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Decision Making

To kill or to violate?

By Charles Foster

A highly intelligent 32 year old woman has profound anorexia. She has had it for years. It is complicated by alcohol and opiate dependency, and by personality disorder. Her BMI is 11.3. A healthy BMI is around 20. Less than 17.7 is in the anorexic range. Less than 14 indicates dangerous weight loss. Over the last 4 years her BMI has been well below 14. She describes her life as ‘pure torment’. All the things she wanted to do have been frustrated by her illness. She feels unable to give anything to the world, or to take anything out. For years she has had intense treatment for her anorexia and related conditions. On about 10 occasions she has been sectioned under the Mental Health Act. One of those periods lasted almost 4 months. Twice she has executed advance decisions refusing life-saving or life-prolonging treatment.
There are only two options: death or the violation of her autonomy . If she is not admitted against her will to hospital, detained there for not less than a year, and forcibly fed under physical or chemical restraint, she will die. She understands this perfectly well. She doesn’t actively seek death, but doesn’t want to be force fed. As well as the anorexic’s usual horror of calories, the forcible medical administration of nutrition reminds her horribly of the sexual abuse she suffered as a child.Read More »To kill or to violate?

A Teeny-Weeny Baby Puzzle

I have been thinking about babies recently, for various reasons (let’s call them Saul).  It had always struck me that procreation was a classic example of a prisoner’s dilemma.  It was good for each couple to have children, but if everyone churned out these resource-chomping monsters it was disastrous for us all.

That was until friends (philosophers) kindly pointed out that study after study shows that having children actually makes people unhappy.Read More »A Teeny-Weeny Baby Puzzle

Nudge Drugs: should the social side-effects of medications weigh into public health?

You are a public health official responsible for the purchasing of medications for the hospitals within your catchment area in the NHS. Your policies significantly affect which, out of the serpentine lists of heart disease medications, for example, are available to your patients. Today, you must choose between purchasing one of three heart disease medications: Drug A, Drug B, and Drug C. They are pretty similar in efficacy, and all three have been being used for many years. Drug B is slightly less expensive than Drug A and Drug C, but there is emerging evidence that it increases the likelihood that patients will take “bad bets,” i.e. make large gambles when the chance of winning is low (and thus might contribute to large social costs). Drug C costs a tiny bit more than Drug A, but there is some evidence that Drug C may help decrease implicit racial bias. You have been briefed on the research suggesting that implicit racial bias can lead to people making choices that consistently and unintentionally limit the opportunities of certain groups, even when all the involved parties show explicit commitments to social equality.  Finally, there is emerging evidence that drug A both helps people abstain from alcohol and dissociates negative emotional content from memories.

Which drug should you purchase?

 

Let us begin to think about this question through the lens of the idea of the “Nudge,” which has exploded onto the public sphere (and blogosphere) since Thaler and Sunstein’s published their book, “Nudge: improving decisions about health, wealth, and happiness.”   (see the blog here). I briefly and incompletely introduce nudges here, in hopes that we may soon move on to discuss the kind of “nudge drugs” our thought experiment considers.

Read More »Nudge Drugs: should the social side-effects of medications weigh into public health?

Unbelievers are bad and have defective brains

By Charles Foster

You’d better believe that believers are better.

So far as religiosity is concerned, humanity, say Cooper and Pullig , is divided fairly neatly into three clusters: Skeptics, Nominals and Devouts. The bulk of the evidence suggests that there is a relationship between religiousness and moral reasoning. That relationship, though, is complex. Its anatomy needs a lot of exploration. Cooper’s and Pullig’s exciting and audacious paper, which concerns broadly Christian religiosity amongst marketing students in the US, suggests that narcissism is a factor in explaining why individuals make wrong ethical decisions. That in itself isn’t surprising. Narcissism, for instance, is a predictor of white-collar crime in business: narcissistic individuals tend to think that they are above the laws that govern the behaviour of lesser mortals. What is perhaps surprising is that ethical decision-making was affected by narcissism only in Nominals and Devouts. The reasons for that can be speculated about very entertainingly. But I want to highlight one almost incidental observation: ‘Notably, Skeptics in general exhibit worse ethical judgment than respondents in either of the other two clusters.’

Read More »Unbelievers are bad and have defective brains

A World without Advertising?

Recently , UNICEF launched their Children’s Rights and Business Principles, the sixth of which says that businesses should ‘use marketing and advertising that respect and support children’s rights’. This is hard to deny, as is the claim that many companies are seeking unjustifiably to manipulate children and their parents for profit. Indeed there seems little reason to restrict… Read More »A World without Advertising?

Kony 2012 and Saying What You Mean

Kony 2012 has become the highest profile issue of international justice on social media by far. For those without a Facebook account, Kony 2012 is a slick 30-minute YouTube film about Joseph Kony, leader of the Lords Resistance Army. The video explicitly seeks to mobilise support for efforts to arrest Kony, who has been indicted by the International Criminal Court for crimes against humanity, particularly against children. As I type, the video, released Monday, is approaching 70 million views. The video has also attracted a fair share of criticism, much of which I’m not sure is honest.

Read More »Kony 2012 and Saying What You Mean

Love and other drugs, or why parents should chemically enhance their marriages

By Brian Earp

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Love and other drugs, or why parents should chemically enhance their marriages

Valentine’s day has passed, and along with it the usual rush of articles on “the neuroscience of love” – such as this one from Parade magazine. The penner of this particular piece, Judith Newman, sums up the relevant research like this:

It turns out that love truly is a chemical reaction. Researchers using MRIs to look at the brain activity of the smitten have found that an interplay of hormones and neurotransmitters create the state we call love.

My humble reckoning is that there’s more to “the state we call love” than hormones and neurotransmitters, but it’s true that brain chemistry is heavily involved in shaping our experience of amour. In fact, we’re beginning to understand quite a bit about the cerebral circuitry involved in love, lust, and human attachment—so much so that a couple of Oxford philosophers have been inspired to suggest something pretty radical.

They think that it’s time we shifted from merely describing this circuitry, and actually intervened in it directly—by altering our brains pharmacologically, through the use of what they call “love drugs.”

Read More »Love and other drugs, or why parents should chemically enhance their marriages

Obligatory Ventilation: why Elective Ventilation should not be elective

On the BBC’s Moral Maze this evening, the question of elective ventilation was discussed at some length. (For those who missed it, the program is still available here). There were several striking features of that discussion, but one argument that stood out was the argument against elective ventilation based on the importance of respecting the autonomy of patients, and the absence of consent, This has been the basis of previous ethical concerns about Elective Ventilation.

But actually, it seems to me that the consent/autonomy argument is completely upside down.* Patient autonomy provides one of the strongest arguments in favour of elective ventilation. So strong, in fact, that the proposed form of Elective Ventilation should arguably not be ‘elective’. It is morally obligatory that we embrace Elective Ventilation.Read More »Obligatory Ventilation: why Elective Ventilation should not be elective