In Western society, weight moralization is reflected in the belief that weight is controllable across the weight spectrum. However, the effect of holding such beliefs is unclear. We therefore propose that these beliefs affect people differently depending on their BMI. When confronted with negative, self-related feedback, people’s coping strategies are often reflected in the ways they relate to their self. We examine three such self-to-self relations (i.e., reassured, inadequate, and hated self). Extending prior research, we predict that weight controllability beliefs (...) are related to positive self-to-self relations for adults with a low, and to negative self-to-self relations for adults with a high BMI. Accordingly, we expected that weight controllability beliefs would be associated with defensive avoidance among people with a high, but not with a low BMI. We tested our hypotheses in a sample of 348 adults who participated in an online survey. Weight controllability beliefs were associated with increased defensive avoidance in people with high BMI, and with decreased defensive avoidance in adults with a low BMI. Forms of self-to-self relating fully mediated this association, demonstrating positive effects on adults with a low, and negative effects on adults with a high BMI. Additionally, in an open ending section, we found seven social settings that deprive people from satisfying their need to belong and to be accepted due to their weight. We discuss our findings against a call for a less moralized public discourse about overweight and obesity that is particularly relevant in the context of the current COVID-19 pandemic. (shrink)

Freud proposes that in unconscious processing, logical connections are also (heavily) based upon phonological similarities. Repressed concerns, for example, would also be expressed by way of phonologic ambiguity. In order to investigate a possible unconscious influence of phonological similarity, 31 participants were submitted to a tachistoscopic subliminal priming experiment, with prime and target presented at 1ms. In the experimental condition, the prime and one of the 2 targets were phonological reversed forms of each other, though graphemically dissimilar (e.g., “nice” and (...) “sign”); in the control condition the targets were pseudo-randomly attributed to primes to which they don’t belong. The experimental task was to “blindly” pick the choice most similar to the prime. ERPs were measured with a focus on the N320, which is known to react selectively to phonological mismatch in supraliminal visual word presentations. The N320 amplitude-effects at the electrodes on the midline and at the left of the brain significantly predicted the participants’ net behavioral choices more than half a second later, while their subjective experience is one of arbitrariness. Moreover, the social desirability score (SDS) significantly correlates with both the behavioral and the N320 brain responses of the participants. It is proposed that in participants with low SDS the phonological target induces an expected reduction of N320 and this increases their probability to pick this target. In contrast, high defensive participants have a perplexed brain reaction upon the phonological target, with a negatively peaking N320 as compared to control and this leads them to avoid this target more often. Social desirability, which is understood as reflecting defensiveness, might also manifest itself as a defense against the (energy-consuming) ambiguity of language. The specificity of this study is that all of this is happening totally out of awareness and at the level of very elementary linguistic distinctions. (shrink)

BackgroundMedical errors, unsatisfactory outcomes, or treatment complications often prompt patient complaints about healthcare providers. In response, physicians may adopt defensive practices to mitigate objections, avoid complaints, and navigate lengthy trial processes or other potential threats. However, such defensive medicine (DM) practices can carry risks, including potential harm to patients and the imposition of unnecessary costs on both patients and the healthcare system. Moreover, these practices may run counter to accepted ethical standards in medicine.MethodsThis qualitative study involved conducting semi-structured (...) interviews with 43 physicians, among whom 38 were faculty members at medical universities, 42 had administrative experience at various levels of the health system, and 23 had previously served as health system policymakers. On average, the participants had approximately 23.5 years of clinical experience. The selection of participants was based on purposive sampling. Data collection through interviews continued until data saturation was achieved.ResultsBased on the findings, DM manifests in both positive and negative forms, illustrated by instances like ordering unnecessary lab tests, imaging, or consultations, reluctance to admit high-risk patients, and avoiding high-risk procedures. The study participants identified a range of underlying and contextual factors contributing to DM, encompassing organizational-managerial, social, personal, and factors inherent to the nature of defensive medical practices. The results also highlight proposed strategies to address and prevent DM, which can be grouped into organizational-managerial, social, and those focused on modifying the medical complaints management system.ConclusionDM is a multifaceted and significant phenomenon that necessitates a comprehensive understanding of its various aspects, including interconnected and complex structures and underlying and contextual factors. While the results of this study offer a solid foundation for informing policy decisions within the healthcare system and include some explanatory policy suggestions, we encourage policymakers to complement the findings of this study with other available evidence to address any potential limitations and to gain a more comprehensive understanding of the policymaking process related to DM. (shrink)

Background Defensive medicine is physicians’ deviation from standard medical care which is primarily intended either to reduce or avoid medico legal litigation. Although the Federal Ethics Committee review in Ethiopia has shown that applications for medical/surgical error investigation claims are increasing at an alarming rate, there is no study to date done to estimate the degree of defensive practice done by the physicians with an intention of avoiding this increasing legal claim. This study assessed the practice of (...) class='Hi'>defensive medicine among highly litigious disciplines (surgery) and described factors associated with its practice. Methods Cross sectional quantitative study using online survey questionnaires was conducted to assess the degree of defensive practice and six factors (age, years of experience, specialty, monthly income, place of practice and previous medico legal history) associated with its practice were assessed among surgeons working in Ethiopia. Results A total of 430 surgeons directly received an online survey questionnaire and 236 of them successfully completed the questionnaire making the response rate 51.2%. Nearly half of the study participants (51.7%) were aware of the concept of defensive medicine and 174 (74%) reported performing one form of defensive practice. Twenty-nine (12.3%) of the participants have legal dispute history, though only 1.3% of them ended up in penalty. Avoiding high risk procedures was the commonest defensive act performed by 60% of the participants, followed by ordering tests unnecessarily (52.1%). Multinomial logistic regression model showed that there was no association between age of the participant, place of practice, year of experience and defensive practice. This model also showed that cardiothoracic and vascular surgeons perform less defensively than surgeons with other specialty with P value of 0.02. Conclusion The practice of defensive medicine is widespread among surveyed Ethiopian surgeons and further studies are required to objectively estimate the effect of defensive practice on the health care system of the country. Policy makers need to develop strategy towards decreasing this high rate of defensive practice. (shrink)

