Background: The management of challenging behaviours in inpatient with intellectual disability and/or autism spectrum disorders can lead to an escalation of control measures. In these complex situations where patients have an intellectual disability/autism spectrum disorder accompanied by a psychiatric comorbidity, the experiences of caregivers related to the crisis management have rarely been studied. Purpose: This study examined the moral experiences of caregivers related to challenging behaviours’ management and alternatives to control measures. Research design: Using Charles Taylor’s hermeneutic framework, a 2-month (...) focused ethnography with a participatory approach was used. Participants and research context: Sixteen caregivers were interviewed in a Canadian mental health setting for adults with intellectual disability/autism spectrum disorder and psychiatric comorbidity. Ethical considerations: The research was conducted in compliance with the Declaration of Helsinki and local Research Ethics Board approval. Written informed consent was collected systematically from participants. Findings: By accounting for caregivers’ moral experiences, this study sheds light on a neglected dimension of the care relationship: the vulnerability of the caregiver. We highlight the main barriers and facilitators to alternatives to control measures. First, a caregiver’s vulnerability was characterised by the overall impact of challenging behaviours and the moral distress associated with the use of control measures and exclusion mechanisms of intellectual disability/autism spectrum disorder patients. Second, a strong ambiguity between care and control measures and a lack of inclusive approaches were identified as the two main barriers to challenging behaviour management. Third, the involvement, both professional and personal, of caregivers was deemed necessary to implement alternatives to control measures. Discussion: A conflict of values opposes two conceptions of autonomy: a rational autonomy, which is counterproductive to the reduction of control measures, versus a relational autonomy based on shared vulnerability. Conclusion: The recognition of caregiver’s vulnerability is a benchmark to create alternative approaches, which defuse the logic of control and promote an ethics of care within which caregivers’ self-concern can be understood as fostering mutual respect. (shrink)

Recently, natural language pragmatics started to make use of decision-, game-, and information theoretical tools to determine the usefulness of questions and assertions in a quantitative way. In the first part of this paper several of these notions are related with each other. It is shown that under particular natural assumptions the utility of questions and answers reduces to their informativity, and that the ordering relation induced by utility sometimes even reduces to the logical relation of entailment. The (...) second part of the paper shows how different proposals (using either protocols or likelihood functions) to measure the relevance/utility of non-partitional questions come down to the same thing. (shrink)

Comparisons between utilities pose a pressing problem if, while incapable of being grounded, they are required in ethical deliberation. My aim is to consider whether there are epistemological impediments to implementing such ethical choices. Can we find ourselves being persuaded of the ethical need to compare utilities of different individuals, yet unable to do so because the comparisons cannot be warranted? I argue that the problem cannot arise; no plausible moral principle will invoke magnitudes which are inscrutable.

A mixture preorder is a preorder on a mixture space (such as a convex set) that is compatible with the mixing operation. In decision theoretic terms, it satisfies the central expected utility axiom of strong independence. We consider when a mixture preorder has a multi-representation that consists of real-valued, mixture-preserving functions. If it does, it must satisfy the mixture continuity axiom of Herstein and Milnor (1953). Mixture continuity is sufficient for a mixture-preserving multi-representation when the dimension of the mixture (...) space is countable, but not when it is uncountable. Our strongest positive result is that mixture continuity is sufficient in conjunction with a novel axiom we call countable domination, which constrains the order complexity of the mixture preorder in terms of its Archimedean structure. We also consider what happens when the mixture space is given its natural weak topology. Continuity (having closed upper and lower sets) and closedness (having a closed graph) are stronger than mixture continuity. We show that continuity is necessary but not sufficient for a mixture preorder to have a mixture-preserving multi-representation. Closedness is also necessary; we leave it as an open question whether it is sufficient. We end with results concerning the existence of mixture-preserving multi-representations that consist entirely of strictly increasing functions, and a uniqueness result. (shrink)

Causal decision theory attends to probabilities used to obtain an option's expected utility but for completeness should also attend to utilities of possible outcomes. A suitable formula for an option's expected utility uses a certain type of conditional utility.

