In this introduction we set out some salient themes that will help structure understanding of a c... more In this introduction we set out some salient themes that will help structure understanding of a complex set of intersecting issues discussed in this special issue on the work of Marc Lewis: (1) conceptual foundations of the disease model, (2) tolerating the disease model given sociopolitical environments, and (3) A third wave: refining conceptualization of addiction in the light of Lewis's model.
What are the requirements of respect for others as agents? 1 Chris regularly travels to another t... more What are the requirements of respect for others as agents? 1 Chris regularly travels to another town for work and sometimes attends conferences further afield. When at conferences Chris often engages in casual sexual liaisons and is also conducting an on-again, off-again affair in the town he travels to for work. Chris has a spouse, Jo, and two teenage children. Chris and Jo get on well; their children are navigating adolescence with mixed success. Chris is comfortable with his extra-curricular activities and judges it best not to tell Jo about them. Jo would feel betrayed, and might even end the marriage which would likely be bad for their children and disruptive all round. So Chris lies as necessary, and endorses Jo's ideal conception of their marriage in their friendship group. Chris may be right that, all things considered, it would be better to keep Jo in the dark. It is possible that everyone will be happier if the status quo is maintained. We do not wish to adjudicate that point here. Even so, it appears that Chris wrongs Jo. Jo is being deliberately deprived of information that is clearly material to her values, her interests, and to decisions that she might make regarding her marriage. Chris thus substitutes his own judgment for Jo's. She is not given the opportunity to reflect on the true state of their marriage or a voice in the decisions Chris makes about it. The wrong of deception, has, since Kant, been characterised as a failure of respect for the agency of the other. According to Kant, as rational beings capable of evaluating and setting their own ends, persons are not to be treated as mere means to another's end. In lying we manipulate the other's rational capacities in order to achieve ends we know, or fear, they would not share. This is paradigmatically a failure of respect. Truthfulness then, is seen as a central mode of respect for each other's agency. We agree. But we claim that a closer examination of our goals qua agents and of the ways in which agency can be supported or undermined in our interactions with each other reveals a further and distinct mode of respect for agency. The importance of truthfulness lies in significant part in the ways in which it answers to and supports our agential need to make intelligible, to make sense of our world, other people, and ourselves. Thus, we take as the main burden of this paper to draw out the notion of sense-making and highlight its importance for human agency. Since sense-making is something we often do together, and that we can support or undermine, it generates norms of interaction that we claim constitute a distinctive mode of recognition and respect for another's agency. The authors wish to thank two anonymous referees for this JOURNAL for their extensive remarks responding to earlier versions of the manuscript. Both reviewers' insightful critical engagement greatly improved the article. We also especially thank Doug McConnell for generously reading an early draft and for written comments. For helpful discussions we thank audiences at the University of Melbourne Philosophy Department, and the Philosophy department at Deakin University. 1 We are primarily concerned in this paper with what Stephen Darwall has termed recognition respect. See
Jennifer Blumenthal-Barby (2024) has called for bioethics to end talk about personhood, asserting... more Jennifer Blumenthal-Barby (2024) has called for bioethics to end talk about personhood, asserting that such talk has the tendency to confuse and offend. It will be argued that this has only limited application for (largely) private settings. However, in other settings theorizing about personhood leaves a gap in which there is the risk that the offending concept will get uptake elsewhere, and so the problem Blumenthal-Barby nominates may not be completely avoided. In response to this risk, an argument is presented in support of the idea that the role of philosophers and bioethicists, far from ending talk of personhood, ought to be to clarify the concept, and to do so in nuanced ways, given its application for specific kinds of impairments. The case of dementia is used to illustrate this in the context of person-centered care. Ironically, given the stigma attaching to dementia, far from the need to end talk of personhood, bioethicists are needed to rescue the concept and to clarify its role.
The trauma and anguish professional people encounter in their work over time can lead to losses i... more The trauma and anguish professional people encounter in their work over time can lead to losses in competence, and occupational burnout. However, the practice of detachment designed to avoid these outcomes can tip over into losses in the ability to connect with clients, and even to alienation from the professional role itself. Some have thought that the proper regulation of levels of empathic concern ensures a balance between these two poles. I argue against this, and instead advocate for a stance I call compassionate understanding. I contend that this best achieves sustained professionalism while remaining morally attuned to the norms of one's occupation. I focus on healthcare to illustrate what is at stake in compassionate understanding, though the position I defend has applications across a significant range of professions.