Two putative functions of emotion experience ? its roles in intentional action and in social understanding ? were investigated using a group of individuals (repressors) known to have impaired anxiety experience. Repressors, low-anxious, high-anxious, and defensive high-anxious individuals were asked to give a public presentation, and then given the opportunity to avoid the presentation. Repressors were the group most likely to avoid giving the presentation, but were the least likely to give an emotional explanation for their avoidance. By (...) contrast, they were not less likely than other groups to provide negative emotional explanations of another person?s behaviour in a film clip. We concluded that: (1) repressors are impaired in self- but not in other-explanation using emotion, implying that ?simulation? is not the method used by repressors to ground their folk psychology, (2) the intentional avoidance shown by repressors is indicative of some intact first-order phenomenal anxiety experience but that they lack second-order awareness of this anxiety experience. (shrink)

A person who is liable to defensive harm has forfeited his rights against the imposition of the harm, and so is not wronged if that harm is imposed. A number of philosophers, most notably Jeff McMahan, argue for an instrumental account of liability, whereby a person is liable to defensive harm when he is either morally or culpably responsible for an unjust threat of harm to others, and when the imposition of defensive harm is necessary to avert (...) the threatened unjust harm. Others may favour a purely noninstrumental account of liability: one that looks only to the past behaviour of the potentially liable person. We argue that both views are vulnerable to serious objections. Instead we develop and defend a new view of liability to defensive harm: the pluralist account. The pluralist account states that liability to defensive harm has at least two bases. First, if an attacker is morally or culpably responsible for an unjust attack then he has forfeited what we call his agency right, and in doing so he has made himself partially liable to defensive harm. Whether the attacker is fully liable to defensive harm depends, however, on whether the imposition of defensive harm would infringe a different right held by the attacker: his humanitarian right. Humanitarian rights are rights to be provided with urgently needed resources or to be protected from serious harms when others can do so at reasonably low cost. We argue the pluralist account avoids the objections to which the instrumental and noninstrumental views are vulnerable, coheres with our intuitive reactions in a wide range of cases, and sheds new light on the way different rights combine to determine a person's liability to suffer harm. (shrink)

Nations are understood to have a right to go to war, not only in defense of individual rights, but in defense of their own political standing in a given territory. This paper argues that the political defensive privilege cannot be satisfactorily explained, either on liberal cosmopolitan grounds or on pluralistic grounds. In particular, it is argued that pluralistic accounts require giving implausibly strong weight to the value of political communities, overwhelming the standing of individuals. Liberal cosmopolitans, it is argued, (...) underestimate the difficulties in disentangling a state’s role in upholding or threatening individual interests from its role in providing the social context that shapes and determines those very interests. The paper proposes an alternative theory, “prosaic statism”, which shares the individualistic assumptions of liberal cosmopolitanism, but avoids a form of fundamentalism about human rights, and is therefore less likely to recommend humanitarian intervention in non-liberal states. (shrink)

Two putative functions of emotion experience — its roles in intentional action and in social understanding — were investigated using a group of individuals (repressors) known to have impaired anxiety experience. Repressors, low-anxious, high-anxious, and defensive high-anxious individuals were asked to give a public presentation, and then given the opportunity to avoid the presentation. Repressors were the group most likely to avoid giving the presentation, but were the least likely to give an emotional explanation for their avoidance. By (...) contrast, they were not less likely than other groups to provide negative emotional explanations of another person’s behaviour in a film clip. We concluded that: (1) repressors are impaired in self- but not in other-explanation using emotion, implying that “simulation” is not the method used by repressors to ground their folk psychology, (2) the intentional avoidance shown by repressors is indicative of some intact first-order phenomenal anxiety experience but that they lack second-order awareness of this anxiety experience. (shrink)

BackgroundDefensive practice occurs when physicians provide services, such as tests, treatments and referrals, mainly to reduce their perceived legal or reputational risks, rather than to advance patient care. This behaviour is counter to physicians’ ethical responsibilities, yet is widely reported in surveys of doctors in various countries. There is a lack of qualitative research on the drivers of defensive practice, which is needed to inform strategies to prevent this ethically problematic behaviour.MethodsA qualitative interview study investigated the views and experiences (...) of physicians in Australia on defensive practice and its contribution to low value care. Interviewees were recruited based on interest in medico-legal issues or experience in a health service involved in ‘Choosing Wisely’ initiatives. Semi-structured interviews averaged 60 min in length. Data were coded using the Theoretical Domains Framework, which encapsulates theories of behaviour and behaviour change.ResultsAll participants (n = 17) perceived defensive practice as a problem and a contributor to low value care. Behavioural drivers of defensive practice spanned seven domains in the TDF: knowledge, focused on inadequate knowledge of the law and the risks of low value care; skills, emphasising patient communication and clinical decision-making skills; professional role and identity, particularly clinicians’ perception of patient expectations and concern for their professional reputation; beliefs about consequences, especially perceptions of the beneficial and harmful consequences of defensive practice; environmental context and resources, including processes for handling patient complaints; social influences, focused on group norms that encourage or discourage defensive behaviour; and emotions, especially fear of missing a diagnosis. Overall, defensive practice is motivated by physicians’ desire to avoid criticism or scrutiny from a range of sources, and censure from their professional peers can be a more potent driver than perceived legal consequences.ConclusionsThe findings call for strengthening knowledge and skills, for example, to improve clinicians’ understanding of the law and their awareness of the risks of low value care and using effective communication strategies with patients. Importantly, supportive cultures of practice and organisational environments are needed to create conditions in which clinicians feel confident in avoiding defensive practice and other forms of low value care. (shrink)

In response to the claim that the properties typically used to distinguish System 1 from System 2 crosscut one another, Carruthers, Evans, and Stanovich have abandoned the System 1/System 2 distinction. Evans and Stanovich both opt for a dual-process theory, according to which Type-1 processes are autonomous and Type-2 processes use working memory and involve cognitive decoupling. Carruthers maintains a two-system account, according to which there is an intuitive system and a reflective system. I argue that these defenses of dual-process (...) theory face two problems. First, as pointed out by Sloman, these new dual-process theories cast the net of “reasoning” too wide. Second, and more importantly, this singular distinction cannot accomplish the explanatory work needed to support dual-process theory. These theorists must fall back on using various properties from the Standard Menu in explanations, thereby committing these accounts to a “Standard View” that they had hoped to avoid. Thus, these theorists face a.. (shrink)

