In this article, we suggest that the evidence regarding the social determinants of health calls for a deep re‐thinking of our understanding of distributive justice. Focusing on John Rawls's theory of distributive justice in particular, we argue that a full reckoning with the social determinants of health requires a re‐working of Rawls's principles of justice. We argue first that the social bases of health – a Rawlsian conception of the social determinants of health – should be considered a social (...) primary good. We argue second that including the social bases of health as a social primary good would lead the parties to the original position to choose an additional principle of justice and assign it lexical priority over Rawls's second principle. According to this principle, inequalities in people's share of the social bases of health are to be arranged so as to improve the health status of those least advantaged on the social health gradient. -/- . (shrink)

The principal goal of Alex John London's For the Common Good is to "articulate a new vision for the philosophical foundations of research ethics" which "moves issues of justice from the periphery of the field to the very center." At the core of this new vision is an understanding of research as a "collaborative social activity between free and equal persons," which aims to develop the knowledge public institutions require to establish and maintain a social order in which people (...) may set and pursue their plans of life. Clinical and social scientific research are not therefore morally optional activities, in London's view, but rather the way public institutions acquire the knowledge they... (shrink)

Although the principle of fair subject selection is a widely recognized requirement of ethical clinical research, it often yields conflicting imperatives, thus raising major ethical dilemmas regarding participant selection. In this paper, we diagnose the source of this problem, arguing that the principle of fair subject selection is best understood as a bundle of four distinct sub-principles, each with normative force and each yielding distinct imperatives: (1) fair inclusion; (2) fair burden sharing; (3) fair opportunity; and (4) fair distribution of (...) third-party risks. We first map out these distinct sub-principles, and then identify the ways in which they yield conflicting imperatives for the design of inclusion and exclusion criteria, and the recruitment of participants. We then offer guidance for how decision makers should navigate these conflicting imperatives to ensure that participants are selected fairly. (shrink)

John Turri gives an example that he thinks refutes what he takes to be “G. E. Moore's view” that omissive assertions such as “It is raining but I do not believe that it is raining” are “inherently ‘absurd'”. This is that of Ellie, an eliminativist who makes such assertions. Turri thinks that these are perfectly reasonable and not even absurd. Nor does she seem irrational if the sincerity of her assertion requires her to believe its content. A commissive counterpart (...) of Ellie is Di, a dialetheist who asserts or believes that The Russell set includes itself but I believe that it is not the case that the Russell set includes itself. Since any adequate explanation of Moore's paradox must handle commissive assertions and beliefs as well as omissive ones, it must deal with Di as well as engage Ellie. I give such an explanation. I argue that neither Ellie's assertion nor her belief is irrational yet both are absurd. Likewise neither Di's assertion nor her belief is irrational yet in contrast neither is absurd. I conclude that not all Moore-paradoxical assertions or beliefs are irrational and that the syntax of Moore's examples is not sufficient for the absurdity found in them. (shrink)

A brief account of educational aims, focussing on preparation for a life of autonomous well-being.

I argue that incomprehensibility (what the ancient skeptics called acatalepsia) plays a central role in the skepticism of both Bayle and Hume. I challenge a commonly held view (recently argued by Todd Ryan) that Hume, unlike Bayle, does not present oppositions of reason--what Kant called antimonies.

Some have argued for a division of epistemic labor in which mathematicians supply truths and philosophers supply their necessity. We argue that this is wrong: mathematics is committed to its own necessity. Counterfactuals play a starring role.

Moderate scientism is the view that empirical science can help answer questions in nonscientific disciplines. In this paper, we evaluate moderate scientism in philosophy. We review several ways that science has contributed to research in epistemology, action theory, ethics, philosophy of language, and philosophy of mind. We also review several ways that science has contributed to our understanding of how philosophers make judgments and decisions. Based on this research, we conclude that the case for moderate philosophical scientism is strong: scientific (...) practice has promoted significant progress in philosophy and its further development should be welcomed and encouraged. (shrink)

