In this case report, we describe a woman with advancing dementia who still retained decisional capacity and was able to clearly articulate her request for deactivation of her implanted cardiac pacemaker—a scenario that would result in her death. In this case, the patient had the autonomy to make her decision, but clinicians at an outside hospital refused to deactivate her pacemaker even though they were in unanimous agreement that the patient had capacity to make this decision, citing personal discomfort and (...) a belief that her decision seemed out of proportion to her suffering. We evaluated her at our hospital, found her to have decision-making capacity, and deactivated her pacer resulting in her death about 9 days later. While some clinicians may be comfortable discussing patient preferences for device deactivation in patients who are imminently dying, we can find no reports in the literature of requests for device deactivation from patients with terminal diagnoses who are not imminently dying. (shrink)

For paediatric medicine to advance, research must be conducted specifically with children. Concern about poor recruitment has led to debate about payments to child research participants. Although concerns about undue influence by such ‘compensation’ have been expressed, it is useful to determine whether children can relate the time and inconvenience associated with participation to the value of payment offered. This study explores children's ability to determine fair remuneration for research participation, and reviews payments to children participating in research. Forty children (...) were interviewed before outpatient visits at two London Hospitals: Great Ormond Street Children's Hospital and the Whittington Hospital District General Hospital. Children were asked to value their involvement in two hypothetical research scenarios – the first an ‘additional blood sample’, the second also involving daily oral oil capsules taken for a fortnight before further venesection. Background knowledge about familiarity with money, and experience with hospitalisation was assessed. The mean valuation of involvement in the second scenario (£13.18) was higher than in the first (£2.84) (p<0.001). This higher valuation persisted when children were categorised into groups ‘aged 12+’ and ‘below 12’. Those undergoing a blood test on the day placed a higher valuation on participation in the second scenario (£10.43, £21.67, p=0.044). These children aged 8–16 demonstrated the capacity to discern a fair valuation for participation in medical research. The monetary sums are influenced by the time and inconvenience involved in the research, and by the extent of recent experience with hospital procedures. The authors review current ethical thinking regarding payments to child research participants and suggest that a fair wage model might be an ethically acceptable way to increase participation of children in research. (shrink)

Prader-Willi syndrome (PWS) is one of the 25 syndromic forms of obesity, in which patients present—in addition to different degrees of obesity—intellectual disability, endocrine disturbs, hyperphagia and/or other signs of hypothalamic dysfunction. In front of a severe/extreme obesity and the failure of non-invasive treatments, bariatric surgery is proposed as a therapeutic option. The complexity of the clinical condition, which could affect the long-term effects of bariatric surgery, and the frequent association with a mild to severe intellectual disability raise some ethical (...) concerns in the treatment of obese PWS adolescents. This article analyses these issues referring to the principles of healthcare ethics: beneficence/non-maleficence (proportionality of treatments; minimisation of risks); respect of autonomy; justice. Based on these principles, three hypothetical scenarios are defined: (1) obese PWS adolescent, capable of making an autonomous decision; (2) obese PWS adolescent with a severe intellectual disability, whose parents agree with bariatric surgery; (3) obese PWS adolescent with a life-threatening condition and a severe intellectual disability, whose parents do not agree with bariatric surgery. The currently available evidence on efficacy and safety of bariatric surgery in PWS adolescents with extreme or severe obesity and the lack of adequate long-term follow-up suggests great caution even in a very life-threatening condition. Clinicians must always obtain a full IQ assessment of patients by psychologists. A multidisciplinary team is needed to analyse the clinical, psychological, social and ethical aspects and organise support for patient and parents, involving also the hospital ethical committee or, if necessary, legal authorities. (shrink)

Background This study used a scenario- and discussion-based approach to teach preclinical medical students the socio-philosophical aspects of psychiatry and qualitatively evaluated the learning outcomes in a medical humanities course in Taiwan. Methods The seminar session focused on three hypothetical psychiatry cases. Students discussed the cases in groups and were guided by facilitators from multiple disciplines and professions. At the end of the semester, students submitted a narrative report comprising their reflections on the cases and discussions. The authors utilized (...) content analysis to categorize students’ narratives into three facets, namely, the philosophical, social and individual. Results In total 163 preclinical medical students participated in the class; 150 of them mentioned the scenario-based lesson in their reports; 33.3% of these reports discussed the case at the philosophical dimension (n = 50), 45.3% at the social dimension (n = 68), and 26.6% at the individual dimension (n = 40). Four major themes emerged: (1) a psychiatric diagnosis has far-reaching consequences for an individual’s life, (2) the social structure affects how patients experience psychiatric disorders, (3) students related personal experience or those of friends and family to understand psychiatric disorders, and (4) medical humanities are of particular importance in psychiatric education. Conclusions This study demonstrated that the scenario-based discussions led by a multidisciplinary team of facilitators can benefit medical students with limited clinical experience to contemplate the socio-philosophical aspects of psychiatry. The authors suggest that this pedagogical model during preclinical education should be encouraged. (shrink)

This study investigated the attitudinal responses of 403 undergraduate students with respect to nine hypothetical marketing moral dilemmas. Participants varied by gender, major, and age.It was found that undergraduate women responded more ethically on the hypothetical marketing moral dilemmas, as hypothesized. Secondly, chosen major did not make a difference on cognitive, affective, or behavioral responses. Further, the overall means for each scenario were in the morally correct direction in every case. Also, all intercorrelations for each story were significant. (...) Finally, whenever there was a nonchance finding for age, the oldest participants answered more morally than the youngest subjects. (shrink)

