” Some may not find the latter, considered by itself, troubling. But I argue that the thesis that division multiplies desert faces a potentially serious problem, which arises in the context of personal fusion. It is difficult to see how to maintain a particular family of desert views in light of the cases here presented. (shrink)

In an intriguing essay, G. A. Cohen has defended a conservative bias in favour of existing value. In this paper, we consider whether Cohen’s conservatism raises a new challenge to the use of human enhancement technologies. We develop some of Cohen’s suggestive remarks into a new line of argument against human enhancement that, we believe, is in several ways superior to existing objections. However, we shall argue that on closer inspection, Cohen’s conservatism fails to offer grounds for a strong sweeping (...) objection to enhancement, and may even offer positive support for forms of enhancement that preserve valuable features of human beings. Nevertheless, we concede that Cohen’s arguments may suggest some plausible and important constraints on the modality of legitimate and desirable enhancements. (shrink)

There is evidence to suggest that some patients who undergo Deep Brain Stimulation can experience changes to dispositional, emotional and behavioural states that play a central role in conceptions of personality, identity, autonomy, authenticity, agency and/or self. For example, some patients undergoing DBS for Parkinson’s Disease have developed hypersexuality, and some have reported increased apathy. Moreover, experimental psychiatric applications of DBS may intentionally seek to elicit changes to the patient’s dispositional, emotional and behavioural states, in so far as dysfunctions in (...) these states may undergird the targeted disorder. Such changes following DBS have been of considerable interest to ethicists, but there is a considerable degree of conflict amongst different parties to this debate about whether DBS really does change PIAAAS, and whether this matters. This paper explores these conflicting views and suggests that we may be able to mediate this conflict by attending more closely to what parties to the debate mean when they invoke the concepts lumped together under the acronym PIAAAS. Drawing on empirical work on patient attitudes, this paper outlines how these different understandings of the concepts incorporated into PIAAAS have been understood in this debate, and how they may relate to other fundamental concepts in medical ethics such as well-being and autonomy. The paper clarifies some key areas of disagreement in this context, and develops proposals for how ethicists might fruitfully contribute to future empirical assessments of apparent changes to PIAAAS following DBS treatment. (shrink)

: Artificial intelligences and robots increasingly mimic human mental powers and intelligent behaviour. However, many authors claim that ascribing human mental powers to them is both conceptually mistaken and morally dangerous. This article defends the view that artificial intelligences can have human-like mental powers, by claiming that both human and artificial minds can be seen as extended minds – along the lines of Chalmers and Clark’s view of mind and cognition. The main idea of this article is that the Extended (...) Mind Model is independently plausible and can easily be extended to artificial intelligences, providing a solid base for concluding that artificial intelligences possess minds. This may warrant viewing them as morally responsible agents. Keywords: Artificial Intelligence; Mind; Moral Responsibility; Extended Cognition Intelligenze artificiali come menti estese. Perché no? Riassunto: Intelligenze artificiali e robot simulano in misura sempre crescente le capacità mentali e i comportamenti intelligenti umani. Molti autori, tuttavia, sostengono che attribuire loro capacità mentali umane sia concettualmente errato e moralmente pericoloso. In questo lavoro si difende l’idea per cui le intelligenze artificiali possano avere capacità mentali simili a quelle umane, sostenendo che menti umane e artificiali possano essere considerate come menti estese – sulla scorta della prospettiva di Chalmers e Clark circa la mente e la cognizione. L’idea principale alla base di questo lavoro è che il Modello della Mente Estesa abbia plausibilità a prescindere e che possa essere facilmente esteso alle intelligenze artificiali, fornendo una base solida per concludere che le intelligenze artificiali possiedano delle menti e si possano considerare come agenti moralmente responsabili. Parole chiave: Intelligenza artificiale; Mente; Responsabilità morale; Conoscenza estesa. (shrink)

The possibility of a human head transplant poses unprecedented philosophical and neuroethical questions. Principal among them are the personal identity of the resultant individual, her metaphysical and social status: Who will she be and how should the “new” person be treated - morally, legally and socially - given that she incorporates characteristics of two distinct, previously unrelated individuals, and possess both old and new physical, psychological, and social experiences that would not have been available without the transplant? We contend that (...) this situation challenges linguistic conventions and conceptual binaries, and calls into question the major philosophical approaches to personal identity: animalism and reductionism. We examine these views critically vis-a-vis head transplantation and conclude that they fail to provide an adequate account of the identity of the resultant individual because both neglect the key role of embodiment for personal identity. We maintain that embodiment is central to personal identity and a radical alteration of the body will also radically alter that person, making her a different person. Consequently, a human head transplant will result in an individual partly continuous with the head/brain, and partly continuous with the body donor. We conclude that the resultant person would be different from both the individual whose head was transplanted and the one to whose body the “new” head is attached. (shrink)