This sparkling collection of essays both defines and reassesses the concept of Utility. Using it as a touchstone for the consideration of the place of ethics in the recent history of design, the collection offers a way into the issues which concern design decision-makers today. It offers previously unpublished research into diverse topics such as the investigation into the hitherto undiscovered designs for a utility vehicle, and it reveals a fresh perspective on the philosophy behind the concept of (...) Utility as a design theory. (shrink)

In Decision Space: Multidimensional Utility Analysis, first published in 2001, Paul Weirich increases the power and versatility of utility analysis and in the process advances decision theory. Combining traditional and novel methods of option evaluation into one systematic method of analysis, multidimensional utility analysis is a valuable tool. It provides formulations of important decision principles, such as the principle to maximize expected utility; enriches decision theory in solving recalcitrant decision problems; and provides in particular for the (...) cases in which an expert must make a decision for a group of people. The multiple dimensions of this analysis create a decision space broad enough to accommodate all factors affecting an option's utility. The book will be of interest to advanced students and professionals working in the subject of decision theory, as well as to economists and other social scientists. (shrink)

How should rational believers pursue the aim of truth? Epistemic utility theorists have argued that by combining the tools of decision theory with an epistemic form of value—gradational accuracy, proximity to the truth—we can justify various epistemological norms. I argue that deriving these results requires using decision rules that are different in important respects from those used in standard (practical) decision theory. If we use the more familiar decision rules, we can’t justify the epistemic coherence norms that epistemic (...) class='Hi'>utility theory had hoped to justify. In short, those of us who are attracted to the project of epistemic utility theory face a dilemma. If we choose “consequentialist” rules, then we can vindicate the idea that rational belief has the aim of accuracy—but at the cost of giving up attractive epistemic norms. (shrink)

In 1991 Mark Nelson argued that if time is infinitely long towards the future, then under certain easily met conditions traditional utilitarianism is unable to discriminate among actions. For under these conditions, each action produces the same infinite amount of utility, and thus it seems that utilitarianism must judge all actions permissible, judge all actions impermissible, or remain completely silent. In response to this criticism of utilitarianism, I argued that utilitarianism had the resources for dealing with at least some (...) cases of infinite utility. More specifically, I defended the following principle as being part of the "spirit" of traditional (total) utilitarianism: -/- PMU*: An action a1 has better consequences than an action a2 if and only if there is a time t such that for any later time t' the cumulative amount of utility produced by a1 up to t' is greater than that produced by action a2 up to t'. -/- For the usual finite cases, this principle agrees exactly with the standard approach of comparing totals. For infinite cases, however, it can distinguish among two actions each of which produces an infinite amount of utility. It says, for example, that an action that produces 2 units of utility at each time has better consequences than an action that produces 1 unit of utility at each time -- even though they both produce the same infinite amount of utility. Of course, cases where one action produces more utility than a second at each time are going to be rather rare. PMU* is not limited to such cases, however; it also has bite in cases such as the following: -/- Time a1: 1, 1, 1, 1, 2, 2, 2, 2, 2, ... a2: 3, 3, 3, 3, 1, 1, 1, 1, 1, ... -/- For although the cumulative utility of a1 up to and including the fourth time is only 4 utiles and a2's is 12, a1 starts catching up after that, ties a2 in the 12th time, and stays ahead after that. Thus, PMU* judges a1 as having better consequences than a2. I claimed that PMU* better captured the "spirit" of traditional utilitarianism than the usual sum total view -- on the grounds that almost anyone inclined to defend traditional utilitarianism would, upon reflection, want to hold, for example, that 2 utiles at every time is indeed better than 1 utile at each time. Two responses to my view have since been given in this journal. Luc Van Liederkerke has argued that PMU* violates an anonymity (neutrality, impartiality) condition that is central to utilitarianism. And James Cain has argued that PMU* is not person-centered, and that being so is central to utilitarianism. Here I will reply to the criticisms. Basically, I will acknowledge that each is right about an important point, but deny that this establishes that the core idea underlying PMU* is less plausible than the standard sum-ranking versions of utilitarianism. (shrink)

Suppose that time is infinitely long towards the future, and that each feasible action produces a finite amount of utility at each time. Then, under appropriate conditions, each action produces an infinite amount of utility. Does this mean that utilitarianism lacks the resources to discriminate among such actions? Since each action produces the same infinite amount of utility, it seems that utilitarianism must judge all actions permissible, judge all actions impermissible, or remain completely silent. If the future (...) is infinite, that is, the prospects for utilitarianism look bleak. (shrink)

