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Nathan Stout

Case Western Reserve University-University Hospitals, Clinical Ethics, Clinical Ethicist/Clinical Assistant Professor

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I am a Clinical Ethicist at University Hospitals, Cleveland Medical Center and Clinical Assistant Professor in the Department of Bioethics in the Case Western Reserve University School of Medicine. My research and teaching specialties are in Ethics, Biomedical Ethics, Agency & Responsibility, and Moral Psychology.

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Papers by Nathan Stout

A Mixed Judgment Standard for Surrogate Decision Making

Journal of Medicine and Philosophy (Forthcoming)

The Substituted Judgment Standard (SJS) for surrogate decision-making dictates that a surrogate, ... more The Substituted Judgment Standard (SJS) for surrogate decision-making dictates that a surrogate, when making medical decisions on behalf of an incapacitated patient, ought to make the decision that the patient would have made if the patient had decisional capacity. Despite its intuitive appeal, however, SJS has been the target of a variety of criticisms. Most objections to SJS appeal to epistemic difficulties involved in determining what a patient would have decided in a given case. In this paper, I offer an alternative standard for surrogate decision-making that avoids these difficulties. I then offer an account of its theoretical underpinnings which shows that it preserves the central moral justification for SJS, namely, respect for patient autonomy.

Further Ethical Concerns for Neurotechnological Thought Apprehension in Medicine

American Journal of Bioethics - Neuroscience, 2019

On the Significance of Praise

American Philosophical Quarterly

In recent years there has been an explosion of philosophical work on blame. Much of this work has... more In recent years there has been an explosion of philosophical work on blame. Much of this work has focused on explicating the nature of blame or on examining the norms that govern it, and the primary motivation for theorizing about blame seems to derive from blame’s tight connection to responsibility. However, very little philosophical attention has been given to praise and its attendant practices. In this paper, I identify three possible explanations for this lack of attention. My goal is to show that each of these lines of thought is mistaken and to argue that praise is deserving of careful, independent analysis by philosophers interested in theorizing about responsibility.

Emotional Awareness and Responsible Agency

Autism, Meta-Cognition, and the Deep Self

Salience, Imagination, and Moral Luck

Reasons-Responsiveness and Moral Responsibility: the Case of Autism

Theories of moral responsibility can be separated, roughly and with exceptions, into three broad ... more Theories of moral responsibility can be separated, roughly and with exceptions, into three broad categories depending on which features or abilities of agents the theory takes to be central for ascriptions of praise and blame (or the appropriateness thereof). Quality of will theories hold that the matter of an agent's responsibility for a particular action is decided by determining whether or not the action expressed an objectionable quality of will on the agent's part. Mesh theories claim that agents are responsible for acts which flow from the agent's " real self, " or for actions that come from an appropriate mesh between certain key aspects of her agency. Finally, reasons-responsive theories claim that agents are responsible for their actions insofar as they possess the rational capacity to recognize reasons for acting and to guide their actions in accordance with those reasons. The focus of this paper will be the latter sort of theory, and I will be primarily interested in John Martin Fischer and Mark Ravizza's version of it as presented in their seminal work, Responsibility and Control. Theirs is, by far, the most influential such theory, and it gives the most comprehensive statement of the reasons-responsive approach to moral responsibility on offer. However, I think that it is open to an important challenge from the empirical literature on autism spectrum disorder (ASD). More specifically, I think that evidence that individuals with ASD show signs of a pervasive deficit in counterfactual thinking opens the possibility of counterexamples that give reason to think that Fischer and Ravizza's construal of reasons-responsiveness fails to meet the necessary and sufficient conditions for moral responsibility as they claim.

Assembling an Army: Considerations for Just War Theory

Conversation, Responsibility, and Autism Spectrum Disorder

Autism, Episodic Memory, and Moral Exemplars

Ticking Bombs and Moral Luck

In this paper, I take up the task of further examining the ticking bomb argument in favor of the ... more In this paper, I take up the task of further examining the ticking bomb argument in favor of the use of torture. In doing so, I will focus on some recent scholarship regarding ticking bomb methodology introduced by Fritz Allhoff. I will then propose a set of ticking bomb variations which, I believe, call into question some of Allhoff's conclusions. My goal is to show that ticking bomb methodology is misguided in its attempt to justify torture insofar as its proponents seem to ignore certain nonconsequentialist factors that are latent in the various types of uncertainty in real-world ticking bomb cases. Once this fact is recognized, I claim, the normative claims about torture that follow can be denied by appealing to it. I then argue that, even if we grant a certain level of uncertainty within the ticking bomb argument, torture is not justified. Rather, the implementation of torture, even if it yields positive results, is nothing more than a case of moral luck. In other words, the supposed "success" of torture in the ticking bomb cases lies entirely outside the agent's control. Thus, if the outcome of the use of torture is in no way controlled by the agent, then the agent's actions cannot be justified by appealing to that outcome.

