There is a tension between Laudato si's consistent emphasis on relationships and interconnectedness and its acceptance of anthropocentrism. While Laudato si’ does reject certain problematic forms of anthropocentrism, the encyclical does not assert an alternative to this traditional framework. This article contends that “relatiocentrism” provides the best avenue for developing the convictions expressed within Laudato si’ while moving beyond the limitations of the encyclical itself. In so doing, this essay explores the use of narrative as a means of shaping identity (...) by mapping significant relationships and points of meaning. It examines the central anthropological claims of the encyclical and the tensions these create with anthropocentric narratives. And it examines relatiocentrism in light of the biblical creation accounts, the eschatological perspective of Laudato si’, and virtue ethics. The essay concludes by suggesting further theological and moral implications of this shift in perspective. (shrink)

The public discourse surrounding sex and severe disability over the past 40 years has largely focused on protecting vulnerable populations from abuse. However, health professionals and activists are increasingly recognising the inherent sexuality of disabled persons and attempting to find ways to accommodate their intimacy needs. This essay explores several ethical issues arising from such efforts.

Totalism is the view that one distribution of well-being is better than another just in case the one contains a greater sum of well-being than the other. Many philosophers, following Parfit, reject totalism on the grounds that it entails the repugnant conclusion: that, for any number of excellent lives, there is some number of lives that are barely worth living whose existence would be better. This paper develops a theory of welfare aggregation—the lexical-threshold view—that allows totalism to avoid the repugnant (...) conclusion, as well as its analogues involving suffering populations and the lengths of individual lives. The theory is grounded in some independently plausible views about the structure of well-being, identifies a new source of incommensurability in population ethics, and avoids some of the implausibly extreme consequences of other lexical views, without violating the intuitive separability of lives. (shrink)

Lara Buchak argues for a version of rank-weighted utilitarianism that assigns greater weight to the interests of the worse off. She argues that our distributive principles should be derived from the preferences of rational individuals behind a veil of ignorance, who ought to be risk averse. I argue that Buchak’s appeal to the veil of ignorance leads to a particular way of extending rank-weighted utilitarianism to the evaluation of uncertain prospects. This method recommends choices that violate the unanimous preferences of (...) rational individuals and choices that guarantee worse distributions. These results, I suggest, undermine Buchak’s argument for rank-weighted utilitarianism. (shrink)

Substituted judgment has increasingly become the accepted standard for rendering decisions for incapacitated adults in the USA. A broad exception exists with regard to patients with diminished capacity secondary to depressive disorders, as such patients’ previous wishes are generally not honoured when seeking to turn down life-preserving care or pursue aid-in-dying. The result is that physicians often force involuntary treatment on patients with poor medical prognoses and/or low quality of life as a result of their depressive symptoms when similarly situated (...) incapacitated patients without such depressive symptoms would have their previous wishes honoured via substituted judgment. This commentary argues for reconsidering this approach and for using a substituted judgment standard for a subset of EMP/LQL patients seeking death. (shrink)

According to asymmetric comparativism, it is worse for a person to exist with a miserable life than not to exist, but it is not better for a person to exist with a happy life than not to exist. My aim in this paper is to explain how asymmetric comparativism could possibly be true. My account of asymmetric comparativism begins with a different asymmetry, regarding the (dis)value of early death. I offer an account of this early death asymmetry, appealing to the (...) idea of conditional goods, and generalize it to explain how asymmetric comparativism could possibly be true. I also address the objection that asymmetric comparativism has unacceptably antinatalist implications. (shrink)

Embodied simulation and the epistemic motivation to search for the of other people's behaviors are not necessary for specific and functional responding to, and hence processing of, human facial expressions. Rather, facial expression processing can be achieved through lower-cognitive, heuristical perceptual processing and expression of prototypical morphological musculature movement patterns that communicate discrete trustworthiness and capacity cues to conspecifics.