“Gettier cases” have played a major role in Anglo-American analytic epistemology over the past fifty years. Philosophers have grouped a bewildering array of examples under the heading “Gettier case.” Philosophers claim that these cases are obvious counterexamples to the “traditional” analysis of knowledge as justified true belief, and they treat correctly classifying the cases as a criterion for judging proposed theories of knowledge. Cognitive scientists recently began testing whether philosophers are right about these cases. It turns out that philosophers were (...) partly right and partly wrong. Some “Gettier cases” are obvious examples of ignorance, but others are obvious examples of knowledge. It also turns out that much research in this area of philosophy is marred by experimenter bias, invented historical claims, dysfunctional categorization of examples, and mischaracterization by philosophers of their own intuitive judgments about particular cases. Despite these shortcomings, lessons learned from studying “Gettier cases” are leading to important insights about knowledge and knowledge attributions, which are central components of social cognition. (shrink)

Many philosophers hypothesize that our concept of personal identity is partly constituted by the one-person-one-place rule, which states that a person can only be in one place at a time. This hypothesis has been assumed by the most influential contemporary work on personal identity. In this paper, we report a series of studies testing whether the hypothesis is true. In these studies, people consistently judged that the same person existed in two different places at the same time. This result undermines (...) some widely held philosophical assumptions, supports others, and fits well with recent discoveries on identity judgments about inanimate objects and non-human animals. (shrink)

Does Anne Conway (1631–79) hold that the created world consists of a single underlying substance? Some have argued that she does; others have argued that she is a priority monist and so holds that there are many created substances, but the whole created world is ontologically prior to each particular creature. Against both of these proposals, this article makes the case for a substance pluralist interpretation of Conway: individual creatures are distinct substances, and the whole created world is not ontologically (...) prior to the individual creatures that compose it. The basic argument for such a view draws on Conway's claims about the freedom and moral responsibility of individual creatures. The pluralist reading is straightforwardly compatible with these claims, while the monistic readings are not. (shrink)

The consequence argument purports to show that determinism is true only if no one has free will. Judgments about whether the argument is sound depend on how one understands locutions of the form 'p and no one can render p false'. The main interpretation on offer appeals to counterfactual sufficiency: s can render p false just in case there is something s can do such that, were s to do it, p would be false; otherwise, s cannot render p false. (...) Here I show that, in the context of the consequence argument, this interpretation conflicts with widely endorsed principles governing the logic of counterfactuals. (shrink)

Remembering seems, to philosophers and scientists, one of the most mystifying of human activities. Yet natural language users have no problem understanding what is meant by ‘memory’. Memory is simply the ability to recall personally experienced events and certain kinds of information such as facts, names, or faces; or how to perform certain actions, like riding a bike or playing chess. It is on this basis that people sometimes make claims about themselves or others having a good or bad memory, (...) especially for things like names, numbers, or faces. Why then is memory such a mystery? Because, firstly, of its diversity: memory enables us to perform a plethora of different tasks, including the continuous interpretation of every moment of consciousness. Secondly, different forms of memory have different standards of accuracy, and often dramatically different criteria for success. (shrink)

The problem of standard of care in clinical research concerns the level of treatment that investigators must provide to subjects in clinical trials. Commentators often formulate answers to this problem by appealing to two distinct types of obligations: professional obligations and natural duties. In this article, I investigate whether investigators also possess institutional obligations that are directly relevant to the problem of standard of care, that is, those obligations a person has because she occupies a particular institutional role. I examine (...) two types of institutional contexts: (1) public research agencies – agencies or departments of states that fund or conduct clinical research in the public interest; and (2) private-for-profit corporations. I argue that investigators who are employed or have their research sponsored by the former have a distinctive institutional obligation to conduct their research in a way that is consistent with the state's duty of distributive justice to provide its citizens with access to basic health care, and its duty to aid citizens of lower income countries. By contrast, I argue that investigators who are employed or have their research sponsored by private-for-profit corporations do not possess this obligation nor any other institutional obligation that is directly relevant to the ethics of RCTs. My account of the institutional obligations of investigators aims to contribute to the development of a reasonable, distributive justice-based account of standard of care. (shrink)

In this article, I ask whether a principle analogous to the principle of clinical equipoise should govern the design and conduct of RCTs evaluating the effectiveness of policy interventions. I answer this question affirmatively, and introduce and defend the principle of policy equipoise. According to this principle, all arms of a policy RCT must be, at minimum, in a state of equipoise with the best proven policy that is also morally and practically attainable and sustainable. For all arms of a (...) policy RCT, policy experts must either reasonably disagree about whether the trial arms are more effective than this policy, or know that they are. (shrink)

