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Socially responsible publishers, such as the BMJ, have demonstrated a commitment to health equity and working toward rectifying the structural racism that exists both in health care and in medical publishing.(1) The commitment of academic... more
Socially responsible publishers, such as the BMJ, have demonstrated a commitment to health equity and working toward rectifying the structural racism that exists both in health care and in medical publishing.(1) The commitment of academic publishers to collecting information relevant to promoting equity and diversity is important and commendable where it leads to that result.(2) But collecting sensitive demographic data is not a morally neutral activity. Rather, it carries with it both known and potential risks. Among these are issues around privacy or data misuse, as well as more basic concerns about how, when, or why people should be categorized in certain ways and/or made to conceive of themselves or their identities in certain terms.(3) If such data are to be collected, therefore, their effectiveness in achieving the stated ends must have a sufficiently compelling evidence base so as to justify the various risks involved. And where possible, these risks must also be identified and minimised.
Past research has found that the value of a person’s activities can affect observers’ judgements about whether that person is experiencing certain emotions (e.g., people consider morally good agents happier than morally bad agents). One... more
Past research has found that the value of a person’s activities can affect observers’ judgements about whether that person is experiencing certain emotions (e.g., people consider morally good agents happier than morally bad agents). One proposed explanation for this effect is that emotion attributions are influenced by judgments about fittingness (whether the emotion is merited). Another hypothesis is that emotion attributions are influenced by judgments about the agent’s true self (whether the emotion reflects how the agent feels “deep down”). We tested these hypotheses in six studies. After finding that people think a wide range of emotions can be fitting and reflect a person’s true self (Study 1), we tested the predictions of these two hypotheses for attributions of happiness, love, sadness, and hatred. We manipulated the emotions’ fittingness (Studies 2a-b and 3) and whether the emotions reflected an agent's true self (Studies 3 and 5), measuring emotion attributions as well as fittingness judgments and true self judgments. The fittingness manipulation only impacted emotion attributions in the cases where it also impacted true self judgments, whereas the true self manipulation impacted emotion attribution in all cases, including those where it did not impact fittingness judgments. These results cast serious doubt on the fittingness hypothesis and offer some support for the true self hypothesis, which could be developed further in future work.
Testimony from hundreds of medical students and numerous physicians and scholars suggests that unconsented intimate exams (UIEs) are unlikely to be rare, isolated incidents. However, much is unknown about the frequency of these exams and... more
Testimony from hundreds of medical students and numerous physicians and scholars suggests that unconsented intimate exams (UIEs) are unlikely to be rare, isolated incidents. However, much is unknown about the frequency of these exams and the circumstances in which they take place. The Community Bioethics Forum, founded and chaired by one of the authors of this commentary, is a consultative group of diverse community members who provide insights on law and policy to policy-makers and medical associations. Connecticut legislators asked the CBF to provide their views on proposed “explicit consent” legislation, and during those discussions, concerning narratives emerged about members’ (and their loved ones’) personal experiences with UIEs.

To gain greater clarity on the demographic patterns and frequency of UIEs, we conducted the first national survey on UIEs. Data from this survey suggest that UIEs may occur under a broader range of circumstances than addressed by most law and policy. The survey resulted in nearly the exact same rate of affirmative responses between males and females in answer to whether they had received a UIE within the past five years. The survey results also showed evidence of racial disparity. Additional research is needed to understand the nature of UIEs.
A recent article in the Journal of Pediatric Psychology has attracted much media attention for its analysis of a subject that has long been debated: how do our beliefs about male-female differences influence our decision-making?... more
A recent article in the Journal of Pediatric Psychology has attracted much media attention for its analysis of a subject that has long been debated: how do our beliefs about male-female differences influence our decision-making? Specifically, do our beliefs about the pain expressions of boys and girls influence our assessment of their pain experience? In this interview, the study's lead author clarifies some misinterpretations of the study that were promoted by sources including the New York Times.
Objective: Accurate assessment of pain is central to diagnosis and treatment in healthcare, especially in pediatrics. However, few studies have examined potential biases in adult observer ratings of children’s pain. Cohen et al. (2014)... more
Objective: Accurate assessment of pain is central to diagnosis and treatment in healthcare, especially in pediatrics. However, few studies have examined potential biases in adult observer ratings of children’s pain. Cohen et al. (2014) reported that adult participants rated a child undergoing a medical procedure as feeling more pain when the child was described as a boy as compared to a girl, suggesting a possible gender bias. To confirm, clarify, and extend this finding, we conducted a replication experiment and follow-up study examining the role of explicit gender stereotypes in shaping such asymmetric judgments.

Method: In an independent, pre-registered, direct replication and extension study with open data and materials (https://osf.io/t73c4/), we showed participants the same video from Cohen et al. (2014), with the child described as a boy or a girl depending on condition. We then asked adults to rate how much pain the child experienced and displayed, how typical the child was in these respects, and how much they agreed with explicit gender stereotypes concerning pain response in boys versus girls.

Results: Similar to Cohen et al. (2014), but with a larger and more demographically diverse sample, we found that the ‘boy’ was rated as experiencing more pain than the ‘girl’ despite identical clinical circumstances and identical pain behavior cross conditions. Controlling for explicit gender stereotypes eliminated the effect.