Using student self-reported cheating admissions and answers from a hypothetical cheating scenario, this paper analyzes the effects of individual and situational factors on potential cheating behavior. Results confirm several conclusions about student factors that are related to cheating. The probability of cheating is associated with younger students, lower GPAs, alcohol consumption, fraternity/sorority membership, and having cheated in high school. Student perceptions of the certainty and severity of punishment appear to have a negative and significant impact on the probability of (...) cheating on in-class assignments. Students who report a belief that cheating is never acceptable appear to be significantly less likely to cheat in any circumstance. This study illustrates the context-dependent nature of academic dishonesty, and the associated difficulty in understanding the relationships between measurable factors and cheating behavior. (shrink)

In the present super-aging society, issues concerning what treatment should be given for incapacitated patients have become more important than ever before. This paper discusses whether or not an incapacitated patient’s refusal of treatment should be respected. The authors present a complete hypothetical scenario involving a 75-year-old moderately demented man suffering from malignant lymphoma. Of primary importance are the respect for patient dignity and the protection of human rights. Acts such as coercion, disregard, restriction, and surveillance can be unethical (...) in many situations. The effectiveness of chemotherapy for malignant lymphoma and its adverse outcomes could offset each other, leaving no net benefits for the patient. The patient is vulnerable and this very vulnerability requires the utmost protection and care. However, protection must be sensitive and comprehensive and the protection of his life at the expense of many other valuable factors is not justifiable. Coercing unwanted treatment would be intrusion, not protection, because of the physical and psychological suffering. When the refusal is explicit, consistent, and stable enough, it should to be viewed as true and current desire. Due to moderate dementia, the patient has lost his rational capacity, but his emotional capacity remains. If the remaining portion of his personality is rooted in his feelings, these feelings should be respected as much as possible. Those involved in the care of the patients who refuse treatment should not force them to undergo it simply on the grounds that it may be an established standard in their own country. What must be asked first is whether or not forced treatment would promote the patient’s subjective well-being. Additionally, treatment decisions should not be distorted due to the selfishness or discriminatory feelings of those involved in his care. In situations in which patients lack decisionmaking capacities, overriding the patients’ refusals of treatment should be regarded as an exception, rather than a standard course of action. Even in patients who are incapacitated, treatment refusal could stem from the feelings of the individual. Their subjective wellbeing would not be improved through close observation, restraint, denial, and coercion, the purpose of which they does not understand. (shrink)

Causal and predictive learning research often employs intuitive and familiar hypothetical scenarios to facilitate learning novel relationships. The allergist task, in which participants are asked to diagnose the allergies of a fictitious patient, is one example of this. In such studies, it is common practice to ask participants to ignore their existing knowledge of the scenario and make judgments based only on the relationships presented within the experiment. Causal judgments appear to be sensitive to instructions that modify assumptions (...) about the scenario. However, the extent to which prior knowledge continues to affect competition for associative learning, even after participants are instructed to disregard it, is unknown. To answer this, we created a cue competition design that capitalized on prevailing beliefs about the allergenic properties of various foods. High and low allergenic foods were paired with foods moderately associated with allergy to create two compounds; high + moderate and low + moderate. We expected high allergenic foods to produce greater competition for associative memory than low allergenic foods. High allergenic foods may affect learning either because they generate a strong memory of allergy or because they are more salient in the context of the task. We therefore also manipulated the consistency of the high allergenic cue-outcome relationship with prior beliefs about the nature of the allergies. A high allergenic food that is paired with an inconsistent allergenic outcome should generate more prediction error and thus more competition for learning, than one that is consistent with prior beliefs. Participants were instructed to either use or ignore their knowledge of food allergies to complete the task. We found that while participants were able to set aside their prior knowledge when making causal judgments about the foods in question, associative memory was weaker for the cues paired with highly allergenic foods than cues paired with low allergenic foods regardless of instructions. The consistency manipulation had little effect on this result, suggesting that the effects in associative memory are most likely driven by selective attention to highly allergenic cues. This has implications for theories of causal learning as well as the way causal learning tasks are designed. (shrink)

Trolley problems have been used in the development of moral theory and the psychological study of moral judgments and behavior. Most of this research has focused on people from the West, with implicit assumptions that moral intuitions should generalize and that moral psychology is universal. However, cultural differences may be associated with differences in moral judgments and behavior. We operationalized a trolley problem in the laboratory, with economic incentives and real-life consequences, and compared British and Chinese samples on moral behavior (...) and judgment. We found that Chinese participants were less willing to sacrifice one person to save five others, and less likely to consider such an action to be right. In a second study using three scenarios, including the standard scenario where lives are threatened by an on-coming train, fewer Chinese than British participants were willing to take action and sacrifice one to save five, and this cultural difference was more pronounced when the consequences were less severe than death. (shrink)

We conducted focus groups with 47 potential jurors who were presented with diferent scenarios in a hypothetical malpractice case involving failure to order a PSA test. Better documentation that a patient made an informed decision to decline a PSA test appeared to provide more medical-legal protection for physicians, especially with the use of a decision aid.