Governments are increasingly using randomized controlled trials (RCTs) to evaluate policy interventions. RCTs are often understood to provide the highest quality evidence regarding the causal efficacy of an intervention. While randomization plays an essential epistemic role in the context of policy RCTs however, it also plays an important distributive role. By randomly assigning participants to either the intervention or control arm of an RCT, people are subject to different policies and so, often, to different types and levels of benefits. In (...) this paper, I identify one necessary condition as well as a set of sufficient conditions for the permissible use of random assignment by government agencies. I argue first that random assignment is permissible only if it is consistent with governments’ duty to realize morally important outcomes. I argue second that random assignment is permissible in cases where investigators are in a state of genuine equipoise regarding all arms of the experiment and the policy to which people have a claim of justice. Finally, I defend a set of conditions under which random assignment is permissible in cases where one or more arms of a policy RCT are reasonably expected to be either superior or inferior to this policy. (shrink)

Australia, Canada, and New Zealand currently apply health requirements to prospective immigrants, denying residency to those with health conditions that are likely to impose an “excessive demand” on their publicly funded health and social service programs. In this paper, I investigate the charge that such policies are wrongfully discriminatory against persons with disabilities. I first provide a freedom-based account of the wrongness of discrimination according to which discrimination is wrong when and because it involves disadvantaging people in the exercise of (...) their freedom on the basis of morally arbitrary features of their identity. Discrimination is permissible, I suggest, when it is necessary to advance a valuable exercise of the discriminating agent’s freedom. I then apply this account to the case of social cost health requirements. Against critics of these requirements, I argue that it is sometimes permissible for states to discriminate against prospective immigrants with disabilities. States may do so, I suggest, when such discriminatory treatment is necessary to prevent an increase in rates of mortality and/or morbidity amongst citizens. Alongside critics of social cost health requirements however, I argue that existing policies are likely a form of wrongful discrimination insofar as they are too broad to satisfy this standard. (shrink)

The duty to rescue is a highly plausible and powerful ethical principle. It requires agents to assist others in extreme need in cases where doing so does not conflict with some weighty moral aim; requires little personal sacrifice; and is likely to significantly benefit the recipients.1 As a general obligation, it binds all persons simply qua persons, and it is owed to all persons simply qua persons. Clinical investigators working in low-income countries frequently encounter sick or destitute people to whom (...) they might possess a duty to rescue. Investigators may often ask themselves, what can I do, what should I do, to help? Such investigators often help people in the future by carrying out their... (shrink)

Many high-income countries have skill-selective immigration policies, favoring prospective immigrants who are highly skilled. I investigate whether it is permissible for high-income countries to adopt such policies. Adopting what Joseph Carens calls a " realistic approach " to the ethics of immigration, I argue first that it is in principle permissible for high-income countries to take skill as a consideration in favor of selecting one prospective immigrant rather than another. I argue second that high-income countries must ensure that their skill-selective (...) immigration policies do not contribute to the non-fulfillment of their duty to aid residents of low-and middle-income countries. (shrink)

A principal rationale for public policy is to address market failures. Pareto efficiency is therefore a highly common and relatively non-controversial evaluative criterion for many policy analyses and is discussed at length in policy analysis texts. This makes sense, for Pareto improvements involve making at least one person better off without making anyone worse off. Who could object to that? But does efficiency deserve the prominence it enjoys in public policy? Is one policy option better than another, at least in (...) one respect, simply because it is more Pareto efficient? Or, is efficiency valuable for some other reason? In this chapter, I discuss Pareto efficiency as an evaluative criterion and argue that it is a stand-in for a more foundational criterion: wellbeing. I begin with an overview of Pareto efficiency, discuss the various ways in which it is operationalized to evaluate policy options, and argue that it is valuable insofar as more efficient states of affairs promise more wellbeing than less efficient states of affairs. I then raise questions regarding whether the conception of wellbeing presupposed by Pareto efficiency – preference satisfaction – is a defensible conception of wellbeing. I go on to introduce three alternative conceptions of wellbeing which have been proposed and defended by both philosophers and policy scholars, namely, hedonism, objective goods views, and the capability approach, and suggest ways in which each can be operationalized as an evaluative criterion. I close by discussing four ‘theory-free’ approaches to thinking about the impact of policies on the quality of people’s lives. Such approaches reject the idea that there is one single theory of wellbeing that should be used to evaluate policy options, and instead develop ways to evaluate the impact of policies on people’s lives that are not grounded in a specific theory. (shrink)

The value of health states is often understood to depend on their impact on the goodness of people's lives. As such, prominent health states metrics are grounded in particular conceptions of wellbeing – e.g. hedonism or preference satisfaction. In this paper, I consider how liberals committed to the public justification requirement – the requirement that public officials choose laws and policies that are justifiable to their citizens – should evaluate health states. Since the public justification requirement prohibits public officials from (...) appealing to controversial conceptions of the good life, liberals committed to this principle face a significant puzzle. (shrink)

Journal of Political Philosophy, EarlyView.