Conclusions: Explicit gender stereotypes—e.g., that boys are more stoic or girls are more emotive—may bias adult assessment of children’s pain.
Moralistic punishment is common in humans and functions to discourage perceived moral transgressions. Research in neuroeconomics suggests that moralistic punishment behavior is associated with activity in neural systems involved in... more
Moralistic punishment is common in humans and functions to discourage perceived moral transgressions. Research in neuroeconomics suggests that moralistic punishment behavior is associated with activity in neural systems involved in detecting norm violations and in value-based decision-making. Separately, research in philosophy and social psychology highlights different moral expectations for girls/women and boys/men. Here, we synthesize these perspectives to propose a framework for investigating gender disparities in punishment. We propose such disparities may arise through multiple channels, including (1) differences in how the neural salience network responds to perceived norm violations, with stronger responses when women (vs. men) violate feminine-coded norms, and when men (vs. women) violate masculine-coded norms; and (2) differences in how the neural valuation network tracks the value of punishment decisions, with stronger responses when punishing gender-specific norm violations. We review literature on gendered moral expectations and neural mechanisms underlying moralistic punishment, and suggest hypotheses for future research.
Well written, tightly argued, provocative, and original, Metz's book is a mustread contribution. In addition to skillfully and judiciously bringing African moral philosophy into conversation with Western analytic philosophy, Metz has done... more
Well written, tightly argued, provocative, and original, Metz's book is a mustread contribution. In addition to skillfully and judiciously bringing African moral philosophy into conversation with Western analytic philosophy, Metz has done the field a service by putting social and interpersonal relationships at the heart of his theory-and encouraging others to do the same. Going forward, especially given his explicit desire to accommodate or explain common moral intuitions, it might be that more direct engagement with the empirical literatures in relationship science and experimental moral psychology would further strengthen his theory.
Tomasello (2020) argues that a sense of moral obligation emerges from the creation of a collaborative "we" motivating us to fulfill our cooperative duties. We suggest that "we" takes many forms, entailing different obligations, depending... more
Tomasello (2020) argues that a sense of moral obligation emerges from the creation of a collaborative "we" motivating us to fulfill our cooperative duties. We suggest that "we" takes many forms, entailing different obligations, depending on the type (and underlying functions) of the relationship(s) in question. We sketch a framework of such types, functions, and obligations to guide future research.
Recent research has relied on trolley-type sacrificial moral dilemmas to study utilitarian versus nonutili- tarian modes of moral decision-making. This research has generated important insights into people’s attitudes toward instrumental... more
Recent research has relied on trolley-type sacrificial moral dilemmas to study utilitarian versus nonutili- tarian modes of moral decision-making. This research has generated important insights into people’s attitudes toward instrumental harm—that is, the sacrifice of an individual to save a greater number. But this approach also has serious limitations. Most notably, it ignores the positive, altruistic core of utilitarianism, which is characterized by impartial concern for the well-being of everyone, whether near or far. Here, we develop, refine, and validate a new scale—the Oxford Utilitarianism Scale—to dissociate individual differences in the ‘negative’ (permissive attitude toward instrumental harm) and ‘positive’ (impartial concern for the greater good) dimensions of utilitarian thinking as manifested in the general population. We show that these are two independent dimensions of proto-utilitarian tendencies in the lay population, each exhibiting a distinct psychological profile. Empathic concern, identification with the whole of humanity, and concern for future generations were positively associated with impartial beneficence but negatively associated with instrumental harm; and although instrumental harm was associated with subclinical psychopathy, impartial beneficence was associated with higher religiosity. Importantly, although these two dimensions were independent in the lay population, they were closely associated in a sample of moral philosophers. Acknowledging this dissociation between the instrumental harm and impartial beneficence components of utilitarian thinking in ordinary people can clarify existing debates about the nature of moral psychology and its relation to moral philosophy as well as generate fruitful avenues for further research.
A growing body of research has focused on so-called ‘utilitarian’ judgments in moral dilemmas in which participants have to choose whether to sacrifice one person in order to save the lives of a greater number. However, the relation... more
A growing body of research has focused on so-called ‘utilitarian’ judgments in moral dilemmas in which participants have to choose whether to sacrifice one person in order to save the lives of a greater number. However, the relation between such ‘utilitarian’ judgments and genuine utilitarian impartial concern for the greater good remains unclear. Across four studies, we investigated the relationship between ‘utilitarian’ judgment in such sacrificial dilemmas and a range of traits, attitudes, judgments and behaviors that either reflect or reject an impartial concern for the greater good of all. In Study 1, we found that rates of ‘utilitarian’ judgment were associated with a broadly immoral outlook concerning clear ethical transgressions in a business context, as well as with sub-clinical psychopathy. In Study 2, we found that ‘utilitarian’ judgment was associated with greater endorsement of rational egoism, less donation of money to a charity, and less identification with the whole of humanity, a core feature of classical utilitarianism.  In Studies 3 and 4, we found no association between ‘utilitarian’ judgments in sacrificial dilemmas and characteristic utilitarian judgments relating to assistance to distant people in need, self-sacrifice and impartiality, even when the utilitarian justification for these judgments was made explicit and unequivocal. This lack of association remained even when we controlled for the antisocial element in ‘utilitarian’ judgment. Taken together, these results suggest that there is very little relation between sacrificial judgments in the hypothetical dilemmas that dominate current research, and a genuine utilitarian approach to ethics.
Understanding the cognitive underpinnings of moral judgment is one of most pressing problems in psychological science. Some highly-cited studies suggest that reliance on intuition decreases utilitarian (expected welfare maximizing)... more
Understanding the cognitive underpinnings of moral judgment is one of most pressing problems in psychological science. Some highly-cited studies suggest that reliance on intuition decreases utilitarian (expected welfare maximizing) judgments in sacrificial moral dilemmas in which one has to decide whether to instrumentally harm (IH) one person to save a greater number of people. However, recent work suggests that such dilemmas are limited in that they fail to capture the positive, defining core of utilitarianism: commitment to impartial beneficence (IB). Accordingly, a new two-dimensional model of utilitarian judgment has been proposed that distinguishes IH and IB components. The role of intuition on this new model has not been studied. Does relying on intuition disfavor utilitarian choices only along the dimension of instrumental harm or does it also do so along the dimension of impartial beneficence? To answer this question, we conducted three studies (total N = 970, two preregistered) using conceptual priming of intuition versus deliberation on moral judgments. Our evidence converges on an interaction effect, with intuition decreasing utilitarian judgments in IH-as suggested by previous work-but failing to do so in IB. These findings bolster the recently proposed two-dimensional model of utilitarian moral judgment, and point to new avenues for future research.
One of the key sources of support for the view that challenging people's beliefs about free will may undermine moral behavior is a classic study by Vohs and Schooler (2008). These authors reported that exposure to certain prompts... more
One of the key sources of support for the view that challenging people's beliefs about free will may undermine moral behavior is a classic study by Vohs and Schooler (2008). These authors reported that exposure to certain prompts suggesting that free will is an illusion increased cheating behavior among study participants. In the present paper, we report several attempts to replicate this influential and widely cited work. Over a series of four high-powered studies (three preregistered) we tested the relationship between (1) anti-free-will prompts and free will beliefs and (2) free will beliefs and immoral behavior. Our primary task was to closely replicate the findings from Vohs and Schooler (2008) using the same or similar manipulations and measurements as the ones used in their original studies. Our efforts were largely unsuccessful. We suggest that manipulating free will beliefs in a robust way is more difficult than has been implied by prior work, and that the proposed link with immoral behavior may be similarly tenuous.
In fourteen studies, we tested whether political conservatives’ stronger free will beliefs were linked to stronger and broader tendencies to moralize, and thus a greater motivation to assign blame. In Study 1 (meta-analysis of five... more
In fourteen studies, we tested whether political conservatives’ stronger free will beliefs were linked to stronger and broader tendencies to moralize, and thus a greater motivation to assign blame. In Study 1 (meta-analysis of five studies, n=308,499) we show that conservatives have stronger tendencies to moralize than liberals, even for moralization measures containing zero political content (e.g., moral badness ratings of faces and personality traits). In Study 2, we show that conservatives report higher free will belief, and this is statistically mediated by the belief that people should be held morally responsible for their bad behavior (n=14,707). In Study 3, we show that political conservatism is associated with higher attributions of free will for specific events. Turning to experimental manipulations of our hypothesis, we show that: when conservatives and liberals see an action as equally wrong there is no difference in free will attributions (Study 4); when conservatives see an action as less wrong than liberals, they attribute less free will (Study 5); and specific perceptions of wrongness account for the relation between political ideology and free will attributions (Study 6a and 6b). Finally, we show that political conservatives and liberals even differentially attribute free will for the same action depending on who performed it (Studies 7a-d). Our results suggest political differences in free will belief are at least partly explicable by conservatives’ tendency to moralize, which strengthens motivation to justify blame with stronger belief in free will and personal accountability.
Background: Recent literature on addiction and judgments about the characteristics of agents has focused on the implications of adopting a ‘brain disease’ versus ‘moral weakness’ model of addiction. Typically, such judgments have to do... more
Background: Recent literature on addiction and judgments about the characteristics of agents has focused on the implications of adopting a ‘brain disease’ versus ‘moral weakness’ model of addiction. Typically, such judgments have to do with what capacities an agent has (e.g., the ability to abstain from substance use). Much less work, however, has been conducted on the relationship between addiction and judgments about an agent’s identity, including whether or to what extent an individual is seen as the same person after becoming addicted. Methods: We conducted a series of vignette-based experiments (total N = 3,620) to assess lay attitudes concerning addiction and identity persistence, systematically manipulating key characteristics of agents and their drug of addiction. Conclusions: In Study 1, we found that US participants judged an agent who became addicted to drugs as being closer to ‘a completely different person’ than ‘completely the same person’ as the agent who existed prior to the addiction. In Studies 2-6, we investigated the intuitive basis for this result, finding that lay judgments of altered identity as a consequence of drug use and addiction are driven primarily by perceived negative changes in the moral character of drug users, who are seen as having deviated from their good true selves.
Given the prominence of Muslim veils—in particular the hijab and full-face veil—in public discourse concerning the place of Muslims in Western society, we examined their impact on non-Muslims’ responses at both explicit and implicit... more
Given the prominence of Muslim veils—in particular the hijab and full-face veil—in public discourse concerning the place of Muslims in Western society, we examined their impact on non-Muslims’ responses at both explicit and implicit levels. Results revealed that responses were more negative toward any veil compared with no veil, and more negative toward the full-face veil relative to the hijab: for emotions felt toward veiled women (Study 1), for non-affective attitudinal responses (Study 2), and for implicit negative attitudes revealed through response latency measures (Studies 3a and 3b). Finally, we manipulated the perceived reasons for wearing a veil, finding that exposure to positive reasons for wearing a veil led to better predicted and imagined contact (Study 4). Practical and theoretical implications are discussed.
When we say that what two people feel for each other is 'true love,' we seem to be doing more than simply clarifying that it is in fact love they feel, as opposed to something else. That is, an experience or relationship might be a... more
When we say that what two people feel for each other is 'true love,' we seem to be doing more than simply clarifying that it is in fact love they feel, as opposed to something else. That is, an experience or relationship might be a genuine or actual instance of love without necessarily being an instance of true love. But what criteria do people use to determine whether something counts as true love? This chapter explores three hypotheses. The first holds that the ordinary concept of true love picks out love that is highly prototypical. The second, that it picks out love that is especially good or valuable. The third, that people distinguish between psychological states that are 'real' or not, and that it picks out love that is real. Two experiments provide evidence against the first hypothesis and in favor of the second and third. Implications for real-life disagreements about love are also discussed.
In this essay I examine the racial achievement gap in American education in terms of an impaired psychosocial developmental process. I argue that the well-documented academic underperformance of certain minority groups may stem from the... more
In this essay I examine the racial achievement gap in American education in terms of an impaired psychosocial developmental process. I argue that the well-documented academic underperformance of certain minority groups may stem from the unfavorable resolution of a key developmental crisis in constituent members’ early scholastic experience. I go on to suggest that individual educators can play an important role in eliminating the achievement gap by changing the way they teach in their own classrooms. In part, they may do so by adopting a "transcultural" pedagogy or teaching style, according to which both teachers and their minority students develop (at minimum) transcultural proficiencies and (at maximum) transcultural identities, as a promising way to achieve two important ends. First, the fostering of an academically-industrious self-concept in members of historically underachieving minority groups and hence, second, the closing of the achievement gap "from the bottom up"—one classroom at a time.
Unconscious mental processes (such as the automatic activation of racial stereotypes) can lead to such phenomena as negative pygmalion effects and stereotype threat, both of which directly interfere with black students' academic success,... more
Unconscious mental processes (such as the automatic activation of racial stereotypes) can lead to such phenomena as negative pygmalion effects and stereotype threat, both of which directly interfere with black students' academic success, thus widening the racial achievement gap. Because stereotype activation occurs automatically and outside of conscious awareness, there is the disturbing possibility that nothing can be done to fully mitigate its harmful effects. It is proposed, however, on the basis of recent cross-disciplinary research, that by expending deliberate effort along the personal, instructional, and environmental dimensions, conscientious teachers can counteract these effects and help close the achievement gap.
The unconscious mind tends to disregard negations in its processing of semantic meaning. Therefore, messages containing negated concepts can ironically prime mental representations and evaluations that are opposite to those intended. We... more
The unconscious mind tends to disregard negations in its processing of semantic meaning. Therefore, messages containing negated concepts can ironically prime mental representations and evaluations that are opposite to those intended. We hypothesized that the subtle presentation of a negated concept (e.g., “no smoking”) would activate ironic motivational orientations as well. We tested this hypothesis in a public health context. Smokers viewed photographs in which no-smoking signs were either inconspicuously embedded (prime) or edited out (control). Primed smokers showed amplified automatic approach tendencies toward smoking-related stimuli, but not toward smoking-unrelated stimuli. Since passive priming effects generally serve to facilitate forms of action, not inhibit them, anti-smoking and other public health campaigns may ironically increase the very behaviors they seek to reduce.
Well-being after successful cancer treatment depends on more than merely reducing the risk of disease recurrence. Cancer survival can be characterized by uncertainty, fear, and the interpretation of bodily sensations as potentially... more
Well-being after successful cancer treatment depends on more than merely reducing the risk of disease recurrence. Cancer survival can be characterized by uncertainty, fear, and the interpretation of bodily sensations as potentially symptomatic of cancer recurrence. This fear can lead to over-vigilance about bodily sensations and precautionary visits to the doctor, both of which can increase the chance of early detection but can also increase anxiety and decrease quality of life. In this Personal View, we consider the medical, psychological, and ethical issues related to the practice of self-directed symptom monitoring after completion of cancer treatment, focusing on the role of doctor–patient communication. We ask how clinicians can account for the plurality of values that patients might have when it comes to deciding on how to manage and respond to experiences of post-cancer symptoms. We advocate a shared decision making approach that incorporates the assessment of an individual’s cancer recurrence risks as well as psychosocial considerations regarding fear of cancer recurrence and mental health. We aim to raise awareness of the potential quality-of-life implications of symptom-monitoring practices, emphasizing the need for a balance between physical and psychological health in people living beyond cancer.
In 1863, Fyodor Dostoevsky wrote, “Try to pose for yourself this task: not to think of a polar bear – and you will see that the cursed thing will come to mind every minute.” According to a recent research paper from Oxford’s Department... more
In 1863, Fyodor Dostoevsky wrote, “Try to pose for yourself this task: not to think of a polar bear – and you will see
that the cursed thing will come to mind every minute.” According to a recent research paper from Oxford’s Department of Experimental Psychology conducted by the author and his colleagues, Dostoevsky’s observation on ironic thought processes has public health implications for no-smoking signs. [Research subsequently published as Earp, B. D., Dill, B., Harris, J., Ackerman, J. M., & Bargh, J. A. (2013). No sign of quitting: Incidental exposure to “no
smoking” signs ironically boosts cigarette-approach tendencies in smokers. Journal of Applied Social Psychology,
Vol. 43, No. 10, 2158–2162.]
This chapter summarizes an emerging sub-discipline of both empirical bioethics and experimental philosophy (“x-phi”) which has variously been referred to as experimental philosophical bioethics, experimental bioethics, or simply “bioxphi”... more
This chapter summarizes an emerging sub-discipline of both empirical bioethics and experimental philosophy (“x-phi”) which has variously been referred to as experimental philosophical bioethics, experimental bioethics, or simply “bioxphi” (Earp, Latham and Tobia, 2020; Earp et al., 2020; Lewis, 2020; Mihailov, Hannikainen and Earp, 2021). Like empirical bioethics, bioxphi uses data-driven research methods to capture what various stakeholders think (feel, judge, etc.) about moral issues of relevance to bioethics. However, like its other parent discipline of x-phi, bioxphi tends to favor experiment-based designs drawn from the cognitive sciences (Knobe, 2016)—including psychology, neuroscience, and behavioral economics—to tease out why and how stakeholders think as they do.
For someone with an outsized influence on a field he helped to create, Dan Callahan was anything but overbearing. Physically compact, thin, and wiry in older age, he spoke at the rapid speed of his mind and with the same warm spirit that... more
For someone with an outsized influence on a field he helped to create, Dan Callahan was anything but overbearing. Physically compact, thin, and wiry in older age, he spoke at the rapid speed of his mind and with the same warm spirit that animated his eyes, which danced with a wise intelligence and good humor. When I met him I was in my late 20s, just finding my footing in bioethics. I had no idea what I was doing. My background was in cognitive science and philosophy, mostly, but through a series of accidents I had started writing essays about bioethical themes and submitting them to bioethical journals. Suddenly on the cusp of what would become a year-long residency at The Hastings Center-an experience from which I grew as much as a person as a scholar-in-training-I found myself seated in the decidedly quaint living room of Dan and Sidney Callahan, who had invited me to dinner.
One of the great ongoing debates of the 21st century is whether technology—broadly construed—has proven itself to be on balance beneficial or detrimental to, among other aspects, the moral dimensions of civil society. Technology permeates... more
One of the great ongoing debates of the 21st century is whether technology—broadly construed—has proven itself to be on balance beneficial or detrimental to, among other aspects, the moral dimensions of civil society. Technology permeates all aspects of modern life, transforming the way we live, communicate, interact, and work. Does it foster or detract from a good society? How can we determine what a “good” society is?  “Technophobes” and “technophiles” will give different answers, but so will scholars and individuals who fall between those extremes. Because technologies engender promise and potential as well as uncertainties and risk, we must critically evaluate how technological advancements are shaping or eroding a “Good Society.”
Parens (2015) defends a habit of thinking he calls “binocularity,” which involves switching between analytical lenses (much as one must switch between seeing the duck vs. the rabbit in Wittgenstein’s famous example). Applying this habit... more
Parens (2015) defends a habit of thinking he calls “binocularity,” which involves switching between analytical lenses (much as one must switch between seeing the duck vs. the rabbit in Wittgenstein’s famous example). Applying this habit of thought to a range of debates in contemporary bioethics, Parens urges us to acknowledge the ways in which our personal intuitions and biases shape our thinking about contentious moral issues. In this review of Parens’s latest book, we reflect on our own position as participants in the so-called “enhancement” debates, where a binocular approach could be especially useful. In particular, we consider the case of “love drugs,” a subject on which we have sometimes reached very different conclusions. We finish with an analogy to William James’s (1907) distinction between “tender-minded” rationalists and “tough-minded” empiricists, and draw some general lessons for improving academic discourse.
Biggar (2015) argues that “religion” deserves a place in secular medicine. Against this view, I argue that religion (as most people would understand the term) should not play a role in shaping secular health policy, and I provide some... more
Biggar (2015) argues that “religion” deserves a place in secular medicine. Against this view, I argue that religion (as most people would understand the term) should not play a role in shaping secular health policy, and I provide some illustrations of the dangers of the contrary. However, I also suggest that—upon closer inspection—Biggar seems to be using the term “religion” to refer to obliquely to what most people would call “moral philosophy.” On this less controversial interpretation, Biggar’s proposal is inoffensive—but unoriginal.
In this chapter, we introduce the notion of “moral neuroenhancement,” offering a novel definition as well as spelling out three conditions under which we expect that such neuroenhancement would be most likely to be permissible (or even... more
In this chapter, we introduce the notion of “moral neuroenhancement,” offering a novel definition as well as spelling out three conditions under which we expect that such neuroenhancement would be most likely to be permissible (or even desirable). Furthermore, we draw a distinction between first-order moral capacities, which we suggest are less promising targets for neurointervention, and second-order moral capacities, which we suggest are more promising. We conclude by discussing concerns that moral neuroenhancement might restrict freedom or otherwise “misfire,” and argue that these concerns are not as damning as they may seem at first.
The moral enhancement (or bioenhancement) debate seems stuck in a dilemma. On the one hand, the more radical proposals, while certainly novel and interesting, seem unlikely to be feasible in practice, or if technically feasible then most... more
The moral enhancement (or bioenhancement) debate seems stuck in a dilemma. On the one hand, the more radical proposals, while certainly novel and interesting, seem unlikely to be feasible in practice, or if technically feasible then most likely imprudent. But on the other hand, the more “sensible” proposals – sensible in the sense of being both practically achievable and more plausibly ethically justifiable – can be rather hard to distinguish from both “traditional” forms of moral enhancement, such as non-drug-mediated social or moral education, and non-moral forms of bioenhancement, such as “smart drug” style cognitive enhancement. In this essay, I argue that bioethicists have paid insufficient attention to an alternative form of moral bioenhancement—or at least a likely candidate—that falls somewhere between these two extremes, namely the (appropriately qualified) use of certain psychedelic drugs.
Peterson et al. (2023) present a range of ethical issues that arise when considering the use of psychedelic substances within medicine. But psychedelics are, by their nature, boundary-dissolving, and we suggest that progress in the Ethics... more
Peterson et al. (2023) present a range of ethical issues that arise when considering the use of psychedelic substances within medicine. But psychedelics are, by their nature, boundary-dissolving, and we suggest that progress in the Ethics of Psychedelic Medicine is best made within a broader-ranging Psychedelic Bioethics, which encompasses not just medicine, but wider society, including the breadth of cultural containers and settings in which these compounds are used.
Psychedelics, including psilocybin, and other consciousness-altering compounds such as 3,4-methylenedioxymethamphetamine (MDMA), currently are being scientifically investigated for their potential therapeutic uses, with a primary focus on... more
Psychedelics, including psilocybin, and other consciousness-altering compounds such as 3,4-methylenedioxymethamphetamine (MDMA), currently are being scientifically investigated for their potential therapeutic uses, with a primary focus on measurable outcomes: for example, alleviation of symptoms or increases in self-reported well-being. Accordingly, much recent discussion about the possible value of these substances has turned on estimates of the magnitude and duration of persisting positive effects in comparison to harms. However, many have described the value of a psychedelic experience with little or no reference to such therapeutic benefits, instead seeming to find the experience valuable in its own right. How can we make sense of such testimony? Could a psychedelic experience be valuable even if there were no persisting beneficial effects? If so, how? Using the concept of psychological richness, combined with insights from the philosophy of aesthetics and the enhancement literature, this essay explores potential sources of value in the acute subjective experience, apart from the value derived from persisting beneficial effects.
The psychedelic psilocybin has shown promise both as treatment for psychiatric conditions and as a means of improving well-being in healthy individuals. In some jurisdictions (e.g., Oregon, USA), psilocybin use for both purposes is or... more
The psychedelic psilocybin has shown promise both as treatment for psychiatric conditions and as a means of improving well-being in healthy individuals. In some jurisdictions (e.g., Oregon, USA), psilocybin use for both purposes is or will soon be allowed and yet, public attitudes toward this shift are understudied. We asked a nationally representative sample of 795 US Americans to evaluate the moral status of psilocybin use in an appropriately licensed setting for either treatment of a psychiatric condition or well-being enhancement. Showing strong bipartisan support, participants rated the individual’s decision as morally positive in both contexts. These results can inform effective policy-making decisions around supervised psilocybin use, given robust public attitudes as elicited in the context of an innovative regulatory model. We did not explore attitudes to psilocybin use in unsupervised or non-licensed community or social settings.
Evidence suggests that psychedelics bring about their therapeutic outcomes in part through the subjective or qualitative effects they engender and how the individual interprets the resulting experiences. However, psychedelics are... more
Evidence suggests that psychedelics bring about their therapeutic outcomes in part through the subjective or qualitative effects they engender and how the individual interprets the resulting experiences. However, psychedelics are contraindicated for individuals who have been diagnosed with certain mental illnesses, on the grounds that these subjective effects may be disturbing or otherwise counter-therapeutic. Substantial resources are therefore currently being devoted to creating psychedelic substances that produce many of the same biological changes as psychedelics, but without their characteristic subjective effects. In this article, we consider ethical issues arising from the prospect of such potential 'non-subjective' psychedelics. We are broadly supportive of efforts to produce such substances for both scientific and clinical reasons. However, we argue that such non-subjective psychedelics should be reserved for those special cases in which the subjective effects of psychedelics are specifically contraindicated, whereas classic psychedelics that affect subjective experience should be considered the default and standard of care. After reviewing evidence regarding the subjective effects of psychedelics, we raise a number of ethical concerns around the prospect of withholding such typically positive, meaningful, and therapeutic experiences from most patients.
Psychedelics such as psilocybin reliably produce significantly altered states of consciousness with a variety of subjectively experienced effects. These include certain changes to perception, cognition, and affect, which we refer to here... more
Psychedelics such as psilocybin reliably produce significantly altered states of consciousness with a variety of subjectively experienced effects. These include certain changes to perception, cognition, and affect, which we refer to here as the acute subjective effects of psychedelics. In recent years, psychedelics such as psilocybin have also shown considerable promise as therapeutic agents when combined with talk therapy: for example, in the treatment of major depression or substance use disorder. However, it is currently unclear whether the aforementioned acute subjective effects are necessary to bring about the observed therapeutic effects of psilocybin and other psychedelics. This uncertainty has sparked a lively – though still largely-hypothetical – debate on whether psychedelics without subjective effects (“nonsubjective psychedelics” or “non-hallucinogenic psychedelics”) could still have the same therapeutic impact, or whether the acute subjective effects are in fact necessary for this impact to be fully realized.
The enhancement debate in neuroscience and biomedical ethics tends to focus on the augmentation of certain capacities or functions: memory, learning, attention, and the like. Typically, the point of contention is whether these... more
The enhancement debate in neuroscience and biomedical ethics tends to focus on the augmentation of certain capacities or functions: memory, learning, attention, and the like. Typically, the point of contention is whether these augmentative enhancements are permissible for individuals with no particular ‘medical’ disadvantage along any of the dimensions of interest. Rarely addressed in the literature, however, is the fact that sometimes the diminishment of a capacity or function, under the right set of circumstances, could plausibly contribute to an individual’s overall well-being: more is not always better, and sometimes less is more. Such cases may be especially likely, we suggest, when trade-offs in our modern environment have shifted since the environment of evolutionary adaptation. In this article, we introduce the notion of “diminishment as enhancement” and go on to defend a welfarist conception of enhancement. We show how this conception resolves a number of definitional ambiguities in the enhancement literature, and we suggest that it can provide a useful framework for thinking about the use of emerging neurotechnologies to promote human flourishing.
Davis (2014) called for "extreme caution" in the use of non-invasive brain stimulation (NIBS) to treat neurological disorders in children, due to gaps in scientific knowledge. We are sympathetic to his position. However, we must also... more
Davis (2014) called for "extreme caution" in the use of non-invasive brain stimulation (NIBS) to treat neurological disorders in children, due to gaps in scientific knowledge. We are sympathetic to his position. However, we must also address the ethical implications of applying this technology to minors. Compensatory trade-offs associated with NIBS present a challenge to its use in children, insofar as these trade-offs have the effect of limiting the child's future options. The distinction between treatment and enhancement has some normative force here. As the intervention moves away from being a treatment toward being an enhancement—and thus toward a more uncertain weighing of the benefits, risks, and costs—considerations of the child’s best interests (as judged by the parents) diminish, and the need to protect the child's (future) autonomy looms larger. NIBS for enhancement involving trade- offs should therefore be delayed, if possible, until the child reaches a state of maturity and can make an informed, personal decision. NIBS for treatment, by contrast, is permissible insofar as it can be shown to be at least as safe and effective as currently approved treatments, which are (themselves) justified on a best interests standard.
What does the reality of COVID-19 say about bioethics as a discipline, or the role of bioethicists in society? Why are so many ‘pandemic ethics’ plans or triage heuristics being suddenly thrown together? Is it a problem that multiple... more
What does the reality of COVID-19 say about bioethics as a discipline, or the role of bioethicists in society? Why are so many ‘pandemic ethics’ plans or triage heuristics being suddenly thrown together? Is it a problem that multiple conflicting proposals for how to allocate scarce resources (eg, ventilators) are being published on an almost daily basis? How can we reach a consensus about such questions and should consensus be a goal? What should the role be for bioethicists in this kind of crisis, are we equipped to pass judgment on such high-stakes, real-life normative questions?
In order to ensure that children are treated ethically, we need to ground their rights and interests in stable principles that do not force us accept untenable conclusions.
The concept of medical necessity is often used to explain or justify certain decisions—for example, which treatments should be allowed under certain conditions—as though it had an obvious, agreed-upon meaning as well as an inherent... more
The concept of medical necessity is often used to explain or justify certain decisions—for example, which treatments should be allowed under certain conditions—as though it had an obvious, agreed-upon meaning as well as an inherent normative force. In introducing this special issue of Clinical Ethics on medical necessity, we argue that the term, as used in various discourses, generally lacks a definition that is clear, non-circular, conceptually plausible, and fit-for-purpose.  We propose that future work on this concept should address three main questions: what medical necessity is (i.e., what makes something medically necessary, as opposed to something else); what the concept does (what ‘work’ is it doing when invoked in different settings); and what should follow, normatively, from the fact that something is indeed medically necessary (on some plausible conception)?
Pickering et al. (2022) argue that patients who refuse doctor-recommended treatments should in some cases be deemed incompetent to decide about their own medical care—in part because of their decision to refuse treatment— even if they... more
Pickering et al. (2022) argue that patients who refuse doctor-recommended treatments should in some cases be deemed incompetent to decide about their own medical care—in part because of their decision to refuse treatment— even if they would otherwise have been considered competent. This, then, would allow doctors to override the patients’ will and to enact the treatment against their wishes. Such a proposal should be rejected. Among other problems, Pickering et al. fail to distinguish the “apparent” self-harmfulness of a decision (i.e., based on the judgment of an outside party) from the actual (net) self-harmfulness of a decision based on the patient’s own distinctive worldview and values. They also rely on a false equivalence between dissimilar approaches to decision-making to dismiss the dominant anti- paternalist paradigm. Pursuing their suggestion would thus foster morally objectionable paternalism in medicine. It could lead to the imposition of genuinely unwanted treatments on non-consenting patients, and to the wrongful infringement of patients’ bodily integrity.
How shall we decide for others who cannot (currently) decide for themselves? And who-or what, in the case of artificial intelligence-should make the decision? The present issue of the journal tackles several interrelated topics, many of... more
How shall we decide for others who cannot (currently) decide for themselves? And who-or what, in the case of artificial intelligence-should make the decision? The present issue of the journal tackles several interrelated topics, many of them having to do with surrogate decision making. For example, the feature article by Jardas et al. (1) explores the potential use of artificial intelligence (AI) to predict incapacitated patients' likely treatment preferences based on their sociodemographic characteristics, raising questions about the means by which we come to decide for others. And a clinical ethics round table led by Wilkinson and Pillay (2) examines the case of a premature baby on life support whose primary surrogate is herself incapacitated. Together, these examples force us to think more deeply about the meaning and significance of taken-for-granted concepts: respect for autonomy, substituted judgment, best interests. We'll consider the baby first and then turn to AI.
As society increasingly integrates artificial intelligence (AI) into its fabric, AI ethics education in primary schools becomes necessary. Drawing parallels between the integration of foundational subjects such as languages and... more
As society increasingly integrates artificial intelligence (AI) into its fabric, AI ethics education in primary schools becomes necessary. Drawing parallels between the integration of foundational subjects such as languages and mathematics and the pressing need for AI literacy, we argue for mandatory, age-appropriate AI education focusing on technical proficiency and ethical implications. Analogous to how sex and drug education prepare youth for real-world challenges and decisions, AI education is crucial for equipping students to navigate an AI-driven future responsibly. Our study delineates the ethical pillars, such as data privacy and unbiased algorithms, essential for students to grasp, and presents a framework for AI literacy integration in elementary schools. What is needed is a comprehensive, dynamic, and evidence-based approach to AI education, to prepare students for an AI-driven future.
What counts as a good decision depends on the domain. In diagnostic imaging, for instance, a good decision involves diagnosing cancer if and only if the patient has cancer. In clinical ethics, good decision-making is defined in terms of... more
What counts as a good decision depends on the domain. In diagnostic imaging, for instance, a good decision involves diagnosing cancer if and only if the patient has cancer. In clinical ethics, good decision-making is defined in terms of the extent to which the following two goals are met:
1. Accuracy: The decision is the right one, where the “right” decision is that which best aligns with relevant justifying values, principles and their respective weights as they apply to the case at hand.
2. Transparency: The patients are provided with an explanation of the decision in terms of relevant values, principles and how they are weighed. In other words, the patients are offered reasons that explain and justify the decision.
For the use of artificial intelligence in clinical ethics to be ethically justified, it should improve the transparency and accuracy of ethical decision-making beyond that which physicians and ethics committees are currently capable of providing.
Obtaining informed consent from patients prior to a medical or surgical procedure is a fundamental part of safe and ethical clinical practice. Currently, it is routine for a significant part of the consent process to be delegated to... more
Obtaining informed consent from patients prior to a medical or surgical procedure is a fundamental part of safe and ethical clinical practice. Currently, it is routine for a significant part of the consent process to be delegated to members of the clinical team not performing the procedure (e.g. junior doctors). However, it is common for consent-taking delegates to lack sufficient time and clinical knowledge to adequately promote patient autonomy and informed decision-making. Such problems might be addressed in a number of ways. One possible solution to this clinical dilemma is through the use of conversational artificial intelligence (AI) using large language models (LLMs). There is considerable interest in the potential benefits of such models in medicine. For delegated procedural consent, LLM could improve patients’ access to the relevant procedural information and therefore enhance informed decision-making.

In this paper, we first outline a hypothetical example of delegation of consent to LLMs prior to surgery. We then discuss existing clinical guidelines for consent delegation and some of the ways in which current practice may fail to meet the ethical purposes of informed consent. We outline and discuss the ethical implications of delegating consent to LLMs in medicine concluding that at least in certain clinical situations, the benefits of LLMs potentially far outweigh those of current practices.
In this article, we explore the potential of enhancing academic prose and idea generation by fine-tuning a large language model (here, GPT-3) on one’s own previously published writings: AUTOGEN (‘AI Unique Tailored Output GENerator’). We... more
In this article, we explore the potential of enhancing academic prose and idea generation by fine-tuning a large language model (here, GPT-3) on one’s own previously published writings: AUTOGEN (‘AI Unique Tailored Output GENerator’). We develop, test, and describe three distinct AUTOGEN models trained on the prior scholarly output of three of the current authors (SBM, BDE, JS), with a fourth model trained on the combined works of all three. Our AUTOGEN models demonstrate greater variance in quality than the base GPT-3 model, with many outputs outperforming the base model in format, style, overall quality, and novel idea generation. As proof of principle, we present and discuss examples of AUTOGEN-written sections of existing and hypothetical research papers. We further discuss ethical opportunities, concerns, and open questions associated with personalized academic prose and idea generators. Ethical opportunities of personalized LLMs such as AUTOGEN include increased productivity, preservation of writing styles and cultural traditions, and aiding consensus building. However, ethical concerns arise due to the potential for personalized LLMs to reduce output diversity, violate privacy and intellectual property rights, and facilitate plagiarism or fraud. The use of co-authored or multiple-source trained models further complicates issues surrounding ownership and attribution. Open questions concern a potential credit-blame asymmetry for LLM outputs, the legitimacy of licensing agreements in authorship ascription, and the ethical implications of co-authorship attribution for data contributors. Ensuring the output is sufficiently distinct from the source material is crucial to maintaining ethical standards in academic writing. These opportunities, risks, and open issues highlight the intricate ethical landscape surrounding the use of personalized LLMs in academia. We also discuss open technical questions concerning the integration of AUTOGEN-style personalized LLMs with other LLMs, such as GPT-4, for iterative refinement and improvement of generated text. In conclusion, we argue that AUTOGEN-style personalized LLMs offer significant potential benefits in terms of both prose generation and, to a lesser extent, idea generation. If associated ethical issues are appropriately addressed, AUTOGEN alone or in combination with other LLMs can be seen as a potent form of academic enhancement. 