The decline in autobiographical memory function in people with Alzheimer’s dementia (AD) has been... more The decline in autobiographical memory function in people with Alzheimer’s dementia (AD) has been argued to cause a loss of self-identity. Prior research suggests that people perceive changes in moral traits and loss of memories with a “social-moral core” as most impactful to the maintenance of identity. However, such research has so far asked people to rate from a third-person perspective, considering the extent to which hypothetical others maintain their identity in the face of various impairments. In the current study, we examined the impact of perspective, comparing first- and third-person perspectives, as well as memory type. This online study asked 201 participants to consider hypothetical scenarios in which either themselves or another person (their parent, partner, or a stranger) experienced different types of memory failures associated with a diagnosis of AD. For each scenario, participants rated the degree to which the depicted individual remained the same person, and how impactful the impairment was. Social semantic memory failures – involving failures to recognise a loved one – were rated as most detrimental to self-continuity, and procedural memory failures the least. Averaged across all memory types, people considered their own and their partner’s self-continuity to be more resilient to memory failures than that of a parent or stranger. However, this pattern was reversed for some memory types: forgetting semantic or episodic information about close relationships was rated as more detrimental from a first-person than third-person perspective. Our findings suggest that perspective and type of memory impairment interact to impact judgements about the extent to which people maintain their identity when they experience dementia, and highlight the importance of social relationships to maintaining a sense of self.
ABSTRACTMemory loss and other cognitive decline threaten people's capacities to make sense of... more ABSTRACTMemory loss and other cognitive decline threaten people's capacities to make sense of the world and their position within it. In Alzheimer's Disease (AD), such losses occur when the desire to make sense of the experienced world remains. When this desire cannot be satisfied, confusion, agitation, or anger may result. In these situations, a resolution aiming at the truth is not guaranteed to work, and may even exacerbate a difficult situation, since losses to sense making may damage even the receptivity to it. When the truth is out of reach in this way, the aim ought to be instead to create the conditions of proper fit – a fit that is intelligible – between current experience, self‐image, and a world that makes sense. We argue that this aim rests on what we call the demand for sense‐making, a demand that arises for all of us where respect for agency is at stake, and especially so in AD, when it is under threat.
Autonomous individuals are able to make decisions and effectively implement them, but heroin addi... more Autonomous individuals are able to make decisions and effectively implement them, but heroin addiction can compromise this capacity.1 Very severely heroin-addicted persons are disabled in their efforts to implement decisions that would effectively promote their plans and values. For the purposes of this chapter, three salient pathways are available for a person in the grip of severe addiction. First, they may remain in their current situation, continuing to score and consume heroin untreated. Second, they may enter on a course of a maintenance dose of opiates. Or third, they may refuse to give up heroin, thereby triggering a legally mandated treatment regime involving detention in a facility where they receive clinical and transitional support services.2 In the second option, most typically a heroin substitute – either methadone or buprenorphine – is taken, but in some severe cases (about 5 per cent according to Alex Wodak), affected persons are resistant to this approach and in some jurisdictions heroin itself (diamorphine) is given.3 This is known as heroin-assisted treatment, or HAT.
hat happens if we wake up one day and we find out that virtually all of our rela-tionships…betwee... more hat happens if we wake up one day and we find out that virtually all of our rela-tionships…between us and our fellow human beings are commercial; we find out that virtually every relationship we have is a commercially arbitrated relationship with our fellow human being. Can civilisation survive on that narrow definition of how we interact with each other?-Jeremy Rifkin John is standing in a hotel bar when Natasha approaches him. After some small talk she places ten dollars in his hand saying "why don't you buy some drinks-make them Absolut vodkas-I'll be right back". Feeling pleased with himself, John purchases the drinks, and then settles into a comfortable chair. Natasha soon returns, and they begin to chat about the best places to drink. Natasha then shifts the discussion to Absolut vodka. This is something she and her friends always drink, she says. "There are so many flavours now, and it works so well with lime and soda." If Natasha plays her part well John won't realise that, unfortunately, it wasn't his good looks that grabbed her attention. Natasha is an agent for a company that promotes products through undercover marketing techniques. In fact John is simply the latest target for Natasha of hundreds that month. Single guys in bars are fair game for the marketing sting: approach the target, buy him a drink, talk it up, move on to the next customer. Apart from the fact that Natasha hardly touched her drink, John has no reason to be suspicious of her motives. From his point of view, it's been a pleasant social encounter, he's feeling good about himself, and after all, the vodka really was quite fine.