According to the norm of policy equipoise, it is permissible to randomly assign participants to two or more interventions in a public policy randomized controlled trial (RCT) when there is meaningful uncertainty among the relevant expert community regarding which intervention is superior. While this norm is gaining traction in the research ethics literature, the idea of interventional superiority remains unclear. Is one intervention superior to another if it is reasonably expected to realize one outcome of interest more effectively, even though (...) there is uncertainty regarding other outcomes of interest? Or must an intervention be reasonably expected to realize all outcomes of interest more effectively? I address this question in this paper. My aim is to develop and defend an account of interventional superiority for policy RCTs that are authorized, funded, or conducted by government institutions. I defend the greatest value view, according to which one intervention is superior to another if and only if it is reasonably expected to more effectively realize a set of outcomes with greater value. (shrink)

Soda taxes are controversial. While proponents point to their potential health benefits and the public projects that could be funded with their revenue, critics argue that they are paternalistic and regressive. In this paper, we explore the prospects for designing a just soda tax, one that appropriately balances the often-competing ethical considerations of promoting social welfare, respecting people’s autonomy, and ensuring distributive fairness. We argue that policymakers have several paths forward for designing a just soda tax, but that the considerations (...) relevant to ethical policy design are more complicated than is sometimes acknowledged. (shrink)

Policy analyses begin with a systematic overview of the policy problem they address. This includes a comprehensive discussion of the nature and context of the problem, and the institutional and behavioral factors responsible for its emergence. Problem statements must also explain why the status quo is bad or undesirable, why it is something that governments, rather than private actors, should address, and establish that the relevant government institutions have the legitimacy to intervene. In this chapter, I provide an overview of (...) the principal types of policy problems that it is morally appropriate for governments to address. Each type denotes a class of states of affairs that (1) are bad, undesirable, or unjust, (2) the government is particularly well-suited to address, and (3) arise from spheres of action over which the relevant government institutions have the right to intervene. I begin with a discussion of collective action problems, that is, states of affairs in which action by rational and self-interested private actors is collectively self-defeating. I then argue for two additional types of policy problems. First, since the goal of government action is the construction of a just legal order, not merely an efficient one, states of affairs which are unjust constitute an additional type of policy problem. Relatedly, second, whereas analyses of collective action problems typically presuppose the existence of effective government institutions which can address them, such institutions may be deficient and/or unjust. A third type of policy problem is therefore deficient government institutions. -/- . (shrink)

Government agencies and nonprofit organizations have increasingly turned to randomized controlled trials (RCTs) to evaluate public policy interventions. Random assignment is widely understood to be fair when there is equipoise; however, some scholars and practitioners argue that random assignment is also permissible when an intervention is reasonably expected to be superior to other trial arms. For example, some argue that random assignment to such an intervention is fair when the intervention is scarce, for it is sometimes fair to use a (...) lottery to allocate scarce goods. We investigate the permissibility of randomization in public policy RCTs when there is no equipoise, identifying two sets of conditions under which it is fair to allocate access to a superior intervention via random assignment. We also reject oft-made claims that alternative study designs, including stepped-wedge designs and uneven randomization, offer fair ways to allocate beneficial interventions. (shrink)

Governments often aim to improve children’s wellbeing by targeting the decision-making of their parents. In this paper, I explore this phenomenon, providing an ethical evaluation of the ways in which governments target parental decision-making in the context of anti-poverty policies. I first introduce and motivate the concept of parent-targeted paternalism to categorize such policies. I then investigate whether parent-targeted paternalism is ever pro tanto wrong, arguing that it is when directed at parents who meet a threshold of parental competency. I (...) next explore the factors that affect the degree of pro tanto wrongness of paternalistic anti-poverty policies targeting parents, and provide an account of the conditions under which such policies are on balance permissible, and when they are not. Finally, I illustrate the plausibility and usefulness of my framework by considering a case. (shrink)