As a note to readers, this abstract was generated by AUTOGEN and edited for accuracy by the authors. The rest of the text was written manually.
In this reply to our commentators, we respond to ethical concerns raised about the potential use (or misuse) of personalized LLMs for academic idea and prose generation, including questions about career pressures, conformity, (lack of)... more
In this reply to our commentators, we respond to ethical concerns raised about the potential use (or misuse) of personalized LLMs for academic idea and prose generation, including questions about career pressures, conformity, (lack of) meaning, bias, homogeneity of output, and lowered standards. We also highlight further potential benefits raised by a minority of commentators, including benefits relating to equity and diversity. We advocate a co-creation model for guiding human use of LLMs – whether personalized or standard – to produce and share new ideas or content. Thus, in concert with the impressive generative capacities of LLMs, humans must play a role in creating, crafting, curating, and communicating any resulting material, remaining responsible for such vital aspects as meaning-making, imbuing of intention, showing creativity in prompt design and elaboration of initial outputs, careful editing, vetting, fact-checking, and other necessary contributions.
When making substituted judgments for incapacitated patients, surrogates may often struggle to guess what the patient would want if they had capacity. Surrogates may also agonise over having the (sole) responsibility of making such a... more
When making substituted judgments for incapacitated patients, surrogates may often struggle to guess what the patient would want if they had capacity. Surrogates may also agonise over having the (sole) responsibility of making such a determination. To address such concerns, a Patient Preference Predictor (PPP) has been proposed that would use an algorithm to infer the treatment preferences of individual patients from population-level data about the known preferences of people with similar demographic characteristics. However, critics have suggested that even if such a PPP were more accurate, on average, than human surrogates in accurately identifying patient preferences, the proposed algorithm would nevertheless fail to respect the patient’s (former) autonomy since it draws on the ‘wrong’ kind of data: namely, data that are not specific to the individual patient and which therefore may not reflect their actual values, or their reasons for having the preferences they do. Taking such criticisms on board, we here propose a new approach: the Personalized Patient Preference Predictor (P4). The P4 is based on recent advances in machine learning, which allow technologies including large language models to be more cheaply and efficiently ‘fine-tuned’ on person-specific data. The P4, unlike the PPP, would be able to infer an individual patient’s preferences from material (e.g., prior treatment decisions) that is in fact specific to them. Thus, we argue, in addition to being potentially more accurate at the individual level than the previously proposed PPP, the predictions of a P4 would also more directly reflect each patient’s own reasons and values. In this article, we review recent discoveries in artificial intelligence research that suggest a P4 is technically feasible, and argue that, if it is developed and appropriately deployed, it should assuage some of the main autonomy-based concerns of critics of the original PPP. We then consider various objections to our proposal and offer some tentative replies.
Since their public launch a little over a year ago, Large Language Models (LLMs) have inspired a flurry of analysis about what their implications might be for medical ethics, and for society more broadly. (1) Much of the recent debate has... more
Since their public launch a little over a year ago, Large Language Models (LLMs) have inspired a flurry of analysis about what their implications might be for medical ethics, and for society more broadly. (1) Much of the recent debate has moved beyond categorical evaluations of the permissibility or impermissibility of LLM use in different general contexts (for example, at work or school), to more fine-grained discussions of the criteria that should govern their appropriate use in specific domains or toward certain ends (2). With each passing week, it seems more and more inevitable that LLMs will be a pervasive feature of many, if not most, of our lives. It won’t be possible—and wouldn’t be desirable—to prohibit them across the board. We need to learn how to live with LLMs; to identify and mitigate the risks they pose to us, to our fellow creatures, and the environment; and to harness and guide their powers to better ends. This will require thoughtful regulation, sustained cooperation across nations, cultures, and fields of inquiry; and all of this must be grounded in good ethics.
Bioethics grew out of the need to make real-world moral decisions in response to gross human rights abuses, from Nazi war crimes to the Tuskegee Syphilis Study, in the context of rapid technological innovations in healthcare. In the... more
Bioethics grew out of the need to make real-world moral decisions in response to gross human rights abuses, from Nazi war crimes to the Tuskegee Syphilis Study, in the context of rapid technological innovations in healthcare. In the aftermath of World War II, there were incredible advances in life-sustaining medicine, with a corresponding need to decide who should have access to certain treatments in the face of limited resources, and to develop an agreed-upon moral foundation to guide the use of new technologies and prevent their misapplication. Notions of informed consent, respect for persons (autonomy), beneficence, non-maleficence, and justice soon dominated bioethical analysis.

But how do these and other principles apply to particular cases? What does it really mean for a person to give informed consent — and what goes into that process, psychologically? How do doctors actually think about harm and benefit, especially when there is disagreement about what constitutes a harm or benefit for a particular patient? What is the role of social context in shaping these kinds of judgements? When policymakers decide about fair distribution of resources, what factors influence their intuitions about what justice demands? And how do proxy decision makers make sense of respect for persons when personhood is not entirely clear, as in the case of fetuses, or individuals with advanced dementia?

Although bioethicists have occasionally drawn on empirical data to supplement normative bioethical analysis, the emerging field of experimental philosophical bioethics — or bioXphi — seeks to systematically characterize the underlying cognitive processes that bear on moral judgments in a healthcare context. We see this work as having serious significance for medical policy and clinical judgment: generalized research on psychological processes may not apply to real-world decision making in the kinds of life-or-death situations that doctors often face. And formalized models of informed consent may have little to do with the facts on the ground when it comes to factors that influence a patient’s decision to give permission for a surgery.
There is a rich tradition in bioethics of gathering empirical data to inform, supplement, or test the implications of normative ethical analysis. To this end, bioethicists have drawn on diverse methods, including qualitative interviews,... more
There is a rich tradition in bioethics of gathering empirical data to inform, supplement, or test the implications of normative ethical analysis. To this end, bioethicists have drawn on diverse methods, including qualitative interviews, focus groups, ethnographic studies, and opinion surveys to advance understanding of key issues in bioethics. In so doing, they have developed strong ties with neighboring disciplines such as anthropology, history, law, and sociology. Collectively, these lines of research have flourished in the broader field of “empirical bioethics” for more than 30 years (Sugarman & Sulmasy 2010). More recently, philosophers from outside the field of bioethics have similarly employed empirical methods—drawn primarily from psychology, the cognitive sciences, economics, and related disciplines—to advance theoretical debates. This approach, which has come to be called experimental philosophy (or x-phi), relies primarily on controlled experiments to interrogate the concepts, intuitions, reasoning, implicit mental processes, and empirical assumptions about the mind that play a role in traditional philosophical arguments (Knobe et al. 2012). Within the moral domain, for example, experimental philosophy has begun to contribute to long-standing debates about the nature of moral judgment and reasoning; the sources of our moral emotions and biases; the qualities of a good person or a good life; and the psychological basis of moral theory itself (Alfano, Loeb, & Plakias 2018). We believe that experimental philosophical bioethics—or “bioxphi”—can similarly contribute to bioethical scholarship and debate.  Here, we introduce this emerging discipline, explain how it is distinct from empirical bioethics more broadly construed, and attempt to characterize how it might advance theory and practice in this area.
This paper explores an emerging sub-field of both empirical bioethics and experimental philosophy (“x-phi”), which has been called “experimental philosophical bioethics” (“bioxphi”). As an empirical discipline, bioxphi adopts the methods... more
This paper explores an emerging sub-field of both empirical bioethics and experimental philosophy (“x-phi”), which has been called “experimental philosophical bioethics” (“bioxphi”). As an empirical discipline, bioxphi adopts the methods of experimental moral psychology and cognitive science; it does so to make sense of the eliciting factors and underlying cognitive processes that shape people’s normative judgments, particularly about real-world matters of bioethical concern. Yet, as a normative discipline situated within the broader field of bioethics, it also aims to contribute to substantive ethical questions about what should be done in a given context. What are some of the ways in which this aim has been pursued? In this paper, we employ a case study approach to examine and critically evaluate four strategies from the recent literature by which scholars in bioxphi have leveraged empirical data in the service of normative arguments.
Our aim in this chapter is to sample illustrative work on personal identity in experimental philosophical bioethics (bioxphi), explore how it relates to studies in psychology covering similar terrain, and draw out the implications of this... more
Our aim in this chapter is to sample illustrative work on personal identity in experimental philosophical bioethics (bioxphi), explore how it relates to studies in psychology covering similar terrain, and draw out the implications of this work for matters of bioethical concern
In the present chapter, we seek to better understand how laypeople reason about the “true self" of a person with advancing dementia. We are also interested in how such reasoning bears on laypeople’s views about the validity or invalidity... more
In the present chapter, we seek to better understand how laypeople reason about the “true self" of a person with advancing dementia. We are also interested in how such reasoning bears on laypeople’s views about the validity or invalidity of an advance directive (AD) regarding that person’s treatment. Toward that end, we will report the results of two empirical studies we undertook to gain insights into this relationship: namely, between judgments about the true self and whether to follow an AD. To justify our empirical approach, we draw on arguments from the emerging literature on experimental philosophical bioethics, also known experimental bioethics or simply “bioxphi” (Earp, 2019; Lewis, 2020; Mihailov et al., 2021). Bioxphi describes an approach to normative theorizing in bioethics that employs evidence about laypeople’s moral judgments as derived from psychological experiments. In a recent publication, we proposed several means of drawing substantive normative conclusions from argumentative premises that include such evidence (see Earp et al., 2021). We will rehearse some of those proposals in a later section, where we explore potential implications of our findings for competing normative positions in the debate about advanced directives.
Some people with dementia are transformed by the disease, to the point that family members may describe them as a “different person.” These transformations may be negative or positive. What factors affect the judgements of ordinary people... more
Some people with dementia are transformed by the disease, to the point that family members may describe them as a “different person.” These transformations may be negative or positive. What factors affect the judgements of ordinary people about whether an advance directive (AD) should be followed in such cases? We conducted three studies to test the influence of (1) positive versus negative transformation and (2) “treat” versus “withhold treatment” AD on the judgements of US participants (n = 1676) as to whether the AD should be followed and the extent to which the late-stage dementia patient had become a different person. We found that participants generally endorsed following the AD, irrespective of condition, but much less so when the patient had a positive transformation. Participants also favored “treat” over “withhold treatment” ADs. Unexpectedly, we found that AD type affected “different person” judgments: participants registered significantly weaker agreement with the proposition that the patient had become a different person when the AD instructed treatment. We discuss these results in the context of Walsh’s (2020) newly proposed normative model for AD decision-making.
Background: Advance healthcare decision-making presumes that a prior treatment preference expressed with sufficient mental capacity ("T1 preference") should trump a contrary preference expressed after significant cognitive decline ("T2... more
Background: Advance healthcare decision-making presumes that a prior treatment preference expressed with sufficient mental capacity ("T1 preference") should trump a contrary preference expressed after significant cognitive decline ("T2 preference"). This assumption is much debated in normative bioethics, but little is known about lay judgments in this domain. This study investigated participants' judgments about which preference should be followed, and whether these judgments differed depending on a first-person (deciding for one's future self) versus third-person (deciding for a friend or stranger) perspective.
It takes a lifetime of preparation to grieve as the Stoics did – without weeping and wailing, but with a heart full of love.
Sam Harris, in his book The Moral Landscape, argues that “science can determine human values.” Against this view, I argue that while secular moral philosophy can certainly help us to determine our values, science—at least as that word is... more
Sam Harris, in his book The Moral Landscape, argues that “science can determine human values.” Against this view, I argue that while secular moral philosophy can certainly help us to determine our values, science—at least as that word is commonly understood—must play a subservient role. To the extent that science can “determine” what we ought to do, it is only by providing us with empirical information, which can then be slotted into a chain of deductive (moral) reasoning. The premises of such reasoning, however, can in no way be derived from the scientific method: they come, instead, from philosophy—and common sense.
Spanish translation and reprinting of the article, "Science Cannot Determine Human Values" by Brian D. Earp -- original article forthcoming in the journal Think: A Journal of the Royal Institute of Philosophy. The translated article may... more
Spanish translation and reprinting of the article, "Science Cannot Determine Human Values" by Brian D. Earp -- original article forthcoming in the journal Think: A Journal of the Royal Institute of Philosophy. The translated article may be cited as follows: Earp, B. D. (2015). La ciencia no puede determinar los valores humanos. Revista Científica General José María Córdova, Vol. 13, No. 15, 233-243.
It is a hallmark of social and psychological science that its findings should be reproducible across relevant contexts, playing a key role in showcasing the reliability of detected effects. However, following what some have called a... more
It is a hallmark of social and psychological science that its findings should be reproducible across relevant contexts, playing a key role in showcasing the reliability of detected effects. However, following what some have called a “watershed” moment, a “crisis of confidence” has befallen the discipline, with commentators zeroing in on the Reproducibility Project’s low replication estimate of 36-47% (Open Science Collaboration, 2015; see also Pashler & Wagenmakers, 2012; Wiggins & Christopherson, 2019). The theory crisis is another perhaps less well-known challenge, with researchers arguing that many of the theories within social and psychological science are generally of poor quality (Eronen & Bringmann, 2021; Fiedler, 2017; Oberauer & Lewandowsky, 2019). Due to this, theories are often not clearly accepted or refuted, tending to come and go with little of the cumulative progress often associated with scientific knowledge. This chapter will look at how the replication and theory crises facing social and psychological science could interact by examining the relationship between replication and theory development. Following an overview of both crises, the first half of the chapter will look at the way in which replications could support theory development, covering the identification of robust phenomena, the identification of effects’ boundary conditions, and the evaluation of theories’ predictions. The second half of the chapter will consider a number of more recent arguments suggesting that well-specified theory is required for replications to be informative (Irvine, 2021; Klein, 2014; Muthukrishna & Henrich, 2019).
This paper argues that there exists a collective epistemic state of 'Broad Medical Uncertainty' (BMU) regarding the effectiveness of many medical interventions. We outline the features of BMU, and describe some of the main contributing... more
This paper argues that there exists a collective epistemic state of 'Broad Medical Uncertainty' (BMU) regarding the effectiveness of many medical interventions. We outline the features of BMU, and describe some of the main contributing factors. These include flaws in medical research methodologies, bias in publication practices, financial and other conflicts of interest, and features of how evidence is translated into practice. These result in a significant degree of uncertainty regarding the effectiveness of many medical treatments and unduly optimistic beliefs about the benefit / harm profiles of such treatments. We argue for an ethical presumption in favour of openness regarding BMU as part of a 'Corrective Response'. We then consider some objections to this position (the 'Anti-Corrective Response'), including concerns that public honesty about flaws in medical research could undermine trust in healthcare institutions. We suggest that, as it stands, the Anti-Corrective Response is unconvincing.
Honesty about the limitations of medical research, we argue, is a prerequisite for maintaining a trusting relationship between medical institutions (and practitioners) and the public. This is the case both in principle (since to deserve... more
Honesty about the limitations of medical research, we argue, is a prerequisite for maintaining a trusting relationship between medical institutions (and practitioners) and the public. This is the case both in principle (since to deserve trust, healthcare systems and practitioners must fulfill the requirements of trustworthiness, including honesty), and in practice: empirical research suggests that more honest communication about scientific limitations and uncertainty need not substantially erode trust. Accordingly, if trust in medical institutions is warranted, then its maintenance should be promoted by means that do not undermine such trust (i.e., we ought not to lie or deceive as tools to promote trust); not only is there an ethical imperative to avoid such behavior, but it may also be self-defeating (for instance, if such behavior is revealed at some later point).
Responding to recent concerns about the reliability of the published literature in psychology and other disciplines, we formed the X-Phi Replicability Project (XRP) to estimate the reproducibility of experimental philosophy... more
Responding to recent concerns about the reliability of the published literature in psychology and other disciplines, we formed the X-Phi Replicability Project (XRP) to estimate the reproducibility of experimental philosophy (osf.io/dvkpr). Drawing on a representative sample of 40 x-phi studies published between 2003 and 2015, we enlisted 20 research teams across 8 countries to conduct a high-quality replication of each study in order to compare the results to the original published findings. We found that x-phi studies – as represented in our sample – successfully replicated about 70% of the time. We discuss possible reasons for this relatively high replication rate in the field of experimental philosophy and offer suggestions for best research practices going forward.
Societies invest in scientific studies to better understand the world, and attempt to harness such improved understanding to address pressing societal problems. Published research, however, can only be useful for theory or application if... more
Societies invest in scientific studies to better understand the world, and attempt to harness such improved understanding to address pressing societal problems. Published research, however, can only be useful for theory or application if it is credible. In science, a credible finding is one that has repeatedly survived risky falsification attempts. However, state-of-the-art meta-analytic approaches cannot determine the credibility of an eect because they do not account for the extent to which each included study has survived such attempted falsification. To overcome this problem, the following paper outlines a unified framework to estimate the credibility of published research by examining four fundamental falsifiability-related dimensions: (1) method/data transparency, (2) analytic reproducibility, (3) analytic robustness, and (4) eect replicability. A standardized workflow is proposed to quantify the degree to which a finding has survived scrutiny along these four credibility facets. The framework is demonstrated by applying it to published replications in the psychology literature. A web platform implementation of the framework is outlined, and we conclude by encouraging the community of researchers to contribute to the development and crowdsourcing of the platform.
A common way to distinguish science from pseudoscience is that the former puts forward hypotheses that are at least in principle falsifiable. This means that they are capable of being refuted—or falsified—by counter-evidence. To... more
A common way to distinguish science from pseudoscience is that the former puts forward hypotheses that are at least in principle falsifiable. This means that they are capable of being refuted—or falsified—by counter-evidence. To illustrate, astrology is often characterized as a pseudoscience since its predictions are so vague that any number of occurrences could be interpreted as confirmatory. Astronomy, by contrast, is usually seen as scientific in part because it makes extremely precise and hence ‘risky’ predictions: the predictions could turn out to be false, which would require astronomers to update their theories in light of the evidence. In reality, matters are rarely so clear. One can always question the validity of the seemingly contrary evidence rather than change one’s theory, for example, and this is often justified. Accordingly, contemporary philosophers of science tend to look down on falsifiability as overly simplistic. Nevertheless, among many practicing scientists, the notion is still regarded as a useful—if imperfect—heuristic for judging the strength of a hypothesis in terms of its ability to generate new insights when combined with careful observation.
Introduction: To improve the rigor of science, experimental evidence for scientific claims ideally needs to be replicated repeatedly with comparable analyses and new data to increase the collective confidence in the veracity of those... more
Introduction: To improve the rigor of science, experimental evidence for scientific claims ideally needs to be replicated repeatedly with comparable analyses and new data to increase the collective confidence in the veracity of those claims. Large replication projects in psychology and cancer biology have evaluated the replicability of their fields but no collaborative effort has been undertaken in sports and exercise science. We propose to undertake such an effort here. As this is the first large replication project in this field, there is no agreed-upon protocol for selecting studies to replicate. Criticism of previous selection protocols include claims they were non-randomised and non-representative. Any selection protocol in sports and exercise science must be representative to provide an accurate estimate of replicability of the field. Our aim is to produce a protocol for selecting studies to replicate for inclusion in a large replication project in sports and exercise science.
Methods: The proposed selection protocol uses multiple inclusion and exclusion criteria for replication study selection, including: the year of publication and citation rankings, research disciplines, study types, the research question and key dependent variable, study methods and feasibility. Studies selected for replication will be stratified into pools based on instrumentation and expertise required, and will then be allocated to volunteer laboratories for replication. Replication outcomes will be assessed using a multiple inferential strategy and descriptive information will be reported regarding the final number of included and excluded studies, and original author responses to requests for raw data.
The (latest) crisis in confidence in social psychology has generated much heated discussion about the importance of replication, including how it should be carried out as well as interpreted by scholars in the field. For example, what... more
The (latest) crisis in confidence in social psychology has generated much heated discussion about the importance of replication, including how it should be carried out as well as interpreted by scholars in the field. For example, what does it mean if a replication attempt “fails”—does it mean that the original results, or the theory that predicted them, have been falsified? And how should “failed” replications affect our belief in the validity of the original research? In this paper, we consider the replication debate from a historical and philosophical perspective, and provide a conceptual analysis of both replication and falsification as they pertain to this important discussion. Along the way, we highlight the importance of auxiliary assumptions (for both testing theories and attempting replications), and introduce a Bayesian framework for assessing “failed” replications in terms of how they should affect our confidence in original findings.
In a much-discussed New York Times article, psychologist Lisa Feldman Barrett recently claimed, “Psychology is not in crisis.” She was responding to the results of a large-scale initiative called the Reproducibility Project, published in... more
In a much-discussed New York Times article, psychologist Lisa Feldman Barrett recently claimed, “Psychology is not in crisis.” She was responding to the results of a large-scale initiative called the Reproducibility Project, published in Science magazine, which appeared to show that the results from over 60% of a sample of 100 psychology studies did not hold up when independent labs attempted to replicate them. In this paper, I address three major issues:

(1) What did the Reproducibility Project really show, and in what specific sense can the follow-up studies meaningfully be described as “failures to replicate” the original findings? I argue that, contrary to what many are suggesting, very little can be learned about the validity of the original studies based upon a single (apparent) failure to replicate: instead, multiple replications (of sufficient quality) of each contested experiment would be needed before any strong conclusions could be drawn about the appropriate degree of confidence to be placed in the original findings.