The present study explored the relationship between attitudes toward transgender individuals and the judgments people make in transgression scenarios involving transgender and cisgender individuals of different ages in a sample of 184 Romanian students. We used a mixed-method approach and tested the effect of gender identity on participants' punishments in a hypothetical transgression. In hypothetical transgressions involving preadolescent transgender and cisgender agents, results suggested no differences in participants' theft punishments. However, adult cisgender transgressors received significantly harsher punishments (...) compared to transgender transgressors. Our qualitative analyses suggested that the most frequent categories of responses justifying the punishments confirmed the importance of the agent's age. Our findings suggested no significant associations between participants' gender and reported the previous contact with an LGBTQ member and the punishments they chose for child and adult transgressors. Results are discussed in light of their implication in the contemporary, highly LGBTQ intolerant Romanian context. (shrink)

We present a hypothetical process of mind coalescence, where arti cial connections are created between two or more brains. This might simply allow for an improved form of communication. At the other extreme, it might merge the minds into one in a process that can be thought of as a reverse split-brain operation. We propose that one way mind coalescence might happen is via an exocortex, a prosthetic extension of the biological brain which integrates with the brain as seamlessly (...) as parts of the biological brain integrate with each other. An exocortex may also prove to be the easiest route for mind uploading, as a person's personality gradually moves away from the aging biological brain and onto the exocortex. Memories might also be copied and shared even without minds being permanently merged. Over time, the borders of personal identity may become loose or even unnecessary. (shrink)

OBJECTIVE: How outside factors affect physician decision making remains an open question of vital importance. We sought to investigate the importance of various influences on physician decision making when clinical guidelines differ from patient preference. -/- METHODS: An online survey asking 469 primary care providers (PCPs) across four practice sites whether they would order magnetic resonance imaging for a patient with uncomplicated back pain. Participants were randomized to one of four scenarios: a patient's preference for imaging (control), a patient's (...) preference plus a colleague's opinion against imaging (colleague), a patient's preference plus a professional society's recommendation against imaging (profession), or a patient's preference plus an accountable care organization's quality metric that measures physician use of imaging (ACO). Demographic information and the reasoning behind participants' decisions also were obtained. -/- RESULTS: A total of 168 PCPs completed the survey, yielding a 36% completion rate. A majority chose not to pursue imaging: control 68%, colleague 85%, profession 87%, and ACO 78%. Multivariate logistic regression revealed that participants were more likely not to order advanced imaging only when reminded of a professional society recommendation (P = 0.017). Regression also suggested that practice site exerted an effect on the primary outcome. Evidence-based medicine and clinical judgment were the most cited reasons for the decision. -/- CONCLUSIONS: Our results reinforce the potential to leverage professional societies to advance evidence-based medicine and reduce unnecessary testing. At the same time, practice site appeared to exert influence, suggesting that these recommendations must be part of local institutional culture to be effective. (shrink)

Many investigations of moral decision-making employ hypothetical scenarios in which each participant has to choose between two options. One option is usually deemed “utilitarian” and the other either “non-utilitarian” or “deontological”. Very little has been done to establish the validity of such measures. It is unclear what they measure, let alone how well they do so. In this exploratory study, participants were asked about the reasons for their decisions in six hypothetical scenarios. Various concerns contributed to (...) each decision. Action decisions occurred when utilitarian concerns dominated. Bystanding decisions resulted from different concerns or combinations of concerns dominating in different situations, with utilitarianism usually among participants’ concerns. None of the labels usually used for either decision therefore seems entirely appropriate. Five concerns were identified as necessary and sufficient to predict over 85% of participants’ decisions. This suggests great promise for future research, particularly in investigation of real-world moral decisions. (shrink)

Hypothetical trolley problems are widely used to elicit moral intuitions, which are employed in the development of moral theory and the psychological study of moral judgments. The scenarios used are outlandish, and some philosophers and psychologists have questioned whether the judgments made in such unrealistic and unfamiliar scenarios are a reliable basis for theory-building. We present two experiments that investigate whether differences in moral judgment due to the role of the agent, previously found in a standard trolley (...) scenario, persist when the structure of the problem is transplanted to a more familiar context. Our first experiment compares judgments in hypothetical scenarios; our second experiment operationalizes some of those scenarios in the laboratory, allowing us to observe judgments about decisions that are really being made. In the hypothetical experiment, we found that the role effect reversed in our more familiar context, both in judgments about what the actor ought to do and in judgments about the moral rightness of the action. However, in our laboratory experiment, the effects reversed back or disappeared. Among judgments of what the actor ought to do, we found the same role effect as in the standard hypothetical trolley scenario, but the effect of role on moral judgments disappeared. (shrink)

Hypothetical trolley problems are widely used to elicit moral intuitions, which are employed in the development of moral theory and the psychological study of moral judgments. The scenarios used are outlandish, and some philosophers and psychologists have questioned whether the judgments made in such unrealistic and unfamiliar scenarios are a reliable basis for theory-building. We present two experiments that investigate whether differences in moral judgment due to the role of the agent, previously found in a standard trolley (...) scenario, persist when the structure of the problem is transplanted to a more familiar context. Our first experiment compares judgments in hypothetical scenarios; our second experiment operationalizes some of those scenarios in the laboratory, allowing us to observe judgments about decisions that are really being made. In the hypothetical experiment, we found that the role effect reversed in our more familiar context, both in judgments about what the actor ought to do and in judgments about the moral rightness of the action. However, in our laboratory experiment, the effects reversed back or disappeared. Among judgments of what the actor ought to do, we found the same role effect as in the standard hypothetical trolley scenario, but the effect of role on moral judgments disappeared. (shrink)