The “Goldwater rule,” a policy adopted by the American Psychiatry Association in 1973, prohibits organization members from diagnosing or offering professional opinions regarding the mental health of public figures without both first-hand evaluation and authorization. Initially developed in response to a controversial survey of APA members during the 1964 Presidential election campaign, the ethics rule faced few large scale challenges until the election of Donald Trump in 2016. Since that time, a significant number of psychiatrists have either violated or criticized (...) the rule openly. This paper argues that whatever the initial merits of the rule, the prohibition has since been rendered obsolete by the combined lack of professional consensus supporting the policy, absence of a meaningful enforcement mechanism, and the credible statements of non-APA members in the mental health professions regarding public figures. (shrink)

Priority for solid organ transplant generally does not consider the underlying cause of the need for transplantation. This paper argues that a distinctive set of factors justify assigning lower priority to willfully unvaccinated individuals who require transplant as a result of suffering from COVID‐19. These factors include the personal responsibility of the patients for their own condition and the public outrage likely to ensue if willfully unvaccinated patients receive organs at the expense of vaccinated ones. The paper then proposes a (...) three‐prong test for similar deviations from the current allocation standard that incorporates patient responsibility, foreseeability and avoidability, and the frequency of the occurrence. (shrink)

The Rachels–Temkin spectrum arguments against the transitivity of better than involve good or bad experiences, lives, or outcomes that vary along multiple dimensions—e.g., duration and intensity of pleasure or pain. This paper presents variations on these arguments involving combinations of good and bad experiences, which have even more radical implications than the violation of transitivity. These variations force opponents of transitivity to conclude that something good is worse than something that isn’t good, on pain of rejecting the good altogether. That (...) is impossible, so we must reject the spectrum arguments. (shrink)

On February 24, 2022, Russia invaded its neighboring nation, Ukraine, in what is widely regarded in the West as a grave breach of international law. Since that time, the Russian military has been i...

Physicians expressing opinions on medical matters that run contrary to the consensus of experts pose a challenge to licensing bodies and regulatory authorities. While the right to express contrarian views feeds a robust marketplace of ideas that is essential for scientific progress, physicians advocating ineffective or dangerous cures, or actively opposing public health measures, pose a grave threat to societal welfare. Increasingly, a distinction has been made between professional speech that occurs during the physician-patient encounter and public speech that transpires (...) beyond the clinical setting, with physicians being afforded wide latitude to voice empirically false claims outside the context of patient care. This paper argues that such a bifurcated model does not sufficiently address the challenges of an age when mass communications and social media allow dissenting physicians to offer misleading medical advice to the general public on a mass scale. Instead, a three-tiered model that distinguishes between citizen speech, physician speech and clinical speech would best serve authorities when regulating physician expression. (shrink)

Although considerable attention has been devoted to the concepts of “visible” and “invisible” victims in general medical practice, especially in relation to resource allocation, far less consideration has been devoted to these concepts in behavioral health. Distinctive features of mental health care in the United States help explain this gap. This essay explores three specific ways in which the American mental health care system protects potentially “visible” individuals at the expense of “invisible victims” and otherwise fails to meet the needs (...) of great numbers of people with serious psychiatric conditions: prioritization of the wrong patients, incentivization of excessive caution among providers, and a narrow definition of psychiatry's purview. While each of these practices has been discussed elsewhere in the literature, they are rarely considered as part of an interrelated and systemic problem. Reconceptualizing these three issues as aspects of the larger conflict between the interests of “visible” and “invisible” victims may prove a path toward reform. (shrink)

A sample of 460 low-income women completed a mate preference questionnaire and surveys that assessed family background, life history, conscientiousness, sexual motives, self-ratings (e.g., looks), and current circumstances (e.g., income). A cluster analysis revealed two groups of women: women who reported a strong preference for looks and money in a short-term mate and commitment in a long-term mate, and women who reported smaller differences across mating context. Group differences were found in reported educational levels, family background, sexual development, number of (...) children, and motives for having sex. Implications for understanding individual differences in women’s mate-preference trade-offs are discussed. (shrink)

In their analyses of the neural correlates of discrete emotionality, Lindquist et al. do not consider the numerous drawbacks to inferring psychological processes based on currently available cognitive neurometric technology. The authors also disproportionately emphasize the relevance of neuronal activation over deactivation, which, in our opinion, limits the scope and utility of their conclusions.

