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)

A simple argument suggests that we can fruitfully model advanced AI systems using expected utility theory. According to this argument, an agent will need to act as if maximising expected utility if they’re to avoid exploitation. Insofar as we should expect advanced AI to avoid exploitation, it follows that we should expected advanced AI to act as if maximising expected utility. I spell out this argument more carefully and demonstrate that it fails, but show that the manner (...) of its failure is instructive: in exploring the argument, we gain insight into how to model advanced AI systems. (shrink)

In this paper, I investigate the betting behavior of a decision-maker who can influence the likelihood of the events upon which she is betting. In decision theory, this is best known as a situation of moral hazard. Focusing on a particularly simple case, I sketch the first systematic analysis of moral hazard in the canonical Savage framework. From the results of this analysis, I draw two philosophical conclusions. First, from an observational and a descriptive point of view, there need to (...) be no incompatibility between moral hazard and the Savage framework. This qualifies the incompatibility view, that is ubiquitous in decision theory. Second, in general, moral hazard is not sufficient to overcome the challenges posed by state-dependent utility to the behavioral identification of beliefs. This qualifies the sufficiency view, that is influential in decision theory. These two philosophical conclusions are the main contributions of my paper. (shrink)

This paper interrogates the concept of luck in cancer diagnosis. I argue that while it might have some utility for individuals, at the clinical and research level, the concept impedes important prevention efforts and misdirects sources of blame in a cancer diagnosis. Such use, in fact, has the possibility of harming already vulnerable efforts at ameliorating social determinants of health and should therefore be eliminated from research and clinical contexts.

The New Leviathan, originally published in 1942, a few months before the author's death, is the book which R. G. Collingwood chose to write in preference to completing his life's work on the philosophy of history. It was a reaction to the Second World War and the threat which Nazism and Fascism constituted to civilization. The book draws upon many years of work in moral and political philosophy and attempts to establish the multiple and complex connections between the levels of (...) consciousness, society, civilization, and barbarism. Collingwood argues that traditional social contract theory has failed to account for the continuing existence of the non-social community and its relation to the social community in the body politic. He is also critical of the tendency within ethics to confound right and duty. The publication of additional manuscript material in this revised edition demonstrates in more detail how Collingwood was determined to show that right and duty occupy different levels of rational practical consciousness. The additional material also contains Collingwood's unequivocal rejection of relativism. David Boucher's introduction shows that The New Leviathan and The Idea of History are integrally related and that neither can be properly understood independently of the other. He is also concerned to show how many of Collingwood's ideas have a contemporary relevance, and that his ideas on barbarism are not so unusual as they might at first appear. (shrink)

Various U.S. laws, such as the Clean Air Act and the Food Quality Protection Act, require additional protections for susceptible subpopulations who face greater environmental health risks. The main ethical rationale for providing these protections is to ensure that environmental health risks are distributed fairly. In this article, we (1) consider how several influential theories of justice deal with issues related to the distribution of environmental health risks; (2) show that these theories often fail to provide specific guidance concerning policy (...) choices; and (3) argue that an approach to public decision making known as accountability for reasonableness can complement theories of justice in establishing acceptable environmental health risks for the general population and susceptible subpopulations. Since accountability for reasonableness focuses on the fairness of the decision-making process, not the outcome, it does not guarantee that susceptible subpopulations will receive a maximum level of protection, regardless of costs or other morally relevant considerations. (shrink)

Simple heuristics and regression models make different assumptions about behaviour. Both the environment and judgment can be described as fast and frugal. We do not know whether humans are successful when being fast and frugal. We must assess both global accuracy and the costs of Type I and II errors. These may be “smart heuristics that make researchers look simple.”.

The null-hypothesis significance-test procedure (NHSTP) is defended in the context of the theory-corroboration experiment, as well as the following contrasts: (a) substantive hypotheses versus statistical hypotheses, (b) theory corroboration versus statistical hypothesis testing, (c) theoretical inference versus statistical decision, (d) experiments versus nonexperimental studies, and (e) theory corroboration versus treatment assessment. The null hypothesis can be true because it is the hypothesis that errors are randomly distributed in data. Moreover, the null hypothesis is never used as a categorical proposition. Statistical (...) significance means only that chance influences can be excluded as an explanation of data; it does not identify the nonchance factor responsible. The experimental conclusion is drawn with the inductive principle underlying the experimental design. A chain of deductive arguments gives rise to the theoretical conclusion via the experimental conclusion. The anomalous relationship between statistical significance and the effect size often used to criticize NHSTP is more apparent than real. The absolute size of the effect is not an index of evidential support for the substantive hypothesis. Nor is the effect size, by itself, informative as to the practical importance of the research result. Being a conditional probability, statistical power cannot be the apriori probability of statistical significance. The validity of statistical power is debatable because statistical significance is determined with a single sampling distribution of the test statistic based on H0, whereas it takes two distributions to represent statistical power or effect size. Sample size should not be determined in the mechanical manner envisaged in power analysis. It is inappropriate to criticize NHSTP for nonstatistical reasons. At the same time, neither effect size, nor confidence interval estimate, nor posterior probability can be used to exclude chance as an explanation of data. Neither can any of them fulfill the nonstatistical functions expected of them by critics. (shrink)

A principal source of interest in behavioral economics has been its advertised contributions to policies aimed at ‘nudging’ people away from allegedly natural but self-defeating behavior toward patterns of response thought more likely to improve their welfare. This has occasioned controversies among economists and philosophers around the normative limits of paternalism, especially by technical policy advisors. One recent suggestion has been that ‘boosting,’ in which interventions aim to enhance people’s general cognitive skills and representational repertoires instead of manipulating their choice (...) environments behind their backs, avoids the main normative challenges. A limitation in most of this literature is that it has focused on relatively sweeping policy recommendations and consequently on strong polar alternatives of general paternalism and strict laissez faire. We review a real instance, drawn from a consulting project we conducted for an investment bank, of a proposed intervention that is more typical of the kind that economists are more often actually called upon to offer. In this example, the sophistication of current tools for preference attribution, combined with philosophical externalism about the semantics of preferences that makes it less plausible to attribute their literal self-conscious representation to people as propositional attitude content becomes more tightly refined, blocks applicability of the distinction between nudging and boosting. This seems to call for irreducible, context-specific ethical judgment in assessing the appropriateness of the forms of paternalism that economists must actually wrestle with in going about their everyday business. (shrink)

The first domestic death from Ebola in the United States occurred in Texas in October 2014. Family members who were potentially exposed to the infected individual were legally and involuntarily quarantined. Quarantine may not be a recent normal practice in the United States, but it was used extensively during the influenza pandemic in the early 20th century. However, health care ethics comes into play when we quarantine someone whose infection status is unknown versus active. To prevent the spread of a (...) pathogen, one person may be held against his or her will and that person’s freedom is terminated. Quarantine may be acceptable in the case of Ebola, as it is particularly virulent and there have been more and more potential cases in the United States . As a result, the general population may understand how isolation and quarantine may help prevent the spread of Ebola. We must use this epidemic as an opportunity to educate the general population on ways to prevent the sprea .. (shrink)

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

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)

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.

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.

In this paper weak utilities are obtained for acyclic binary relations satisfying a condition weaker than semicontinuity on second countable topological spaces. In fact, in any subset of such a space we obtain a weak utility that characterizes the maximal elements as maxima of the function. The addition of separability of the relation yields the existence of semicontinuous representations. This property of the utility provides a result of existence of maximal elements for a class of spaces that include (...) compact spaces. However, we offer a negative result that continuity may not be reached under such hypotheses. (shrink)