The field of public policy is dominated by the social sciences. Schools and departments of public policy and public administration are largely populated by economists, political scientists, and sociologists, and the vast majority of work in prestigious public policy journals employs empirical methods. This is unsurprising, in one respect, for collecting data, predicting and identifying the causal impacts of policies, and understanding political institutions and processes are massive, important tasks that require the tools of the social sciences. It is surprising, (...) in another respect however, since much policy scholarship and analysis aspires to offer recommendations to policymakers, and recommendations necessarily involve evaluative judgments, for example, that the status quo is deficient and that a certain course of action will make things better. To defend such judgments, policy scholars and analysts cannot appeal to the social sciences alone for these judgments concern the realm of values, not facts. Instead, careful ethical reflection and analysis is required. This need for ethical reflection in public policy is particularly evident in the practice of policy analysis, a principal analytic tool of the field. Policy analyses involve the identification of policy problems, the specification of criteria for evaluating possible solutions, and the recommendation that a policy option offers the best balance of trade offs. This identification of bads, the specification of goods policies should realize, and the weighing of these goods with the judgment that policymakers should or ought to pursue this course of action or that, are all deeply ethical activities. Ethical reflection and analysis is thus a constituent feature of policy analysis, and like the amassing of evidence and projection of outcomes, this reflection and analysis may be performed well or badly. The overall aim of this book is to provide students, scholars, and practitioners of public policy with guidance regarding the ethical dimensions of policy analysis. My aim in this chapter is to set the stage, providing an overview of these dimensions. After providing a brief overview of the practice of policy analysis, I identify the steps of an analysis where analysts must make ethical judgments in order to move forward, and fully articulate the ethical questions they must confront and take a position on. (shrink)

Governments are increasingly making use of field experiments to evaluate policy interventions in the spheres of education, public health and welfare. However, the research ethics literature is largely focused on the clinical context, leaving investigators, institutional review boards and government agencies with few resources to draw on to address the ethical questions they face regarding such experiments. In this article, we aim to help address this problem, investigating the conditions under which informed consent is required for ethical policy research conducted (...) or authorized by government. We argue that investigators need not secure participants' informed consent when conducting government policy experiments if: the government institution conducting or authorizing the experiment possesses a right to rule over the spheres of policy targeted by the research; and data collection does not involve the violation of participants' autonomy rights. (shrink)

The federal system for allocating donated livers in the United States is often criticized for allowing geographic disparities in access to livers. Critics argue that such disparities are unfair on the grounds that where one lives is morally arbitrary and so should not influence one's access to donated livers. They argue instead that livers should be allocated in accordance with the equal opportunity principle, according to which US residents who are equally sick should have the same opportunity to receive a (...) liver, regardless of where they live. In this paper, we examine a central premise of the argument for the equal opportunity principle, namely, that geographic location is a morally arbitrary basis for allocating livers. We raise some serious doubts regarding the truth of this premise, arguing that under certain conditions, factors closely associated with geographic location are relevant to the allocation of livers, and so that candidates' geographic location is sometimes a morally non-arbitrary basis for allocating livers. Geographic location is morally non-arbitrary, we suggest, since by taking it into account, the UNOS may better fulfill its central goals of facilitating the effective and efficient placement of organs for transplantation and increasing organ donation. (shrink)

I critically examine the claim that modal collapse arguments against the traditional doctrine of divine simplicity (DDS) are in general fallacious. In a recent paper, Christopher Tomaszewski alleges that modal collapse arguments against DDS are invalid, owing to illicit substitutions of nonrigid singular terms into intensional contexts. I show that this is not, in general, the case. I show, further, that where existing modal collapse arguments are vulnerable to this charge the arguments can be repaired without any apparent dialectical impropriety. (...) I conclude that the genuine debate over modal collapse and divine simplicity and modal collapse is substantially a controversy over the metaphysics of divine action, and that this constitutes a fruitful direction in which to take future discussions of the subject. (shrink)