Three main claims are made in this paper. First, it is argued that Onora O’Neill has uncovered a serious problem in the way medical ethicists have thought about both respect for autonomy and informed consent. Medical ethicists have tended to think that autonomous choices are intrinsically worthy of respect, and that informed consent procedures are the best way to respect the autonomous choices of individuals. However, O’Neill convincingly argues that we should abandon both these thoughts. Second, it is argued that (...) O’Neill’s proposed solution to this problem is inadequate. O’Neill’s approach requires that a more modest view of the purpose of informed consent procedures be adopted. In her view, the purpose of informed consent procedures is simply to avoid deception and coercion, and the ethical justification for informed consent derives from a different ethical principle, which she calls principled autonomy. It is argued that contrary to what O’Neill claims, the wrongness of coercion cannot be derived from principled autonomy, and so its credentials as a justification for informed consent procedures is weak. Third, it is argued that we do better to rethink autonomy and informed consent in terms of respecting persons as ends in themselves, and a characteristically liberal commitment to allowing individuals to make certain categories of decisions for themselves. Respect for autonomy is in trouble. In recent work in this journal1 and elsewhere,2 O’Neill has forcefully argued that respect for autonomy, as it has come to be used in medical ethics, is philosophically indefensible. If her arguments are sound, then, contrary to the standard view, respect for autonomy cannot be the source of the ethical requirement to seek informed consent before treating a patient or enrolling a participant in a trial. So her critique goes to the heart of contemporary medical ethics: if O’Neill is right, medical ethicists have systematically misunderstood two of the most fundamental concepts they deal with—respect for autonomy and informed consent. This paper has four sections. Section 1 distinguishes between three different ways of talking about respect for autonomy, and looks in more detail at the one that has come to be central to bioethical writing on informed consent—namely, the idea that we should respect autonomous choices. Section 2 argues, following O’Neill, that it is implausible to think that the purpose of informed consent requirements is to respect autonomous choices. Section 3 argues that O’Neill’s proposed reworking of autonomy and informed consent is inadequate. O’Neill’s approach requires us to adopt a more modest view of the purpose of informed consent procedures. In her view, the purpose of informed consent procedures is simply to avoid deception and coercion, and the ethical justification for informed consent derives from a different ethical principle, which she calls principled autonomy. I argue that contrary to what O’Neill claims, we cannot derive the wrongness of coercion from principled autonomy, and so its credentials as a justification for informed consent procedures is weak. Section 4 argues that we do better to rethink autonomy and informed consent in terms of respecting persons as ends in themselves, and a characteristically liberal commitment to allowing individuals to make certain categories of decisions for themselves. (shrink)

An amended bootstrapping can avoid Christensen's counterexamples. Earman and Edidin argue that Christensen's examples to bootstrapping rely on his failure to analyze background knowledge. I add an additional condition to bootstrapping that is motivated by Glymour's remarks on variety of evidence. I argue that it avoids the problems that the examples raise. I defend the modification against the charge that it is holistic, and that it collapses into Bayesianism.

This work presents an analysis of the feeling of guilt and in particular of the cognitive defenses against it. It shows how the need to avoid or mitigate the feeling, with the suffering implied, affects the perception and judgment of oneself and others. It is in fact claimed that to copy with their guilt people try to alter the appraisal processes implied by the emotion. Once described the main cognitive components of the feeling of guilt, an analysis is offered of (...) the interventions of the cognitive defenses on such components, to alter the original appraisal processes underlying the feeling. (shrink)

The objective of the article is to examine the human rights enforcement in Indonesian legal and political system. This is done by studying the legal basis of human rights, the process of proliferation of human rights discourse, and the actual controversies of human rights enforcement. The study has the effect of highlighting some of the immense deficits in ensuring that violations are treated under judicial procedure and the protection of human rights is available and accessible for victims. The author inevitably (...) came into a conclusion that the openness of legal and political arenas for human rights discourses is not followed with a tangible impact on the entitlement positions of the people. The problems of the weak institutions and the unenthusiastic enforcement show that, in Indonesia, human rights are formally adopted as a political strategy to avoid substantial implementation. (shrink)

BackgroundDefensive medicine (DM) practice refers to the ordering or prescription of unnecessary treatments or tests while avoiding risky procedures for critically ill patients with the aim to alleviate the physician’s legal responsibility and preserve reputation. Although DM practice is recognized, its dimensions are still uncertain. The subject has been highly investigated in developed countries, but unfortunately, many developing countries are unable to investigate it properly. DM has many serious ramifications, exemplified by the increase in treatment costs for patients and health (...) systems, patients’ exposure to risks, and negative effects on the psychological health of both health providers and recipients. Ultimately, the most serious consequence is the ethical consequences.MethodsThis work is based on a review of the literature related to DM worldwide and a comparison with the available knowledge found in Jordan. It is qualitative with a descriptive nature, aiming to diagnose the current DM practice in Jordan.ResultsThis is the first published article that discusses DM in Jordan by diagnosing its ethical and economic consequences for the health system as well as for patients. Despite the knowledge of the reasons that support its practice, little is being done to solve this issue. The absence of agreeable medical malpractice law, the dearth of unified medical protocols, the overwhelming pressure imposed by patients on medical staff, and the deteriorating patient-physician relationship are some of the causes of DM practice. Surely, the solution to these issues is to focus on fortifying the ethical and humanitarian aspects on the side of both the physician and the patient to ensure positive collaboration. The ethical aim of the physician to treat the patient faithfully and do what is possible to help combined with the appreciation of the physician’s efforts and the choice to not take advantage of the physician through litigation could be the most reasonable solution in the near future.ConclusionJordan is suffering from DM due to the limited financial expenditure on the health sector and the impracticality of medical malpractice law. The authors highlight that the cardinal step in solving this dilemma is restoring the ethical dimension of the patient-physician relationship. (shrink)