In 1837 Dr Herbert Mayo (1837: 195) described the case of a young lady with two dis-tinct states... more In 1837 Dr Herbert Mayo (1837: 195) described the case of a young lady with two dis-tinct states of existence. When in one state she is merry and in spirits [and] amuses herself with reading and working, sometimes plays on the piano better than at other times, knows everybody, ...
Mary Jean Walker (2012) argues that the narrative form that self-understanding must take is capab... more Mary Jean Walker (2012) argues that the narrative form that self-understanding must take is capable of providing a largely truthful picture of who we are, despite neuropsychological evidence suggesting the contrary. Walker describes three approaches to counter the conclusion of falsity in self-narratives: that some truths are fully intelligible only within a narrative structure; that narratives contain nonfactual content with a significance and meaning otherwise unavailable; and third, and importantly for our purposes, she offers a constraint “on what can count as a correct or good self-narrative . . . to point to ways in which the process of self-narration should be connected to the facts” (70). In this commentary we elaborate on and offer further support to Walker’s claim that “continual intersubjective checking” provides a dynamic and corrective social mechanism for ensuring truth in self-narratives. The importance and ubiquity of the norm of truth-telling is brought into sharp relief when we consider cases of living a lie. (We discuss two such cases at length in Kennett and Matthews [2012].) A spectacular instance of this is the case of Jean-Claude Romand. Romand was completing the second year of a medical degree when he failed to attend a test and then lied that he had passed it. This was the start of a cascading series of extraordinary fabrications in which he told others that he had completed the degree and was practicing as a doctor. His family and friends came to believe Romand was a medical researcher at the World Health Organization (WHO), yet all the while Romand lived a double existence: He spent his time wandering, and would visit the WHO building to consult its free services. He made claims that he was visiting Switzerland on business, but instead would spend his time at the airport studying medical journals. Remarkably, he was able to remain undetected for some 20 years, but finally, at a point when he believed he was about to be unmasked, he killed his family and then (apparently) attempted suicide. Romand was convicted in 1996 and remains in prison. Romand’s case is an extreme example of systematic lying and the double life. Of course, all of us are prone to selfdeception and some of us to confabulation; our point is that it is very plausible that truth-telling in important domains is a norm that does constrain our self-narratives. Despite the cognitive biases Walker surveys that may conceal from us the true causes of some of our actions, we are motivated to give, and succeed for the most part in giving, a truthful account of our actions themselves, both retrospectively and prospectively. We went to work on Saturday, rather than playing golf; we ordered risotto instead of steak; we stud-
Undercover marketing targets potential customers by concealing the commercial nature of an appare... more Undercover marketing targets potential customers by concealing the commercial nature of an apparently social transaction. In a typical case an individual approaches a marketing target apparently to provide some information or advice about a product in a way that ...
This entry has two general aims. The first is to profile the practices of neuromarketing (both cu... more This entry has two general aims. The first is to profile the practices of neuromarketing (both current and hypothetical), and the second is to identify what is ethically troubling about these practices. It will be claimed that neuromarketing does not really present novel ethical challenges, and that marketers are simply continuing to do what they have always done, only now they have at their disposal the tools of neuroscience which they have duly recruited. What will be presupposed is a principle of proportionality: marketing practices are morally objectionable commensurate with the degree to which they impugn the moral sovereignty of market actors. With this principle in mind, it is important to consider the literature which is sceptical about the potential for neuromarketing to be successful. If its claims are overblown, as will be suggested, then the ethical threat neuromarketing is said to pose, can be viewed also as overblown. An area that has worried many is that neuromarketing poses a threat to brain privacy, and so an analysis will be given of the nature of this threat, given the principle of proportionality. It will be argued that worries about brain privacy seem, prima facie, to be justified, but on closer analysis, fall away. However, a residual threat to privacy does remain: the collection over time, and aggregation of private brain information, where the target loses control over its ownership and distribution.