Wild animals probably have net negative lives. Christine Korsgaard rejects the view that we might engineer paradise by redesigning nature and animals so that they have the best possible existences. She believes the genetic changes required would not be identity-preserving, thereby causing animals to cease to exist. I argue, first, that paradise engineering is permissible. Many harms are caused by non-sentient natural entities and processes. Moreover, sentient animals can survive modifications compatible with their psychological persistence over time. Second, we are (...) required to re-engineer nature in order to satisfy animals' right to the resources necessary for a reasonable life. (shrink)

Jeff McMahan's impressive recent defence of the embodied mind theory of personal identity in his highly acclaimed work The Ethics of Killing has undoubtedly reawakened belief that physical continuity is a necessary component of the relation that matters in our self-interested concern for the future. My aim in this paper is to resist this belief in a somewhat roundabout way. I want to address this belief in a somewhat roundabout way by revisiting a classic defence of the belief that enormous (...) changes in the contents of a person's psychology does not preclude justified fear of future pain. I have in mind Bernard Williams' The Self and the Future (1970) in which he argues, against the psychological view, that physical continuity is necessary for survival. I examine Williams' second thought experiment which ostensibly supports that intuition and afterwards defend two related claims. First, I argue that a close examination of the second thought experiment reveals that one's prior commitments to a particular criterion of personal identity can influence one's response to that thought experiment. Second, I argue that Williams' second thought experiment is set out in questionbegging terms. I do not claim, however, that the intuition under consideration lacks justification; I only claim that Williams' second thought experiment does not provide the needed support. (shrink)

Conjoined twinning is said to show that the number of human people—the number of us—can differ from the number of human organisms, and hence that we are not organisms. The paper shows that these arguments either assume the point at issue, rely on dubious and undefended assumptions, or add nothing to more familiar arguments for the same conclusion.

ABSTRACTMany philosophers say that the nature of personal identity has to do with narratives: the stories we tell about ourselves. While different narrativists address different questions of personal identity, some propose narrativist accounts of personal identity over time. The paper argues that such accounts have troubling consequences about the beginning and end of our lives, lead to inconsistencies, and involve backwards causation. The problems can be solved, but only by modifying the accounts in ways that deprive them of their appeal.

In Defending Life: A Moral and Legal Case Against Abortion Choice (2007) and an earlier article in this journal, "Defending Abortion Philosophically"(2006), Francis Beckwith argues that fetuses are, from conception, prima facie wrong to kill. His arguments are based on what he calls a "metaphysics of the human person" known as "The Substance View." I argue that Beckwith’s metaphysics does not support his abortion ethic: Moral, not metaphysical, claims that are part of this Substance View are the foundation of the (...) argument, and Beckwith inadequately defends these moral claims. Thus, Beckwith’s arguments do not provide strong support for what he calls the "pro-life" view of abortion. (shrink)

According to one argument for Animalism about personal identity, animal , but not person , is a Wigginsian substance concept—a concept that tells us what we are essentially. Person supposedly fails to be a substance concept because it is a functional concept that answers the question “what do we do?” without telling us what we are. Since person is not a substance concept, it cannot provide the criteria for our coming into or going out of existence; animal , on the (...) other hand, can provide such criteria. This argument has been defended by Eric Olson, among others. I argue that this line of reasoning fails to show Animalism to be superior to the Psychological Approach, for the following two reasons: (1) human animal , animal , and organism are all functional concepts, and (2) the distinction between what something is and what it does is illegitimate on the reading that the argument needs. (shrink)

Don Marquis has argued most abortions are immoral, for the same reason that killing you or me is immoral: abortion deprives the fetus of a valuable future. Call this account the FLOA. A rival account is Jeff McMahan’s, time-relative interest account of the wrongness of killing. According to this account, an act of killing is wrong to the extent that it deprives the victim of future value and the relation of psychological unity would have held between the victim at the (...) time of death and herself at a later time if she had lived. The TRIA supposedly has two chief advantages over Marquis’s FLOA. First, unlike the FLOA, the TRIA does not rely on the controversial thesis that identity is what matters in survival. Second, the TRIA yields more plausible verdicts about cases. Proponents of the TRIA use the account to argue that abortion is generally permissible, because there would be little to no psychological unity between the fetus and later selves if it lived. I argue that advocates of the TRIA have failed to establish its superiority to the FLOA, for two reasons. First, the two views are on a par with respect to the thesis that identity is what matters in survival. Second, Marquis’s FLOA does not yield the counterintuitive implications about cases that advocates of the TRIA have attributed to it, and the TRIA yields its own share of implausible judgments about cases. (shrink)