Psychiatry has witnessed a new wave of approaches to clinical phenotyping and the study of psychopathology, including the National Institute of Mental Health’s Research Domain Criteria, clinical staging, network approaches, the Hierarchical Taxonomy of Psychopathology, and the general psychopathology factor, as well as a revival of interest in phenomenological psychopathology. The question naturally emerges as to what the relationship between these new approaches is – are they mutually exclusive, competing approaches, or can they be integrated in some way and used (...) to enrich each other? In this opinion piece, we propose a possible integration between clinical staging and phenomenological psychopathology. Domains identified in phenomenological psychopathology, such as selfhood, embodiment, affectivity, etc., can be overlaid on clinical stages in order to enrich and deepen the phenotypes captured in clinical staging (‘high resolution’ clinical phenotypes). This approach may be useful both ideographically and nomothetically, in that it could complement diagnosis, enrich clinical formulation, and inform treatment of individual patients, as well as help guide aetiological, prediction, and treatment research. The overlaying of phenomenological domains on clinical stages may require that these domains are reformulated in dimensional rather than categorial terms. This integrative project requires assessment tools, some of which are already available, that are sensitive and thorough enough to pick up on the range of relevant psychopathology. The proposed approach offers opportunities for mutual enrichment: clinical staging may be enriched by introducing greater depth to phenotypes; phenomenological psychopathology may be enriched by introducing stages of severity and disorder progression to phenomenological analysis. (shrink)

This chapter of the Handbook of Utility Theory aims at covering the connections between utility theory and social ethics. The chapter first discusses the philosophical interpretations of utility functions, then explains how social choice theory uses them to represent interpersonal comparisons of welfare in either utilitarian or non-utilitarian representations of social preferences. The chapter also contains an extensive account of John Harsanyi's formal reconstruction of utilitarianism and its developments in the later literature, especially when society faces uncertainty (...) rather than probabilistic risk. (shrink)

Standard principles of rational decision assume that an option's utility is both comprehensive and accessible. These features constrain interpretations of an option's utility. This essay presents a way of understanding utility and laws of utility. It explains the relation between an option's utility and its outcome's utility and argues that an option's utility is relative to a specification of the option. Utility's relativity explains how a decision problem's framing affects an option's (...) class='Hi'>utility and its rationality even for an agent who is cognitively perfect and lacks only empirical information. The essay rewrites standard laws of utility to accommodate relativization to propositions' specifications. The new laws are generalizations of the standard laws and yield them as special cases. (shrink)

Epistemic utility theory seeks to establish epistemic norms by combining principles from decision theory and social choice theory with ways of determining the epistemic utility of agents’ attitudes. Recently, Moss, 1053–69, 2011) has applied this strategy to the problem of finding epistemic compromises between disagreeing agents. She shows that the norm “form compromises by maximizing average expected epistemic utility”, when applied to agents who share the same proper epistemic utility function, yields the result that agents must (...) form compromises by splitting the difference between their credence functions. However, this “split the difference” norm is in conflict with conditionalization, since applications of the two norms don’t commute. A common response in the literature seems to be to abandon the procedure of splitting the difference in favor of compromise strategies that avoid non-commutativity. This would also entail abandoning Moss’ norm. I explore whether a different response is feasible. If agents can use epistemic utility-based considerations to agree on an order in which they will apply the two norms, they might be able to avoid diachronic incoherence. I show that this response can’t save Moss’ norm, because the agreements concerning the order of compromising and updating it generates are not stable over time, and hence cannot avoid diachronic incoherence. I also show that a variant of Moss’ norm, which requires that the weights given to each agent’s epistemic utility change in a way that ensures commutativity, cannot be justified on epistemological grounds. (shrink)

Utility discounting in intertemporal economic modelling has been viewed as problematic, both for descriptive and normative reasons. However, positive utility discount rates can be defended normatively; in particular, it is rational for future utility to be discounted to take into account model-independent outcomes when decision-making under risk. The resultant values will tend to be smaller than descriptive rates under most probability assignments. This also allows us to address some objections that intertemporal considerations will be overdemanding. A principle (...) for utility discount rates is suggested which is rooted in probability discounting. Utility discounting is defended against objections from Parfit (1984) and Broome (2005); Broome (2012). A sample utility discount rate is estimated. [Open access]. (shrink)