In what sense is a person addicted to drugs or alcohol incompetent, and so a legitimate object of... more In what sense is a person addicted to drugs or alcohol incompetent, and so a legitimate object of coercive treatment? The standard tests for competence do not pick out the capacity that is lost in addiction: the capacity to properly regulate consumption. This paper is an attempt to sketch a justificatory framework for understanding the conditions under which addicted persons may be treated against their will. These conditions rarely obtain, for they apply only when addiction is extremely severe and great harm threatens. It will be argued also that to widen the measures currently in place in some jurisdictions, though philosophically well-motivated, would require very strong evidence of a set of conditions disposing a person to an addictive future. It is doubtful that any such currently available evidence is strong enough to justify coercive treatment. Nevertheless, coercive treatment of addiction is already a reality, with the potential for more, and so some discussion will be presented regarding the extraordinary safeguards necessary to prevent misap-plication of such treatment policies.
Ronald Dworkin argued that Advance Directives informed by a principle of autonomy ought to guide ... more Ronald Dworkin argued that Advance Directives informed by a principle of autonomy ought to guide decisions in relation to the treatment of those in care for dementia. The principle of autonomy in play presupposes a form of competence that is tied to the individual person making the Directive. This paper challenges this individualist assumption. It does so by pointing out that the competence of a patient is inherently relational, and the key illustrative case to make this point is the case of music therapy. In music therapy, a relatively recent treatment modality in aged care, patients previously thought to be permanently unresponsive are shown on the contrary to be capable of significant levels of social agency. The conclusion to draw is that Advance Directives that fail to acknowledge the real possibility of such relational competence are misapplied.
Super-Soldiers: the ethical, legal and social consequences. Ashgate, 2015
When are soldier enhancements permissible in so far as they affect moral autonomy? I answer that... more When are soldier enhancements permissible in so far as they affect moral autonomy? I answer that question by setting out an important condition for moral autonomy: the capacity agents have for psychologically appropriating actions and experiences into a unified morally coherent self conception. For example, a soldier who, in the course of a mission, recklessly kills an unarmed enemy civilian must take responsibility for his actions. What if drugs were available which erased his memory, and removed all guilt for such an act? If this were to take place, the loss of memory would bring about a loss in the ability to identify with it as his own, and so he would be prevented from even the possibility of attempting to justify to himself or others what he has done. In a sense, such an enhancement is the equivalent of hiding evidence, and in that way it prevents the possibility of any restorative moral process. Such an enhancement has also rendered this individual unable to discharge the obligations that relate to the principles which give him his moral identity as a professional soldier. I assume there is agreement that memory deletion in such cases corrodes moral autonomy, but rather than painstakingly go through many different examples of enhancement the strategy here is to put forward a general test of what counts. A key question is this: does the enhancement promote in the agent a capacity for responding to reasons that enable morally unified agency, or does it disrupt this capacity? My approach is to begin with moral autonomy as a non-negotiable value, and so if a certain kind of enhancement is a threat to that value, as we just saw above, then it must be rejected on moral grounds. But there may be examples in which, on the contrary, moral autonomy benefits from an enhancement. It would benefit if it helped the agent to avoid losses to moral autonomy the agent would have sustained without the enhancement. (I’m not claiming the benefits of enhancement stem from causing the agent to have a happier life, even though that too is of course desirable.) Thus, it is an open empirical question – a negotiable value let’s say – concerning which enhancements are permissible, just because of the heterogeneous nature of the effects. So, the moral position is not monolithically opposed to enhancing, nor is it too liberal.
In this introduction we set out some salient themes that will help structure understanding of a c... more In this introduction we set out some salient themes that will help structure understanding of a complex set of intersecting issues discussed in this special issue on the work of Marc Lewis: (1) conceptual foundations of the disease model, (2) tolerating the disease model given sociopolitical environments, and (3) A third wave: refining conceptualization of addiction in the light of Lewis's model.
