Amyotrophic lateral sclerosis (ALS; also called motor neuron disease) is a devastating medical condition that progressively robs patients of their ability to move, speak and eventually breathe. At present, many physicians are hesitant to propose tracheostomy and respiratory support in the terminal phase of ALS. In accordance with the principle of patient autonomy, physicians should respect the right of the ALS patient to accept or refuse any treatment, including mechanical ventilation. Also, in environments where euthanasia or physician-assisted death is legal, (...) such requests can be acceptable. At least two conditions are necessary for full autonomy. To have a claim on full autonomy, people need to have intact cognitive abilities, and to exercise this right they must be able to communicate. In the past, the first condition was in doubt (indeed, overlap with other neurodegenerative diseases is sometimes suspected and some patients with ALS are thought to have associated frontotemporal dementia) and the second was severely compromised in patients with devastating motor impairment (communication being limited to the twitch of a finger or the blink of an eye). In this issue of J Neurol Neurosurg Psychiatry, Lakerveld and colleagues1 investigated cognition in 11 patients with late stage ALS (see page 25). They showed preserved cognitive functioning (ie, language, executive function, intelligence, learning and long term memory) compared with healthy controls. Assessments were exclusively based on a ‘‘yes–no’’ response mode. Because of the absence of verbal and motor communication, the neuropsychological assessment of these patients is complicated, and adapted testing is needed. By using a ‘‘yes–no’’ response mode based on the remaining motor abilities of the patient, this study proves the possibility of assessing patients with minimal motor capacities. (shrink)

This paper critically evaluates Jonathan Lowe's arguments for his non-Cartesian substance dualism. Sections 1 and 2 set out the principal claims of NCSD. The unity argument proposed in Lowe is discussed in Section 3. Throughout his career Lowe offered spirited attacks on reductionism about the self. Section 4 evaluates the anti-reductionist argument that Lowe offers in Subjects of Experience, an argument based on the individuation of mental events. Lowe offers an inventive proposal that the semantic distinction between direct and indirect (...) reference delineates the metaphysical boundary between self and world, and uses this as a further argument against reductionism about the self. This proposal is discussed in Sections 5 and 6. (shrink)

I here respond to several points in Faucher and Machery’s vigorous and informative critique of my volitional account of racism (VAR). First, although the authors deem it a form of "implicit racial bias," a mere tendency to associate black people with "negative" concepts falls short of racial "bias" or prejudice in the relevant sense. Second, such an associative disposition need not even be morally objectionable. Third, even for more substantial forms of implicit racial bias such as race-based fear or disgust, (...) Faucher and Machery offer no account or explanation of when we should consider these racist, in whom, in what respect(s), or why. So, findings of implicit racial bias pose no clear objection to VAR. Fourth, because VAR allows not only racial hate, but also callous indifference, disdain, and other forms of racially driven disregard, to be racist,VAR is not "psychologically monist." Fifth, as VAR allows racist attitudes to be immoral in more than one way, offending against both the moral virtues of benevolence and justice, VAR is not "morally monist" either. I also reveal problems with some of Faucher and Machery’s other claims: Faucher and Machery take too narrow a conception of the types of psychology that can contribute to understanding racism; the internal complexity of hatred, which they approvingly mention, is irrelevant to VAR’s truth and undermines part of their criticism of VAR; whether some forms of racial bias are "racial ills" is irrelevant to VAR, which only analyzes racism; over-attention to implicit racial bias may cloak or exacerbate some of our society’s racial ills, or even constitute a new one. I conclude by noting that Faucher and Machery are not just critics of VAR but also allies of VAR in important controversies against those who insist racism lies primarily in social structures and institutions. (shrink)

Stephen Finlay’s proposed methodology for defending the central theses of his impressive Confusion of Tongues is an underexplored aspect of this work.1 1 His official methodology is analytic : A reduction of normative to non-normative vocabulary. Here, I argue that taking this official line at face-value forces the reader to conclude that the reductions at the heart of that book cannot be correct. In contrast, a philosophical methodology that does not proceed via analyses would better support those reductions, then understood (...) as non-analytic. As we’ll see below, there are independent, empirical reasons to reject a philosophical methodology that proceeds via analyses. I conclude that there is a method for the study of ethical language that better serves Finlay’s primary philosophical aims. The lesson, though, is generalizable: Given the array of normative and meta-normative theories, we want a semantics for normative discourse to be capable of expressing, we should expect that the more plausible such views will not be defended via analyses. (shrink)

The essay contrasts the thesis that deserved punishment is punishment which, as deserved, is obligatory with the weaker thesis that it is punishment which, as deserved, is permissible. The author first outlines an account of the meaning of desert-claims which entails only the weaker thesis and then defends this account against criticisms levied in a recent article that it is ambiguous, cannot explain the moral significance of desert, justifies letting people profit from their crimes, and permits unequal treatment. The essay (...) proceeds to a critique of George Sher's view of deserved punishment, faulting Sher for: (1) his reliance on an implausible understanding of benefits, (2) his inability to justify the punishment of crime-victims for their own crimes, and (3) the inadequacy of his defense of mercy. Finally, the author sketches a role-centered conception of morality within which it becomes clearer how deserved punishment can be justified as the victim's ties to the criminal, and the role-responsibilities derivative therefrom, are vitiated by the latter's misdeeds. (shrink)

Kant held that an agent can perform her moral duty only if she acts from a special incentive or motive, the sense of duty. Philosophers have objected to this, arguing that motives, intentions, and reasons are relevant in determining whether she acted well or evilly, virtuously or viciously, but not in determining whether she did her duty. Note that these arguments, if successful, would show not only that pace Kant, an agent can do her duty without acting from a sense (...) of duty, but more strongly, that she can do it even though her action was wickedly motivated or done with evil intentions. This stronger conclusion is, I think, false and in this essay I want to examine and criticize several arguments put forward in defense of the view that duty and virtue are so divorced from each other that one can discharge one’s moral duty and do what is morally right with a vicious action. (shrink)