(2) Is psychology in crisis or not? And if so, what kind of crisis? I tease apart two senses of crisis here. The first sense is “crisis of confidence,” which is a descriptive or sociological claim referring to the notion that many people, within the profession and without, are, as a matter of fact, experiencing a profound and, in some ways, unprecedented lack of confidence in the validity of the published literature. Whether these people are justified in feeling this way is a separate but related question, and the answer depends on a number of factors, to be discussed. The second sense of “crisis” is “crisis of process” – i.e., the notion that (due in large part to apparent failures to replicate a substantial portion of previously published findings), psychological science is “fundamentally broken,” or perhaps not even a “true” science at all. This notion would be based on the assumption that most or perhaps even all of the findings in a professionally published literature should “hold up” when they are replicated, in order for a discipline to be a “true” science, or not to be in a state of “crisis” in this second sense. But this assumption, I will argue, is erroneous: failures of various sorts in science, including bona fide failures to replicate published results, are often the wellspring of important discoveries and other innovations. Therefore, (apparent) replication failure, even on a wide scale, is no evidence that science is broken, per se. Nevertheless,

(3) This does not mean that there is not substantial room for serious, even radical improvements to be made in the conduct of psychological science. These issues must not be brushed under the rug. Even holding the replication debate aside, that is, we have many at least partially independent reasons to push for deep changes in contemporary research and publication norms. Problems that need urgently to be addressed include: publication bias against “negative” results, the related “file drawer” problem, sloppy statistics and lack of adequate statistical training among many scientists, small sample sizes, inefficient and arbitrary peer review, and so on.
In the New York Times, psychologist Lisa Feldman Barrett argues that "Psychology is Not in Crisis." She is responding to the results of a large-scale initiative called the Reproducibility Project, published in Science magazine, which... more
In the New York Times, psychologist Lisa Feldman Barrett argues that "Psychology is Not in Crisis." She is responding to the results of a large-scale initiative called the Reproducibility Project, published in Science magazine, which appeared to show that the findings from over 60 percent of a sample of 100 psychology studies did not hold up when independent labs attempted to replicate them. She argues that "the failure to replicate is not a cause for alarm; in fact, it is a normal part of how science works." But she's making a pretty big assumption here, which is that the studies we're interested in are "well-designed" and "carefully run." A major reason for the so-called "crisis" in psychology, however, is the fact that a very large number of not-well-designed, and not-carefully-run studies have been making it through peer review for decades.
In his draft paper, James C. Coyne argues that replication initiatives will not salvage the trustworthiness of psychology, due to various limitations inherent in almost any (actually feasible) replication program; instead, he believes... more
In his draft paper, James C. Coyne argues that replication initiatives will not salvage the trustworthiness of psychology, due to various limitations inherent in almost any (actually feasible) replication program; instead, he believes that the bulk of attention should be directed at Questionable Research Practices (QRPs), editorial and publication biases, sloppy statistical reasoning, perverse incentives in the reward structure of science, and so on. This is as opposed to so-called "direct" replications, in particular, especially when it comes to certain sub-fields of the discipline in which such replications would be hard to conduct, much less interpret. I agree with many of Professor Coyne's points, and have made similar arguments elsewhere. However, I think that his discussion of the apparent implications of the now-famous Open Science Collaboration (OSC) paper published in Science (purporting to show that more than half of a sample of 100 psychology studies "failed to replicate" when carried out by independent labs) is flawed in a number of ways. I argue, among other things, that the informational value of the OSC paper is much lower than many people seem to think.
Several proposals for addressing the “replication crisis” in social psychology have been advanced in the recent literature. In this paper, we argue that the “crisis” be interpreted as a disciplinary social dilemma, with the problem facing... more
Several proposals for addressing the “replication crisis” in social psychology have been advanced in the recent literature. In this paper, we argue that the “crisis” be interpreted as a disciplinary social dilemma, with the problem facing early-career researchers being especially acute. To resolve this collective action problem, we offer a structural solution: as a condition of receiving their PhD from any accredited institution, graduate students in psychology should be required to conduct, write up, and submit for publication a high-quality replication attempt of at least one key finding from the literature, focusing on the area of their doctoral research. We consider strengths, weaknesses, and implementation challenges associated with this proposal, and call on our colleagues to offer critical response.
"Over half of psychology studies fail reproducibility test." "Study delivers bleak verdict on validity of psychology experiment results." "Psychology is a discipline in crisis." These and other similar headlines followed the results of a... more
"Over half of psychology studies fail reproducibility test." "Study delivers bleak verdict on validity of psychology experiment results." "Psychology is a discipline in crisis." These and other similar headlines followed the results of a large-scale initiative called the Reproducibility Project, recently published in Science magazine, which appeared to show that a majority of findings from a sample of 100 psychology studies did not hold up when independent labs attempted to replicate them. As it stands, though, it is not at all clear what these replications mean. What the experiments actually yielded in most cases was a different statistical value or a smaller effect-size estimate compared with the original studies, rather than positive evidence against the existence of the underlying phenomenon. This is an important distinction. In psychology, as in any science, we have to make inferences based on statistical estimates, and we should expect those estimates to vary over time. In the typical scenario, an initial estimate turns out to be on the high end (that’s why it ends up getting published in the first place — it looks impressive), and then subsequent estimates are a bit more down to earth. The true effect size, whatever it is, is something that emerges only after many replications (and even then as an approximation) as we repeat the experiment over and over. This means that we need a lot of high quality replications; and any solution to the replication crisis has to start by addressing this core issue.
An interview with Brian D. Earp on the ethics of science and publication, in light of the ongoing replication crisis.
In this brief “field note,” I discuss some of the ways in which scientific-sounding rhetoric and other mental shortcuts in medicine (and other fields) can pose a threat to critical thinking, and thereby undermine our reasoning when it... more
In this brief “field note,” I discuss some of the ways in which scientific-sounding rhetoric and other mental shortcuts in medicine (and other fields) can pose a threat to critical thinking, and thereby undermine our reasoning when it comes to issues of ethical importance.
In this essay, I discuss the problem of plausible-sounding bullshit in science, and I describe one particularly insidious method for producing it. Because it takes so much more energy to refute bullshit than it does to create it, and... more
In this essay, I discuss the problem of plausible-sounding bullshit in science, and I describe one particularly insidious method for producing it. Because it takes so much more energy to refute bullshit than it does to create it, and because bullshit can be so damaging to the integrity of empirical research as well as to the policies that are based upon such research, I suggest that addressing this issue should be a high priority for publication ethics.
Premier academic journals—that is, the journals in which many researchers must publish their work in order to maintain or advance their careers—have historically tended to reject papers reporting “negative” or null findings, including... more
Premier academic journals—that is, the journals in which many researchers must publish their work in order to maintain or advance their careers—have historically tended to reject papers reporting “negative” or null findings, including those derived from “failed” attempts to replicate prior results [1–3]. This tendency was likely due to three main factors. First, the limited space available for publishing articles when journals were printed exclusively on paper. Second, the prestige-related desire of “top” journals to publish new and exciting find- ings—i.e., “discoveries” (often taken to imply a demonstration that something “works,” as opposed to “fails to work”). And third, the difficulty posed by negative findings in terms of how they should be interpreted: do they suggest that there is no effect of interest to be found, or rather that the experiment, whether in its design or execution, was simply inadequate to show the effect even though it is real [4–6]?
Klein (2014) argues that the replication crisis in social psychology is due—at least in large part —to the tendency of psychological theories to be ill-specified. We disagree. First, we use both historical and contemporary examples to... more
Klein (2014) argues that the replication crisis in social psychology is due—at least in large part —to the tendency of psychological theories to be ill-specified. We disagree. First, we use both historical and contemporary examples to show that high-quality replication is possible even in the absence of a well-specified theory; and, second, we argue that it is typically auxiliary assumptions, rather than theories themselves, that need to be more clearly specified in order to understand the implications of a given replication effort.
Ploug and Holm (2015) argue that polarization in scientific communities can generate conflicts of interest for individual researchers. Their proposed solution to this problem is that authors should self-report whether they are polarized... more
Ploug and Holm (2015) argue that polarization in scientific communities can generate conflicts of interest for individual researchers. Their proposed solution to this problem is that authors should self-report whether they are polarized on conflict of interest disclosure forms. I argue that this is unlikely to work. This is because any author with the self-awareness and integrity to identify herself as polarized, would be unlikely to conduct polarized research to begin with. Instead, I suggest that it is the role of (associate-level) editors of journals to detect and report on polarization. One consequence of this view is that they need to be sufficiently familiar with the field of research they are evaluating to know whether polarization is at stake.
In a much-publicized paper, Zhong and Liljenquist (2006) reported evidence that feelings of moral cleanliness are grounded in feelings of physical cleanliness: a threat to people’s moral purity leads them to seek, literally, to cleanse... more
In a much-publicized paper, Zhong and Liljenquist (2006) reported evidence that feelings of moral cleanliness are grounded in feelings of physical cleanliness: a threat to people’s moral purity leads them to seek, literally, to cleanse themselves. In an attempt to replicate and build upon these findings, we conducted a pilot study in which we unexpectedly failed to replicate the original results from the second study of Zhong and Liljenquist’s report. To investigate the source of this issue, we conducted a series of direct replications of Study 2 as reported in Zhong and Liljenquist (2006). We used the authors’ original materials and methods; we investigated samples that were more representative of the general population than in the original experiments; we investigated samples from different countries and cultures; and we substantially increased the power of our statistical tests. Nevertheless, we still failed to replicate Zhong and Liljenquist’s initial reported findings. Our research suggests that more work is needed to clarify the scope and robustness of the original results.
Zhong and Liljenquist (2006) have found evidence that feelings of moral cleanliness are grounded in feelings of physical cleanliness: threats to people’s moral purity lead them to seek to cleanse themselves. Might the link between... more
Zhong and Liljenquist (2006) have found evidence that feelings of moral cleanliness are grounded in feelings of physical cleanliness: threats to people’s moral purity lead them to seek to cleanse themselves. Might the link between morality and physical purity extend beyond surface cleanliness to other domains in which purity seems to play role, such as the consumption of “pure” organic foods or the purifying effects of exercising self-control? The present study seeks to further characterize the relationship between physical and moral purity by testing whether threats to moral purity lead participants to (1) rate consumer products associated with organic naturalness and self-control higher, (2) choose examples of those products as compensation for their experimental participation more frequently, and (3) volunteer for a second study without compensation less frequently after they have chosen “pure” beverages, ostensibly having restored their moral purity by the choice of a pure item. The experiment failed to replicate Zhong and Liljenquist’s findings and did not yield any other systematic effects of these manipulations.  Possible reasons for these null results and avenues for future research are offered and outlined.
In response to recommendations to redefine statistical significance to p ≤ .005, we propose that researchers should transparently report and justify all choices they make when designing a study, including the alpha level.
Although many common uses of p-values for making statistical inferences in contemporary scientific research have been shown to be invalid, no one, to our knowledge, has adequately assessed the main original justification for their use,... more
Although many common uses of p-values for making statistical inferences in contemporary scientific research have been shown to be invalid, no one, to our knowledge, has adequately assessed the main original justification for their use, which is that they can help to control the Type I error rate (Neyman & Pearson, 1928; 1933). We address this issue head-on by asking a specific question: Across what domain, specifically, do we wish to control the Type I error rate? For example, do we wish to control it across all of science, across all of a specific discipline such as psychology, across a researcher’s active lifetime, across a substantive research area, across an experiment, or across a set of hypotheses? In attempting to answer these questions, we show that each one leads to troubling dilemmas wherein controlling the Type I error rate turns out to be inconsistent with other scientific desiderata. This inconsistency implies that we must make a choice. In our view, the other scientific desiderata are much more valuable than controlling the Type I error rate and so it is the latter, rather than the former, with which we must dispense. But by doing so—that is, by eliminating the Type I error justification for computing and using p-values—there is even less reason to believe that p is useful for validly rejecting null hypotheses than previous critics have suggested.
In January of 1927, Dr. Richard D. Mudd of Detroit published a letter in the Journal of the American Medical Association, seeking to vindicate his grandfather, Dr. Samuel A. Mudd, against charges of conspiring in a murder [1]. The victim... more
In January of 1927, Dr. Richard D. Mudd of Detroit published a letter in the Journal of the American Medical Association, seeking to vindicate his grandfather, Dr. Samuel A. Mudd, against charges of conspiring in a murder [1]. The victim was U.S. President Abraham Lincoln; the murderer, actor John Wilkes Booth (see Appendix). In this editorial, I, an erstwhile actor, would like to vindicate my own grandfather, Dr. John Rosslyn Earp, for a letter he published on the same day, just one column over, in the very same issue of the journal [2]. But I mean “vindicate” in its other sense—to prove correct—as we shall see.
Can science tell us what’s objectively true? Or is it merely a clever way to cure doubt – to give us something to believe in, whether it’s true or not? In this essay, I look at the pragmatist account of science expounded by Charles... more
Can science tell us what’s objectively true? Or is it merely a clever way to cure doubt – to give us something to believe in, whether it’s true or not? In this essay, I look at the pragmatist account of science expounded by Charles Sanders Peirce in his 1877 essay, ‘The Fixation of Belief’. Against Peirce, I argue that science does not come naturally to our species, nor does the doubting open-mindedness upon which its practice relies. To the extent that science is successful in ‘curing’ doubt, it’s because it tracks the real state of the world; and I argue that Peirce himself – his pragmatist narrative notwithstanding – is implicitly committed to this view as well.
In this essay I explore the emerging practice of “sharing one’s pronouns,” for example, in one’s email signature or professional website. I explain the reasoning behind this practice, and ask, in particular, whether it is... more
In this essay I explore the emerging practice of “sharing one’s pronouns,” for example, in one’s email signature or professional website. I explain the reasoning behind this practice, and ask, in particular, whether it is all-things-considered desirable that it should become a widespread social norm. I provide arguments in favour of, as well as against, this proposition. Along the way I touch on some ongoing debates within the philosophy of sex and gender.
Gender abolitionists are concerned that the current, dominant gender ideology (DGI) is harmful and systematically oppresses women. Simply reforming gender roles, they argue, is not enough to solve these problems, so they need to be done... more
Gender abolitionists are concerned that the current, dominant gender ideology (DGI) is harmful and systematically oppresses women. Simply reforming gender roles, they argue, is not enough to solve these problems, so they need to be done away with completely. On the other hand, progressive opponents of abolition, although they also object to various aspects of the DGI, are concerned that abolishing gender altogether risks harming trans people. Is there a way to move forward in this thicket?
There is an ongoing public debate about sex, gender and identity that is often quite heated. This is an edited transcript of an informal lecture I recorded in 2019 to serve as a friendly guide to these complex issues. It represents my... more
There is an ongoing public debate about sex, gender and identity that is often quite heated. This is an edited transcript of an informal lecture I recorded in 2019 to serve as a friendly guide to these complex issues. It represents my best attempt, not to score political points for any particular side, but to give an introductory map of the territory so that you can think for yourself, investigate further, and reach your own conclusions about such controversial questions as "What does mean to be a man or a woman?"
There is something of a war going on between, broadly, two groups of people who have very different views about gender. These groups call each other by various names, many of them quite loaded, but let’s just call them Group A and Group... more
There is something of a war going on between, broadly, two groups of people who have very different views about gender. These groups call each other by various names, many of them quite loaded, but let’s just call them Group A and Group B. Group A, on the whole, has a view of gender centred on the connection between physical traits and social positioning. Group B, by contrast, leans more toward a view focused on mental traits and self-understandings. Maybe surprisingly, it turns out that people from these two groups tend to hold very similar beliefs about many, if not most other topics within feminist philosophy and politics: things like abortion rights, say, or the need to address sexual harassment in the workplace. What could be going on?
This is a lightly edited transcript of an informal lecture based on coursework submitted as part of my Ph.D. It was recorded on Whidbey Island, Washington, and published online on January 15th, 2020. I'm a philosopher and cognitive... more
This is a lightly edited transcript of an informal lecture based on coursework submitted as part of my Ph.D. It was recorded on Whidbey Island, Washington, and published online on January 15th, 2020. I'm a philosopher and cognitive scientist who studies gender, sex, identity, sexuality and related topics and I am offering this lecture as a friendly guide to the (often very heated) public debate that is going on around these issues. This is my best attempt, not to score political points for any particular side, but to give an introductory map of the territory so you can think for yourself, investigate further, and reach your own conclusions about such controversial questions as "What does mean to be a man or a woman?" This lecture is not meant to be authoritative; it is not the final word; experts on these topics will find much to quibble with (and perhaps some things to disagree with outright). But for those who would like to take some first steps in getting a sense of the landscape without feeling intimidated, I hope this will be of some use.
If there is a single thread running through this issue of the journal, it may be the complex interplay between the individual and the system(s) of which they are apart, highlighting a need for systems thinking in medical ethics and public... more
If there is a single thread running through this issue of the journal, it may be the complex interplay between the individual and the system(s) of which they are apart, highlighting a need for systems thinking in medical ethics and public health. Such thinking raises at least three sorts of questions in this context: normative questions about the locus of moral responsibility for change when a system is unjust; practical questions about how to change systems in a way that is morally appropriate without triggering unintended, potentially harmful side-effects; and epistemic questions about how to predict the multidimensional consequences of a proposed change or set of changes to an intricate social system such as healthcare. My focus will be on gender bias in the surgical profession.
Focusing on the UK as a case study, this paper argues that having the choice to enter into an international commercial surrogacy arrangement can be harmful, but that neither legalisation nor punitive restriction offers an adequate way to... more
Focusing on the UK as a case study, this paper argues that having the choice to enter into an international commercial surrogacy arrangement can be harmful, but that neither legalisation nor punitive restriction offers an adequate way to reduce this risk. Whether or not having certain options can harm individuals is central to current debates about the sale of organs. We assess and apply the arguments from that debate to international commercial surrogacy, showing that simply having the option to enter into a commercial surrogacy arrangement can harm potential vendors individually and collectively, particularly given its sexed dimension. We reject the argument that legalizing commercial surrogacy in the UK could reduce international exploitation. We also find that a punitive approach towards intended parents utilizing commercial rather than altruistic services is inappropriate. Drawing on challenges in the regulation of forced marriage and female genital cutting, we propose that international collaboration towards control of commercial surrogacy is a better strategy for preserving the delicate balancing of surrogate mothers' protection and children's welfare in UK law.
Sex and sexuality are contentious concepts, blending the deeply personal with the pro- foundly political. They concern most of us in our private spaces of fantasy and mean- ing, relationships and families, pleasure and pain, creation and... more
Sex and sexuality are contentious concepts, blending the deeply personal with the pro- foundly political. They concern most of us in our private spaces of fantasy and mean- ing, relationships and families, pleasure and pain, creation and loss. But sex and sexuality are not solely private matters; with conceptual boundaries moving and being transgressed, they have increasingly been brought into public life and contested in the courts.1 Should we press on with this use of the law, or not? This special issue of the Medical Law Review looks at cutting-edge medical and legal aspects of sex and sexuality.
In this article, we analyse the novel case of Phoenix, a non-binary adult requesting ongoing puberty suppression (OPS) to permanently prevent the development of secondary sex characteristics, as a way of affirming their gender identity.... more
In this article, we analyse the novel case of Phoenix, a non-binary adult requesting ongoing puberty suppression (OPS) to permanently prevent the development of secondary sex characteristics, as a way of affirming their gender identity. We argue that (1) the aim of OPS is consistent with the proper goals of medicine to promote well-being, and therefore could ethically be offered to non-binary adults in principle; (2) there are additional equity-based reasons to offer OPS to non-binary adults as a group; and (3) the ethical defensibility of facilitating individual requests for OPS from non-binary adults also depends on other relevant considerations, including the balance of potential benefits over harms for that specific patient, and whether the patient's request is substantially autonomous. Although the broadly principlist ethical approach we take can be used to analyse other cases of non-binary adults requesting OPS apart from the case we evaluate, we highlight that the outcome will necessarily depend on the individual's context and values. However, such clinical provision of OPS should ideally be within the context of a properly designed research study with long-term follow-up and open publication of results.
The 'born this way' movement for sexual orientation minority rights is premised on the view that sexual orientation is something that can neither be chosen nor changed. Indeed, current sexual orientation change efforts (SOCE) appear to be... more
The 'born this way' movement for sexual orientation minority rights is premised on the view that sexual orientation is something that can neither be chosen nor changed. Indeed, current sexual orientation change efforts (SOCE) appear to be both harmful and ineffective. But what if 'high-tech conversion therapies' (HCT) are invented in the future that are effective at changing sexual orientation? The conceptual basis for the movement would collapse. In this chapter, we argue that the threat of HCT should be taken seriously, motivating a change in tactics for proponents of sexual orientation minority rights. We also discuss some of the practical-ethical and public-policy issues surrounding HCT, in case the technology is one day developed.
Our understanding of the neurochemical bases of human love and attachment, as well as of the genetic, epigenetic, hormonal, and experiential factors that conspire to shape an individual’s sexual orientation, is increasing exponentially.... more
Our understanding of the neurochemical bases of human love and attachment, as well as of the genetic, epigenetic, hormonal, and experiential factors that conspire to shape an individual’s sexual orientation, is increasing exponentially. This research raises the vexing possibility that we may one day be equipped to modify such variables directly, allowing for the creation of “high-tech” conversion therapies or other suspect interventions. In this paper, we discuss the ethics surrounding such a possibility, and call for the development of legal and procedural safeguards for protecting vulnerable children from the application of such technology. We also consider the more difficult case of voluntary, adult “conversion” and argue that in rare cases, such attempts might be permissible under strict conditions.
Following the death of 17-year-old Leelah Alcorn, a transgender teen who committed suicide after forced “conversion therapy,” President Barack Obama called for a nationwide ban on psychotherapy aimed at changing sexual orientation or... more
Following the death of 17-year-old Leelah Alcorn, a transgender teen who committed suicide after forced “conversion therapy,” President Barack Obama called for a nationwide ban on psychotherapy aimed at changing sexual orientation or gender identity. The administration argued that because conversion therapy causes substantial psychological harm to minors, it is neither medically nor ethically appropriate. We fully agree with the President and believe that this is a step in the right direction. Of course, in addition to being unsafe as well as ethically unsound, current conversion therapy approaches aren’t actually effective at doing what they claim to do – changing sexual orientation. But we also worry that this may be a short-term legislative solution to what is really a conceptual problem. The question we ought to be asking is “what will happen if and when scientists do end up developing safe and effective technologies that can alter sexual orientation?”
Following the death of 17-year-old Leelah Alcorn, a transgender teen who committed suicide after forced “conversion therapy,” President Barack Obama called for a nationwide ban on psychotherapy aimed at changing sexual orientation or... more
Following the death of 17-year-old Leelah Alcorn, a transgender teen who committed suicide after forced “conversion therapy,” President Barack Obama called for a nationwide ban on psychotherapy aimed at changing sexual orientation or gender identity. The administration argued that because conversion therapy causes substantial psychological harm to minors; it is neither medically nor ethically appropriate. We fully agree with the president and believe that this is a step in the right direction. Of course, in addition to being unsafe as well as ethically unsound, current conversion therapy approaches aren’t actually effective at doing what they claim to do—changing sexual orientation. But we also worry that this may be a short-term legislative solution to what is really a conceptual problem. The question we ought to be asking is “what will happen if and when scientists do end up developing safe and effective technologies that can alter sexual orientation?”
In this chapter, I question the logical and legal basis of the "born this way" gay rights movement, and I suggest that it is vulnerable to critique. I also raise the prospect of high-tech conversion therapies of the future that, if they... more
In this chapter, I question the logical and legal basis of the "born this way" gay rights movement, and I suggest that it is vulnerable to critique. I also raise the prospect of high-tech conversion therapies of the future that, if they were developed, would undermine even the empirical basis for this movement. Since the fight for gay rights is so important, I suggest, it should be placed on stronger intellectual footing.
Celebrated as the ideal form of romance, a growing cadre of philosophers argue that monogamy is actually unethical. Note: the in-print version is titled, "To Have and to Hold."
For the sake of this chapter, we will assume that sexbots of the future will be non-sentient and lack moral standing: they will be neither moral victims nor moral agents. That is, we will assume that sexbots are ‘mere’ machines that are... more
For the sake of this chapter, we will assume that sexbots of the future will be non-sentient and lack moral standing: they will be neither moral victims nor moral agents. That is, we will assume that sexbots are ‘mere’ machines that are reliably identifiable as such, despite their humanlike appearance and behaviour. Under these stipulations, sexbots themselves can no more be harmed, morally speaking, than your dishwasher. As we will explore, however, there may still be something wrong about the production, distribution, or use of such sexbots.
In September 2015 a well-publicised Campaign Against Sex Robots (CASR) was launched. Modelled on the longer-standing Campaign to Stop Killer Robots, the CASR opposes the development of sex robots on the grounds that the technology is... more
In September 2015 a well-publicised Campaign Against Sex Robots  (CASR) was launched. Modelled on the longer-standing Campaign to Stop Killer Robots, the CASR opposes the development of sex robots on the grounds that the technology is being developed with a particular model of female-male relations (the prostitute-john model) in mind, and that this will prove harmful in various ways. In this chapter, we consider carefully the merits of campaigning against such a technology. We make three main arguments. First, we argue that the particular claims advanced by the CASR are unpersuasive, partly due to a lack of clarity about the campaign’s aims and partly due to substantive defects in the main ethical objections put forward by campaign’s founder(s). Second, broadening our inquiry beyond the arguments proferred by the campaign itself, we argue that it would be very difficult to endorse a general campaign against sex robots unless one embraced a highly conservative attitude towards the ethics of sex, which is likely to be unpalatable to those who are active in the campaign. In making this argument we draw upon lessons from the campaign against killer robots. Finally, we conclude by suggesting that although a generalised campaign against sex robots is unwarranted, there are legitimate concerns that one can raise about the development of sex robots.
On August 12th, 2015, the non-governmental human rights organization Amnesty International voted to put forward a policy supporting the “full” decriminalization of prostitution – i.e., both the buying and the selling of sex. The... more
On August 12th, 2015, the non-governmental human rights organization Amnesty International voted to put forward a policy supporting the “full” decriminalization of prostitution – i.e., both the buying and the selling of sex. The announcement proved controversial, and divided the human rights community as well as those who hold different positions on the question of prohibiting prostitution more generally. In this article, ten philosophers, from ten different universities, representing a wide range of opinion on the issue, spell out some of the key philosophical considerations that play into this contentious debate.
Thomsen (2015) argues that people with disabilities should be granted an exception to a general prohibition on prostitution. In this response, we argue that Thomsen’s call for an exception does not withstand careful scrutiny. The concerns... more
Thomsen (2015) argues that people with disabilities should be granted an exception to a general prohibition on prostitution. In this response, we argue that Thomsen’s call for an exception does not withstand careful scrutiny. The concerns that appear to motivate his argument point instead, we argue, to a case for legalization of prostitution, coupled with sensible health and safety regulations.
Thomsen (2015) argues that people with disabilities should be granted an exception to a general prohibition on paying for sex. In this paper, I argue that Thomsen’s definition of disability is too vague to be useful in identifying who... more
Thomsen (2015) argues that people with disabilities should be granted an exception to a general prohibition on paying for sex. In this paper, I argue that Thomsen’s definition of disability is too vague to be useful in identifying who should be granted an exception to an overall ban, and that Thomsen’s case for a ban also fails to withstand scrutiny. A more reasonable argument, in my view, is that mature individuals should be allowed to decide for themselves (a) what kind of consensual sex they wish to engage in, and (b) in exchange for what.
If there should be a general prohibition on paying for sex, it has recently been argued, an exception should be made for those with disabilities. In this chapter, adapted from a longer journal article, I argue that defining disability in... more
If there should be a general prohibition on paying for sex, it has recently been argued, an exception should be made for those with disabilities. In this chapter, adapted from a longer journal article, I argue that defining disability in this context leads to a dilemma: either the definition will turn out to be so broad as to include almost anyone, or it will be so narrow as to be an unreliable proxy for the real underlying moral issue (namely, the difficulty that some people have in finding a willing sexual partner without having recourse to payment).
As someone who has worked on college campuses to educate men and women about sexual assault and consent, I have seen the barriers to raising awareness and changing attitudes. Chief among them, in my experience, is a sense of... more
As someone who has worked on college campuses to educate men and women about sexual assault and consent, I have seen the barriers to raising awareness and changing attitudes. Chief among them, in my experience, is a sense of skepticism--especially among college-aged men--that sexual assault is even all that dire of a problem to begin with. "1 in 4? 1 in 5? Come on, it can't be that high. That's just feminist propaganda!" A lot of the statistics that get thrown around in this area (they seem to think) have more to do with politics and ideology than with careful, dispassionate science. So they often wave away the issue of sexual assault--and won't engage on issues like affirmative consent. In my view, these are the men we really need to reach. So enter the headline from last week's New York Times coverage of the latest college campus sexual assault survey: "1 in 4 Women Experience Sex Assault on Campus." But that's not what the survey showed.
Research Interests:
Information Systems, Cultural History, Sociology, Cultural Studies, Political Sociology, and 114 more
In 2012, the politician Todd Akin caused a firestorm by suggesting, in the context of an argument about the moral permissibility of abortion, that some forms of rape were “legitimate” (i.e., carried out with great force or violence). This... more
In 2012, the politician Todd Akin caused a firestorm by suggesting, in the context of an argument about the moral permissibility of abortion, that some forms of rape were “legitimate” (i.e., carried out with great force or violence). This seemed to imply that other forms of rape must be “illegitimate” (i.e., carried out with less force or violence). In response, several commentators emphasized that rape is a “heinous crime” and that there are “no varying degrees of rape.” While the intention of these commentators was clear, I argue that they may—inadvertently—have played into the very stereotype of rape (implicitly) endorsed by Akin. Such a response, I claim, actually obscures a range of sexual harms, including some that may not rise to the level of being a crime. I also offer some thoughts on the moral psychology behind anti-abortion arguments of the kind advanced by Akin.
In this chapter, adapted from a longer journal article, I argue that we need to be careful, as a society, about how we talk about rape and other forms of sexual assault. By choosing to describe the effects of rape exclusively in the... more
In this chapter, adapted from a longer journal article, I argue that we need to be careful, as a society, about how we talk about rape and other forms of sexual assault. By choosing to describe the effects of rape exclusively in the harshest of language, thereby obscuring the range of harms that can follow from such assault -- as well as lumping the experience of all victims together -- anti-rape advocates may inadvertently play into a cartoon of rape (the "stranger in an alleyway" conception) that makes it harder to recognize more subtle consent violations in everyday sexual encounters.
Alice Dreger, the historian of science, sex researcher, activist, and author of a much-discussed book of last year, has recently called attention to the loss of ambivalence as an acceptable attitude in contemporary politics and beyond.... more
Alice Dreger, the historian of science, sex researcher, activist, and author of a much-discussed book of last year, has recently called attention to the loss of ambivalence as an acceptable attitude in contemporary politics and beyond. “Once upon a time,” she writes, “we were allowed to feel ambivalent about people. We were allowed to say, ‘I like what they did here, but that bit over there doesn’t thrill me so much.’ Those days are gone. Today the rule is that if someone—a scientist, a writer, a broadcaster, a politician—does one thing we don’t like, they’re dead to us.” I’m going to suggest that this development leads to another kind of loss: the loss of our ability to work together, or better, learn from each other, despite intense disagreement over certain issues. Whether it’s because our opponent hails from a different political party, or voted differently on a key referendum, or thinks about economics or gun control or immigration or social values—or whatever—in a way we struggle to comprehend, our collective habit of shouting at each other with fingers stuffed in our ears has reached a breaking point. It’s time to bring ambivalence back. ... This is not an essay about Alice Dreger. Instead, it’s about the role of ambivalence in contemporary politics, focusing on an emerging strand of feminist politics in particular—what Kate Lyons calls “young feminism.” More ambitiously, it’s about the limits of free speech, the nature of tolerance, and the risk of moral certainty in the fight for gender justice. The epicenter for this discussion is a heated debate over transgender identity, touching on the intimate question of what it means to be a woman. Part of this debate hinges on “what’s behind the curtain” in the exchange over Dreger’s article. Another part hinges on a much more infamous exchange over a 2015 speech by the Australian feminist Germaine Greer (but we’ll get to that later).
In English, as in many other languages, male-gendered pronouns are sometimes used to refer not only to men, but to individuals whose gender is unknown or unspecified, to human beings in general (as in "mankind") and sometimes even to... more
In English, as in many other languages, male-gendered pronouns are sometimes used to refer not only to men, but to individuals whose gender is unknown or unspecified, to human beings in general (as in "mankind") and sometimes even to females (as when the casual "Hey guys" is spoken to a group of women). These so-called he/man or masculine generics have come under fire in recent decades for being sexist, even archaic, and positively harmful to women and girls; and advocates of gender-neutral (or nonsexist) language have put forward serious efforts to discourage their use. Have they been successful, and to what extent? In this paper, I review some of the main arguments in favor of abolishing sexist male generics. I then present three studies tracking the use of he/man terminology in academic, popular, and personal discourse over the past several decades. I show that the use of these terms has fallen dramatically in recent years, while nonsexist alternatives have gradually taken their place. We may be paying witness to the early stages of the ultimate extinction of masculine generics.
Imagine that a thousand people—randomly selected from the U.S. population—had unprotected sex yesterday. How many of them will eventually die from contracting HIV from that single sexual encounter? Now, imagine a different thousand... more
Imagine that a thousand people—randomly selected from the U.S. population—had unprotected sex yesterday. How many of them will eventually die from contracting HIV from that single sexual encounter? Now, imagine a different thousand people. These people will drive from Detroit to Chicago tomorrow—about 300 miles. How many will die on the trip as a result of a car crash? Which of those two numbers is bigger? If you’re anything like the participants in a new study led by Terri D. Conley of the University of Michigan, the HIV estimate should be bigger—a lot bigger. In fact, the average guess for the HIV case was a little over 71 people per thousand, while the average guess for the car-crash scenario was about 4 people per thousand. In other words, participants thought that you are roughly 17 times more likely to die from HIV contracted from a single unprotected sexual encounter than you are to die from a car crash on a 300-mile trip. But here’s the deal: Those estimates aren’t just wrong, they’re completely backward.
To the Editor, We thank Dr. Hadidi for the response[1] to our comment[2] on the study by Wirmer et al. [3]. However, due to significant misrepresentations therein, we must correct the record. Hadidi incorrectly states that our second,... more
To the Editor,