What are the requirements of respect for others as agents? 1 Chris regularly travels to another t... more What are the requirements of respect for others as agents? 1 Chris regularly travels to another town for work and sometimes attends conferences further afield. When at conferences Chris often engages in casual sexual liaisons and is also conducting an on-again, off-again affair in the town he travels to for work. Chris has a spouse, Jo, and two teenage children. Chris and Jo get on well; their children are navigating adolescence with mixed success. Chris is comfortable with his extra-curricular activities and judges it best not to tell Jo about them. Jo would feel betrayed, and might even end the marriage which would likely be bad for their children and disruptive all round. So Chris lies as necessary, and endorses Jo's ideal conception of their marriage in their friendship group. Chris may be right that, all things considered, it would be better to keep Jo in the dark. It is possible that everyone will be happier if the status quo is maintained. We do not wish to adjudicate that point here. Even so, it appears that Chris wrongs Jo. Jo is being deliberately deprived of information that is clearly material to her values, her interests, and to decisions that she might make regarding her marriage. Chris thus substitutes his own judgment for Jo's. She is not given the opportunity to reflect on the true state of their marriage or a voice in the decisions Chris makes about it. The wrong of deception, has, since Kant, been characterised as a failure of respect for the agency of the other. According to Kant, as rational beings capable of evaluating and setting their own ends, persons are not to be treated as mere means to another's end. In lying we manipulate the other's rational capacities in order to achieve ends we know, or fear, they would not share. This is paradigmatically a failure of respect. Truthfulness then, is seen as a central mode of respect for each other's agency. We agree. But we claim that a closer examination of our goals qua agents and of the ways in which agency can be supported or undermined in our interactions with each other reveals a further and distinct mode of respect for agency. The importance of truthfulness lies in significant part in the ways in which it answers to and supports our agential need to make intelligible, to make sense of our world, other people, and ourselves. Thus, we take as the main burden of this paper to draw out the notion of sense-making and highlight its importance for human agency. Since sense-making is something we often do together, and that we can support or undermine, it generates norms of interaction that we claim constitute a distinctive mode of recognition and respect for another's agency. The authors wish to thank two anonymous referees for this JOURNAL for their extensive remarks responding to earlier versions of the manuscript. Both reviewers' insightful critical engagement greatly improved the article. We also especially thank Doug McConnell for generously reading an early draft and for written comments. For helpful discussions we thank audiences at the University of Melbourne Philosophy Department, and the Philosophy department at Deakin University. 1 We are primarily concerned in this paper with what Stephen Darwall has termed recognition respect. See
Jennifer Blumenthal-Barby (2024) has called for bioethics to end talk about personhood, asserting... more Jennifer Blumenthal-Barby (2024) has called for bioethics to end talk about personhood, asserting that such talk has the tendency to confuse and offend. It will be argued that this has only limited application for (largely) private settings. However, in other settings theorizing about personhood leaves a gap in which there is the risk that the offending concept will get uptake elsewhere, and so the problem Blumenthal-Barby nominates may not be completely avoided. In response to this risk, an argument is presented in support of the idea that the role of philosophers and bioethicists, far from ending talk of personhood, ought to be to clarify the concept, and to do so in nuanced ways, given its application for specific kinds of impairments. The case of dementia is used to illustrate this in the context of person-centered care. Ironically, given the stigma attaching to dementia, far from the need to end talk of personhood, bioethicists are needed to rescue the concept and to clarify its role.
The trauma and anguish professional people encounter in their work over time can lead to losses i... more The trauma and anguish professional people encounter in their work over time can lead to losses in competence, and occupational burnout. However, the practice of detachment designed to avoid these outcomes can tip over into losses in the ability to connect with clients, and even to alienation from the professional role itself. Some have thought that the proper regulation of levels of empathic concern ensures a balance between these two poles. I argue against this, and instead advocate for a stance I call compassionate understanding. I contend that this best achieves sustained professionalism while remaining morally attuned to the norms of one's occupation. I focus on healthcare to illustrate what is at stake in compassionate understanding, though the position I defend has applications across a significant range of professions.
The decline in autobiographical memory function in people with Alzheimer’s dementia (AD) has been... more The decline in autobiographical memory function in people with Alzheimer’s dementia (AD) has been argued to cause a loss of self-identity. Prior research suggests that people perceive changes in moral traits and loss of memories with a “social-moral core” as most impactful to the maintenance of identity. However, such research has so far asked people to rate from a third-person perspective, considering the extent to which hypothetical others maintain their identity in the face of various impairments. In the current study, we examined the impact of perspective, comparing first- and third-person perspectives, as well as memory type. This online study asked 201 participants to consider hypothetical scenarios in which either themselves or another person (their parent, partner, or a stranger) experienced different types of memory failures associated with a diagnosis of AD. For each scenario, participants rated the degree to which the depicted individual remained the same person, and how impactful the impairment was. Social semantic memory failures – involving failures to recognise a loved one – were rated as most detrimental to self-continuity, and procedural memory failures the least. Averaged across all memory types, people considered their own and their partner’s self-continuity to be more resilient to memory failures than that of a parent or stranger. However, this pattern was reversed for some memory types: forgetting semantic or episodic information about close relationships was rated as more detrimental from a first-person than third-person perspective. Our findings suggest that perspective and type of memory impairment interact to impact judgements about the extent to which people maintain their identity when they experience dementia, and highlight the importance of social relationships to maintaining a sense of self.