This paper is about the role of interpersonal comparisons in Harsanyi's aggregation theorem. Harsanyi interpreted his theorem to show that a broadly utilitarian theory of distribution must be true even if there are no interpersonal comparisons of well-being. How is this possible? The orthodox view is that it is not. Some argue that the interpersonal comparability of well-being is hidden in Harsanyi's premises. Others argue that it is a surprising conclusion of Harsanyi's theorem, which is not presupposed by any one (...) of the premises. I argue instead that Harsanyi was right: his theorem and its weighted-utilitarian conclusion do not require interpersonal comparisons of well-being. The key to making sense of this possibility is to treat Harsanyi's weights as dimensional constants rather than dimensionless numbers. (shrink)

The integrity of the patient–physician relationship depends on maintaining professional boundaries. While ethicists and professional organisations have devoted significant consideration to the subject of sexual boundary transgressions, the subject of non-sexual boundaries, especially outside the mental health setting, has been largely neglected. While professional organisations may offer guidance on specific subjects, such as accepting gifts or treating relatives, as well as general guidance on transparency and conflict of interest, what is missing is a principle-based method that providers can use to (...) assess non-sexual interactions with patients that transcend norms of practice. This paper attempts to offer an operational model for such assessment that considers not only the traditional emphasis on beneficence, but also incorporates concerns over entanglement and concordance. (shrink)

I present a new argument for the repugnant conclusion. The core of the argument is a risky, intrapersonal analogue of the mere addition paradox. The argument is important for three reasons. First, some solutions to Parfit’s original puzzle do not obviously generalize to the intrapersonal puzzle in a plausible way. Second, it raises independently important questions about how to make decisions under uncertainty for the sake of people whose existence might depend on what we do. And, third, it suggests various (...) difficulties for leading views about the value of a person’s life compared to her nonexistence. (shrink)

I defend the view that a reason for someone to do something is just a reason why she ought to do it. This simple view has been thought incompatible with the existence of reasons to do things that we may refrain from doing or even ought not to do. For it is widely assumed that there are reasons why we ought to do something only if we ought to do it. I present several counterexamples to this principle and reject some (...) ways of understanding "ought" so that the principle is compatible with my examples. I conclude with a hypothesis for when and why the principle should be expected to fail. (shrink)

The American Journal of Bioethics, Volume 12, Issue 9, Page 9-11, September 2012.

Recent research indicates that compensation structure can be used by firms to discourage their employees from whistleblowing. We extend the ethics literature by examining how compensation structures and financial rewards work together to influence managers’ decisions to blow the whistle. Results from an experiment indicate that compensation with restricted stock, relative to stock payments that lack restrictions, can enhance the likelihood that managers will blow the whistle when large rewards are available. However, restricted stock can also threaten the effectiveness of (...) whistleblowing systems without the presence of large financial rewards for whistleblowing. Thus, the large potential rewards for whistleblowing enacted by the Dodd–Frank Act appear timely as firms are moving toward compensation agreements that include greater proportions of restricted stock. (shrink)

This paper reports on the results of an experiment conducted with experienced corporate directors. The study findings indicate that directors employ prospective rationality cognition, and they sometimes make decisions that emphasize legal defensibility at the expense of personal ethics and social responsibility. Directors recognize the ethical and social implications of their decisions, but they believe that current corporate law requires them to pursue legal courses of action that maximize shareholder value. The results suggest that additional ethics education will have little (...) influence on the decisions of many business leaders because their decisions are driven by corporate law, rather than personal ethics. (shrink)