The hypothetical scenarios generally known as trolley problems have become widespread in recent moral philosophy. They invariably require an agent to choose one of a strictly limited number of options, all of them bad. Although they don’t always involve trolleys / trams, and are used to make a wide variety of points, what makes it justified to speak of a distinctive “trolley method” is the characteristic assumption that the intuitive reactions that all these artificial situations elicit constitute an (...) appropriate guide to real-life moral reasoning. I dispute this assumption by arguing that trolley cases inevitably constrain the supposed rescuers into behaving in ways that clearly deviate from psychologically healthy, and morally defensible, human behavior. Through this focus on a generally overlooked aspect of trolley theorizing – namely, the highly impoverished role invariably allotted to the would-be rescuer in these scenarios – I aim to challenge the complacent twin assumptions of advocates of the trolley method that this approach to moral reasoning has practical value, and is in any case innocuous. Neither assumption is true. (shrink)

Through hypothetical scenarios, this paper analyses whether machine learning (ML) could resolve one of the main shortcomings present in Christopher Boorse’s Biostatistical Theory of health (BST). In doing so, it foregrounds the boundaries and challenges of employing ML in formulating a naturalist (i.e., prima facie value-free) definition of health. The paper argues that a sweeping dataist approach cannot fully make the BST truly naturalistic, as prior theories and values persist. It also points out that supervised learning introduces circularity, (...) rendering it incompatible with a naturalistic perspective. Additionally, it underscores the need for pre-existing auxiliary theories to assess results from unsupervised learning. It emphasizes the importance of understanding the epistemological entanglements between data and data processing methods to manage expectations about what data patterns can predict. In conclusion, the paper argues against delegating the final authority for defining complex concepts like health to AI systems, as it necessitates ethical judgment and capacities for deliberation that AI currently lacks. It also warns against granting creators and deployers of AI systems the discretionary authority to determine these definitions outside the wider social discussion, advocating for ongoing public engagement on normative notions. Failure to do so risks limiting individuals and collectives’ ability to shape a just digital future and diminishes their fundamental epistemic agency. (shrink)

A hypothetical scenario is presented in which a female patient is admitted to a private hospital to undergo a mastectomy and breast reconstruction. The surgeons and anaesthetists conducting the different procedures charge three times the medical aid rates. When the patient asks what the co-payments are likely to be, she is informed by the doctors’ accounts section that they can only provide this information after each procedure. The patient’s medical scheme also advises her that it cannot determine the likely (...) co-payments unless she completes the assessment form sent to her. The form requires her to include the costs reflected against the relevant ICD10 codes. The patient cannot complete the form because the doctors’ accounts sections have not informed her about the proposed procedures and the likely costs of each. This article builds on a previous article discussing doctors’ overarching responsibility to disclose medical treatment costs in advance. The present article outlines the legal requirements in the South African Constitution, the National Health Act and the Health Professions Act, and refers to the Promotion of Access to Information Act and Consumer Protection Act. Similar to the earlier article, this article addresses the ethical requirements of the Health Professions Council of South Africa and the internationally recognised biomedical ethical principles. Furthermore, it also refers to the National Patients Charter, the government’s policy document on health care services. (shrink)

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)

In this article, I use Edmund Gettier’s Ten Coins hypothetical scenario to illustrate some reasoning errors in the use of definite descriptions. The Gettier problem, central as it is to modern epistemology, is first and foremost an argument, which Gettier (Analysis 23(6):121–123, 1963) constructs to prove a contrary conclusion to a widely held view in epistemology. Whereas the epistemological claims in the case have been extensively analysed conceptually, the strategies and tools from other philosophical disciplines such as analytic philosophy (...) of language, logic and argumentation that Gettier deploys in the case have scarcely received any attention. This work abstracts from the epistemological content and examines Gettier’s handling of the definite description involved, and how that affects the cogency of his argument. (shrink)

Consider this hypothetical scenario involving a choice not to vaccinate a child. Ms. S has a niece who is autistic. The girl's parents are suspicious that there is some relationship between her autism and her Measles Mumps and Rubella vaccination. They have shared their concerns with Ms. S. She then declines to have her own daughter, Jinny S., vaccinated with the MMR vaccine. To bypass the state's mandatory vaccination requirement, Ms. S claims a state-legislated philosophical exemption, whereby she simply (...) attests to the fact that she is opposed to vaccinating her daughter due to a conscientiously held belief. At the age of four, Jinny goes on a trip by airplane to Germany with her mother. After returning to the United States, she attends daycare despite having some mild cold symptoms. Subsequently, she develops a classic measles rash, at which point her mother brings her to a pediatrician and keeps her home from daycare. (shrink)

1. Imagine the following hypothetical scenario: Sarah is often called an expert on depression: after all, she graduated from medical school and has a PhD in neuroscience. She knows all theories of...

We examined the effects of order of presentation on the moral judgments of professional philosophers and two comparison groups. All groups showed similar-sized order effects on their judgments about hypothetical moral scenarios targeting the doctrine of the double effect, the action-omission distinction, and the principle of moral luck. Philosophers' endorsements of related general moral principles were also substantially influenced by the order in which the hypothetical scenarios had previously been presented. Thus, philosophical expertise does not appear (...) to enhance the stability of moral judgments against this presumably unwanted source of bias, even given familiar types of cases and principles. (shrink)