Morality in a Natural World: Selected Essays in Metaethics. By David Copp

Metaphilosophy, 2008

In Morality in a Natural World, David Copp presents a set of ten essays concerning various compon... more

A Mixed Judgment Standard for Surrogate Decision Making

Journal of Medicine and Philosophy (Forthcoming)

The Substituted Judgment Standard (SJS) for surrogate decision-making dictates that a surrogate, ... more The Substituted Judgment Standard (SJS) for surrogate decision-making dictates that a surrogate, when making medical decisions on behalf of an incapacitated patient, ought to make the decision that the patient would have made if the patient had decisional capacity. Despite its intuitive appeal, however, SJS has been the target of a variety of criticisms. Most objections to SJS appeal to epistemic difficulties involved in determining what a patient would have decided in a given case. In this paper, I offer an alternative standard for surrogate decision-making that avoids these difficulties. I then offer an account of its theoretical underpinnings which shows that it preserves the central moral justification for SJS, namely, respect for patient autonomy.

Further Ethical Concerns for Neurotechnological Thought Apprehension in Medicine

American Journal of Bioethics - Neuroscience, 2019

On the Significance of Praise

American Philosophical Quarterly

In recent years there has been an explosion of philosophical work on blame. Much of this work has... more In recent years there has been an explosion of philosophical work on blame. Much of this work has focused on explicating the nature of blame or on examining the norms that govern it, and the primary motivation for theorizing about blame seems to derive from blame’s tight connection to responsibility. However, very little philosophical attention has been given to praise and its attendant practices. In this paper, I identify three possible explanations for this lack of attention. My goal is to show that each of these lines of thought is mistaken and to argue that praise is deserving of careful, independent analysis by philosophers interested in theorizing about responsibility.

Emotional Awareness and Responsible Agency

Autism, Meta-Cognition, and the Deep Self

Salience, Imagination, and Moral Luck

Reasons-Responsiveness and Moral Responsibility: the Case of Autism

Theories of moral responsibility can be separated, roughly and with exceptions, into three broad ... more Theories of moral responsibility can be separated, roughly and with exceptions, into three broad categories depending on which features or abilities of agents the theory takes to be central for ascriptions of praise and blame (or the appropriateness thereof). Quality of will theories hold that the matter of an agent's responsibility for a particular action is decided by determining whether or not the action expressed an objectionable quality of will on the agent's part. Mesh theories claim that agents are responsible for acts which flow from the agent's " real self, " or for actions that come from an appropriate mesh between certain key aspects of her agency. Finally, reasons-responsive theories claim that agents are responsible for their actions insofar as they possess the rational capacity to recognize reasons for acting and to guide their actions in accordance with those reasons. The focus of this paper will be the latter sort of theory, and I will be primarily interested in John Martin Fischer and Mark Ravizza's version of it as presented in their seminal work, Responsibility and Control. Theirs is, by far, the most influential such theory, and it gives the most comprehensive statement of the reasons-responsive approach to moral responsibility on offer. However, I think that it is open to an important challenge from the empirical literature on autism spectrum disorder (ASD). More specifically, I think that evidence that individuals with ASD show signs of a pervasive deficit in counterfactual thinking opens the possibility of counterexamples that give reason to think that Fischer and Ravizza's construal of reasons-responsiveness fails to meet the necessary and sufficient conditions for moral responsibility as they claim.

Assembling an Army: Considerations for Just War Theory

Conversation, Responsibility, and Autism Spectrum Disorder

Autism, Episodic Memory, and Moral Exemplars

Ticking Bombs and Moral Luck

In this paper, I take up the task of further examining the ticking bomb argument in favor of the ... more In this paper, I take up the task of further examining the ticking bomb argument in favor of the use of torture. In doing so, I will focus on some recent scholarship regarding ticking bomb methodology introduced by Fritz Allhoff. I will then propose a set of ticking bomb variations which, I believe, call into question some of Allhoff's conclusions. My goal is to show that ticking bomb methodology is misguided in its attempt to justify torture insofar as its proponents seem to ignore certain nonconsequentialist factors that are latent in the various types of uncertainty in real-world ticking bomb cases. Once this fact is recognized, I claim, the normative claims about torture that follow can be denied by appealing to it. I then argue that, even if we grant a certain level of uncertainty within the ticking bomb argument, torture is not justified. Rather, the implementation of torture, even if it yields positive results, is nothing more than a case of moral luck. In other words, the supposed "success" of torture in the ticking bomb cases lies entirely outside the agent's control. Thus, if the outcome of the use of torture is in no way controlled by the agent, then the agent's actions cannot be justified by appealing to that outcome.

Morality in a Natural World: Selected Essays in Metaethics. By David Copp

Metaphilosophy, 2008

In Morality in a Natural World, David Copp presents a set of ten essays concerning various compon... more