ABSTRACTMemory loss and other cognitive decline threaten people's capacities to make sense of... more ABSTRACTMemory loss and other cognitive decline threaten people's capacities to make sense of the world and their position within it. In Alzheimer's Disease (AD), such losses occur when the desire to make sense of the experienced world remains. When this desire cannot be satisfied, confusion, agitation, or anger may result. In these situations, a resolution aiming at the truth is not guaranteed to work, and may even exacerbate a difficult situation, since losses to sense making may damage even the receptivity to it. When the truth is out of reach in this way, the aim ought to be instead to create the conditions of proper fit – a fit that is intelligible – between current experience, self‐image, and a world that makes sense. We argue that this aim rests on what we call the demand for sense‐making, a demand that arises for all of us where respect for agency is at stake, and especially so in AD, when it is under threat.
Autonomous individuals are able to make decisions and effectively implement them, but heroin addi... more Autonomous individuals are able to make decisions and effectively implement them, but heroin addiction can compromise this capacity.1 Very severely heroin-addicted persons are disabled in their efforts to implement decisions that would effectively promote their plans and values. For the purposes of this chapter, three salient pathways are available for a person in the grip of severe addiction. First, they may remain in their current situation, continuing to score and consume heroin untreated. Second, they may enter on a course of a maintenance dose of opiates. Or third, they may refuse to give up heroin, thereby triggering a legally mandated treatment regime involving detention in a facility where they receive clinical and transitional support services.2 In the second option, most typically a heroin substitute – either methadone or buprenorphine – is taken, but in some severe cases (about 5 per cent according to Alex Wodak), affected persons are resistant to this approach and in some jurisdictions heroin itself (diamorphine) is given.3 This is known as heroin-assisted treatment, or HAT.
hat happens if we wake up one day and we find out that virtually all of our rela-tionships…betwee... more hat happens if we wake up one day and we find out that virtually all of our rela-tionships…between us and our fellow human beings are commercial; we find out that virtually every relationship we have is a commercially arbitrated relationship with our fellow human being. Can civilisation survive on that narrow definition of how we interact with each other?-Jeremy Rifkin John is standing in a hotel bar when Natasha approaches him. After some small talk she places ten dollars in his hand saying "why don't you buy some drinks-make them Absolut vodkas-I'll be right back". Feeling pleased with himself, John purchases the drinks, and then settles into a comfortable chair. Natasha soon returns, and they begin to chat about the best places to drink. Natasha then shifts the discussion to Absolut vodka. This is something she and her friends always drink, she says. "There are so many flavours now, and it works so well with lime and soda." If Natasha plays her part well John won't realise that, unfortunately, it wasn't his good looks that grabbed her attention. Natasha is an agent for a company that promotes products through undercover marketing techniques. In fact John is simply the latest target for Natasha of hundreds that month. Single guys in bars are fair game for the marketing sting: approach the target, buy him a drink, talk it up, move on to the next customer. Apart from the fact that Natasha hardly touched her drink, John has no reason to be suspicious of her motives. From his point of view, it's been a pleasant social encounter, he's feeling good about himself, and after all, the vodka really was quite fine.
In 1837 Dr Herbert Mayo (1837: 195) described the case of a young lady with two dis-tinct states... more In 1837 Dr Herbert Mayo (1837: 195) described the case of a young lady with two dis-tinct states of existence. When in one state she is merry and in spirits [and] amuses herself with reading and working, sometimes plays on the piano better than at other times, knows everybody, ...