We thank Dr. Hadidi for the response[1] to our comment[2] on the study by Wirmer et al. [3]. However, due to significant misrepresentations therein, we must correct the record.

Hadidi incorrectly states that our second, fourth, and fifth references do not support our conclusions, because they “are not even related” to hypospadias surgery. In fact, Reference 4 in our letter[2] explicitly discusses hypospadias (and hypospadias surgery) at multiple points, including under the broad heading of “congenital genital anomalies” (p. 159). It also refers to the possibility that negative experiences associated with “early” genital surgery – not only neutral or positive experiences as implied by Wirmer et al. – may contribute to “loss to follow-up” (p. 170). Although the authors of Reference 4 mention this possibility in relation to the general category of patients with “DSDs” (a term they previously suggested may or may not include hypospadias), the hypothesis itself is a general one and is therefore relevant to patient attitude surveys, such as the one by Wirmer et al., with significant unexplained loss to follow-up.
To the Editor, Wirmer et al.[1] report on 81 patients (15-43 y/o, Mage = 19.7) who underwent hypospadias surgery before age 2, stating 90% “were satisfied with early hypospadias surgery,” with decisional regret (DR) in 21% (14.8% mild;... more
To the Editor,

Wirmer et al.[1] report on 81 patients (15-43 y/o, Mage = 19.7) who underwent hypospadias surgery before age 2, stating 90% “were satisfied with early hypospadias surgery,” with decisional regret (DR) in 21% (14.8% mild; 6.2% moderate). Dismissing DR classifications as misleading,  they conclude their findings “support the current practice of operating hypospadias in early childhood.” We commend the authors for investigating patient, not only parent, attitudes. But it is premature to answer “Yes” to their broader question: “Should we correct hypospadias during childhood?” “Should” implies an ethical evaluation involving facts and values.
Medical interventions involving a child’s genitalia require careful evaluation. Context matters. Outside of medicine, apart from a small number of circumscribed situations (e.g., diaper changing, help with bathing), adult viewing or... more
Medical interventions involving a child’s genitalia require careful evaluation. Context matters. Outside of medicine, apart from a small number of circumscribed situations (e.g., diaper changing, help with bathing), adult viewing or touching of children’s genitals is prima facie inappropriate and may in some cases be considered abusive. In contrast, a mechanically similar act performed by a medical professional in a clinical encounter is usually assumed to be ethically justified. However, while the range of psychological responses remains under-investigated, it may still elicit uncomfortable emotions or connotations for the child.
Purpose of review. This review seeks to integrate scholarly discussions of nonconsensual medicalized genital procedures, combining insights from the literature on obstetric violence with critiques based on children’s rights. In both... more
Purpose of review. This review seeks to integrate scholarly discussions of nonconsensual medicalized genital procedures, combining insights from the literature on obstetric violence with critiques based on children’s rights. In both literatures, it is increasingly argued that such interventions may constitute, or be experienced as, violations of patients’ sexual boundaries, even if performed without sexual intent. Recent findings. Within the literature on obstetric violence, it is often argued that clinicians who perform unconsented pelvic exams (i.e., for teaching purposes on anaesthetized patients), or unconsented episiotomies during birth and labor, thereby violate patients’ bodily integrity rights. Noting the intimate nature of the body parts involved and the lack of consent by the affected individual, authors increasingly characterize such procedures, more specifically, as sexual boundary violations or even “medical sexual assault.” Separately, critics have raised analogous concerns about medically unnecessary, nonconsensual genital cutting or surgery (e.g., in prepubescent minors), such as ritual ‘nicking’ of the vulva for religious purposes, intersex genital ‘normalization’ surgeries, and newborn penile circumcision. Across literatures, critics contend that the fundamental wrong of such procedures is not (only) the risk of physical or emotional harm they may cause, nor (beliefs about) the good or bad intentions of those performing or requesting them. Rather, it is claimed, it is wrong as a matter of principle for clinicians to engage—to any extent—with patients’ genital or sexual anatomy without their consent outside of certain limited exceptions (e.g., is not possible to obtain the person’s consent without exposing them to a significant risk of serious harm, where this harm, in turn, cannot feasibly be prevented or resolved by any less risky or invasive means). Summary. An emerging consensus among scholars of obstetric violence and of children’s rights is that it is unethical for clinicians to perform any medically unnecessary genital procedures, from physical examination to cutting or surgery, without the explicit consent of the affected person. ‘Presumed’ consent, ‘implied’ consent, and ‘proxy’ consent are thus argued to be insufficient.
We consider the ethics of a healthcare provider intervening into a patient’s genitalia, whether by means of surgery or by 'mere' touching/examination. We argue that the permissibility of such actions in the absence of a relevant medical... more
We consider the ethics of a healthcare provider intervening into a patient’s genitalia, whether by means of surgery or by 'mere' touching/examination. We argue that the permissibility of such actions in the absence of a relevant medical emergency does not primarily turn on third-party judgments of expected levels of physical harm versus benefit, or on related notions such as extensiveness or invasiveness; rather, it turns on the patient’s own consent. In making this argument, we draw attention to the status of the genitals as 'intimate' anatomy -- a status that is not simply erased by being in a medical context. We draw on the work of Talia Mae Bettcher on ‘intimate agency’ to explain why unconsented interventions into the genitalia constitute a distinctive sort of personal violation compared to unconsented contact with various other parts of the human body.
This is a concise summary of some of the main ethical and evidential issues that are raised by genital surgeries performed on young people for "psychosocial" reasons rather than physical health, using female, male, and intersex forms of... more
This is a concise summary of some of the main ethical and evidential issues that are raised by genital surgeries performed on young people for "psychosocial" reasons rather than physical health, using female, male, and intersex forms of genital cutting as illustrative examples. The lecture is drawn from an online course hosted by the Alden March Bioethics Institute of the Albany Medical College. Recorded March 26, 2023.
This editorial review introduces the second part of a two-part special issue on genital cutting and surgery affecting young people. Part 1 emphasized broad questions of anthropology, medicine, ethics, politics, and law, with a particular... more
This editorial review introduces the second part of a two-part special issue on genital cutting and surgery affecting young people. Part 1 emphasized broad questions of anthropology, medicine, ethics, politics, and law, with a particular focus on practices affecting persons with intersex traits: that is, congenital variations in sex characteristics deemed atypical for females or males. This part of the special issue (Part 2) takes a complementary focus. It puts the spotlight on genital modifications affecting those born, not with intersex traits, but with “endosex” traits: congenital sex characteristics deemed biologically normative for either females or males. And yet, as the articles in this collection make clear, even apparent biological normativity does not entail cultural acceptability. Thus, in some societies, it is not only young people born with intersex traits, but also those born with endosex traits, who may be subjected to various forms of non-voluntary genital cutting or surgery without medical necessity. A model for mapping relative voluntariness, consent, and medical necessity-status onto judgments of moral permissibility or impermissibility is proposed. Cultural biases in evaluations of consent and medical necessity are also discussed.
We are proud to introduce this special collection of papers on child genital alteration practices spanning the Global North and South and transcending conventional boundaries of sex and gender. It is increasingly recognized that there is... more
We are proud to introduce this special collection of papers on child genital alteration practices spanning the Global North and South and transcending conventional boundaries of sex and gender. It is increasingly recognized that there is an urgent need to evaluate all forms of genital cutting or surgery, especially those carried out on presumptively pre-autonomous persons, in a systematic way  It is necessary both to clarify what is known about these practices medically and scientifically, but also to work through the cultural, legal, and ethical implications of performing such significant operations on persons who are generally presumed to be incapable of providing morally valid consent to them on their own behalf. This edited collection includes nuanced discussions of female, male, and intersex forms of genital cutting or surgery performed on young people in countries and cultures around the world. Although the focus is on genital operations that are widely argued to be both medically unnecessary and non-consensual, an important lesson that emerges from this collection, as discussed below, is that both the concept of medical necessity and the criteria for giving ethically valid consent to certain body modifications are not a matter of universal consensus. Rather, they are politicized, moralized, and contested. This is nowhere more apparent than in the case of permanent alterations to the sexual or reproductive anatomy of legal minors. When are young people capable of consenting to genital modifications of various kinds, and when should they be protected from choices to modify their sexual anatomy that they may later come to regret?
Laws on genital mutilation, gender affirmation and cosmetic genital surgery are at odds. The key criteria should be medical necessity and consent.
Interview of Brian D. Earp by Tim Hammond for The Empty Closet, on female, male, and intersex genital cutting as relevant for LGBTQI+ issues. Part 1.
Interview of Brian D. Earp by Tim Hammond for The Empty Closet, on female, male, and intersex genital cutting as relevant for LGBTQI+ issues. Part 2.
Purpose of review. To summarize and critically evaluate the moral principles invoked in support of zero-tolerance laws and policies for medically unnecessary female genital cutting (FGC). Recent findings. Most of the moral reasons that... more
Purpose of review. To summarize and critically evaluate the moral principles invoked in support of zero-tolerance laws and policies for medically unnecessary female genital cutting (FGC). Recent findings. Most of the moral reasons that are typically invoked to justify such laws and policies appear to lead to a dilemma. Either these reasons entail that several common Western practices that are widely regarded to be morally permissible and are currently treated as legal—such as intersex “normalization” surgery, female genital “cosmetic” surgery performed on adolescent girls, or infant male circumcision—are in fact morally impermissible and should be discouraged if not legally forbidden; or the reasons are being applied in a biased and prejudicial manner that is itself unethical, as well as inconsistent with Western constitutional requirements of equal treatment of individuals before the law. Summary. In the recent literature, only one principle has been defended that appears capable of justifying a zero-tolerance stance towards medically unnecessary FGC without relying on, exhibiting, or perpetuating unjust cultural or moral double standards. This principle holds that, in countries whose ethicolegal traditions are shaped by a foundational concern for individual rights, respect for bodily integrity, and personal autonomy over sexual boundaries, all non-consenting persons have an inviolable moral right against any medically unnecessary (or medically deferrable) interference with their genitals or other private anatomy. In such countries, therefore, all non-consenting persons, regardless of age, race, ethnicity, parental religion, assigned sex, gender identity, or other individual or group-based features, should be protected from medically unnecessary genital cutting, regardless of the severity of the cutting or the expected level of benefit or harm.
Abstract. Purpose of review: To survey recent arguments in favor of preserving the genital autonomy of children—female, male, and intersex—by protecting them from medically unnecessary genital cutting practices. Recent findings:... more
Abstract. Purpose of review: To survey recent arguments in favor of preserving the genital autonomy of children—female, male, and intersex—by protecting them from medically unnecessary genital cutting practices. Recent findings: Nontherapeutic female, male, and intersex genital cutting practices each fall on a wide spectrum, with far more in common than is generally understood. When looking across cultures and comparing like cases, one finds physical, psychosexual, and symbolic overlaps among the three types of cutting, suggesting that a shared ethical framework may be needed. Summary: All children have an interest in genital autonomy, regardless of their sex or gender.
The World Health Organization (WHO) condemns all medically unnecessary female genital cutting (FGC) that is primarily associated with people of color and the Global South, claiming that such FGC violates the human right to bodily... more
The World Health Organization (WHO) condemns all medically unnecessary female genital cutting (FGC) that is primarily associated with people of color and the Global South, claiming that such FGC violates the human right to bodily integrity regardless of harm-level, degree of medicalization, or consent. However, the WHO does not condemn medically unnecessary FGC that is primarily associated with Western culture, such as elective labiaplasty or genital piercing, even when performed by non-medical practitioners (e.g., body artists) or on adolescent girls. Nor does it campaign against any form of medically unnecessary intersex genital cutting (IGC) or male genital cutting (MGC), including forms that are non-consensual or comparably harmful to some types of FGC. These and other apparent inconsistencies risk undermining the perceived authority of the WHO to pronounce on human rights. This paper considers whether the WHO could justify its selective condemnation of non-Western-associated FGC by appealing to the distinctive role of such practices in upholding patriarchal gender systems and furthering sex-based discrimination against women and girls. The paper argues that such a justification would not succeed. To the contrary, dismantling patriarchal power structures and reducing sex-based discrimination in FGC-practicing societies requires principled opposition to medically unnecessary, non-consensual genital cutting of all vulnerable persons, including insufficiently autonomous children, irrespective of their sex traits or socially assigned gender. This conclusion is based, in part, on an assessment of the overlapping and often mutually reinforcing roles of different types of child genital cutting— FGC, MGC, and IGC—in reproducing oppressive gender systems. These systems, in turn, tend to subordinate women and girls as well as non-dominant males and sexual and gender minorities. The selective efforts of the WHO to eliminate only non-Western- associated FGC exposes the organization to credible accusations of racism and cultural imperialism and paradoxically undermines its own stated goals: namely, securing the long-term interests and equal rights of women and girls in FGC-practicing societies.
The American College of Nurse-Midwives, American Society for Pain Management Nursing, American Academy of Pediatrics, and other largely US-based medical organizations have argued that at least some forms of non-therapeutic child genital... more
The American College of Nurse-Midwives, American Society for Pain Management Nursing, American Academy of Pediatrics, and other largely US-based medical organizations have argued that at least some forms of non-therapeutic child genital cutting, including routine penile circumcision, are ethically permissible even when performed on non-consenting minors. In support of this view, these organizations have at times appealed to potential health benefits that may follow from removing sexually sensitive, non-diseased tissue from the genitals of such minors. We argue that these appeals to “health benefits” as a way of justifying medically unnecessary child genital cutting practices may have unintended consequences. For example, it may create a “loophole” through which certain forms of female genital cutting—or female genital “mutilation” as it is defined by the World Health Organization—could potentially be legitimized. Moreover, by comparing current dominant Western attitudes toward female genital “mutilation” and so-called intersex genital “normalization” surgeries (i.e. surgeries on children with certain differences of sex development), we show that the concept of health invoked in each case is inconsistent and culturally biased. It is time for Western healthcare organizations—including the American College of Nurse-Midwives, American Society for Pain Management Nursing, American Academy of Pediatrics, and World Health Organization—to adopt a more consistent concept of health and a unified ethical stance when it comes to child genital cutting practices.
Arora and Jacobs (2016) assume that liberal societies should tolerate non-therapeutic infant male circumcision, and argue that it follows from this that they should similarly tolerate—or even encourage—what the authors regard as ‘de... more
Arora and Jacobs (2016) assume that liberal societies should tolerate non-therapeutic infant male circumcision, and argue that it follows from this that they should similarly tolerate—or even encourage—what the authors regard as ‘de minimis’ forms of female genital mutilation (as defined by the World Health Organization). In this commentary, I argue that many serious problems would be likely to follow from a policy of increased tolerance for female genital mutilation, and that it may therefore be time to consider a less tolerant attitude toward non-therapeutic infant male circumcision. Ultimately, I suggest that children of whatever sex or gender should be free from having healthy parts of their most intimate sexual organs either damaged or removed, before they can understand what is at stake in such an intervention and agree to it themselves.
This is the official, online supplementary Appendix to the article, “In Defence of Genital Autonomy for Children," published by the Journal of Medical Ethics, which is itself a response to “Female Genital Alteration—A Compromise... more
This is the official, online supplementary Appendix to the article, “In Defence of Genital Autonomy for Children," published by the Journal of Medical Ethics, which is itself a response to “Female Genital Alteration—A Compromise Solution,” by Arora and Jacobs, published in the same journal. The Appendix is divided into two parts. In the first part (Part I), I present an overview of various “overlaps,” both physical and symbolic, between male and female forms of non-therapeutic genital alteration (MGA, FGA). This is to show why the conditional argument by Arora and Jacobs—namely that if it is the case that MGA should be widely tolerated, then so should some forms of FGA—is valid even if it is not, as I argue in my response piece, sound. In the second part (Part II), I provide a point-by-point response to various specific claims by Arora and Jacobs that are misleading, inaccurate, or otherwise problematic, but which I did not have the space to cover in the main article.
In this chapter, an infringement of bodily integrity (BI) is defined as any penetration into a bodily orifice, breaking of the skin, or alteration of a person’s physical form. A violation of a person’s right to BI is any infringement of... more
In this chapter, an infringement of bodily integrity (BI) is defined as any penetration into a bodily orifice, breaking of the skin, or alteration of a person’s physical form. A violation of a person’s right to BI is any infringement of their BI that wrongs them. An autonomous person is wronged by an infringement of their BI if they did not consent to it. If a person is incapable of consenting because they are temporarily non-autonomous – as in the case of an intoxicated adult or a pre-autonomous child – the infringement should be delayed until the individual becomes autonomous and can make their own decision. It is only when the infringement cannot be delayed without putting the person into a situation they would be even less likely to consent to (if they were autonomous) that the infringement does not wrong them. Given the seriousness of violating anyone's right to BI, and especially that of the most vulnerable persons, the appropriate likelihood-of-consent for proceeding with a BI infringement on a child is argued to be at or near the ‘medically necessary’ threshold.
Critics of non-therapeutic genital altering procedures, such as male and female “circumcision” as well as medically unnecessary intersex “normalization” surgeries, often appeal to a child’s right to bodily integrity and to the notion of... more
Critics of non-therapeutic genital altering procedures, such as male and female “circumcision” as well as medically unnecessary intersex “normalization” surgeries, often appeal to a child’s right to bodily integrity and to the notion of sexual harm to explain why such interventions should be seen as morally (and perhaps also legally) impermissible. While I agree that such interventions are normally impermissible, I contend that the concepts of bodily integrity and sexual harm being appealed to are often insufficiently specified to adequately ground the moral claims they are meant to justify. In this talk, I shall try to identify some of the weaknesses in current justifications of a child’s right to bodily integrity, and point the way toward a more robust defense of genital and sexual autonomy for minors.
n 2015, a senior British judge, Sir James Munby, stated that nontherapeutic childhood male circumcision must be a “significant harm.” His reasoning was that the law currently treats all forms of nontherapeutic cutting or alteration of... more
n 2015, a senior British judge, Sir James Munby, stated that nontherapeutic childhood male circumcision must be a “significant harm.” His reasoning was that the law currently treats all forms of nontherapeutic cutting or alteration of female genitalia as significantly harmful, including forms that are less invasive than male circumcision (such as “pricking” of the clitoral hood). In his words, “to dispute that the more invasive procedure [i.e., male circumcision] involves the significant harm involved in the less invasive [female] procedures would seem almost irrational.” Against this view, one could note that most men who were circumcised in infancy do not appear to regard themselves as “significantly harmed” by the procedure, seeing it instead as “normal” in their culture or community. However, most women who have undergone even “extreme” forms of nontherapeutic female genital cutting similarly do not regard themselves as harmed, since such cutting is normative in their culture(s), viewed as a means to bodily enhancement. In the latter case, it is often argued that the typical lack of self-perceived harm may be due to a paucity of relevant information (i.e., “they do not know what they are missing”), as well as a greater likelihood of believing various myths about un- modified female genitalia (e.g., the myth that the clitoris, if not cut, will grow to the size of a penis). Might a similar explanation apply to the case of men who do not regard themselves as harmed by circumcision? In this paper, I report the results of a new empirical study exploring the association between American men’s satisfaction with being circumcised and their endorsement of false beliefs concerning natural penile anatomy and the effects of circumcision.
We seek to clarify and assess the underlying moral reasons for opposing all medically unnecessary genital cutting of female minors, no matter how severe. We find that within a Western medicolegal framework, these reasons are compelling.... more
We seek to clarify and assess the underlying moral reasons for opposing all medically unnecessary genital cutting of female minors, no matter how severe. We find that within a Western medicolegal framework, these reasons are compelling. However, they do not only apply to female minors, but rather to non-consenting persons of any age irrespective of sex or gender. Keeping our focus exclusively on a Western context for the purposes of this article, we argue as follows: Under most conditions, cutting any person’s genitals without their informed consent is a serious violation of their right to bodily integrity. As such, it is morally impermissible unless the person is non-autonomous (incapable of consent) and the cutting is medically necessary.
Legal outcomes often depend on the adjudication of what may appear to be straightforward distinctions. In this article, we consider two such distinctions that appear in medical and family law deliberations: the distinction between... more
Legal outcomes often depend on the adjudication of what may appear to be straightforward distinctions. In this article, we consider two such distinctions that appear in medical and family law deliberations: the distinction between religion and culture, and between therapeutic and non-therapeutic. These distinctions can impact what constitutes ‘reasonable parenting’ or a child’s ‘best interests’ and thus the limitations that may be placed on parental actions. Such distinctions are often imagined to be asocial facts, there for the judge to discover. We challenge this view, however, by examining the controversial case of B and G [2015]. In this case, Sir James Munby stated that the cutting of both male and female children’s genitals for non-therapeutic reasons constituted ‘significant harm’ for the purposes of the Children Act 1989. He went on to conclude, however, that while it can never be reasonable parenting to inflict any form of non-therapeutic genital cutting on a female child, such cutting on male children was currently tolerated. We argue that the distinctions between religion/culture and therapeutic/non- therapeutic upon which Munby LJ relied in making this judgment cannot in fact ground categorically differential legal treatment of female and male children. We analyse these distinctions from a systems theoretical perspective - specifically with reference to local paradoxes - to call into question the current legal position. Our analysis suggests that conventional distinctions drawn between religion/culture and the therapeutic/non-therapeutic in other legal contexts require much greater scrutiny than they are usually afforded.
In 2012 the American Academy of Pediatrics (AAP) released a policy statement and technical report stating that the health benefits of newborn male circumcision outweigh the risks. In response, a group of mostly European doctors suggested... more