In recent years, several authors have called to ground descriptive and normative decision theory on neuro-psychological measures of utility. In this paper, I combine insights from the best available neuro-psychological findings, leading philosophical conceptions of welfare and contemporary decision theory to rebut these prominent calls. I argue for two claims of general interest to philosophers, choice modellers and policy makers. First, severe conceptual, epistemic and evidential problems plague ongoing attempts to develop accurate and reliable neuro-psychological measures of utility. (...) And second, even if these problems are solved, neuro-psychological measures of utility lack the potential to inform welfare analyses and policy evaluations. (shrink)

This paper contrasts the value maximization norm of welfare economics that is central to law and economics in its prescriptive mode to the Aristotelian/Aquinian principles of Catholic social thought. The reluctance (or inability) of welfare economics and law and economics to make judgments about about utilities (or preferences) differs profoundly from the Catholic tradition (rooted in Aristotle as well as religious faith) of contemplation of the nature of the good. This paper also critiques the interesting argument by Stephen Bainbridge that (...) homo economicus bears a certain affinity to fallen man, and that law and economics thus provides appropriate rules for a fallen world. From a Catholic perspective, the social vision of neo-classical economics and its progeny (welfare economics and law and economics) rests on a concept of human autonomy and a utilitarian concept of pleasure inconsistent with the Aristotelian and Aquinean concept of virtue and the conception of civic happiness articulated by Antonio Genovesi and other Catholic economists. (shrink)

Matthew Adler's Measuring Social Welfare is an introduction to the social welfare function (SWF) methodology. This essay questions some ideas at the core of the SWF methodology having to do with the relation between the SWF and the measure of well-being. The facts about individual well-being do not single out a particular scale on which well-being must be measured. As with physical quantities, there are multiple scales that can be used to represent the same information about well-being; no one scale (...) is special. Like physical laws, the SWF and its ranking of distributions cannot depend on exactly which of these scales we use. Adler and other theorists in the SWF tradition have used this idea to derive highly restrictive constraints on the shape of the SWF. These constraints rule out seemingly plausible views about distributive justice and population ethics. I argue, however, that these constraints stem from a simple but instructive mistake. The SWF should not be applied to vectors of numbers such as 1 and 2, but rather to vectors of dimensioned quantities such as 1 util and 2 utils. This seemingly pedantic suggestion turns out to have far-reaching consequences. Unlike the orthodox SWF approach, treating welfare levels as dimensioned quantities lets us distinguish between real changes in well-being and mere changes in the unit of measurement. It does this without making the SWF depend on the scale on which welfare is measured, and in a way that avoids the restrictive constraints on the shape of the SWF. (shrink)

This paper axiomatizes a recursive utility model that captures both intertemporal utility smoothing defined across time and ambiguity aversion defined over states. The resulting representation adapts Wakai model of intertemporal utility smoothing as an aggregator function, where the utility of the certainty equivalent of future uncertainty is computed by Gilboa and Schmeidler multiple-priors utility. The model also permits the separation of intertemporal utility smoothing from ambiguity aversion.

A mixture preorder is a preorder on a mixture space (such as a convex set) that is compatible with the mixing operation. In decision theoretic terms, it satisfies the central expected utility axiom of strong independence. We consider when a mixture preorder has a multi-representation that consists of real-valued, mixture-preserving functions. If it does, it must satisfy the mixture continuity axiom of Herstein and Milnor (1953). Mixture continuity is sufficient for a mixture-preserving multi-representation when the dimension of the mixture (...) space is countable, but not when it is uncountable. Our strongest positive result is that mixture continuity is sufficient in conjunction with a novel axiom we call countable domination, which constrains the order complexity of the mixture preorder in terms of its Archimedean structure. We also consider what happens when the mixture space is given its natural weak topology. Continuity (having closed upper and lower sets) and closedness (having a closed graph) are stronger than mixture continuity. We show that continuity is necessary but not sufficient for a mixture preorder to have a mixture-preserving multi-representation. Closedness is also necessary; we leave it as an open question whether it is sufficient. We end with results concerning the existence of mixture-preserving multi-representations that consist entirely of strictly increasing functions, and a uniqueness result. (shrink)