While theories of animal rights maintain that nonhuman animals possess prima facie rights, such as the right to life, the dominant philosophies of animal rights permit the killing of nonhuman animals for reasons of self-defense. I argue that the animal rights discourse on defensive killing is problematic because it seems to entail that any nonhuman animal who poses a threat to human beings can be justifiably harmed without question. To avoid this human-privileged conclusion, I argue that the animal rights (...) position needs to both (1) deploy a new criterion of liability to defensive harm, and (2) seriously consider whether human beings themselves are liable to defensive harm in human-animal conflicts. By shifting the focus to whether humans are liable to defensive harm, we will find that in many situations of human-animal conflict, human beings are actually the ones liable to be harmed because they are often culpable or, to some degree, morally responsible for posing an unjust threat to nonhuman animals. (shrink)

Joanna Mary Firth and Jonathan Quong argue that both an instrumental account of liability to defensive harm, according to which an aggressor can only be liable to defensive harms that are necessary to avert the threat he poses, and a purely noninstrumental account which completely jettisons the necessity condition, lead to very counterintuitive implications. To remedy this situation, they offer a “pluralist” account and base it on a distinction between “agency rights” and a “humanitarian right.” I argue, first, (...) that this distinction is spurious; second, that the conclusions they draw from this distinction do not cohere with its premises; third, that even if one granted the distinction, Firth’s and Quong’s implicit premise that you can forfeit your agency rights but not your “humanitarian right” is unwarranted; fourth, that their attempt to mitigate the counterintuitive implications of their own account in the Rape case relies on mistaken ad-hoc assumptions; fifth, that even if they were successful in somewhat mitigating said counterintuitive implications, they would still not be able to entirely avoid them; and sixth, that even in the unlikely case that none of these previous five critical points are correct, Firth and Quong still fail to establish that aggressors can be liable to unnecessary defensive harm since they fail to establish that unnecessary harm can ever be defensive in the first place. (shrink)

Prior studies suggest that psychological difficulties arise from higher trait rejection sensitivity (RS)—heightened vigilance and differential detection of social rejection cues and defensive response to. On the other hand, from an evolutionary perspective, rapid and efficient detection of social rejection cues can be considered beneficial. We conducted a survey and an electrophysiological experiment to reconcile this seeming contradiction. We compared the effects of RS and rejection detection capability (RDC) on perceived interpersonal experiences (Study 1) and on neurocognitive processes in (...) response to cues of social rejection (disgusted faces; Study 2). We found that RS and RDC were not significantly related, although RS was positively related to perceived social rejection experiences and RDC was positively related to perceived social inclusion experiences. Event-related brain potentials (ERPs) revealed that higher RS was related to cognitive avoidance (i.e., P1) and heightened motivated attention (i.e., late positive potential: LPP), but not to facial expression encoding (i.e., N170) toward disgusted faces. On the other hand, higher RDC was related to heightened N170 amplitude, but not to P1 and LPP amplitudes. These findings imply that sensitivity to rejection is apparently distinct from the ability to detect social rejection cues and instead reflects intense vigilance and defensive response to those cues. We discussed an alternative explanation of the relationship between RS and RDC from a signal detection perspective. (shrink)

The aim of this paper is to evaluate the claim that the disclosure of surgeons' performance data could lead to the practice of defensive medicine. I argue that disclosure could actually encourage surgeons to practice a new form of defensive medicine, one that has not hitherto been noted. I explore a possible way of avoiding this problem.

The performance records of cardiac surgeons have been disclosed publicly in several states in the USA, for example New York and Pennsylvania, since the early 1990s. In response to the growing interest in the quality of healthcare, such records have also begun to be disclosed in the UK, starting in 2004. Various studies seem to show that disclosure has, indeed, contributed to the improvement of the quality of healthcare.1 However, at the same time, disclosure does have its critics.2 In this (...) paper, I discuss what I call the ‘defensive medicine objection’ to the disclosure of performance data; that disclosure is not justified because it could cause surgeons to experience high levels of anxiety3, which might eventually lead to the practice of defensive medicine. Although this objection is often mentioned by ethicists and medical professionals4 it has never been carefully analysed or evaluated. The aim of this paper is to consider it in detail. I argue in favour of the objection; disclosure could, indeed, lead to the practice of defensive medicine if it is not conducted properly.5 This paper has the following structure. In Section 2 I discuss the anxiety that surgeons may experience regarding the disclosure of performance data. In Section 3 I introduce a traditional definition of defensive medicine. In Section 4 I argue that disclosure could encourage surgeons to perform a new form of defensive medicine, one that is not captured by the traditional definition. In Section 5 I undermine the claim that surgeons have no good reason to be anxious about disclosure. In Section 6 I consider a possible way of avoiding.. (shrink)

This study explores how paradoxical tensions between economic growth and environmental protection are avoided through organizational mythmaking. By examining the European oil and gas supermajors’ “CEO-speak” about climate change, we show how mythmaking facilitates the disregarding, diverting, and/or displacing of sustainability tensions. In doing so, our findings further illustrate how certain defensive responses are employed: regression, or retreating to the comforts of past familiarities, fantasy, or escaping the harsh reality that fossil fuels and climate change are indeed irreconcilable, and (...) projecting, or shifting blame to external actors for failing to address climate change. By highlighting the discursive effects of enacting these responses, we illustrate how the European oil and gas supermajors self-determine their inability to substantively address the complexities of climate change. We thus argue that defensive responses are not merely a form of mismanagement as the paradox and corporate sustainability literature commonly suggests, but a strategic resource that poses serious ethical concerns given the imminent danger of issues such as climate change. (shrink)

In this paper I explain the present adversarial collective bargaining process (ACB) and then critique it on legal and ethical grounds. A new methodology, that I describe as the collaborative collective bargaining process (CCB), will then be explained and similarly critiqued. I argue that replacing the present ACB model with the CCB model will result in better long-term results for all parties concerned. This is because the ACB model is comparable, in many respects, to the adversarial process used in court (...) litigation. It is a combat model based on power. ACB makes the battle lines clear, and it grants victory to the more convincing display of power, but it leaves casualties. Indeed it cannot operate except upon the casualties of the opposing party, and those casualties are the basis for ever-renewed combat. Tactics employed in ACB to achieve victory include deception, lying and the abandonment of truth as a moral value. I argue that, in sharp contrast, CCB can foster an environment which encourages candor and truthfulness. By following the CCB model, the parties can avoid the negative and self-defeating elements of ACB and can work together toward mutually beneficial goals by the use of an ethically defensible approach to labor negotiations. (shrink)