Oppression can be unjust from a luck egalitarian point of view even when it is the consequence of choices for which it is reasonable to hold persons responsible. This is for two reasons. First, people who have not been oppressed are unlikely to anticipate the ways in which their choices may lead them into oppressive conditions. Facts about systematic phenomena (like oppression) are often beyond the epistemic reach of persons who are not currently subject to such conditions, even when they (...) possess adequate information about the particular consequences of their choices. Second, people may be (much) less responsible for remaining in oppressive conditions, even if they are responsible for entering circumstances of oppression. Oppression that results from a person’s choice may cause or contribute to dramatic changes in that person, and these changes may be sufficient to undermine the person’s responsibility for the results of her earlier choice. (shrink)

Paltrow and colleagues focus on the deleterious consequences that could occur if Roe were overturned, including food and housing insecurity, loss of employment, bankruptcy, unjustified arres...

The respect for one’s conscience is rooted in a broader respect for the human person. The conscience represents a person’s ability to identify the values and goods that inform her moral identity. Ignoring or overriding a person’s conscience can lead to significant moral and emotional distress. Refusals to respect a person’s conscientious objection to cases of killing are a source of incisive distress, since judgments that it is impermissible to kill so-and-so are typically held very strongly and serve as central (...) moral commitments in one’s moral identity. I think it is wrong for a college basketball coach to pay his players, but I think it is really wrong to kill people. This article argues that any and all arguments for not respecting a conscientious objection to abortion commit a deontic fallacy. Briefly, arguments for the permissibility of abortion are structurally such that abortion is at best permissible, not obligatory. Now, arguments to justify overriding or ignoring a person’s objection to performing action (α) must understand action (α) as being obligatory. Thus, arguments for ignoring conscientious objections to performing abortion are incongruent with the actual philosophical justifications for abortion. Such arguments, then, commit a deontic fallacy. (shrink)

John P. Lizza has long been a major figure in the scholarly literature on criteria for death. His searching and penetrating critiques of the dominant biological paradigm, and his defense of a theory of death of the person as a psychophysical entity, have both significantly advanced the literature. In this special issue, Lizza reinforces his critiques of a strictly biological approach. In my commentary, I take up Lizza’s challenge regarding a biological concept of death. He is certainly right to point (...) out that science is not value-free; however, this does not imply that there cannot be a characterization of biological death that can be shown to be superior to other concepts. After characterizing and justifying such a theory of biological death, I show that patients who meet the diagnostic criteria for brain death are unequivocally biologically alive. However, with respect to concepts of personhood and related ideas, I urge the acceptance of a pluralism of such concepts for matters of public policy. (shrink)

We have a strong intuition that personal identity is a determinate relationship. Parfit famously challenged this intuition. In this paper I explain how narrative identity theories can face that challenge and defend that personal identity is determinate thanks to what I call the social narrativity thesis. This move will raise some concerns regarding the also strong intuition that personal identity is what matters when we care about our future existence. I address this concern to show that narrative identity theories can (...) account for both intuitions at the same time. (shrink)

In 1973, the Supreme Court of the United States issued Roe v. Wade, a historic and contentious decision that established abortion as a fundamental constitutional right. This ruling protected aborti...

Good physical experiments conform to the basic methodological standards of experimental design: they are objective, reliable, and valid. But is this also true of thought experiments? Especially problems of personal identity have engendered hypothetical scenarios that are very distant from the actual world. These imagined situations have been conspicuously ineffective at resolving conflicting intuitions and deciding between the different accounts of personal identity. Using prominent examples from the literature, I argue that this is due to many of these thought experiments (...) not adhering to the methodological standards that guide experimental design in nearly all other disciplines. I also show how empirically unwarranted background assumptions about human physiology render some of the hypothetical scenarios that are employed in the debate about personal identity highly misleading. (shrink)

There are numerous ways people can improve their cognitive capacities: good nutrition and regular exercise can produce long-term improvements across many cognitive domains, whilst commonplace stimulants such as coffee temporarily boost levels of alertness and concentration. Effects like these have been well-documented in the medical literature and they raise few ethical issues. More recently, however, clinical research has shown that the off-label use of some pharmaceuticals can, under certain conditions, have modest cognition-improving effects. Substances such as methylphenidate and modafinil can (...) improve capacities such as working memory and concentration in some healthy individuals. Unlike their more mundane predecessors, these methods of “cognitive enhancement” are thought to raise a multitude of ethical issues. This paper presents the six principal ethical issues raised in relation to pharmacological cognitive enhancers —issues such as whether: the medical safety-profile of PCEs justifies restricting or permitting their elective or required use; the enhanced mind can be an “authentic” mind; individuals might be coerced into using PCEs;, there is a meaningful distinction to be made between the treatment vs. enhancement effect of the same PCE; unequal access to PCEs would have implications for distributive justice; and PCE use constitutes cheating in competitive contexts. In reviewing the six principal issues, the paper discusses how neuroscientific research might help advance the ethical debate. In particular, the paper presents new arguments about the contribution neuroscience could make to debates about justice, fairness, and cheating, ultimately concluding that neuroscientific research into “personalized enhancement” will be essential if policy is to be truly informed and ethical. We propose an “ethical agenda” for neuroscientific research into PCEs. (shrink)