In 2012 the American Academy of Pediatrics (AAP) released a policy statement and technical report stating that the health benefits of newborn male circumcision outweigh the risks. In response, a group of mostly European doctors suggested that this conclusion may have been due to cultural bias among the AAP Task Force on Circumcision, since their conclusion differed from that of international peer organizations despite relying on a similar evidence base. In this article, we evaluate the charge of cultural bias as well as the response to it by the AAP Task Force. Along the way, we discuss ongoing disagreements about the ethical status of nontherapeutic infant male circumcision, and draw some more general lessons about the problem of cultural bias in medicine.
In 2012, the American Academy of Pediatrics (AAP) updated its policy on infant male circumcision, arguing that the benefits of the procedure outweigh the risks. In response, medical authorities from Europe and Canada argued that the AAP... more
In 2012, the American Academy of Pediatrics (AAP) updated its policy on infant male circumcision, arguing that the benefits of the procedure outweigh the risks. In response, medical authorities from Europe and Canada argued that the AAP report exhibited cultural bias in favor of circumcision. In this commentary, originally published at the University of Oxford’s Practical Ethics website, I argue that the AAP is on less secure footing than it seems to think. Taking into consideration both scientific and ethical perspectives, I conclude that circumcision before an age of consent is not an appropriate health-promotion strategy.
The Centers for Disease Control and Prevention (CDC) has announced a set of provisional guidelines concerning male circumcision, in which they suggest that the benefits of the surgery outweigh the risks. In this brief comment, I highlight... more
The Centers for Disease Control and Prevention (CDC) has announced a set of provisional guidelines concerning male circumcision, in which they suggest that the benefits of the surgery outweigh the risks. In this brief comment, I highlight a few of the key scientific and ethical issues worth considering in interpreting the CDC recommendations.
The current legal status and medical ethics of routine or religious penile circumcision of minors is a matter of ongoing controversy in many countries. We focus on the United Kingdom as an illustrative example, giving a detailed analysis... more
The current legal status and medical ethics of routine or religious penile circumcision of minors is a matter of ongoing controversy in many countries. We focus on the United Kingdom as an illustrative example, giving a detailed analysis of the most recent British Medical Association guidance from 2019. We argue that the guidance paints a confused and conflicting portrait of the law and ethics of the procedure in the UK context, reflecting deeper, unresolved moral and legal tensions surrounding child genital cutting practices more generally. Of particular note is a lack of clarity around how to apply the "best interests" standard-ordinarily associated with time-sensitive proxy decision making regarding therapeutic options for a medically unwell patient-to a parental request for a medically unnecessary surgery to be carried out on the genitalia of a healthy child. Challenges arise in measuring and assigning weights to intended sociocultural or religious/spiritual benefits, and even to health-related prophylactic benefits, and in balancing these against potential physical, functional, and psychosexual risks or harms. Also of concern are apparently inconsistent safeguarding standards being applied to children based on their birth sex categorization or gender of rearing. We identify and discuss recent trends in British and international medical ethics and law, finding gradual movement toward a more unified standard for evaluating the permissibility of surgically modifying healthy children's genitals before they can meaningfully participate in the decision.
In 2015, the Canadian Paediatric Society (CPS) updated its position statement on newborn male circumcision. Reaching a different conclusion from that of the American Academy of Pediatrics (AAP) in 2012, the CPS did not find that the... more
In 2015, the Canadian Paediatric Society (CPS) updated its position statement on newborn male circumcision. Reaching a different conclusion from that of the American Academy of Pediatrics (AAP) in 2012, the CPS did not find that the benefits of the procedure outweigh the risks and harms. In this brief commentary, I discuss some of the main strengths and weaknesses of the latest CPS policy.
Omole and colleagues (2020) describe state-of-the-art techniques for performing newborn penile circumcision. Their technical discussion is sound. Other parts of their article, however, are not in sync with current literature. Physicians... more
Omole and colleagues (2020) describe state-of-the-art techniques for performing newborn penile circumcision. Their technical discussion is sound. Other parts of their article, however, are not in sync with current literature. Physicians should be aware of the rapidly changing ethico-legal landscape in this area. A recent federal court case clarified that even a sterilized ‘ritual nick’ to the pediatric vulva for religious reasons constitutes physical assault, with implications for male circumcision. In response, a group of more than 90 physicians, medical ethicists, legal scholars and other experts argued: “cutting any person’s genitals without their informed consent is a serious violation of their right to bodily integrity [and is] morally impermissible unless the person is nonautonomous (incapable of consent) and the cutting is medically necessary” (Brussels Collaboration, 2019).
According to Brian Morris (2013), “Science supports infant circumcision” and “so should skeptics.” It would be more accurate to say that ‘Brian Morris supports infant circumcision,’ and that skeptics can think for themselves. In this... more
According to Brian Morris (2013), “Science supports infant circumcision” and “so should skeptics.” It would be more accurate to say that ‘Brian Morris supports infant circumcision,’ and that skeptics can think for themselves. In this paper, we critically assess the arguments and evidence presented by Morris in his recent article, and draw some general lessons for the ongoing debate about the science and ethics of infant male circumcision.
A debate between a rabbi and a bioethicist on the morality of circumcision.
Penile circumcision is often claimed to be simpler, safer, and more cost-effective when performed in the neonatal period as opposed to later in life, with a greater benefit-to-risk ratio. In the first part of this paper, we critically... more
Penile circumcision is often claimed to be simpler, safer, and more cost-effective when performed in the neonatal period as opposed to later in life, with a greater benefit-to-risk ratio. In the first part of this paper, we critically examine the evidence base for these claims, and find that it is not as robust as is commonly assumed. In the second part, we demonstrate that, even if one simply grants these claims for the sake of argument, it still does not follow that neonatal circumcision is ethically permissible - absent urgent medical necessity. Based on a careful consideration of the relevant evidence, arguments, and counterarguments, we conclude that medically unnecessary penile circumcision—like other medically unnecessary genital procedures, such as ‘cosmetic’ labiaplasty—should not be performed on an individual who is too young (or otherwise unable) to provide meaningful consent to the procedure.
In a recent editorial, Dr. Andrew L. Freedman, a member of the 2012 AAP task-force on circumcision, argues that “health issues” are only a “small piece of the puzzle” when it comes to this procedure. “Although parents may use the... more
In a recent editorial, Dr. Andrew L. Freedman, a member of the 2012 AAP task-force on circumcision, argues that “health issues” are only a “small piece of the puzzle” when it comes to this procedure. “Although parents may use the conflicting medical literature to buttress their own beliefs and desires,” he writes, “for the most part parents choose what they want for a wide variety of nonmedical reasons,” including “religion, culture, aesthetic preference, familial identity, and personal experience.”[1, p. e20160594] Dr. Freedman is correct that nonmedical factors may reasonably factor into a person’s decision about circumcision. But one may question his assumption that this person should be someone other than the individual who would be affected by the surgery were it to take place.
For a small country, Iceland makes a big impact globally. Recently, the Nordic island proposed legislation that would, before the age of consent, criminalise male circumcision that is unnecessary "for health reasons," stating individuals... more
For a small country, Iceland makes a big impact globally. Recently, the Nordic island proposed legislation that would, before the age of consent, criminalise male circumcision that is unnecessary "for health reasons," stating individuals who remove "part or all of the sexual organs shall be imprisoned for up to six years."
For a small country, Iceland has had a big impact on global media coverage recently, following its proposed ban on male circumcision before an age of consent. We first discuss self-determination and informed consent, before addressing... more
For a small country, Iceland has had a big impact on global media coverage recently, following its proposed ban on male circumcision before an age of consent. We first discuss self-determination and informed consent, before addressing claims about potential health benefits and harms. We then explore the religious significance of circumcision for some groups, and ask what implications this should have.
Research Interests:
Religion, Sociology, Sociology of Religion, Law, Criminal Law, and 66 more
In many cultures, children with intersex traits are subjected to medically unnecessary genital operations in an attempt to reshape their sexual anatomy to approximate a more stereotypical male or female appearance. In addition to these... more
In many cultures, children with intersex traits are subjected to medically unnecessary genital operations in an attempt to reshape their sexual anatomy to approximate a more stereotypical male or female appearance. In addition to these surgeries, there are three main patterns of medically unnecessary genital operations performed on non-intersex children across the globe. In the first pattern, the dominant culture endorses routine or religious genital cutting only of boys, as in the United States, Israel, Afghanistan, or Saudi Arabia, for instance. In these cultures, girls are ineligible for genital cutting, or may be seen as deserving protection from it. In the second pattern, neither boys nor girls of the dominant culture have their genitals cut unless there is a strict medical indicationwhich in these contexts is rare. This is the prevailing pattern throughout Europe and indeed most other parts of the world. In the third pattern, both boys and girls of the dominant culture have their genitals cut for non-medical reasons, for example, in the context of a rite of passage or religious initiation. Typically, this occurs around puberty, but the timing ranges from right after birth to before marriage. In this chapter, I present a moral argument in favor of the second, "European" pattern, both as a matter of ethics and gender equality. I do not discuss legal implications. In other words, I argue that, morally speaking, neither boys nor girls who are too young to consent should have their genitals cut-to any extent-unless it is medically necessary to do so, whether or not they have intersex traits. The alternative, from a gender equality perspective, would be to argue that both boys and girls should have their genitals cut on an equal basis, for example, by a doctor using sterile instruments. But from an ethical perspective, I argue, this would not be acceptable.
Is the non-therapeutic circumcision of infant males morally permissible? The most recent major developments in this long-simmering debate were (a) the 2012 release of a policy statement and technical report on circumcision by the American... more
Is the non-therapeutic circumcision of infant males morally permissible? The most recent major developments in this long-simmering debate were (a) the 2012 release of a policy statement and technical report on circumcision by the American Academy of Pediatrics (AAP), and (b) the decision of a German court that ritual circumcision is an unconstitutional form of bodily injury. In this editorial I address the AAP's claims as well as evaluate religious motivations more specifically. I suggest that the AAP's "health benefits" arguments are weak, and that religious circumcision is in tension with post-Enlightenment ethical and legal norms--the root of much of the current controversy. I conclude by asking how this tension might begin to be resolved.
Critics of non-therapeutic male and female childhood genital cutting claim that such cutting is harmful. It is therefore puzzling that ‘circumcised’ women and men do not typically regard themselves as having been harmed by the cutting,... more
Critics of non-therapeutic male and female childhood genital cutting claim that such cutting is harmful. It is therefore puzzling that ‘circumcised’ women and men do not typically regard themselves as having been harmed by the cutting, notwithstanding the loss of sensitive, prima facie valuable tissue. For female genital cutting (FGC), a commonly proposed solution to this puzzle is that women who had part(s) of their vulvae removed before sexual debut ‘do not know what they are missing’ and may ‘justify’ their genitally altered state by adopting false beliefs about the benefits of FGC, while simultaneously stigmatising unmodified genitalia as unattractive or unclean. Might a similar phenomenon apply to neonatally circumcised men? In this survey of 999 US American men, we find that greater endorsement of false beliefs concerning circumcision and penile anatomy predicts greater satisfaction with being circumcised, while among genitally intact men, a trend in the opposite direction occurs: greater endorsement of false beliefs predicts less satisfaction with being genitally intact. These findings provide tentative support for the hypothesis that the lack of harm reported by many circumcised men, like the lack of harm reported by their female counterparts in societies that practice FGC, may be related to holding inaccurate beliefs concerning unaltered genitalia and the consequences of childhood genital modification.
We sought to quantify early deaths following neonatal circumcision (same hospital admission) and to identify factors associated with such mortality. We performed a retrospective analysis of all patients who underwent circumcision while... more
We sought to quantify early deaths following neonatal circumcision (same hospital admission) and to identify factors associated with such mortality. We performed a retrospective analysis of all patients who underwent circumcision while hospitalized during the first 30 days of life from 2001-2010 using the National Inpatient Sample (NIS). Over 10 years, 200 early deaths were recorded among 9,833,110 subjects (1 death per 49,166 circumcisions). Note: this figure should not be interpreted as causal but correlational: it may include both under-counting and over-counting of deaths attributable to circumcision. Compared to survivors, subjects who died following newborn circumcision were more likely to have associated co-morbid conditions, such as cardiac disease (OR: 697.8 [378.5-1286.6] p<0.001), coagulopathy (OR: 159.6 [95.6-266.2] p<0.001), fluid and electrolyte disorders (OR: 68.2 [49.1-94.6] p<0.001), or pulmonary circulatory disorders (OR: 169.5 [69.7-412.5] p<0.001). Recognizing these factors could inform clinical and parental decisions, potentially reducing associated risks.
In December of 2014, an anonymous working group under the United States’ Centers for Disease Control and Prevention (CDC) issued a draft of the first-ever federal recommendations regarding male circumcision. In accordance with the... more
In December of 2014, an anonymous working group under the United States’ Centers for Disease Control and Prevention (CDC) issued a draft of the first-ever federal recommendations regarding male circumcision. In accordance with the American Academy of Pediatrics’ circumcision policy from 2012 - but in contrast to the more recent 2015 policy from the Canadian Paediatric Society as well as prior policies (still in force) from medical associations in Europe and Australasia - the CDC suggested that the benefits of the surgery outweigh the risks. In this article, we provide a brief scientific and conceptual analysis of the CDC’s assessment of benefit vs. risk, and argue that it deserves a closer look. Although we set aside the burgeoning bioethical debate surrounding the moral permissibility of performing non-therapeutic circumcisions on healthy minors, we argue that, from a scientific and medical perspective, current evidence suggests that such circumcision is not an appropriate public health measure for developed countries such as the United States.
McMath (2105) argues that while a child’s interest in future autonomy should generally be respected in relation to his own interests, the well-being of other parties may require that his autonomy be overridden in the interests of public... more
McMath (2105) argues that while a child’s interest in future autonomy should generally be respected in relation to his own interests, the well-being of other parties may require that his autonomy be overridden in the interests of public health. At the same time, McMath seems conflicted about whether the seriousness of the threat of HIV, especially in developed countries, can in fact justify the sacrifice of individual freedom that is entailed by circumcision in infancy or early childhood (that is, the freedom to make one’s own decision about whether to undergo an elective genital surgery at an age of understanding). In this context, McMath’s discussion about the child’s interest in making decisions that reflect his mature preferences and values when he is older is compelling. But when considering arguments for paternalism in the name of public health, we suggest that McMath moves too quickly from certain empirical premises to associated policy proposals, skipping over gaps in evidence as well as important questions of value.
Campaigns to circumcise millions of boys and men to reduce HIV transmission are being conducted throughout eastern and southern Africa, recommended by the World Health Organization and implemented by the United States government and... more
Campaigns to circumcise millions of boys and men to reduce HIV transmission are being conducted throughout eastern and southern Africa, recommended by the World Health Organization and implemented by the United States government and Western NGOs. In the United States, proposals to mass-circumcise African and African American men are long standing, and have historically relied on racist beliefs and stereotypes. The present campaigns were started in haste, without adequate contextual research, and the manner in which they have been carried out implies troubling assumptions about culture, health, and sexuality in Africa, as well as a failure to properly consider the economic determinants of HIV prevalence. This critical appraisal examines the history and politics of these circumcision campaigns while highlighting the relevance of race and colonialism. It argues that the "circumcision solution" to African HIV epidemics has more to do with cultural imperialism than with sound health policy, and concludes that African communities need a means of robust representation within the regime.
What are the effects of circumcision on sexual function and experience? And what does sex—in the sense related to gender—have to do with the ethics of circumcision? Jacobs and Arora (2015) give short shrift to the first of these... more
What are the effects of circumcision  on sexual function and experience? And what does sex—in the sense related to gender—have to do with the ethics of circumcision? Jacobs and Arora (2015) give short shrift to the first of these questions; and they do not seem to have considered the second. In this commentary, I explore the relationship between sex (in both senses) and infant male circumcision, and draw some conclusions about the ongoing debate regarding this controversial practice.
Shabanzadeh et al (1) claim in their title that “Male circumcision does not result in inferior perceived male sexual function.” Yet such a categorical conclusion does not follow from the data and analysis presented in the paper itself. As... more
Shabanzadeh et al (1) claim in their title that “Male circumcision does not result in inferior perceived male sexual function.” Yet such a categorical conclusion does not follow from the data and analysis presented in the paper itself. As the authors state, there was “considerable clinical heterogeneity in circumcision indications and procedures, study designs, quality and reporting of results” in the studies they reviewed, which precluded an objective, quantitative assessment. Inadequate follow-up periods of only 1-2 years in the prospective studies imply that their results cannot be generalized beyond that range. In addition, “Risks of observer and selective reporting bias were present in the included studies …  only half of the studies included validated questionnaires and some studies reported only parts of questionnaires.”
Feldblum et al. (2015) argue that voluntary medical male circumcision (VMMC) using the ShangRing device leads to increased sexual pleasure, universally satisfying cosmetic outcome, and virtually no delayed complications in a 2-3 year... more
Feldblum et al. (2015) argue that voluntary medical male circumcision (VMMC) using the ShangRing device leads to increased sexual pleasure, universally satisfying cosmetic outcome, and virtually no delayed complications in a 2-3 year follow-up study. In this commentary, I suggest that socially desirable responding (SDR) is a likely candidate explanation for at least some of these reported findings, and I argue that this should have been controlled for using available measures. I also highlight evidence from the authors’ own study for risk compensation as a result of circumcision (including decreased condom use and an increase in number of sexual partners) and ask why this adverse outcome was not emphasized as a cause for concern. I conclude by providing 6 concrete suggestions for improving future studies on circumcision.
A recent study (Bossio, Pukall, & Steele, 2016) reported that neonatal circumcision is not associated with changes in adult penile sensitivity, leading to viral coverage in both traditional and online media. In this commentary the author... more
A recent study (Bossio, Pukall, & Steele, 2016) reported that neonatal circumcision is not associated with changes in adult penile sensitivity, leading to viral coverage in both traditional and online media. In this commentary the author questions the conclusions drawn from the study and explores the relationship between objective assessments of penile sensitivity and subjective sexual experience and satisfaction. The author concludes with suggestions for improving future research.
Bossio et al. (in press) report that circumcision does not reduce sensitivity of the penis. However, their own results show that the foreskin is the most sensitive part of the penis to tactile stimulation, as well as more sensitive to... more
Bossio et al. (in press) report that circumcision does not reduce sensitivity of the penis. However, their own results show that the foreskin is the most sensitive part of the penis to tactile stimulation, as well as more sensitive to warmth than the penile glans. Since the foreskin is (a) the most touch-sensitive part of the penis, and (b) it is removed by circumcision, circumcision reduces sensitivity of the penis by definition. Further problems with the study by Bossio et al. are discussed.
Surgically modifying the genitals of children—female, male, and intersex—has drawn increased scrutiny in recent years. In Western societies, it is illegal to modify the healthy genitals of female children in any way or to any extent in... more
Surgically modifying the genitals of children—female, male, and intersex—has drawn increased scrutiny in recent years. In Western societies, it is illegal to modify the healthy genitals of female children in any way or to any extent in the absence of a strict medical indication. By contrast, modifying the healthy genitals of male children and intersex children is currently permitted. In this journal in 2015, Stephen R. Munzer discussed a controversial German court case from 2012 (and its aftermath) that called into question the legal status of nontherapeutic male circumcision (NTC), particularly as it is carried out in infancy or early childhood. Whether NTC is legal before an age of consent depends partly upon abstract principles relating to the best interpretation of the relevant laws, and partly upon empirical and conceptual questions concerning the degree to which, and ways in which, such circumcision can reasonably be understood as a harm. In this article, we explore some of these latter questions in light of Professor Munzer's analysis, paying special attention to the subjective, personal, and individually and culturally variable dimensions of judgments about benefit versus harm. We also highlight some of the inconsistencies in the current legal treatment of male versus female forms of nontherapeutic childhood genital alteration, and suggest that problematically gendered assumptions about the sexual body may play a role in bringing about and sustaining such inconsistencies.
Moral and legal opposition to the non-therapeutic cutting of children's genitals has traditionally focused on female children. In recent years, however, a growing movement of scholars, activists, and individuals affected by childhood... more
Moral and legal opposition to the non-therapeutic cutting of children's genitals has traditionally focused on female children. In recent years, however, a growing movement of scholars, activists, and individuals affected by childhood genital cutting have argued that all children, regardless of sex or gender, should be protected from such intimate violations. By drawing attention to the overlapping harms to which female, male, and intersex children may be exposed as a result of having their genitals cut, this movement posits a sex and gender neutral—that is, human—right to bodily integrity and genital autonomy. This article introduces and outlines some of the main arguments supporting this perspective.
I elaborate on one of the key psychosocial considerations raised by Connor et al. (2019), namely the potentially stigmatizing nature of much current activist, academic, and social-policy discourse surrounding non-Western forms of FGC. I... more
I elaborate on one of the key psychosocial considerations raised by Connor et al. (2019), namely the potentially stigmatizing nature of much current activist, academic, and social-policy discourse surrounding non-Western forms of FGC. I explore how this discourse may, at least along certain dimensions, inadvertently harm the very people it is intended to help, focusing on possible implications for sexual experience. Mindful of this concern, I conclude with some suggestions for how ethical opposition to FGC can be grounded in a principled way that does not further stigmatize individuals who have already been affected by non-consensual, medically unnecessary genital cutting.
An un-consenting child, an unnecessary surgery: what are the moral similarities and differences between male and female circumcision?