Acts are functions from states of nature into finite-support distributions over a set of ‘deterministic outcomes’. We characterize preference relations over acts which have a numerical representation by the functional J(f)=min>∫u∘ f dP¦PϵC where f is an act, u is a von Neumann-Morgenstern utility over outcomes, and C is a closed and convex set of finitely additive probability measures on the states of nature. In addition to the usual assumptions on the preference relation as transitivity, completeness, continuity and monotonicity, (...) we assume uncertainty aversion and certainty-independence. The last condition is a new one and is a weakening of the classical independence axiom: It requires that an act f is preferred to an act g if and only if the mixture of f and any constant act h is preferred to the same mixture of g and h. If non-degeneracy of the preference relation is also assumed, the convex set of priors C is uniquely determined. Finally, a concept of independence in case of a non-unique prior is introduced. (shrink)

As a defender of the fundamental importance of Mendel’s experiments for understanding heredity, the English biologist William Bateson did much to publicize the usefulness of Mendelian science for practical breeders. In the course of his campaigning, he not only secured a reputation among breeders as a scientific expert worth listening to but articulated a vision of the ideal relations between pure and applied science in the modern state. Yet historical writing about Bateson has tended to underplay these utilitarian elements of (...) his program, to the extent of portraying him, notably in still-influential work from the 1960s and 1970s, as a type specimen of the scientist who could not care less about application. This paper offers a corrective view of Bateson himself—including the first detailed account of his role as an expert witness in a courtroom dispute over the identity of a commercial pea variety—and an inquiry into the historiographic fate of his efforts in support of Mendelism’s productivity. For all that a Marxian perspective classically brings applied science to the fore, in Bateson’s case, and for a range of reasons, it did the opposite during the Cold War. (shrink)

Bioethics, Volume 36, Issue 4, Page 423-433, May 2022.

Consider a subjective expected utility preference relation. It is usually held that the representations which this relation admits differ only in one respect, namely, the possible scales for the measurement of utility. In this paper, I discuss the fact that there are, metaphorically speaking, two additional dimensions along which infinitely many more admissible representations can be found. The first additional dimension is that of state-dependence. The second—and, in this context, much lesser-known—additional dimension is that of act-dependence. The simplest (...) implication of their usually neglected existence is that the standard axiomatizations of subjective expected utility fail to provide the measurement of subjective probability with satisfactory behavioral foundations. (shrink)

Utilitarianism is a “consequentialist” doctrine: that actions are right or wrong in proportion as they produce good or bad consequences. Mill’s version is also a “hedonistic” doctrine. Consequences are good insofar as they have more happiness or less unhappiness; bad, as they have more unhap- piness or less happiness; and by happiness and unhappiness, Mill means pleasure and pain. In English, the words “happiness” and “unhappiness” do not have the same connotations as “pleasure” and “pain.” “Happiness” implies feeling good about (...) one’s life as well as feeling good. “Happiness” is found in relationships with friends and loved ones and in a sense of accomplishment. “Pleasure” seems to be something that is momentary and more sensational. But according to Mill’s psy- chology, a happy life consists in many pleasures and few pains. The happiness of relationships with friends and loved ones is reducible to the joys and satisfactions in the moments of one’s life that arise from these relationships. The happiness of a sense of accomplishment consists of the pleasurable states of consciousness that arise from a sense of accomplishment. The happiness of self-respect and the unhap- piness of self-disrespect consist of the pleasurable and painful states of conscious- ness that these involve. This reduction of happiness and unhappiness to pleasures and pains is a controversial element in Mill’s philosophy. I leave it to the reader to think about that reduction. In what follows, it will be assumed. (shrink)