The standard view of "believes" and other propositional attitude verbs is that such verbs express relations between agents and propositions. A sentence of the form “S believes that p” is true just in case S stands in the belief-relation to the proposition that p; this proposition is the referent of the complement clause "that p." On this view, we would expect the clausal complements of propositional attitude verbs to be freely intersubstitutable with their corresponding proposition descriptions—e.g., "the proposition that p"—as (...) they are in the case of "believes." In many cases, however, intersubstitution of that-clauses and proposition descriptions fails to preserve truth value or even grammaticality. These substitution failures lead some philosophers to reject the standard view of propositional attitude reports. Others conclude that propositional attitude verbs are systematically ambiguous. I reject both these views. On my view, the that-clause complements of propositional attitude verbs denote propositions, but proposition descriptions do not. (shrink)

This paper presents a new kind of problem in the ethics of distribution. The problem takes the form of several “calibration dilemmas,” in which intuitively reasonable aversion to small-stakes inequalities requires leading theories of distribution to recommend intuitively unreasonable aversion to large-stakes inequalities. We first lay out a series of such dilemmas for prioritarian theories. We then consider a widely endorsed family of egalitarian views and show that they are subject to even more forceful calibration dilemmas than prioritarian theories. Finally, (...) we show that our results challenge common utilitarian accounts of the badness of inequalities in resources. (shrink)

Extensive measurement is the standard measurement-theoretic approach for constructing a ratio scale. It involves the comparison of objects that can be concatenated in an additively representable way. This paper studies the implications of extensively measurable welfare for social choice theory. We do this in two frameworks: an Arrovian framework with a fixed population and no interpersonal comparisons, and a generalized framework with variable populations and full interpersonal comparability. In each framework we use extensive measurement to introduce novel domain restrictions, independence (...) conditions, and constraints on social evaluation. We prove a welfarism theorem for these domains and characterize the social welfare functions that satisfy the axioms of extensive measurement at both the individual and social levels. The main results are simple axiomatizations of strong dictatorship in the Arrovian framework and classical utilitarianism in the generalized framework. (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)

ABSTRACT Sometimes it seems that an existing bearer of value should be preserved even though it could be destroyed and replaced with something of equal or greater value. How can this conservative intuition be explained and justified? This paper distinguishes three answers, which I call existential, attitudinal, and object-affecting conservatism. I raise some problems for existential and attitudinal conservatism, and suggest how they can be solved by object-affecting conservatism.

Is well-being the kind of thing that can be summed across individuals? This paper takes a measurement-theoretic approach to answering this question. To make sense of adding well-being, we would need to identify some natural "concatenation" operation on the bearers of well-being that satisfies the axioms of extensive measurement and can therefore be represented by the arithmetic operation of addition. I explore various proposals along these lines, involving the concatenation of segments within lives over time, of entire lives led alongside (...) one another or in sequence, and of evaluatively basic propositions via conjunction. All of these proposals turn out to carry highly controversial commitments about the good. I do not claim that these commitments are unacceptable. But they suggest that we cannot simply take for granted, as many philosophers do, that there is any such thing as the sum of well-being. (shrink)

Artificial intelligence (AI) holds considerable promise for transforming clinical diagnostics. While much has been written both about public attitudes toward the use of AI tools in medicine and about uncertainty regarding legal liability that may be delaying its adoption, the interface of these two issues has so far drawn less attention. However, understanding this interface is essential to determining how jury behaviour is likely to influence adoption of AI by physicians. One distinctive concern identified in this paper is a ‘negative (...) outcome penalty paradox’ (NOPP) in which physicians risk being penalised by juries in cases with negative outcomes, whether they overrule AI determinations or accept them. The paper notes three reasons why AI in medicine is uniquely susceptible to the NOPP and urges serious further consideration of this complex dilemma. (shrink)

We disagree with Dixon et al. by maintaining that prejudice is primarily rooted in aversive reactions toward out-group members. However, these reactions are not indicative of negative attributes, such as trait bigotry, but rather normative homophily for peers with similar perceived attributes. Cognitive biases such as stereotype threat perpetuate perceptions of inequipotential and subsequent discrimination, irrespective of individuals' personality characteristics.