Counterfactual reasoning -- envisioning hypothetical scenarios, or possible worlds, where some circumstances are different from what (f)actually occurred (counter-to-fact) -- is ubiquitous in human cognition. Conventionally, counterfactually-altered circumstances have been treated as "small miracles" that locally violate the laws of nature while sharing the same initial conditions. In Pearl's structural causal model (SCM) framework this is made mathematically rigorous via interventions that modify the causal laws while the values of exogenous variables are shared. In recent years, however, this (...) purely interventionist account of counterfactuals has increasingly come under scrutiny from both philosophers and psychologists. Instead, they suggest a backtracking account of counterfactuals, according to which the causal laws remain unchanged in the counterfactual world; differences to the factual world are instead "backtracked" to altered initial conditions (exogenous variables). In the present work, we explore and formalise this alternative mode of counterfactual reasoning within the SCM framework. Despite ample evidence that humans backtrack, the present work constitutes, to the best of our knowledge, the first general account and algorithmisation of backtracking counterfactuals. We discuss our backtracking semantics in the context of related literature and draw connections to recent developments in explainable artificial intelligence (XAI). (shrink)

Intuition—spontaneous, nondeliberative assessment—has long been indispensable in theoretical and practical philosophy alike. Recent research by psychologists and experimental philosophers has challenged our understanding of the nature and authority of moral intuitions by tracing them to “fast,” “automatic,” “button-pushing” responses of the affective system. This view of the affective system contrasts with a growing body of research in affective neuroscience which suggests that it is instead a flexible learning system that generates and updates a multidimensional evaluative landscape to guide decision and (...) action. With this latter view in mind, I revisit some of the classic hypothetical scenarios used in experimental moral psychology. (shrink)

The notion of risk plays a central role in economics, finance, health, psychology, law and elsewhere, and is prevalent in managing challenges and resources in day-to-day life. In recent work, Duncan Pritchard (2015, 2016) has argued against the orthodox probabilistic conception of risk on which the risk of a hypothetical scenario is determined by how probable it is, and in favour of a modal conception on which the risk of a hypothetical scenario is determined by how modally close (...) it is. In this article, we use Pritchard’s discussion as a springboard for a more wide-ranging discussion of the notion of risk. We introduce three different conceptions of risk: the standard probabilistic conception, Pritchard’s modal conception, and a normalcy conception that is new (though it has some precursors in the psychological literature on risk perception). Ultimately, we argue that the modal conception is ill-suited to the roles that a notion of risk is required to play and explore the prospects for a form of pluralism about risk, embracing both the probabilistic and the normalcy conceptions. (shrink)

Philosophy and science employ abstract hypothetical scenarios- thought experiments - to illustrate, defend, and dispute theoretical claims. Since thought experiments furnish no new empirical observations, the method prompts two epistemological questions: whether anything may be learnt from the merely hypothetical, and, if so, how. Various sceptical arguments against the use of thought experiments in philosophy are discussed and criticized. The thesis that thought experiments in science provide a priori knowledge through non-sensory grasping of abstract entities is discussed (...) and rejected. The thesis that thought experimentation consists in manipulations of mental models is examined and found to be of limited epistemological relevance. It is argued that thought experiments are associated with characteristic arguments in a manner similar to ordinary experiments. It is further argued that thought experiments function in the same way as experiments in general: by providing premises for their associated arguments. Like other experiments, a thought experiment is successful when the premises it provides are true. This holds both for philosophical and scientific thought experiments. An argument schema is proposed and shown to be a formal analogue to that associated with ordinary experiments; similar in being subject to epistemological holism; but differing in being modal: in employing statements about possibility and necessity. The evaluation of thought experiments thus depends on how modal statements may be justified. Intuition and conceivability are discussed as sources of modal justification and found problematic. Instead it is suggested that evaluation proceed by accommodation of the statements describing the experiment's hypothetical scenario. The method of accommodation is developed and applied to five influential thought experiments in philosophy: the brain in a vat; Putnam's Twin Earth; Burge's arthritis example; Searle's Chinese Room; and Newcomb's problem. Its application shows some of these to be failed, others to be successful only relative to controversial philosophical doctrines. (shrink)

Full ectogenesis as the complete externalization of human reproduction by bypassing the bodily processes of gestation and childbirth can be considered the culmination of genetic and reproductive technologies. Despite its still being a hypothetical scenario, it has been discussed for decades as the ultimate means to liberate women from their reproductive tasks in society and hence finally end fundamental gender injustices generally. In the debate about the application of artificial wombs to achieve gender equality, one aspect is barely mentioned (...) but is of crucial relevance from a medical‐ethical perspective: whether and how could full ectogenesis be justified as a proper use of medicine? After characterizing the technology as a special form of human enhancement and as an extension of medical practice that goes beyond the traditional field of medicine, this paper critically assesses the theoretical possibilities of legitimizing this extension. We identify two ways of justification: either one argues that ectogenesis fulfils a proper goal of medicine (a justification we call pathologization), or one argues that the application of ectogenesis achieves a non‐medical goal (which we call medicalization). Because it is important from a medical‐ethical point of view to avoid an inappropriate instrumentalization or misuse of medicine and thus an undue medicalization of non‐medical problems, a set of necessary conditions has to be met. It is doubtful whether full ectogenesis for non‐medical purposes could fulfil these conditions. Rather, its comprehensive usage could be seen as a revolutionary modification of what it means to be human. (shrink)

Frank Jackson often writes as if his descriptivist account of public language meanings were just plain common sense. How else are we to explain how different speakers manage to communicate using a public language? And how else can we explain how individuals arrive at confident judgments about the reference of their words in hypothetical scenarios? Our aim in this paper is to show just how controversial the psychological assumptions behind in Jackson’s semantic theory really are. First, we explain (...) how Jackson’s theory goes well beyond the commonsense platitudes he cites in its defence. Second, we sketch an alternative explanation of those platitudes, the jazz model of meaning, which we argue is more psychologically realistic. We conclude that the psychological picture presupposed by Jackson’s semantic theory stands in need of a much more substantial defence than he has so far offered. (shrink)

