That liberalism requires governments to be agnostic to at least some deeply-held commitments of their citizens is uncontroversial. Much less agreed-upon is why....

Background: Advance healthcare decision-making presumes that a prior treatment preference expressed with sufficient mental capacity ("T1 preference") should trump a contrary preference expressed after significant cognitive decline ("T2 preference"). This assumption is much debated in normative bioethics, but little is known about lay judgments in this domain. This study investigated participants' judgments about which preference should be followed, and whether these judgments differed depending on a first-person (deciding for one's future self) versus third-person (deciding for a friend or stranger) perspective.

In the Meno, Phaedo, and Phaedrus, Plato outlines the controversial thesis of a priori knowledge that all learning is a form of recollection—anamnesis. He uses this as an argument for the immortality of the soul via reincarnation. Because of this latter claim, the thesis is widely mocked by contemporary evolutionarily-informed materialists. But we can safely reject the metaphysical claim without abandoning the insight of the epistemological one. And indeed, modern evolutionary theory can explain how learning—at least of the sort that (...) depends on certain a priori concepts—can be a kind of recollection. Through this metaphor, natural selection is a process by which information about the world is transmitted across time. When we learn by reasoning about a priori knowledge, then, we in an important sense rely on information in our genomes—if not our souls—information acquired by the process of natural selection—if not conscious acquisition. Thinking of a priori knowledge with the metaphor of anamnesis elucidates two essential features of the relationship between epistemology and ontology. First, it emphasizes that there is necessarily a time-delay between our a priori knowledge and the universe to which it bears a relationship, if any. Second, it clarifies that a priori knowledge is knowledge that enhances reproductive fitness—which could well be because it reflects ontology faithfully, but could as easily be a kind of innate nominalism. (shrink)

As older people begin to develop dementia, we confront ethical questions about when and how to intervene in their increasingly compromised decision-making. The prevailing approach in bioethics to tackling this challenge has been to develop theories of “decision-making capacity” based on the same characteristics that entitle the decisions of moral persons to respect in general. This article argues that this way of thinking about the problem has missed the point. Because the disposition of property is an identity-dependent right, what matters (...) in dementia and decision-making is an individual’s personal identity with their prior self, not their moral personhood. Therefore, in considering when and how we ought to intervene in the decision-making of those with dementia, we must look to the philosophy of personal identity rather than personhood. (shrink)

Because dementia can cause individuals to make decisions that they otherwise would not, the law needs a mechanism to determine which decisions are entitled to the respect of the legal system and which may be overridden by others. In the philosophical literature, three primary theories for how to make this determination have been offered. First, "Cognitivism" posits that whether a decision should be recognized is a function of the mechanical functioning of the individual's brain at the time the decision is (...) made. Second, "Essentialism" holds that decisions should be recognized so long as they are consistent with the cluster of values and attributes that define the individual. Third, "Narrativism" argues that decisions should be respected where they follow from the life story of the individual making them.In the growing tradition of experimental philosophy, this Article empirically analyzes support for these three alternative theories in a mixed-methods study involving a population of American seniors, including an online survey (n=235) and interviews (n=25). Close analysis of the results revealed a near-consensus that Narrativism is the theoretical framework through which participants understood the question of when the legal system should intervene in private decision-making. In short, participants wanted the legal capacity to make decisions taken from them only when dementia became so advanced that they would no longer be the same person they previously had been, which they understood as a question of narrative continuity. (shrink)

When people develop dementia, their ability to make important decisions recognized by law—such as to change an estate plan, make a large purchase, or get married or divorced—is increasingly comprom...