And 23 more

This is a response to the commentaries on our recent book, Love Drugs: The Chemical Future of Relationships. We begin by exploring what love is and whether it can be chemically modified. We then focus on questions about the ethics of... more
This is a response to the commentaries on our recent book, Love Drugs: The Chemical Future of Relationships. We begin by exploring what love is and whether it can be chemically modified. We then focus on questions about the ethics of attempting such modification, both at the level of the individual or couple and at the level of society. We conclude with some summary observations and big-picture reflections about the future of this debate.
A précis of our book 'Love Drugs: The Chemical Future of Relationships' (Stanford University Press, 2020; published in the UK by Manchester University Press as 'Love Is the Drug: The Chemical Future of Our Relationships'). For a special... more
A précis of our book 'Love Drugs: The Chemical Future of Relationships' (Stanford University Press, 2020; published in the UK by Manchester University Press as 'Love Is the Drug: The Chemical Future of Our Relationships'). For a special symposium on the book in Philosophy and Public Issues.
Is there a pill for love? What about an "anti-love drug", to help us get over an ex? This book argues that certain psychoactive substances, including MDMA—the active ingredient in Ecstasy—may help ordinary couples work through... more
Is there a pill for love? What about an "anti-love drug", to help us get over an ex? This book argues that certain psychoactive substances, including MDMA—the active ingredient in Ecstasy—may help ordinary couples work through relationship difficulties and strengthen their connection. Others may help sever an emotional connection during a breakup. These substances already exist, and they have transformative implications for how we think about love. This book builds a case for conducting research into "love drugs" and "anti-love drugs" and explores their ethical implications for individuals and society. Scandalously, Western medicine tends to ignore the interpersonal effects of drug-based interventions. Why are we still in the dark about the effects of these drugs on romantic partnerships? And how can we overhaul scientific research norms to take relationships more fully into account?

Ethicists Brian D. Earp and Julian Savulescu say that the time to think through such questions is now. Biochemical interventions into love and relationships are not some far-off speculation. Our most intimate connections are already being influenced by drugs we ingest for other purposes. Controlled studies are underway to see whether artificial brain chemicals can enhance couples therapy. And conservative religious groups are experimenting with certain medications to quash romantic desires—and even the urge to masturbate—among children and vulnerable sexual minorities. Simply put, the horse has bolted. Where it runs is up to us. Love Drugs arms us with the latest scientific knowledge and a set of ethical tools that we can use to decide if these sorts of medications should be a part of our society. Or whether a chemical romance will be right for us.
What if there were a pill for love? Or an anti-love drug, designed to help us break up? This controversial and timely new book argues that recent medical advances have brought chemical control of our romantic lives well within our grasp.... more
What if there were a pill for love? Or an anti-love drug, designed to help us break up?

This controversial and timely new book argues that recent medical advances have brought chemical control of our romantic lives well within our grasp. Substances affecting love and relationships, whether prescribed by doctors or even illicitly administered, are not some far-off speculation - indeed our most intimate connections are already being influenced by pills we take for other purposes, such as antidepressants.

Treatments involving certain psychoactive substances, including MDMA-the active ingredient in Ecstasy-might soon exist to encourage feelings of love and help ordinary couples work through relationship difficulties. Others may ease a breakup or soothe feelings of rejection. Such substances could have transformative implications for how we think about and experience love.

This brilliant intervention into the debate builds a case for conducting further research into "love drugs" and "anti-love drugs" and explores their ethical implications for individuals and society. Rich in anecdotal evidence and case-studies, the book offers a highly readable insight into a cutting-edge field of medical research that could have profound effects on us all.

Will relationships be the same in the future? Will we still marry? It may be up to you to decide whether you want a chemical romance.
There is ongoing disagreement about the moral implications of developing and/or using neurotechnologies that would affect romantic love and relationships. In this paper, we argue that scientists should actively pursue a research program... more
There is ongoing disagreement about the moral implications of developing and/or using neurotechnologies that would affect romantic love and relationships. In this paper, we argue that scientists should actively pursue a research program into such technology. Our call for research is based in part on the fact that a number of pharmaceuticals already in use are very likely to have ramifications for our relationships (romantic and otherwise), and we suggest that we should attempt to understand the effects of these drugs on our interpersonal commitments. In a similar vein, we argue for a shift in scientific research norms, according to which the study of relationships and other social factors would be given higher priority than they currently are given. Finally, in an appendix, we discuss our use of the term “love drug,” and consider whether it is appropriate in light of debates about neuroreductionism.
Modern relationships break down in part because of a mismatch between our psycho-sexual natures and our relationship values, embedded within the context of modernity. If we hold our environment and our values constant, might we make up... more
Modern relationships break down in part because of a mismatch between our psycho-sexual natures and our relationship values, embedded within the context of modernity. If we hold our environment and our values constant, might we make up the difference through direct intervention in our psycho-sexual machinery - the neurochemical enhancement of love? Risks and objections, as well as practical considerations are considered.
You love your partner and they love you. Or you used to love each other, viscerally, in a way that didn't involve any second-guessing. Now your love is more of an abstract idea: a thought more than a feeling. Closer to a memory than... more
You love your partner and they love you. Or you used to love each other, viscerally, in a way that didn't involve any second-guessing. Now your love is more of an abstract idea: a thought more than a feeling. Closer to a memory than something that defines your daily lives. Could these drugs save your relationship? Two bioethicists explore the ecstatic (and thorny) future of chemical-infused relationship therapy.
Over the past few years, we and our colleagues have been exploring the ethical implications of what we call “love drugs” and “anti-love drugs.” We use these terms informally to refer to “current, near-future, and more speculative... more
Over the past few years, we and our colleagues have been exploring the ethical implications of what we call “love drugs” and “anti-love drugs.” We use these terms informally to refer to “current, near-future, and more speculative distant-future technologies that would enhance or diminish, respectively, the romantic bond between couples engaged in a relationship” (Earp, Sandberg, and Savulescu 2016). In a recent “qualified defense” of our work, Andrew McGee (in press) suggests that if we would only stop using the word “love” so expansively, our ethical proposals might gain more traction. Specifically, he argues that “many of the putative instances of love” that we discuss in our papers “are not in fact instances of love at all” but are rather what he describes as “unhealthy or treatable obsessions.” By more carefully distinguishing between the two, he suggests, “there is much more likely to be less concern about medicalization and authenticity” in the case of pharmaceutical or other biotechnological interventions into the latter.
Chemical and other interventions into the biological dimensions of love are currently possible and will likely become more powerful in years to come. This chapter explores some of the conceptual issues surrounding what it would mean to... more
Chemical and other interventions into the biological dimensions of love are currently possible and will likely become more powerful in years to come. This chapter explores some of the conceptual issues surrounding what it would mean to change love with biochemical agents, and presents a handful of case studies of individuals and couples who might desire to use such agents as a way of enhancing their love and relationships. The chapter then discusses a number of ethical and other worries that would likely be raised by the development or use of such biotechnologies and offers some tentative responses. Ultimately, it is argued that love-enhancing biotechnology is not just a conceptual possibility, but may already be practically feasible, and is likely in some cases to be morally desirable.
In her target article, Karola Kreitmair (in press) discusses what she calls direct to consumer neurotechnologies (DTC neurotechnologies): technologies available on the market for monitoring or modulating neurological and psychological... more
In her target article, Karola Kreitmair (in press) discusses what she calls direct to consumer neurotechnologies (DTC neurotechnologies): technologies available on the market for monitoring or modulating neurological and psychological functioning. Kreitmair’s aim is to identify a set of basic ethical concerns that apply to this class of technologies – a class which, Kreitmair acknowledges, is unwieldy. We recently undertook a similar project in a joint pair of papers (Danaher, Nyholm, and Earp 2018a, 2018b): we identified an unwieldy class of what we call quantified relationship technologies (QR technologies): technologies used for tracking or logging aspects of romantic or other intimate relationships with the aim of improving them. In our articles, we identified and critically assessed a set of ethical concerns related to such technologies. In this commentary, we wish to explore the relationship between our treatment of the ethics of QR technologies and Kreitmair’s treatment of the ethics of DTC neurotechnologies.
Our critics argue that quantified relationships (QR) will threaten privacy, undermine autonomy, reinforce problematic business models, and promote epistemic injustice. We do not deny these risks. But to determine the appropriate policy... more
Our critics argue that quantified relationships (QR) will threaten privacy, undermine autonomy, reinforce problematic business models, and promote epistemic injustice. We do not deny these risks. But to determine the appropriate policy response, it will be necessary to assess their likelihood, scope, and severity; how feasibly they can be mitigated by various means; and whether and to what extent they are (or can be made to be) counterbalanced or even outweighed by the benefits QR technologies might bring for individuals, relationships, and society.
The growth of self-tracking and personal surveillance has given rise to the Quantified Self movement. Members of this movement seek to enhance their personal well-being, productivity and self-actualization through the tracking and... more
The growth of self-tracking and personal surveillance has given rise to the Quantified Self movement. Members of this movement seek to enhance their personal well-being, productivity and self-actualization through the tracking and gamification of personal data. The technologies that make this possible can also track and gamify aspects of our interpersonal, romantic relationships. Several authors have begun to challenge the ethical and normative implications of this development. In the present article, we build upon this work to provide a detailed ethical analysis of the Quantified Relationship (QR). We identify eight core objections to QR and subject them to critical scrutiny. We argue that although critics raise legitimate concerns, there are ways in which tracking technologies can be used to support and facilitate good relationships. We thus adopt a stance of cautious openness towards this technology and advocate the development of a research agenda for the positive use of QR technologies.
Pharmaceuticals or other emerging technologies could be used to enhance (or diminish) feelings of lust, attraction, and attachment in adult romantic partnerships. While such interventions could conceivably be used to promote individual... more
Pharmaceuticals or other emerging technologies could be used to enhance (or diminish) feelings of lust, attraction, and attachment in adult romantic partnerships. While such interventions could conceivably be used to promote individual (and couple) well-being, their widespread development and/or adoption might lead to “medicalization” of human love and heartache—for some, a source of serious concern. In this essay, we argue that the “medicalization of love” need not necessarily be problematic, on balance, but could plausibly be expected to have either good or bad consequences depending upon how it unfolds. By anticipating some of the specific ways in which these technologies could yield unwanted outcomes, bioethicists and others can help direct the course of love’s “medicalization”—should it happen to occur—more toward the “good” side than the “bad.”
In 2015, we published an article entitled “The Medicalization of Love,” in which we argued that both good and bad consequences could be expected to follow from love’s medicalization, depending upon how the process unfolded. A flurry of... more
In 2015, we published an article entitled “The Medicalization of Love,” in which we argued that both good and bad consequences could be expected to follow from love’s medicalization, depending upon how the process unfolded. A flurry of commentaries followed; here we offer some preliminary thoughts in reply to the more substantial of the criticisms that were raised. We focus in particular on the nature of love itself as well as the role it plays (or should play) in our lives; we also touch on a number of practical issues concerning the likely effects of any plausible “real life” love drugs, and conclude with a call for careful regulation.
At first blush, love may seem like a poor prospect for pharmacological intervention. The reflexive dualist in us wants to say that romantic relationships are matters of the soul, and that souls ought to be free of medical tinkering.... more
At first blush, love may seem like a poor prospect for pharmacological intervention. The reflexive dualist in us wants to say that romantic relationships are matters of the soul, and that souls ought to be free of medical tinkering. Oxford ethicist Brian Earp argues that we should resist these intuitions, and be open to the upswing in human well-being that successful love drugs could bring about. Over a series of several papers, Earp and his colleagues, Anders Sandberg and Julian Savulescu, make a convincing case that couples should be free to use "love drugs," and that in some cases, they may be morally obligated to do so. I recently caught up with Earp and his colleagues by email to ask them about this fascinating ethical frontier. What follows is a condensed version of our exchange.
Think of who takes drugs like MDMA and magic mushrooms and images of waved, 20-somethings partying is more likely to come to mind than a middle-aged couple sat in front of a marriage counselor, thrashing out their deepest regrets and... more
Think of who takes drugs like MDMA and magic mushrooms and images of waved, 20-somethings partying is more likely to come to mind than a middle-aged couple sat in front of a marriage counselor, thrashing out their deepest regrets and long-held resentments. But, according to the authors of a new book, that scene could—and indeed should—become more common in the near future.
In Love Drugs: The Chemical Future of Relationships, co-authors Brian D. Earp, an expert in health policy and ethics at institutions including Yale University, and Julian Savulescu, director of the Uehiro Centre for Practical Ethics at the U.K.'s University of Oxford, explore how both legal and currently illicit substances could be used to improve our relationship with our emotional state.