In 2008 the Human Fertilisation and Embryology Act amendments made deliberately choosing to bring disability into the world, using assisted reproduction, a criminal offence. This paper considers whether the legal prohibition above, should influence other policy areas concerning the welfare of future children such as new possibilities presented by foetal surgery and in utero gene therapy. If we have legal duties to avoid disability in one context should this influence our avoidance of disability in this other context? This paper (...) investigates whether the State might have a stake in wider promotion of practices to reduce the degree of disability in foetuses that will come to exist. Not selecting for disability does not affect the welfare of any future individual, whereas treating in utero abnormalities can optimize the eventual child’s welfare; antenatal interventions stand to improve clinical outcomes and welfare should that specific child be born. I explore why the State may want to intervene in the antenatal setting and to what extent, if at all; the State should implement these technologies. I argue that if the State is justified in intervening to outlaw the choosing to create disabled lives using assisted reproductive techniques, it is also justified in putting pressure on prospective parents to accept therapies in utero to help their child be born less disabled. However, I qualify this with the argument that the State is not justified in using force or the criminal law in this situation during pregnancy. (shrink)

In his article "How Certain Boundaries and Ethics Diminish Therapeutic Effectiveness", Lazarus asserts that many clinicians are adhering to strict therapeutic boundaries and ethics in a fear-driven effort to avoid unwarranted malpractice claims. Although I agree that maintenance of conventional therapeutic boundaries is apt to minimize malpractice claims in most cases, I believe that is because such boundaries are critical to protect patients' welfare and thereby promote effective treatment. My reasoning, discussed next, revolves around the following premises: 1. For many, (...) if not most, types of patient problems and patient populations, boundaries and the personal meaning of the therapeutic boundaries are an arena in which critical emotional issues are manifested and worked through. 2. Clear, consistent boundaries provide a structure and safety for many patients that is a curative factor in itself. 3. Patients' reactions to alterations in usual therapeutic boundaries are often unpredictable ahead of time (even if requested by the patient) and typically complex, ambivalent, and heavily colored by transferential meaning. 4. Because alterations in therapeutic boundaries typically add a new therapist role or activity that involves potential gratification of personal needs of the therapist, objectivity in evaluating such a change may be compromised by the inherent self-interest. 5. Consistent, clear boundaries need have no impact on therapist warmth and empathy. (shrink)

Since Seligman's 1971 statement that the vast majority of phobias are about objects essential to the survival of a species, a multitude of laboratory studies followed, supporting the finding that humans learn to fear and detect snakes (and other animals) faster than other stimuli. Most of these studies used schematic drawings, images, or pictures of snakes, and only a small amount of fieldwork in naturalistic environments was done. We address fear preparedness theories, and automatic fast detection data from mainstream laboratory (...) data and compares it with ethobehavioural information relative to snakes, predator-prey interaction, and snakes’ defensive kinematics strikes in order to analyse their potential matching. From this analysis four main findings arose, namely that: 1) Snakebites occur when people are very close to the snake and are unaware or unable to escape the bite; 2) Human visual detection and escape response is slow compared to the speed of snake strikes; 3) In natural environments, snake experts are often unable to see snakes existing nearby; 4) animate objects in general capture more attention over other stimuli and dangerous but recent objects in evolutionary terms are also able to be detected fast. The issues mentioned above pose several challenges to evolutionary psychology-based theories expecting to find special-purpose neural modules. The older selective habituation hypothesis (Schleidt, 1961), that prey animals start with a rather general predator image from which specific harmless cues are removed by habituation might deserve reconsideration. (shrink)

Philosophical defenses of parents’ rights typically appeal to the interests of parents, the interests of children, or some combination of these. Here I propose that at least in the case of biological, non-adoptive parents, these rights have a different normative basis: namely, these rights should be accorded to biological parents because of the compensatory duties such parents owe their children by virtue of having brought them into existence. Inspried by Seana Shiffrin, I argue that procreation inevitably encumbers the wills of (...) children in otherwise morally objectionable ways. Such subjection generates duties to compensate children, even if the child’s life is on balance a benefit to her. The right to procreate is thus conditioned on prospective parent’s willingness to compensate for the harms of procreation. And because parents bear such compensatory duties, they must be accorded permissions (i.e., rights) to fulfill these duties. These rights include familiar exclusionary rights to promote children’s welfare, etc. Moreover, because subjecting children to harms or the risks thereof violates their autonomy, parental duties (and rights) include the provision of education and other goods that enable their subsequent autonomy as adults. Grounding parental rights in compensatory procreative duties avoids problems associated with appeals to the interests of children (e.g., that these interests do not seem to generate exclusive parental rights) or to the interests of parents (e.g., that these interests do not appear strong enough to permit the creation of a new, vulnerable human individual). (shrink)

Contemporary defenses of the doctrine of double effect are mainly focused on avoiding the absurdity charge raised by Judith Thomson (). There are two strategies proposed in the literature for refuting Thomson's argument. In this paper I argue that answering Thomson's challenge comes at a heavy price: while both versions of the DDE that are developed within these two strategies successfully avoid the absurdity charge, they also remain incomplete. Thomson's argument reveals that the proponents of the DDE can at best (...) provide a partial defense of the claim that intentions can be relevant to permissibility. (shrink)