Over the past decade Identity Management has become a central theme in information technology, policy, and administration in the public and private sectors. In these contexts the term ‘Identity Management’ is used primarily to refer to ways and methods of dealing with registration and authorization issues regarding persons in organizational and service-oriented domains. Especially due to the growing range of choices and options for, and the enhanced autonomy and rights of, employees, citizens, and customers, there is a growing demand for (...) systems that enable the regulation of rights, duties, responsibilities, entitlements and access of innumerable people simultaneously. ‘Identity Management’ or ‘Identity Management Systems’ have become important headings under which such systems are designed and implemented. But there is another meaning of the term ‘identity management’, which is clearly related and which has gained currency. This second construal refers to the need to manage our moral identities and our identity related information. This paper explores the relation between the management of our (moral) identities and ‘Identity Management’ as conceptualized in IT discourse. (shrink)

The controversial question of whether a future child can be harmed by the use of reproductive technology turns on the way that the future child's identity is understood. As a result, analysis of the ethical and legal obligations to the children of reproductive technology that are based upon the possibility of such harm depends upon the conception of identity that is used. This paper reviews the contributions of two recent books, David DeGrazia's Human Identity and Bioethics (2005) and Philip Peters' (...) How Safe is Safe Enough? (2004) to this area of inquiry. It suggests that the use of a narrative rather than numerical conception of identity makes it possible to coherently claim that future children can be harmed by the use of reproductive technologies and that, as a result, potential parents can have obligations regarding the use of those technologies based upon that possibility of harm. (shrink)

Patients with borderline personality disorder sometimes request to be admitted to hospital under compulsory care, often under the argument that they cannot trust their suicidal impulses if treated voluntarily. Thus, compulsory care is practised as a form of Ulysses contract in such situations. In this normative study we scrutinize the arguments commonly used in favour of such Ulysses contracts: the patient lacking free will, Ulysses contracts as self-paternalism, the patient lacking decision competence, Ulysses contracts as a defence of the authentic (...) self, and Ulysses contracts as a practical solution in emergency situations. In our study, we have accepted consequentialist considerations as well as considerations of autonomy. We conclude that compulsory care is not justified when there is a significant uncertainty of beneficial effects or uncertainty regarding the patient’s decision-making capacity. We have argued that such uncertainty is present regarding BPD patients. Hence, Ulysses contracts including compulsory care should not be used for this group of patients. (shrink)

The paper discusses criticisms against pharmacological cognitive enhancement from a liberal perspective. The criticisms point to the consequences of cognitive enhancement in third parties and in the agents, as well as in independent values. According to the article, these criticisms are not convincing. On the contrary, it argues that under certain assumptions there are good reasons in favor of free access to cognitive enhancement.

In the last few decades, assisted reproduction has introduced new challenges to the way people conceive and build their families. While the numbers of donor-conceived individuals have increased worldwide, there are still many controversies concerning access to donor information. Is there a fundamental moral right to know one’s genetic background? What does identity in DC families mean? Is there any relationship between identity formation and disclosure of genetic origins? These questions are addressed by analysing core regulatory discourse. This analysis shows (...) that the notion of narrative identity is suitable for defining and answering these questions. This review analyses the meaning of resemblance in DC families and the way donors are selected following affinity-ties and discusses disclosure strategies and agreements. As a preliminary conclusion, it could be said that, in the field of third-party reproduction, knowing about the donor conception significantly contributes towards the development of a narrative identity and also serves as a moral basis for the child’s right to know. (shrink)

What are you and I essentially? When do you and I come into and go out of existence? A common response is that we are essentially organisms, that is, we come into existence as organisms and go out of existence when we cease to be organisms. Jeff McMahan has put forward two arguments against the Organism View: the case of dicephalus and a special case of hemispheric commissurotomy. In this paper, I defend the Organism View against these two cases. Because (...) it is possible to devise more McMahanian-type cases, I also provide a more general solution to these kinds of cases. (shrink)