We are living through an era of increased robotisation. Some authors have already begun to explore the impact of this robotisation on legal rules and practice. In doing so, many highlight potential liability gaps that might arise through robot misbehaviour. Although these gaps are interesting and socially significant, they do not exhaust the possible gaps that might be created by increased robotisation. In this article, I make the case for one of those alternative gaps: the retribution gap. This gap arises (...) from a mismatch between the human desire for retribution and the absence of appropriate subjects of retributive blame. I argue for the potential existence of this gap in an era of increased robotisation; suggest that it is much harder to plug this gap than it is to plug those thus far explored in the literature; and then highlight three important social implications of this gap. (shrink)

Social scientists and research ethicists have begun, somewhat belatedly, to confront and address the ethical challenges raised by public policy experiments. In doing so however, they have not fully availed themselves of the large and sophisticated literature on the ethics of clinical research which has developed over the past 40 years. While clinical and public policy research are different, I argue that the clinical research ethics literature yields valuable insights for discussions of the ethics of policy experiments. Focusing on seven (...) ethical issues which have received a good deal of attention in public and scholarly discussions of the ethics of policy experiments, I make use of the history of reflection on the ethics of clinical research to provide guidance to researchers planning and conducting policy experiments. (shrink)

In this chapter, we provide an overview of the ethical considerations relevant to the use of nudges in organ donation policy. We do not defend a position on the permissibility of nudging in this context, but instead aim to clearly outline the strongest arguments on the different sides of this issue that have been presented in the English-language scholarly bioethics literature. We also highlight the questions that are in need of further investigation. In part 1, we briefly discuss nudging before (...) considering proposals to use nudges to increase the number of registered organ donors, including opt-out donor registration systems and the use of “nudge statements.” In part 2, we discuss the use of nudges to influence the decision-making of family members in circumstances where they have a veto over the donation of their loved one’s organs. (shrink)

This chapter provides a critical overview and interpretation of fair subject selection in clinical and social scientific research. It first provides an analytical framework for thinking about the problem of fair subject selection. It then argues that fair subject selection is best understood as a set of four subprinciples, each with normative force and each with distinct and often conflicting implications for the selection of participants: fair inclusion, fair burden sharing, fair opportunity, and fair distribution of third-party risks. It then (...) defends an approach to navigating the conflicting imperatives of these subprinciples, one which privileges the need to include epistemically distinct groups in research, before concluding by considering the most pressing research questions regarding fair subject selection. (shrink)

In this case discussion, Barnhill and Devine collect and present a significant amount of recent research on the various reasons why people struggle to succeed in weight loss programmes. Specifically, the authors focus on what they call ‘behavioural weight loss interventions’, which are ‘research, clinical or public health efforts to promote individual healthy eating and physical activity behaviours’. As defined, this is a very broad category of interventions and presumably includes all kinds of dieting and weight loss programmes or promotion (...) efforts short of private or independently chosen programmes. The authors argue, in a nutshell, that these clinical, research, and public health interventions have low efficacy, and while they may have some health or other benefits, the balance of evidence presented shows that they harm people in multiple ways. (shrink)

There is a concern that the widespread deployment of autonomous machines will open up a number of ‘responsibility gaps’ throughout society. Various articulations of such techno-responsibility gaps have been proposed over the years, along with several potential solutions. Most of these solutions focus on ‘plugging’ or ‘dissolving’ the gaps. This paper offers an alternative perspective. It argues that techno-responsibility gaps are, sometimes, to be welcomed and that one of the advantages of autonomous machines is that they enable us to embrace (...) certain kinds of responsibility gap. The argument is based on the idea that human morality is often tragic. We frequently confront situations in which competing moral considerations pull in different directions and it is impossible to perfectly balance these considerations. This heightens the burden of responsibility associated with our choices. We cope with the tragedy of moral choice in different ways. Sometimes we delude ourselves into thinking the choices we make were not tragic ; sometimes we delegate the tragic choice to others ; sometimes we make the choice ourselves and bear the psychological consequences. Each of these strategies has its benefits and costs. One potential advantage of autonomous machines is that they enable a reduced cost form of delegation. However, we only gain the advantage of this reduced cost if we accept that some techno-responsibility gaps are virtuous. (shrink)