Repression has become an empirical fact that is at once obvious and problematic. Fragmented clinical and laboratory traditions and disputed terminology have resulted in a Babel of misunderstandings in which false distinctions are imposed (e.g., between repression and suppression) and necessary distinctions not drawn (e.g., between the mechanism and the use to which it is put, defense being just one). “Repression” was introduced by Herbart to designate the (nondefensive) inhibition of ideas by other ideas in their struggle for consciousness. Freud (...) adapted repression to the defensive inhibition of “unbearable” mental contents. Substantial experimental literatures on attentional biases, thought avoidance, interference, and intentional forgetting exist, the oldest prototype being the work of Ebbinghaus, who showed that intentional avoidance of memories results in their progressive forgetting over time. It has now become clear, as clinicians had claimed, that the inaccessible materials are often available and emerge indirectly (e.g., procedurally, implicitly). It is also now established that the Ebbinghaus retention function can be partly reversed, with resulting increases of conscious memory over time (hypermnesia). Freud's clinical experience revealed early on that exclusion from consciousness was effected not just by simple repression (inhibition) but also by a variety of distorting techniques, some deployed to degrade latent contents (denial), all eventually subsumed under the rubric of defense mechanisms (“repression in the widest sense”). Freudian and Bartlettian distortions are essentially the same, even in name, except for motive (cognitive vs. emotional), and experimentally induced false memories and other “memory illusions” are laboratory analogs of self-induced distortions. Key Words: avoidance; Bartlett; defense; denial; distortion; Ebbinghaus; false-memories; Freud; inhibition; repression; suppression. (shrink)

Revonsuo proposed an intriguing and detailed evolutionary theory of dreams which stipulates that the biological function of dreaming is to simulate threatening events and to rehearse threat avoidance behaviors. The goal of the present study was to test this theory using a sample of 212 recurrent dreams that was scored using a slightly expanded version of the DreamThreat rating scale. Six of the eight hypotheses tested were supported. Among the positive findings, 66% of the recurrent dream reports contained one (...) or more threats, the threats tended to be dangerous and aimed at the dreamer, and when facing a threat, the dreamer tended to take defensive or evasive actions that were possible and reasonable. However, less than 15% of the recurrent dreams depicted realistic and probable situations critical for one’s physical survival or reproductive success and the dreamer rarely succeeded in fleeing the threat despite important and appropriate efforts. The findings thus provide mixed support for the threat simulation theory. (shrink)

The primary method for defending biocentric individualism—a prominent theory of the moral value of organisms—is to appeal to the fact that certain things are good for or bad for living creatures, even if they are not sentient. This defense is typically and frequently met with the objection that we can determine what is good for some living creature without thereby having any moral reason or obligation to promote or avoid undermining it. In this paper I show how a theory of (...) the morality of defensive violence undermines this objection. (shrink)

Exotic ontologies are all the rage. Distant from common sense and often science as well, views like mereological essentialism, nihilism, and fourdimensionalism appeal to our desire to avoid arbitrariness, anthropocentrism, and metaphysical conundrums.1 Such views are defensible only if they are materially adequate, only if they can “reconstruct” the world of common sense and science. (No disrespect to the heroic metaphysicians of antiquity, but this world is not just an illusion.) In the world of common sense and science, bicycles survive (...) changes in their parts, billiard balls strike one another, and nothing travels faster than light. The mereological essentialist denies the rst, but offers this replacement: “there exist successions of numerically distinct, but appropriately related, bicycles with different parts” (Chisholm, , chapter ). The nihilist denies the second, but offers this replacement: “there exist X s and Y s such that the X s are arranged billiard-ball-wise, the Y s are also arranged billiard-ball-wise, and the X s strike the Y s”.2 The four-dimensionalist denies the third, but offers this replacement: “no sequences of matter-stages that are related by genidentity travel faster than light”.3 There is room for disagreement over what exactly “reconstruction” amounts to, but at a minimum: when a metaphysical theory reconstructs ordinary sentences φ1. . . as replacement sentences ψ1. . . , ordinary and scienti c evidence must not refute the view that, strictly speaking, it is ψ1. . . rather than φ1. . . that are true. The metaphysician needs reconstruction in order to face the tribunal of experience. An intriguing newcomer to the contemporary scene is the ancient doctrine of monism, the claim that “reality is one”.4 I will argue that, contrary to.. (shrink)

Film studies has largely avoided the biocultural turn that has swept through other areas of the humanities. This resistance may be understood in terms of the field’s recent distaste for grand theory—and in terms of the loose, social-constructionist thinking that is one residue of that distaste. Fortunately, a biocultural approach to cinema can offer film studies a necessary and defensible set of assumptions. It can also offer interpretive tools and potential ways of conceptualizing perennial concerns like authorship and genre. This (...) essay demonstrates the last two points through an evolutionary reading of Howard Hawks’s musical Gentlemen Prefer Blondes (1953) and through proposals for new ways of approaching auteurism and pornography. (shrink)

The proposed justification avoids problems that invalidate the familiar entitlement, utility, and interest-based justifications; interprets private property as necessary for controlling resources we need for our well-being; recognizes that the possession, uses, and limits of private property must be justified differently; and combines the defensible portions of the familiar but unsuccessful attempts at justification with a more complex account that combines the defensible portions of previous justificatory attempts with a new pluralistic approach that treats the right to private property as (...) a conventional, defeasible, but indispensable right. (shrink)

This paper explores and defends the idea that mental properties and their physical bases jointly cause their physical effects. The paper evaluates the view as an emergentist response to the exclusion problem, comparing it with a competing nonreductive physicalist solution, the compatibilist solution, and argues that the joint causation view is more defensible than commonly supposed. Specifically, the paper distinguishes two theses of closure, Strong Closure and Weak Closure, two causal exclusion problems, the overdetermination problem and the supervenience problem, and (...) argues that emergentists can avoid the overdetermination problem by denying Strong Closure and respond to the supervenience problem by accepting the joint causation view. (shrink)

In _Beyond Prejudice_, Evelyn B. Pluhar defends the view that any sentient conative being—one capable of caring about what happens to him or herself—is morally significant, a view that supports the moral status and rights of many nonhuman animals. Confronting traditional and contemporary philosophical arguments, she offers in clear and accessible fashion a thorough examination of theories of moral significance while decisively demonstrating the flaws in the arguments of those who would avoid attributing moral rights to nonhumans. Exposing the traditional (...) view—which restricts the moral realm to autonomous, fully fledged "persons"—as having horrific implications for the treatment of many humans, Pluhar goes on to argue positively that sentient individuals of any species are no less morally significant than the most automomous human. Her position provides the ultimate justification that is missing from previous defenses of the moral status of nonhuman animals. In the process of advancing her position, Pluhar discusses the implications of determining moral significance for children and "abnormal" humans as well as its relevance to population policies, the raising of animals for food or product testing, decisions on hunting and euthanasia, and the treatment of companion animals. In addition, the author scrutinizes recent assertions by environmental ethicists that all living things or that natural objects and ecosystems be considered highly morally significant. This powerful book of moral theory challenges all defenders of the moral status quo—which decrees that animals decidedly do not count—to reevaluate their convictions. (shrink)