Social signaling models predict that subtle variation in climatic temperature induces systematic changes in expressed cognition. An experiment showed that perceived room temperature was associated with variability in self-descriptions, social reactions of others, and desiring differing types of social networks. The findings reflect the tendency to inflate capacity demonstrations in warmer climates as a result of the social networking opportunities they enable.

Since several landmark legal decisions in the 1970s and 1980s, substituted judgment has become widely accepted as an approach to decision‐making for incapacitated patients that incorporates their autonomy and interests. Two notable exceptions have been cases involving minors and those involving cognitively or psychiatrically impaired individuals who never previously possessed the ability to contemplate the medical decisions involved in their care. While a best interest standard may have universal merit in pediatric cases, this paper argues that substituted judgement has been (...) rejected too broadly for “never‐capacitated” patients. It then lays out a three‐condition test for using substituted judgment in these cases. For a subset of “never‐capacitated” patients who belong to distinctive religious or cultural communities with clear medical values and have an appropriate surrogate, these values may prove helpful in vindicating the interests of the never‐capacitated and should not be blanketly dismissed. (shrink)

How should we choose between uncertain prospects in which different possible people might exist at different levels of wellbeing? Alex Voorhoeve and Marc Fleurbaey offer an egalitarian answer to this question. I give some reasons to reject their answer and then sketch an alternative, which I call person-affecting prioritarianism.

Limitations on reproductive decision making, including forced sterilization and involuntary birth control, raise significant ethical challenges. In the United States, these issues are further complicated by a disturbing history of the abuse and victimization of vulnerable populations. One particularly fraught challenge is the risk of teratogenicity posed by moodstabilizing psychiatric medications in patients who are incapable of appreciating such dangers. Long-acting reversible contraception (LARC) offers an intervention to prevent pregnancy among individuals who receive such treatments, but at a cost to (...) their reproductive autonomy. This article examines the ethical issues involved in the use of involuntary LARC for patients on teratogenic psychiatric medications (TPMs) and argues that such an approach can only be justified as a last resort after a careful consideration of the alternatives and an assessment of potential risks and benefits. (shrink)

Welfarism is the view that individual welfare is the only thing that matters. One important contribution of social choice theory has been to provide a precise formulation and axiomatic characterization of welfarism using Amartya Sen's framework of social welfare functionals. This paper is motivated by the observation that the standard formalization of welfarism is too restrictive, since a welfarist social planner need not be committed to maximizing a preference ordering or any other binary relation over alternatives. We therefore provide a (...) characterization of welfarism in a more general choice-functional setting and show that welfarism, so understood, carries no commitment to rationalizability. This characterization is compatible with welfare values having any structure whatsoever. It also sheds light on different formulations of anonymity, revealing only some of these to be fundamental requirements of impartiality. (shrink)

This essay advocates for the wholesale reevaluation of the process used by American medical schools for selecting physicians, examining fundamental questions such as the purpose of physicians and the nature of meritocracy. It raises questions about the size of medical school classes, the specific academic requirements, and the inadequacy of current efforts to increase diversity. Ultimately, the essay argues for consideration of a range of reforms that will focus on the community-empowering aspects of medical admissions decisions.

Major depressive disorder is one of the most common serious illnesses worldwide; the disease is also among those with the lowest rates of treatment. Barriers to access to care, both practical and psychological, contribute significantly to these low treatment rates. Among such barriers are regulations in many nations that require a physician’s prescription for most pharmacological treatments including selective serotonin reuptake inhibitors (SSRIs). These rules are designed to protect patients. However, such regulations involve a tradeoff between the welfare of “visible” (...) victims, who might suffer negative consequences from a lack of regulation, and the well-being of invisible “victims,” who likely experience negative consequences that result from increased barriers to care. This article explores these tradeoffs and argues in favor of shifting SSRIs from prescription-only to over-the-counter status. (shrink)