Mary Jean Walker (2012) argues that the narrative form that self-understanding must take is capab... more Mary Jean Walker (2012) argues that the narrative form that self-understanding must take is capable of providing a largely truthful picture of who we are, despite neuropsychological evidence suggesting the contrary. Walker describes three approaches to counter the conclusion of falsity in self-narratives: that some truths are fully intelligible only within a narrative structure; that narratives contain nonfactual content with a significance and meaning otherwise unavailable; and third, and importantly for our purposes, she offers a constraint “on what can count as a correct or good self-narrative . . . to point to ways in which the process of self-narration should be connected to the facts” (70). In this commentary we elaborate on and offer further support to Walker’s claim that “continual intersubjective checking” provides a dynamic and corrective social mechanism for ensuring truth in self-narratives. The importance and ubiquity of the norm of truth-telling is brought into sharp relief when we consider cases of living a lie. (We discuss two such cases at length in Kennett and Matthews [2012].) A spectacular instance of this is the case of Jean-Claude Romand. Romand was completing the second year of a medical degree when he failed to attend a test and then lied that he had passed it. This was the start of a cascading series of extraordinary fabrications in which he told others that he had completed the degree and was practicing as a doctor. His family and friends came to believe Romand was a medical researcher at the World Health Organization (WHO), yet all the while Romand lived a double existence: He spent his time wandering, and would visit the WHO building to consult its free services. He made claims that he was visiting Switzerland on business, but instead would spend his time at the airport studying medical journals. Remarkably, he was able to remain undetected for some 20 years, but finally, at a point when he believed he was about to be unmasked, he killed his family and then (apparently) attempted suicide. Romand was convicted in 1996 and remains in prison. Romand’s case is an extreme example of systematic lying and the double life. Of course, all of us are prone to selfdeception and some of us to confabulation; our point is that it is very plausible that truth-telling in important domains is a norm that does constrain our self-narratives. Despite the cognitive biases Walker surveys that may conceal from us the true causes of some of our actions, we are motivated to give, and succeed for the most part in giving, a truthful account of our actions themselves, both retrospectively and prospectively. We went to work on Saturday, rather than playing golf; we ordered risotto instead of steak; we stud-
Undercover marketing targets potential customers by concealing the commercial nature of an appare... more Undercover marketing targets potential customers by concealing the commercial nature of an apparently social transaction. In a typical case an individual approaches a marketing target apparently to provide some information or advice about a product in a way that ...
This entry has two general aims. The first is to profile the practices of neuromarketing (both cu... more This entry has two general aims. The first is to profile the practices of neuromarketing (both current and hypothetical), and the second is to identify what is ethically troubling about these practices. It will be claimed that neuromarketing does not really present novel ethical challenges, and that marketers are simply continuing to do what they have always done, only now they have at their disposal the tools of neuroscience which they have duly recruited. What will be presupposed is a principle of proportionality: marketing practices are morally objectionable commensurate with the degree to which they impugn the moral sovereignty of market actors. With this principle in mind, it is important to consider the literature which is sceptical about the potential for neuromarketing to be successful. If its claims are overblown, as will be suggested, then the ethical threat neuromarketing is said to pose, can be viewed also as overblown. An area that has worried many is that neuromarketing poses a threat to brain privacy, and so an analysis will be given of the nature of this threat, given the principle of proportionality. It will be argued that worries about brain privacy seem, prima facie, to be justified, but on closer analysis, fall away. However, a residual threat to privacy does remain: the collection over time, and aggregation of private brain information, where the target loses control over its ownership and distribution.
In what sense is a person addicted to drugs or alcohol incompetent, and so a legitimate object of... more In what sense is a person addicted to drugs or alcohol incompetent, and so a legitimate object of coercive treatment? The standard tests for competence do not pick out the capacity that is lost in addiction: the capacity to properly regulate consumption. This paper is an attempt to sketch a justificatory framework for understanding the conditions under which addicted persons may be treated against their will. These conditions rarely obtain, for they apply only when addiction is extremely severe and great harm threatens. It will be argued also that to widen the measures currently in place in some jurisdictions, though philosophically well-motivated, would require very strong evidence of a set of conditions disposing a person to an addictive future. It is doubtful that any such currently available evidence is strong enough to justify coercive treatment. Nevertheless, coercive treatment of addiction is already a reality, with the potential for more, and so some discussion will be presented regarding the extraordinary safeguards necessary to prevent misap-plication of such treatment policies.
Ronald Dworkin argued that Advance Directives informed by a principle of autonomy ought to guide ... more Ronald Dworkin argued that Advance Directives informed by a principle of autonomy ought to guide decisions in relation to the treatment of those in care for dementia. The principle of autonomy in play presupposes a form of competence that is tied to the individual person making the Directive. This paper challenges this individualist assumption. It does so by pointing out that the competence of a patient is inherently relational, and the key illustrative case to make this point is the case of music therapy. In music therapy, a relatively recent treatment modality in aged care, patients previously thought to be permanently unresponsive are shown on the contrary to be capable of significant levels of social agency. The conclusion to draw is that Advance Directives that fail to acknowledge the real possibility of such relational competence are misapplied.