Loneliness in medicine is a serious problem not just for patients, for whom illness is intrinsically isolating, but also for physicians in the contemporary condition of medicine. We explore this problem by investigating the ideal physician-patient relationship, whose analogy with friendship has held enduring normative appeal. Drawing from Talbot Brewer and Nir Ben-Moshe, we argue that this appeal lies in a dynamic form of companionship incompatible with static models of friendship-like physician-patient relationships: a mutual refinement of embodied virtue that draws (...) both persons together. The ideal physician-patient relationship has a dialectical character that fosters each member's improvement of phenomenologically recognizing and embodying moral virtues. A key component of this dynamic is a commitment to the common goal of the patient's health, realized through joint interactivities and conversations over time. The physician's presence to the patient's suffering—understood best as an alienating phenomenological condition for the patient—orients and discloses possibilities for virtuous caregiving by structuring the meanings of the goals, conversations, and joint narrative constitutive of their relationship. Presence to suffering, paradoxically, is perhaps an important prerequisite for this dynamic partnership. These activities dialectically build an interpretive horizon of understanding through which moral goods and character refinement—in and for the other—may become revealed for both persons in their shared being-in-the-world. This analysis of suffering, mood, and revealing of (possible) moral goods has implications for addressing the modern problem of loneliness for patients and physicians, who are increasingly inhibited from building flourishing relationships with each other. (shrink)

In this paper, I transcend the abstract engagement of J. L. Austin's Speech Acts theory and explore their sociopolitical advantages, using the Nigerian social space as my primary experimental field. Nigerian social space is quite hierarchical and progresses along apparently asymmetrical lines of social relationship (in most cases). This in turn, accentuates some sort of power dynamics. In every communication, there is an implicit reinforcement of the social fabric as well as the power dynamic, either through one person's percep6of the (...) social status of the other or, of one's emphasis of power dynamic over the other. Austin's theory comes to the fore as a very laudable framework to map this interesting sociological facts. This work then, offers a philosophical contribution to an otherwise, sociological/anthropological fact. My job in this paper, is to explore a sociopolitical negotiation of Austin's theory in a multiethnic nation-state as Nigeria where hierarchy and power dynamics are heavily emphasized. This paper thus highlights the importance of the perlocutionary acts and the felicity conditions, and also accentuates their implications for social interactions and power dynamics in the Nigerian social space. (shrink)

Visualizing and mental imagery are thought to be cognitive states by all sides of the imagery debate. Yet the phenomenology of those states has distinctly visual ingredients. This has potential consequences for the hypothesis that vision is cognitively impenetrable, the ability of visual processes to ground perceptual warrant and justification, and the distinction between cognitive and perceptual phenomenology. I explore those consequences by describing two forms of visual ambiguity that involve visualizing: the ability to visually experience a picture surface as (...) flat after it has caused volumetric nonconceptual contents, and the ability to use a surface initially perceived as flat to visualize three-dimensional scenes. In both cases, the visual processes which extract viewer-centered volumetric shapes have to rely solely on monocular depth cues in the absence of parallax and stereopsis. Those processes can be cognitively penetrated by acts of visualizing, including ones that draw on conceptual information about kinds. However, the penetrability of the visual processes does not weaken their ability to provide perceptual warrant and justification for beliefs. The reason is that picture perceptions—whether they are stimulus -driven or based on acts of visualizing—are different to object perceptions both phenomenologically and in terms of their functional roles as states. Thus, although the penetrability of the visual processes does mean that subjects can have visual experiences with contradictory contents, perceptual belief is adopted at most towards one set of contents, and questions of warrant and justification are raised only for those contents. A rule-proving exception is provided by trompe-l’oeils. (shrink)

Demonstratives seem to have posed a severe difficulty for Frege’s philosophy of language, to which his doctrine of incommunicable senses was a reaction. In “The Thought,” Frege briefly discusses sentences containing such demonstratives as “today,” “here,” and “yesterday,” and then turns to certain questions that he says are raised by the occurrence of “I” in sentences (T, 24-26). He is led to say that, when one thinks about oneself, one grasps thoughts that others cannot grasp, that cannot be communicated. However, (...) nothing could be more out of the spirit of Frege’s account of sense and thought than an incommunicable, private thought. In the first part of the paper, I explain the problem demonstratives pose for Frege, and explore three ways he might have dealt with it. I argue that none of these ways provides Frege with a solution to his problem consistent with his philosophy of language. The first two are plausible as solutions, but contradict his identification of the sense expressed by a sentence with a thought. The third preserves the identification, but is implausible. In the second part, I suggest that Frege was led to his doctrine of incommunicable senses as a result of some appreciation of the difficulties his account of demonstratives faces, for these come quickly to the surface when we think about “I.” I argue that incommunicable senses won’t help. I end by trying to identify the central problem with Frege’s approach, and sketching an alternative. (shrink)