A growing body of empirical evidence suggests that folk knowledge attribution practices regarding some epistemological thought experiments differ significantly from the consensus found in the philosophical literature. More specifically, laypersons are likely to ascribe knowledge in the so-called Authentic Evidence Gettier-style cases, while most philosophers deny knowledge in these cases. The intuitions shared by philosophers are often used as evidence in favor (or against) certain philosophical analyses of the notion of knowledge. However, the fact that these intuitions are not universal, (...) as non-philosophers do not sympathize with verdicts made by philosophers, is problematic and requires some explanation. Recently, a promising theoretical approach emerged that could be used to explain away unexpected folk knowledge attributions. According to the protagonist projection hypothesis, when subjects answer questions about some hypothetical scenario, their judgments might result from adopting the cognitive perspective of the protagonist in the given scenario. Previous experimental findings suggest protagonist projection might be responsible for problematic knowledge attributions in Gettier-style cases. This paper reports data collected in an experiment which focused on five different Authentic Evidence Gettier-style scenarios and investigated the impact of protagonist projection on folk knowledge ascriptions in such cases. The results bring some support to the protagonist projection hypothesis, but do not allow to explain away a substantial number of problematic folk knowledge attributions. (shrink)

I suggest that the social justice issues raised by Internet regulation can be exposed and examined by using a methodology adapted from that described by John Rawls in 'A Theory of Justice'. Rawls' theory uses the hypothetical scenario of people deliberating about the justice of social institutions from the 'original position' as a method of removing bias in decision-making about justice. The original position imposes a 'veil of ignorance' that hides the particular circumstances of individuals from them so that (...) they will not be influenced by self-interest. I adapt Rawls' methodology by introducing an abstract description of information technology to those deliberating about justice from within the original position. This abstract description focuses on computing devices that users can use to access information and information networks that information devices use to communicate. The abstractness of this description prevents the particular characteristics of the Internet and the computing devices in use from influencing the decisions about the just use and regulation of information technology and networks. From this abstract position, the principles of justice that the participants accept for the rest of society will also apply to the computing devices people use to communicate, and to Internet regulation. (shrink)

Thought experiments invite us to evaluate philosophical theses by making judgements about hypothetical cases. When the judgements and the theses conflict, it is often the latter that are rejected. But what is the nature of the judgements such that they are able to play this role? I answer this question by arguing that typical judgements about thought experiments are in fact judgements of normal counterfactual sufficiency. I begin by focusing on Anna-Sara Malmgren’s defence of the claim that typical judgements (...) about thought experiments are mere possibility judgements. This view is shown to fail for two closely related reasons: it cannot account for the incorrectness of certain misjudgements, and it cannot account for the inconsistency of certain pairs of conflicting judgements. This prompts a reconsideration of Timothy Williamson’s alternative proposal, according to which typical judgements about thought experiments are counterfactual in nature. I show that taking such judgements to concern what would normally hold in instances of the relevant hypothetical scenarios avoids the objections that have been pressed against this kind of view. I then consider some other potential objections, but argue that they provide no grounds for doubt. (shrink)

This chapter considers how imagination generates emotion. ‘Supposition-imagination’ (S-imagination) is distinguished from ‘enactment-imagination’ (E-imagination). The former kind of imagination involves entertaining or supposing various hypothetical scenarios; with the latter kind of imagination, one tries to create a kind of facsimile of a mental state. Thus, one might try to create a perception-like state as in visual imagination or motoric imagination. It is argued that this much richer form of imagination generates typical emotional reactions to fiction. Emotional reactions to (...) fiction are generated in several different ways, including a process in which we E-imagine being a hypothetical reader or observer of fact. (shrink)

Merchant and Rockness (1994, p. 92) characterize earnings management as "probably the most important ethical issue facing the accounting profession" and provide initial evidence of the ethical judgments of various organizational members. The current study extends their work by examining the extent to which an individual''s ethically-related judgments in response to earnings management activities are associated with the individual''s role.In an experimental study, evening MBA students read three hypothetical scenarios involving a manager engaging in earnings management. The (...) class='Hi'>scenarios involved a gain from an operating activity, a gain from an accounting activity, and a loss from an accounting activity. Before reading the cases, however, participants were randomly assigned to one of three roles: a shareholder, another manager from the company who is unfamiliar with the manager in the case, or another manager from the company who is familiar with the manager in the case. Following each case, participants made four ethically related judgments. (shrink)

Is it a stronger interference with people's freedom to withdraw options they currently have than to withhold similar options they do not have? Drawing on recent theorizing about sociopolitical freedom, this article identifies considerations that often make this the case for public policy. However, when applied to tobacco control, these considerations are shown to give us at best only very weak freedom-based reason to prioritize the status quo. This supports a popular argument for so-called “endgame” tobacco control measures: If we (...) believe that cigarettes would and should be withheld from entering markets in hypothetical scenarios in which they do not yet exist, then we also have reason to seek their abolition in situations, such as ours, in which cigarettes do exist—if necessary by banning their sale. The same considerations are then used to disarm objections that have recently been raised to using nudges in public policy. (shrink)