In this article I articulate and defend an African moral theory, i.e., a basic and general principle grounding all particular duties that is informed by sub-Saharan values commonly associated with talk of "ubuntu" and cognate terms that signify personhood or humanness. The favoured interpretation of ubuntu (as of 2007) is the principle that an action is right insofar as it respects harmonious relationships, ones in which people identify with, and exhibit solidarity toward, one another. I maintain that this is the (...) most defensible moral theory with an African pedigree at the time, and that it should be developed further with an eye to rivalling dominant Western theories such as utilitarianism and Kantianism. (NB: a mildly revised version, avoiding some typos and phrases that invite misinterpretation, appeared as a chapter in Isaac Ukpokolo, ed., _Themes, Issues and Problems in African Philosophy_ London: Palgrave Macmillan, 2017, pp. 97-119.). (shrink)

On an account of virtue as skill, virtues are acquired in the ways that skills are acquired. In this paper I focus on one implication of that account that is deserving of greater attention, which is that becoming more skillful requires learning from one’s failures, but that turns out to be especially challenging when dealing with moral failures. In skill acquisition, skills are improved by deliberate practice, where you strive to correct past mistakes and learn how to overcome your current (...) limitations. A similar story applies to virtue acquisition, as moral failures will be a part of anyone’s life, and we will all have to learn from these experiences. However, despite the importance of being able to learn from our mistakes, this is very difficult in practice, given that failure of any kind can be distressing, and especially so for moral failure. The distress created by a recognition of moral failure often prompts responses of anger, avoidance, or defensiveness; rather than attempts to make amends and when necessary to work on self-improvement. The most potentially distressing response to moral failure is shame, as it is often associated with defensiveness. It is here where emotion regulation will be important to manage that distress, and I focus on the skill of emotion differentiation. I argue that emotion differentiation is a promising strategy for distinguishing the emotions we may experience in the wake of failure, including shame, and to encourage those emotions that motivate self-improvement. Thus, emotion regulation is important for virtue acquisition. (shrink)

In recent years, virtue epistemology has won the attention of a wide range of philosophers. A developed form of the position has been expounded forcefully by Ernest Sosa and represents the most plausible version of reliabilism to date. Through the person of Alvin Plantinga, virtue epistemology has taken philosophy of religion by storm, evoking objections and defenses in a wide variety of journals and volumes. Historically, virtue epistemology has its roots in the work of Thomas Reid, and the explosion of (...) Reid scholarship in the last few years is perhaps both a cause and an effect of recent interest in the position.In this paper I want to examine the virtues and vices of virtue epistemology. My conclusion will be that the position is correct, when qualified appropriately. The central claim of virtue epistemology is that, Gettier problems aside, knowledge is true belief which results from a cognitive virtue. In section one I will clarify this claim with some brief remarks about the nature of virtues in general, and cognitive virtues in particular. In section two I will consider two objections to the theory of knowledge which results. In section three of the paper I will argue that virtue epistemology can be qualified so as to avoid the objections raised in section two. Finally, I will argue that the amendments which solve the objections of section two also allow us to solve a version of the dreaded generality problem. (shrink)

What makes a measure of well-being valid? The dominant approach today, construct validation, uses psychometrics to ensure that questionnaires behave in accordance with background knowledge. Our first claim is interpretive—construct validation obeys a coherentist logic that seeks to balance diverse sources of evidence about the construct in question. Our second claim is critical—while in theory this logic is defensible, in practice it does not secure valid measures. We argue that the practice of construct validation in well-being research is theory avoidant, (...) favoring a narrow focus on statistical tests while largely ignoring relevant philosophical considerations. (shrink)

Autonomous vehicles have the potential to save tens of thousands of lives, but legal and social barriers may delay or even deter manufacturers from offering fully automated vehicles and thereby cost lives that otherwise could be saved. Moral philosophers use “thought experiments” to teach us about what ethics might say about the ethical behavior of AVs. If a manufacturer designing an AV decided to make what it believes is an ethical choice to save a large group of lives by steering (...) away from the large group towards a single individual, could the manufacturer be liable to that single individual? I believe the answer is yes. This article discusses famous “trolley problem” thought experiments in moral philosophy, which news articles have recently applied to AVs. After establishing a hypothetical case, applying product liability law to AV behavior may show a way, in some jurisdictions, that will permit a manufacturer to implement an ethical choice without triggering liability, but liability risk remains. I then turn to possible traditional defenses to see if they prevent liability for a manufacturer making what it believes is an ethical design choice—necessity, defense of self, and the sudden emergency doctrine. None of them provides an effective defense. Under current law, maximizing collision avoidance appears to minimize legal risk. I conclude that the only way to provide effective protection to a manufacturer seeking to implement ethical choices about AV behavior is through special legislation or regulation. (shrink)

One reason to posit governing laws is to explain the uniformity of nature. Explanatory power can be purchased by accepting new primitives, and scientists invoke laws in their explanations without providing any supporting metaphysics. For these reasons, one might suspect that we can treat laws as wholly unanalyzable primitives. (John Carroll’s *Laws of Nature* (1994) and Tim Maudlin’s *The Metaphysics Within Physics* (2007) offer recent defenses of primitivism about laws.) Whatever defects primitive laws might have, explanatory weakness should not be (...) one of them. However, in this essay I’ll argue that wholly primitive laws cannot explain the uniformity of nature. The basic argument is based on the following idea: though a primitive law that P makes P likely, the primitive status of the law provides no reason to think that P must describe (or otherwise give rise to) a natural regularity. After identifying the problem for primitive laws, I consider an extension of the objection to all theories of governing laws and suggest that it may be avoided by a version of the Dretske/Tooley/Armstrong theory according to which laws are relations between universals. (shrink)