Super-Soldiers: the ethical, legal and social consequences. Ashgate, 2015
When are soldier enhancements permissible in so far as they affect moral autonomy? I answer that... more When are soldier enhancements permissible in so far as they affect moral autonomy? I answer that question by setting out an important condition for moral autonomy: the capacity agents have for psychologically appropriating actions and experiences into a unified morally coherent self conception. For example, a soldier who, in the course of a mission, recklessly kills an unarmed enemy civilian must take responsibility for his actions. What if drugs were available which erased his memory, and removed all guilt for such an act? If this were to take place, the loss of memory would bring about a loss in the ability to identify with it as his own, and so he would be prevented from even the possibility of attempting to justify to himself or others what he has done. In a sense, such an enhancement is the equivalent of hiding evidence, and in that way it prevents the possibility of any restorative moral process. Such an enhancement has also rendered this individual unable to discharge the obligations that relate to the principles which give him his moral identity as a professional soldier. I assume there is agreement that memory deletion in such cases corrodes moral autonomy, but rather than painstakingly go through many different examples of enhancement the strategy here is to put forward a general test of what counts. A key question is this: does the enhancement promote in the agent a capacity for responding to reasons that enable morally unified agency, or does it disrupt this capacity? My approach is to begin with moral autonomy as a non-negotiable value, and so if a certain kind of enhancement is a threat to that value, as we just saw above, then it must be rejected on moral grounds. But there may be examples in which, on the contrary, moral autonomy benefits from an enhancement. It would benefit if it helped the agent to avoid losses to moral autonomy the agent would have sustained without the enhancement. (I’m not claiming the benefits of enhancement stem from causing the agent to have a happier life, even though that too is of course desirable.) Thus, it is an open empirical question – a negotiable value let’s say – concerning which enhancements are permissible, just because of the heterogeneous nature of the effects. So, the moral position is not monolithically opposed to enhancing, nor is it too liberal.
In this essay I focus on a quality inherent in that range of feelings we associate with an experi... more In this essay I focus on a quality inherent in that range of feelings we associate with an experience described as ‘flow’. Csíkszentmihályi describes it as a state that arises in people involved in some skilled activity who become fully immersed in it; they reach a state of ‘intrinsic motivation’ and loss of self-awareness; their actions seem to occur spontaneously so that they seem to become simultaneously a passive witness to their own highly skilled agency. There are skilled movements and manoeuvres in sailing in which the equipment becomes, as we say, “an extension of oneself”. Under these conditions the sailor has usually reached such a level of proficiency that the state of flow just described may obtain. Moments of flow are relatively rare, and are highly prized by those who know what to look for. Losing oneself in the activity in this way is one of its highpoints, a point which makes it thereby significant and meaningful. Excellence in sailing confers a kind of fulfilment we rarely attain. It is, for this reason, an ideal worth striving for.
Ethically, what happens when our social, political, and commercial activities transfer to the vir... more Ethically, what happens when our social, political, and commercial activities transfer to the virtual environment? In such an environment self-presentations and interpersonal engagement are subject to digital filters, new forms of anonymity are enabled, and the nature of accountability and trust must be re-imagined. The internet presents us with a dual use problem-in which the same technology can be used for harm and for good-as well as a problem in which online and offline practices intersect, thereby creating novel ethical difficulties. The incremental evolution of the new online normativity means that agents online easily lose sight of what is morally at stake in how they act there, as well as how they may be targeted. These considerations provide the framework used here for analyzing many of the most recent ethical problems and issues. These include: (1) persuasive technologies, such as micro-targeting, e-nudges, digital choice architecture, and gamification; (2) cyberhate, including such categories as trolling, or flaming; (3) online scams, including phishing, lottery scams, or romance scams; (4) virtuality, which raises a dilemma for deciding what is harmful, as well as questions concerning the genuineness of online relationships and identity; (5) information control and flow, with issues for internet freedom versus censorship, surveillance, cybersecurity, and cyberwar; and (6) digital attacks on democracy, especially algorithmic manipulation of data feeds.
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Papers by Steve Matthews