Health research increasingly relies on organized collections of health data and biological samples. There are many types of sample and data collections that are used for health research, though these are collected for many purposes, not all of which are health-related. These collections exist under different jurisdictional and regulatory arrangements and include: 1) Population biobanks, cohort studies, and genome databases 2) Clinical and public health data 3) Direct-to-consumer genetic testing 4) Social media 5) Fitness trackers, health apps, and biometric data (...) sensors Population biobanks, cohort studies, and genome databases Clinical and public health data Direct-to-consumer genetic testing Social media Fitness trackers, health apps, and biometric data sensors Ethical, legal, and social challenges of such collections are well recognized, but there has been limited attention to the broader societal implications of the existence of these collections. Although health research conducted using these collections is broadly recognized as beneficent, secondary uses of these data and samples may be controversial. We examine both documented and hypothetical scenarios of secondary uses of health data and samples. In particular, we focus on the use of health data for purposes of: Forensic investigations Civil lawsuits Identification of victims of mass casualty events Denial of entry for border security and immigration Making health resource rationing decisions Facilitating human rights abuses in autocratic regimes Forensic investigations Civil lawsuits Identification of victims of mass casualty events Denial of entry for border security and immigration Making health resource rationing decisions Facilitating human rights abuses in autocratic regimes Current safeguards relating to the use of health data and samples include research ethics oversight and privacy laws. These safeguards have a strong focus on informed consent and anonymization, which are aimed at the protection of the individual research subject. They are not intended to address broader societal implications of health data and sample collections. As such, existing arrangements are insufficient to protect against subversion of health databases for non-sanctioned secondary uses, or to provide guidance for reasonable but controversial secondary uses. We are concerned that existing debate in the scholarly literature and beyond has not sufficiently recognized the secondary data uses we outline in this paper. Our main purpose, therefore, is to raise awareness of the potential for unforeseen and unintended consequences, in particular negative consequences, of the increased availability and development of health data collections for research, by providing a comprehensive review of documented and hypothetical non-health research uses of such data. (shrink)

Certain characteristics make machine learning a powerful tool for processing large amounts of data, and also particularly unsuitable for explanatory purposes. There are worries that its increasing use in science may sideline the explanatory goals of research. We analyze the key characteristics of ML that might have implications for the future directions in scientific research: epistemic opacity and the ‘theory-agnostic’ modeling. These characteristics are further analyzed in a comparison of ML with the traditional statistical methods, in order to demonstrate what (...) it is specifically that makes ML methodology substantially unsuitable for reaching explanations. The analysis is given broader philosophical context by connecting it with the views on the role of prediction and explanation in science, their relationship, and the value of explanation. We proceed to show, first, that ML disrupts the relationship between prediction and explanation commonly understood as a functional relationship. Then we show that the value of explanation is not exhausted in purely predictive functions, but rather has a ubiquitously recognized value for both science and everyday life. We then invoke two hypothetical scenarios with different degrees of automatization of science, which help test our intuitions on the role of explanation in science. The main question we address is whether ML will reorient or otherwise impact our standard explanatory practice. We conclude with a prognosis that ML would diversify science into purely predictively oriented research based on ML-like techniques and, on the other hand, remaining faithful to anthropocentric research focused on the search for explanation. (shrink)

Deutsch 2010 (The Review of Philosophy and Psychology 1: 447–460) claims that hypothetical scenarios are evaluated using arguments, not intuitions, and therefore experiments on intuitions are philosophically inconsequential. Using the Gettier case as an example, he identifies three arguments that are supposed to point to the right response to the case. In the paper, I present the results of studies ran on Polish, Indian, Spanish, and American participants that suggest that there’s no deep difference between evaluating the Gettier (...) case with intuitions and evaluating it with Deutsch’s arguments. Specifically, I argue that one would find these arguments persuasive if and only if one is already disposed to exhibit the relevant intuition. (shrink)

In, “The Turing Triage Test”, published in Ethics and Information Technology, I described a hypothetical scenario, modelled on the famous Turing Test for machine intelligence, which might serve as means of testing whether or not machines had achieved the moral standing of people. In this paper, I: (1) explain why the Turing Triage Test is of vital interest in the context of contemporary debates about the ethics of AI; (2) address some issues that complexify the application of this test; (...) and, (3) in doing so, defend a way of thinking about the question of the moral standing of intelligent machines, which takes the idea of “seriousness” seriously. This last objective is, in fact, my primary one and is motivated by the sense that, to date, much of the “philosophy” of AI has suffered from a profound failure to properly distinguish between things that we can say and things that we can really mean. (shrink)

To assist in resolving ethical questions surrounding unregulated mHealth research, we conducted in-depth qualitative interviews with experts from four key stakeholder groups: patient/research advocates, researchers, regulatory professionals, and mobile app/device developers. They discussed challenges and potential solutions in the context of two hypothetical scenarios involving unregulated mHealth research, including notifications/permissions for research use of mHealth data, data access procedures, new primary data collection, offering individual research results, and data sharing and dissemination.

In modal subordination, a modal sentence is interpreted relative to a hypothetical scenario introduced in an earlier sentence. In this paper, I argue that this phenomenon reflects the fact that the interpretation of modals is an ANAPHORIC process. Modal morphemes introduce sets of possible worlds, representing alternative hypothetical scenarios, as entities into the discourse model. Their interpretation depends on evoking sets of worlds recording described and reference scenarios, and relating such sets to one another using familiar (...) notions of restricted, preferential quantification. This proposal relies on an extended model of environments in dynamic semantics to keep track of associations between possible worlds and ordinary individuals; it assumes that modal meanings and other lexical meanings encapsulate quantification over possible worlds. These two innovations are required in order for modals to refer to sets of possible worlds directly as static objects in place of the inherently dynamic objects—quite different from the referents of pronouns and tenses—used in previous accounts. The simpler proposal that results offers better empirical coverage and suggests a new parallel between modal and temporal interpretation. (shrink)