In an earlier paper [3], D. H. Mellor and I argued that physicalism faces a dilemma: 'physical' is either taken in very restrictive sense, in which case physicalism is clearly false; or it is taken in a very broad sense, in which case the doctrine is almost empty. The challenge to the physicalist is to define a doctrine which is both defensible and substantial. Philip Pettit [4] accepts this challenge, and responds with a definition of physicalism which he thinks avoids (...) the dilemma. Pettit's definition of physicalism involves four claims, two about entities, two about laws. Claims 1 and 3, concerning the existence of microphysical entities and microphysical laws, should not be questioned. Claims 2 and 4 are what make Pettit's theory physicalist: 2 says that microphysical entities constitute everything, 4 says that microphysical laws govern everything. I shall argue that the various ways Pettit offers of understanding these claims are in tension with one another, with the result that his definition does not avoid the dilemma posed in [3]. (shrink)

Since cyberattacks are nonphysical, standard theories of casus belli — which typically rely on the violent and forceful nature of military means — appear inapplicable. Yet, some theorists have argued that cyberattacks nonetheless can constitute just causes for war — generating a unilateral right to defensive military action — when they cause significant physical damage through the disruption of the target's computer systems. I show that this view suffers from a serious drawback: it is too permissive concerning the types (...) of actions that generate casus belli since many essentially peaceful and non-violent mechanisms can nonetheless cause physical damage. I resolve this difficulty by developing a sovereignty-based account of casus belli and applying it to cyberwarfare. I argue that legitimate states have a constrained right to unilaterally respond with military force to unfriendly actions that bypass or overwhelm the political deliberations of the target state in order to force a change in behaviour contrary to the determinations of the people of the target state. This new account of casus belli avoids the problems of the consequence-based view by plausibly restricting the types of unfriendly action that give rise to casus belli and yet offers an attractive explanation for why some cyberattacks nonetheless do generate a potential right to a unilateral defensive response. (shrink)

The late 20th century saw great movement in the philosophy of language, often critical of the fathers of the subject-Gottlieb Frege and Bertrand Russell-but sometimes supportive of (or even defensive about) the work of the fathers. Howard Wettstein's sympathies lie with the critics. But he says that they have often misconceived their critical project, treating it in ways that are technically focused and that miss the deeper implications of their revolutionary challenge. Wettstein argues that Wittgenstein-a figure with whom the (...) critics of Frege and Russell are typically unsympathetic-laid the foundation for much of what is really revolutionary in this late 20th century movement. The subject itself should be of great interest, since philosophy of language has functioned as a kind of foundation for much of 20th century philosophy. But in fact it remains a subject for specialists, since the ideas are difficult and the mode of presentation is often fairly technical. In this book, Wettstein brings the non-specialist into the conversation (especially in early chapters); he also reconceives the debate in a way that avoids technical formulation. The Magic Prism is intended for professional philosophers, graduate students, and upper division undergraduates. (shrink)

This article offers a novel, conservative account of material constitution, one that incorporates sortal essentialism and features a theory of dominant sortals. It avoids coinciding objects, temporal parts, relativizations of identity, mereological essentialism, anti-essentialism, denials of the reality of the objects of our ordinary ontology, and other departures from the metaphysic implicit in ordinary ways of thinking. Defenses of the account against important objections are found in Burke 1997, 2003, and 2004, as well as in the often neglected six paragraphs (...) that conclude section V of this article. (shrink)

Although convinced by Frankfurt-style cases that moral responsibility does not require the ability to do otherwise, semicompatibilists have not wanted to accept a parallel claim about moral responsibility for omissions, and so they have accepted asymmetrical requirements on moral responsibility for actions and omissions. In previous work, I have presented a challenge to various attempts at defending this asymmetry. My view is that semicompatibilists should give up these defenses and instead adopt symmetrical requirements on moral responsibility for actions and omissions, (...) and in this paper I highlight three advantages of doing so: first, it avoids a strange implication of the truth of determinism; second, it allows for a principled reply to Philip Swenson’s recent ‘No Principled Difference Argument’; third, it provides a reason to reject a crucial inference rule invoked by Peter van Inwagen’s ‘Direct Argument’ for the incompatibility of moral responsibility and determinism. (shrink)

Algorithmic predictions are promising for insurance companies to develop personalized risk models for determining premiums. In this context, issues of fairness, discrimination, and social injustice might arise: Algorithms for estimating the risk based on personal data may be biased towards specific social groups, leading to systematic disadvantages for those groups. Personalized premiums may thus lead to discrimination and social injustice. It is well known from many application fields that such biases occur frequently and naturally when prediction models are applied to (...) people unless special efforts are made to avoid them. Insurance is no exception. In this paper, we provide a thorough analysis of algorithmic fairness in the case of insurance premiums. We ask what “fairness” might mean in this context and how the fairness of a premium system can be measured. For this, we apply the established fairness frameworks of the fair machine learning literature to the case of insurance premiums and show which of the existing fairness criteria can be applied to assess the fairness of insurance premiums. We argue that two of the often-discussed group fairness criteria, independence (also called statistical parity or demographic parity) and separation (also known as equalized odds), are not normatively appropriate for insurance premiums. Instead, we propose the sufficiency criterion (also known as well-calibration) as a morally defensible alternative that allows us to test for systematic biases in premiums towards certain groups based on the risk they bring to the pool. In addition, we clarify the connection between group fairness and different degrees of personalization. Our findings enable insurers to assess the fairness properties of their risk models, helping them avoid reputation damage resulting from potentially unfair and discriminatory premium systems. (shrink)

The case for secrecy in voting depends on the assumption that voters reliably vote for the political outcomes they want to prevail. No such assumption is valid. Accordingly, voting procedures should be designed to provide maximal incentive for voters to vote responsibly. Secret voting fails this test because citizens are protected from public scrutiny. Under open voting, citizens are publicly answerable for their electoral choices and will be encouraged thereby to vote in a discursively defensible manner. The possibility of bribery, (...) intimidation or blackmail moderates this argument but such dangers will be avoidable in many contemporary societies without recourse to secrecy. (shrink)