One fairly common view about practical reason has it that whether you have a reason to act is not determined by what you know, or believe, or are justified in believing. Your reasons are determined by the facts. Perhaps there are two kinds of reasons, and however it goes with motivating reasons, normative reasons are determined by the facts, not your take on the facts. One fairly common version of this view has it that what's reasonable for you to do (...) is determined by what you know or believe. Any view that drives this kind of wedge between reasons and rationality is inherently unstable. I argue against this view, criticize the arguments typically presented in its favor, and sketch an alternative. (shrink)

The paper begins by reviewing two problems for fallibilism: the lottery problem, or the problem of explaining why fallible evidence, though otherwise excellent, is not enough to know that one will lose the lottery, and Gettier problems. It is then argued that both problems can be resolved if we note an important illocutionary force of knowledge attributions: namely, that when we attribute knowledge to someone we mean to give the person credit for getting things right. Alternatively, to say that a (...) person knows is to say that she got things right due to her own abilities, efforts and actions, rather than due to dumb luck, or blind chance, or something else. (shrink)

On the extended mind hypothesis (EM), many of our cognitive states and processes are hybrids, unevenly distributed across biological and nonbiological realms. In certain circumstances, things - artifacts, media, or technologies - can have a cognitive life, with histories often as idiosyncratic as those of the embodied brains with which they couple. The realm of the mental can spread across the physical, social, and cultural environments as well as bodies and brains. My independent aims in this chapter are: first, to (...) describe two compatible but distinct movements or "waves" within the EM literature, arguing for the priority of the second wave (and gesturing briefly toward a third); and, second, to defend and illustrate the interdisciplinary implications of EM as best understood, specifically for historical disciplines, by sketching two case studies. (shrink)

This chapter argues that scientific and philosophical progress in our understanding of the living world requires that we abandon a metaphysics of things in favour of one centred on processes. We identify three main empirical motivations for adopting a process ontology in biology: metabolic turnover, life cycles, and ecological interdependence. We show how taking a processual stance in the philosophy of biology enables us to ground existing critiques of essentialism, reductionism, and mechanicism, all of which have traditionally been associated with (...) substance ontology. We illustrate the consequences of embracing an ontology of processes in biology by considering some of its implications for physiology, genetics, evolution, and medicine. And we attempt to locate the subsequent chapters of the book in relation to the position we defend. (shrink)

Perceptual Confidence is the view that perceptual experiences assign degrees of confidence. After introducing, clarifying, and motivating Perceptual Confidence, I catalogue some of its more interesting consequences, such as the way it blurs the distinction between veridical and illusory experiences, a distinction that is sometimes said to carry a lot of metaphysical weight. I also explain how Perceptual Confidence fills a hole in our best scientific theories of perception and why it implies that experiences don't have objective accuracy conditions.

John Stuart Mill's Utilitarianism is one of the most important, controversial, and suggestive works of moral philosophy ever written. Mill defends the view that all human action should produce the greatest happiness overall, and that happiness itself is to be understood as consisting in "higher" and "lower" pleasures. This volume uses the 1871 edition of the text, the last to be published in Mill's lifetime. The text is preceded by a comprehensive introduction assessing Mill's philosophy and the alternatives to (...) utilitarianism, and discussing some of the specific issues Mill raises in Utilitarianism. (shrink)

I argue against the orthodox view of the relationship between propositional and doxastic justification. The view under criticism is: if p is propositionally justified for S in virtue of S's having reason R, and S believes p on the basis of R, then S's belief that p is doxastically justified. I then propose and evaluate alternative accounts of the relationship between propositional and doxastic justification, and conclude that we should explain propositional justification in terms of doxastic justification. If correct, this (...) proposal would constitute a significant advance in our understanding of the sources of epistemic justification. (shrink)

Cognitivism in respect to the arts refers to a constellation of positions that share in common the idea that artworks often bear, in addition to aesthetic value, a significant kind of cognitive value. In this paper I concentrate on three things: (i) the challenge of understanding exactly what one must do if one wishes to defend a cognitivist view of the arts; (ii) common anti-cognitivist arguments; and (iii) promising recent attempts to defend cognitivism.