Background: Due to recent legislations on euthanasia and its current practice in the Netherlands and Belgium, issues of end-of-life medicine have become very vital in many European countries. In 2002, the Ethics Working Group of the German Association for Palliative Medicine (DGP) has conducted a survey among its physician members in order to evaluate their attitudes towards different end-of-life medical practices, such as euthanasia (EUT), physician-assisted suicide (PAS), and terminal sedation (TS). Methods: An anonymous questionnaire was sent to the 411 (...) DGP physicians, consisting of 14 multiple choice questions on positions that might be adopted in different hypothetical scenarios on situations of “intolerable suffering” in end-of-life care. For the sake of clarification, several definitions and legal judgements of different terms used in the German debate on premature termination of life were included. For statistical analysis t-tests and Pearson-correlations were used. Results: The response rate was 61% (n=251). The proportions of the respondents who were opposed to legalizing different forms of premature termination of life were: 90% opposed to EUT, 75% to PAS, 94% to PAS for psychiatric patients. Terminal sedation was accepted by 94% of the members. The main decisional bases drawn on for the answers were personal ethical values, professional experience with palliative care, knowledge of alternative approaches, knowledge of ethical guidelines and of the national legal frame. Conclusions: In sharp contrast to similar surveys conducted in other countries, only a minority of 9.6% of the DGP physicians supported the legalization of EUT. The misuse of medical knowledge for inhumane killing in the Nazi period did not play a relevant role for the respondents’ negative attitude towards EUT. Palliative care needs to be stronger established and promoted within the German health care system in order to improve the quality of end-of-life situations which subsequently is expected to lead to decreasing requests for EUT by terminally ill patients. (shrink)

There is a vast literature that seeks to uncover features underlying moral judgment by eliciting reactions to hypothetical scenarios such as trolley problems. These thought experiments assume that participants accept the outcomes stipulated in the scenarios. Across seven studies, we demonstrate that intuition overrides stipulated outcomes even when participants are explicitly told that an action will result in a particular outcome. Participants instead substitute their own estimates of the probability of outcomes for stipulated outcomes, and these probability (...) estimates in turn influence moral judgments. Our findings demonstrate that intuitive likelihoods are one critical factor in moral judgment, one that is not suspended even in moral dilemmas that explicitly stipulate outcomes. Features thought to underlie moral reasoning, such as intention, may operate, in part, by affecting the intuitive likelihood of outcomes, and, problematically, moral differences between scenarios may be confounded with non-moral intuitive probabilities. (shrink)

We have all become used to the rapid change around us, and with it, the shifting landscape of medical ethics. It appears, however, that the acceleration phase of change in biomedical sciences is only just beginning, and we need to be prepared for new challenges ahead. This issue of the journal considers several of them: in epigenome editing, 1 in bioprinting 2 and in cryonics. 3 With all of these developments, we need to be doing our ethical thinking proactively rather (...) than reactively; and we need to consider not only what we think the ethical problems might be but what frameworks we have for arguing how we should address them. There are several approaches that could be taken 4 each with their own advantages and limitations. The most fun—and the one we are perhaps best at—is to consider hypothetical scenarios, the ethical controversies associated with... (shrink)

Normative political theorists frequently compare hypothetical scenarios for the purpose of identifying reasons to prefer one kind of institution to alternatives. We examine three types of "unfair" comparisons and the reasoning errors associated with each. A theorist makes an _obscure comparison_ when one (or more) of the alternatives under consideration is underspecified; a theorist makes a _mismatched comparison_ when they fail to hold fixed the relevant contextual factors while comparing alternatives; and a theorist makes an _irrelevant comparison_ when (...) they compare alternatives assuming contextual factors that differ in important respects from those they "should" assume given their theoretical aims. We then introduce the notion of a modeling mindset and show how this mindset can help theorists detect and avoid the three types of error. We conclude with a reconstruction of Cohen's (2009) camping trip thought experiment to illustrate the approach. (shrink)

The current paper examines whether knowledge of an ethical principle influences moral awareness and ethical decision making. Using hypothetical scenarios and a behavioral task, three experiments examine the effects of deepening people’s knowledge of ethical principles. In each study, an analogical encoding learning intervention led to greater knowledge of an ethical principle, which in turn resulted in a greater likelihood of moral awareness and making ethical decisions. These findings suggest that moral awareness is partly a matter of the (...) depth of individuals’ knowledge of ethical principles. The findings provide further reasons to link work on ethics with work on expertise and knowledge transfer as well as indicate new approaches to ethics training. (shrink)

Are trust relationships involving humans and artificial agents possible? This controversial question has become a hotly debated topic in the emerging field of machine ethics. Employing a model of trust advanced by Buechner and Tavani :39–51, 2011), I argue that the “short answer” to this question is yes. However, I also argue that a more complete and nuanced answer will require us to articulate the various levels of trust that are also possible in environments comprising both human agents and AAs. (...) In defending this view, I show how James Moor’s model for distinguishing four levels of ethical agents in the context of machine ethics :18–21, 2006) can help us to develop a framework that differentiates four levels of trust. Via a series of hypothetical scenarios, I illustrate each level of trust involved in HA–AA relationships. Finally, I argue that these levels of trust reflect three key factors or variables: the level of autonomy of the individual AAs involved, the degree of risk/vulnerability on the part of the HAs who place their trust in the AAs, and the kind of interactions that occur between the HAs and AAs in the trust environments. (shrink)