The principle of exchange seems to be limited in its application, and it cannot serve as a link between utilitarianism and the idea of a market for interpersonal relations. Our preferences concern the inner states of other people as well as their overt behavior. The neglect of this aspect of our preferences is a result of the coupling of utilitarianism with behaviorism. The problem is thus behaviorism, not consequentialism. It might be argued that commensurability is wrong because it sanctions impure (...) practices - aside from any principle of exchange. In reply, it may be argued that the principle of purity is an intuitive one, which must be justified at a higher level. At the intuitive level, the purity principle competes with the view that practices are in some cases too pure already, and that blind purity cannot be maintained without educational deception. The apparent difficulty of making tradeoffs among different kinds of consequences is a problem in practice, not a problem in principle. The difficulty may indeed justify certain prescriptive rules, but a blanket prohibition against impure practices would seem to require considerable defense. (shrink)

Mill's most famous departure from Bentham is his distinction between higher and lower pleasures. This article argues that quality and quantity are independent and irreducible properties of pleasures that may be traded off against each other higher pleasures’ lexically dominate lower ones, and that the distinction is compatible with hedonism. I show how this interpretation not only makes sense of Mill but allows him to respond to famous problems, such as Crisp's Haydn and the oyster and Nozick's experience machine.

The COVID‐19 pandemic has raised important universal public health challenges. Conceiving ethical responses to these challenges is a public health imperative but must take context into account. This is particularly important in sub‐Saharan Africa (SSA). In this paper, we examine how some of the ethical recommendations offered so far in high‐income countries might appear from a SSA perspective. We also reflect on some of the key ethical challenges raised by the COVID‐19 pandemic in low‐income countries suffering from chronic shortages in (...) health care resources, and chronic high morbidity and mortality from non‐COVID‐19 causes. A parallel is drawn between the distribution of severity of COVID‐19 disease and the classic “Fortune at the bottom of the pyramid” model that is relevant in SSA. Focusing allocation of resources during COVID‐19 on the ‘thick’ part of the pyramid in Low‐to‐Middle Income Countries (LMICs) could be ethically justified on utilitarian and social justice grounds, since it prioritizes a large number of persons who have been economically and socially marginalized. During the pandemic, importing allocation frameworks focused on the apex of the pyramid from the global north may therefore not always be appropriate. In a post‐COVID‐19 world, we need to think strategically about how health care systems can be financed and structured to ensure broad access to adequate health care for all who need it. The root problems underlying health inequity, exposed by COVID‐19, must be addressed, not just to prepare for the next pandemic, but to care for people in resource poor settings in non‐pandemic times. (shrink)

How many serious mistakes can a brilliant philosopher make in a single paragraph? Many think that Mill answers this question by example—in the third paragraph of Chapter IV of Utilitarianism. Here is the notorious paragraph: The only proof capable of being given that an object is visible, is that people actually see it. The only proof that a sound is audible, is that people hear it: and so of the other sources of our experience. In like manner, I apprehend, the (...) sole evidence it is possible to produce that anything is desirable, is that people do actually desire it. If the end which the utilitarian doctrine proposes to itself were not, in theory and in practice, acknowledged to be an end, nothing could ever convince any person that it was so. No reason can be given why the general happiness is desirable, except that each person, so far as he believes it to be attainable, desires his own happiness. This, however, being a fact, we have not only all the proof which the case admits of, but all which it is possible to require, that happiness is a good: that each person's happiness is a good to that person, and the general happiness, therefore, a good to the aggregate of all persons. Happiness has made out its title as one of the ends of conduct, and consequently one of the criteria of morality. (shrink)

It is widely held that under ordinal utility, utility differences are ill-defined. Allegedly, for these to be well-defined (without turning to choice under risk or the like), one should adopt as a new kind of primitive quaternary relations, instead of the traditional binary relations underlying ordinal utility functions. Correlatively, it is also widely held that the key structural properties of quaternary relations are entirely arbitrary from an ordinal point of view. These properties would be, in a nutshell, (...) the hallmark of cardinal utility. While much is obviously true in these two tenets, this note explains why, as stated, they should be abandoned. Any ordinal utility function induces a rich quaternary relation. There is such a thing as ordinal utility differences. Furthermore, this induced quaternary relation respects, apart from completeness, the most standard structural properties of quaternary relations. These properties are, from an ordinal point of view, anything but arbitrary; from a quaternary perspective only completeness should be considered the hallmark—if any—of cardinal utility. These facts are explained to be especially relevant to the critical appreciation of the ordinalist methodology. (shrink)