The book comes amid what is known as the psychedelic renaissance, as researchers around the world investigate the potential benefits of using psychedelic drugs in controlled medical settings to treat mental disorders like depression, anxiety and PTSD.

Newsweek spoke to Earp about the future and ethics of toying with love and drugs.
Purpose of review. Well-functioning romantic relationships are important for long-term health and well-being, but they are often difficult to sustain. This difficulty arises (in part) because of an underlying tension between our... more
Purpose of review. Well-functioning romantic relationships are important for long-term health and well-being, but they are often difficult to sustain. This difficulty arises (in part) because of an underlying tension between our psychobiological natures, culture/environment, and modern love and relationship goals. One possible solution to this predicament is to intervene at the level of psychobiology, enhancing partners’ interpersonal connection through neurochemical modulation. This article focuses on a single, promising biobehavioral sub-system for such intervention: the attachment system, based largely upon the expression of the neuropeptide oxytocin. Could the exogenous administration of oxytocin—under the right conditions—be used to facilitate relational or marital well-being?

Recent findings. If so, it would require considerable forethought. Recent research complicates the popular image of oxytocin as a universal social enhancer or ‘love hormone’ and shows that it may exert a variety of different effects, at different dosages, on different people, under different circumstances. Accordingly, we discuss what is known about oxytocin, including its “good” and “bad” effects on human behavior and on higher-order functional processes.

Summary. Building upon animal-model, human preclinical, and clinical findings, we outline a proposal for the use of oxytocin in the therapeutic neuroenhancement of contemporary romantic relationships. Highlighting key targets for future research along the way, we then conclude by discussing some of the clinical and ethical considerations that would pertain to the implementation of this knowledge in applied settings.
We argue that the fragility of contemporary marriages—and the corresponding high rates of divorce—can be explained (in large part) by a three-part mismatch: between our relationship values, our evolved psycho-biological natures, and our... more
We argue that the fragility of contemporary marriages—and the corresponding high rates of divorce—can be explained (in large part) by a three-part mismatch: between our relationship values, our evolved psycho-biological natures, and our modern social, physical, and technological environment. “Love drugs” could help address this mismatch by boosting our psycho-biologies while keeping our values and our environment intact. While individual couples should be free to use pharmacological interventions to sustain and improve their romantic connection, we suggest that they may have an obligation to do so as well, in certain cases. Specifically, we argue that couples with offspring may have a special responsibility to enhance their relationships for the sake of their children. We outline an evolutionarily-informed research program for identifying promising biomedical enhancements of love and commitment.
Breaking up is hard to do. If drugs could ease the pain, should we use them, David Robson asks neuro-ethicist Brian D. Earp.
Breaking up is hard to do. If drugs could ease the pain, when should we use them, asks neuro-ethicist Brian D. Earp. Please note: this interview appeared in print as "A dangerous prescription?"
“Love hurts”— as the saying goes — and a certain amount of pain and difficulty in intimate relationships is unavoidable. Sometimes it may even be beneficial, since adversity can lead to personal growth, self-discovery, and a range of... more
“Love hurts”— as the saying goes — and a certain amount of pain and difficulty in intimate relationships is unavoidable. Sometimes it may even be beneficial, since adversity can lead to personal growth, self-discovery, and a range of other components of a life well-lived. But other times, love can be downright dangerous. It may bind a spouse to her domestic abuser, draw an unscrupulous adult toward sexual involvement with a child, put someone under the insidious spell of a cult leader, and even inspire jealousy-fueled homicide. How might these perilous devotions be diminished? The ancients thought that treatments such as phlebotomy, exercise, or bloodletting could “cure” an individual of love. But modern neuroscience and emerging developments in psychopharmacology open up a range of possible interventions that might actually work. These developments raise profound moral questions about the potential use—and misuse—of such anti-love biotechnology. In this essay we describe a number of prospective love-diminishing interventions, and offer a preliminary ethical framework for dealing with them responsibly should they arise.
Recent research suggests that romantic love may be literally addictive. Although the exact nature of the relationship between love and addiction has been described in inconsistent terms throughout the literature, we offer a framework that... more
Recent research suggests that romantic love may be literally addictive. Although the exact nature of the relationship between love and addiction has been described in inconsistent terms throughout the literature, we offer a framework that distinguishes between a narrow view and a broad view of love addiction. The narrow view counts only the most extreme, harmful forms of love or love-related behaviors as being potentially addictive in nature. The broad view, by contrast, counts even basic social attachment as being on a spectrum of addictive motivations, underwritten by similar neurochemical processes as more conventional addictions. We argue that on either understanding of love-as-addiction, treatment decisions should hinge on considerations of harm and well-being rather than on definitions of disease. Implications for the ethical use of anti-love biotechnology are considered.
We thank C. S. I. Jenkins and Neil Levy for their thoughtful comments on our article about love and addiction (Earp, Wudarczyk, Foddy, & Savulescu, in press). While we do not have room for a comprehensive reply, we would like to touch on... more
We thank C. S. I. Jenkins and Neil Levy for their thoughtful comments on our article about love and addiction (Earp, Wudarczyk, Foddy, & Savulescu, in press). While we do not have room for a comprehensive reply, we would like to touch on a few main issues.
“Neuroreductionism” is the tendency to reduce complex mental phenomena to brain states, confusing correlation for physical causation. In this paper, we illustrate the dangers of this popular neuro-fallacy, by looking at an example drawn... more
“Neuroreductionism” is the tendency to reduce complex mental phenomena to brain states, confusing correlation for physical causation. In this paper, we illustrate the dangers of this popular neuro-fallacy, by looking at an example drawn from the media: a story about “hypoactive sexual desire disorder” in women. We discuss the role of folk dualism in perpetuating such a confusion, and draw some conclusions about the role of “brain scans” in our understanding of romantic love.
How might emerging and future technologies—sex robots, love drugs, anti-love drugs, or algorithms to track, quantify, and ‘gamify’ romantic relationships—change how we understand and value love? We canvass some of the main ethical worries... more
How might emerging and future technologies—sex robots, love drugs, anti-love drugs, or algorithms to track, quantify, and ‘gamify’ romantic relationships—change how we understand and value love? We canvass some of the main ethical worries posed by such technologies, while also considering whether there are reasons for “cautious optimism” about their implications for our lives.  Along the way, we touch on some key ideas from the philosophies of love and technology.
German translation and reprinting of the article, "Neuroreductionism about sex and love" by Julian Savulescu and Brian D. Earp, originally published in Think: A Journal of the Royal Institute of Philosophy, Vol. 13, No. 38, 7-12. The... more
German translation and reprinting of the article, "Neuroreductionism about sex and love" by Julian Savulescu and Brian D. Earp, originally published in Think: A Journal of the Royal Institute of
Philosophy, Vol. 13, No. 38, 7-12. The translated article may be cited as follows: Savulescu, J., & Earp, B. D. (2014). Neuroreduktionismus von Sex und Liebe. Phänomenal - Zeitschrift für Gestalttheoretische Psychotherapie, Vol. 6, No. 2, 3-5.
Warum es sinnvoll sein kann, mit chemischen Substanzen in unser Beziehungsleben einzugreifen. Und warum wir vielleicht sogar dazu verpflichtet sind.
Research Interests:
Pharmacology, Neuroscience, Sociology, Psychology, Clinical Psychology, and 39 more
If you believe in the existence of an infinitely good, -knowing, and -powerful deity (“God”), how do you explain the reality of evil—including the inexpressible suffering and death of innocents? Wouldn’t God be forced to vanquish such... more
If you believe in the existence of an infinitely good, -knowing, and -powerful deity (“God”), how do you explain the reality of evil—including the inexpressible suffering and death of innocents? Wouldn’t God be forced to vanquish such suffering due to God’s very nature? Alvin Plantinga has argued, convincingly, that if the possibility of ultimate goodness somehow necessarily required that evil be allowed to exist, God, being omnibenevolent, would have to allow it. But as John Hick has noted, the mere logical possibility of such a situation might not be enough to console the doubting theist. We need a positive reason to believe that evil as we know it is compatible with God’s existence. So, Hick offers a “soul-making” theodicy—or vindication—of God, suggesting the human soul cannot fully progress to toward spiritual maturity (a kind of ultimate good on his account) without grappling with evil. In this short piece I argue that, if we accept Hick’s premises about souls and soul-making, we can indeed make sense of evil to some extent. But, I suggest, his account cannot justify the type or amount of evil we see in the world, so his theodicy does not succeed.
What to do with the missing shade of blue (MSB)? Some have argued that Hume's famous thought experiment undermines his central doctrine-the "copy principle"-such that he should have revised his whole theory in light of it. Others contend... more
What to do with the missing shade of blue (MSB)? Some have argued that Hume's famous thought experiment undermines his central doctrine-the "copy principle"-such that he should have revised his whole theory in light of it. Others contend that the MSB is not a true or actual counterexample to the copy principle, but merely an apparent or conceivable one, so that he had no such obligation to revise. In this essay, I argue that even if the MSB is a true counterexample, Hume would not have been obligated to revise his theory, given methodological resources he makes available to himself elsewhere in his work and his overarching empiricist aims. And I offer a new suggestion for why he might have included and even highlighted the MSB in his writings despite its being so very vexing and peculiar.
A growing literature suggests that facial expression of certain emotions, such as fear or anger, may be pre-consciously detectable by observers, possibly facilitating more rapid neural processing for adaptive reasons. Might facial... more
A growing literature suggests that facial expression of certain emotions, such as fear or anger, may be pre-consciously detectable by observers, possibly facilitating more rapid neural processing for adaptive reasons. Might facial expressions of pain be similarly privileged for pre-conscious detection and processing? In this paper, we provide theoretical reasons for and against this proposition and critically analyze the small amount of empirical data on the question that has been published to date. Although we argue that these data point to a tentative “yes,” we also highlight experimental design features that we think could be strengthened going forward.
Daniel Dennett (1996) has disputed David Chalmers’ (1995) assertion that there is a “hard problem of consciousness” worth solving in the philosophy of mind. In this paper I defend Chalmers against Dennett on this point: I argue that there... more
Daniel Dennett (1996) has disputed David Chalmers’ (1995) assertion that there is a “hard problem of consciousness” worth solving in the philosophy of mind. In this paper I defend Chalmers against Dennett on this point: I argue that there is a hard problem of consciousness, that it is distinct in kind from the so-called easy problems, and that it is vital for the sake of honest and productive research in the cognitive sciences to be clear about the difference. But I have my own rebuke for Chalmers on the point of explanation. Chalmers (1995, 1996) proposes to “solve” the hard problem of consciousness by positing qualia as fundamental features of the universe, alongside such ontological basics as mass and space-time. But this is an inadequate solution: to posit, I will urge, is not to explain. To bolster this view, I borrow from an account of explanation by which it must provide “epistemic satisfaction” to be considered successful (Rowlands, 2001; Campbell, 2009), and show that Chalmers’ proposal fails on this account. I conclude that research in the science of consciousness cannot move forward without greater conceptual clarity in the field.
In cognitive science, there is an ongoing debate about the architecture of the mind: does it consist of a number of mental “organs” each managing a different function in isolation, or is it more of general processor, adaptable to a wide... more
In cognitive science, there is an ongoing debate about the architecture of the mind: does it consist of a number of mental “organs” each managing a different function in isolation, or is it more of general processor, adaptable to a wide range of tasks? One corner of this debate has centered on face processing. This is because face-perception is crucial to normal human functioning and some evidence shows that faces may be processed by the brain in a privileged way compared to other types of stimuli. For example, in EEG brain recordings, the N170 is a characteristic signal that occurs after a participant is exposed to an image of a face, but it is much less pronounced when other stimuli are shown. More than 15 years of research on the “N170 face effect” have yielded the standard view that the N170 is at the very least face-sensitive, and possibly even face-specific, that is, indexing modular processes tied exclusively to facial geometries. The specificity claim is clearly stronger, and hence subject to significant controversy; while the more conservative “sensitivity” claim had been regarded (until recently) as effectively settled. Nevertheless, Thierry and colleagues, in a contentious 2007 article, sought to undermine even this ‘conservative’ consensus: they argued that the apparent face-responsiveness of the N170 in prior research was due to systematic flaws in experimental design. Fiery debate has followed. In this review, we put the debate in its historical and philosophical context, and try to spell out some of the theoretical and logical assumptions that underlie the claims of the competing camps. We then show that the best available evidence counts, at least partially, against the Thierry et al. construal of the N170. Accordingly, it would be premature to abandon the “conservative” account of the N170, according to which it is—minimally—responsive to faces. We conclude by returning to the more controversial claim about face-specificity, and try to clarify what such a view would entail from a theoretical standpoint.
For David Hodgson, human beings must be free—in some sense adequate to ground personal responsibility—and it becomes the work of his book to demonstrate how. The premises he starts with, however, simply do not lead to the conclusion he... more
For David Hodgson, human beings must be free—in some sense adequate to ground personal responsibility—and it becomes the work of his book to demonstrate how. The premises he starts with, however, simply do not lead to the conclusion he would like us to draw. Or they do not without smuggling in a trainload of assumptions all along the way. Hence, although the project sets out with great promise, the reader is left with little more than a sort of “free-will-of-the-gaps.”
In this paper I scrutinize the so-called China Brain thought experiment famously articulated by Ned Block (1978) to see whether it refutes functionalism as a theory of consciousness. I argue that it does not. Block’s case rests on a... more
In this paper I scrutinize the so-called China Brain thought experiment famously articulated by Ned Block (1978) to see whether it refutes functionalism as a theory of consciousness. I argue that it does not. Block’s case rests on a single premise, P, in the following argument: (P) a creature with a China Brain would lack qualitative experience, despite its being (R) a functional replica of you or me, and working under the assumption that we have (M) rich mental life complete with qualia. Yet if a China Brain-creature (Mr. Li) were truly and completely R, and yet P were true as the thought experiment purports to show, functionalism would have to be false. Since I want to reject that conclusion, I must do one of the following: (1) deny that Mr. Li is (or, stronger, could even in principle be) truly R in the first place; (2) grant that Mr. Li is (or could in principle be) truly R and grant that P, but deny that we have M; or (3) grant that Mr. Li is (or could in principle be) truly R and grant that we have M, but deny that P. I opt for the third option. First, I paint a picture according to which Mr. Li's having M would not seem as implausible as it does at first. That is, I try to make the premise P seem less intuitive. But in case I am unpersuasive in this first approach, I employ a second tactic as well. This one is to suggest that we cannot know, even in principle whether P, so it is an irrelevant intuition upon which to base the China Brain attack. In any case, the China Brain fails to provide a true counterexample to functionalism.
Do bees have feelings? What would that mean? And if they do have feelings, how should we treat them? Do we have a moral obligation toward insects? A short commentary on Bateson, M., Desire, S., Gartside, S. E., & Wright, G. A. (2011).... more
Do bees have feelings? What would that mean? And if they do have feelings, how should we treat them? Do we have a moral obligation toward insects? A short commentary on Bateson, M., Desire, S., Gartside, S. E., & Wright, G. A. (2011). Agitated honeybees exhibit pessimistic cognitive biases. Current Biology, 21(12), 1070-1073.
The present research explores the relationship between moral evaluations and intuitions about the causes of human behavior, in particular freedom of the will. Two studies test for a self-serving bias in intuitions about free will. Study 1... more
The present research explores the relationship between moral evaluations and intuitions about the causes of human behavior, in particular freedom of the will. Two studies test for a self-serving bias in intuitions about free will. Study 1 explores whether individuals may seek to exculpate themselves from wrongdoing by denying free will, while justifying blame of others by endorsing free will. Study 2 explores whether individuals may justify personal failures by denying free will, while taking credit for personal successes by endorsing free will. In neither study do the data show the predicted differences between conditions. However, an unexpected finding is reported. By pooling the data from both experiments and collapsing across conditions, it is shown that participants give greater endorsement of free will whenever actions are described from a first-person, instead of third-person, perspective—a tentative “I have more free will than you do” effect. Possible explanations for these findings are discussed, as are avenues for further research on this topic.
How do we know that we are not just brains-in-vats, with all of our “experiences” simply the projections of a supercomputer onto our neurons? Melissa Garland thinks that this puzzle has been solved—she finds Hilary Putnam’s Twin Earth... more
How do we know that we are not just brains-in-vats, with all of our “experiences” simply the projections of a supercomputer onto our neurons? Melissa Garland thinks that this puzzle has been solved—she finds Hilary Putnam’s Twin Earth thought experiment convincing, and she thinks that it allows us to “escape the vat” (as she puts it in her title) – but only at a price. Specifically, she thinks that escaping the vat requires us to give up the doctrine of self-knowledge, which is the notion that we have special knowledge of our own mental states. In this commentary [originally delivered as a talk at the 1st Annual Dartmouth College Undergraduate Philosophy Conference], I raise some critical questions about Garland’s argument. My main question concerns the “importance” of the doctrine of self-knowledge—and what is really so bad about having to give it up—in light of recent findings in the field of cognitive science.
Our judgments of whether an action is morally wrong depend on who is involved and their relationship to one another. But how, when, and why do social relationships shape such judgments? Here we provide new theory and evidence to address... more
Our judgments of whether an action is morally wrong depend on who is involved and their relationship to one another. But how, when, and why do social relationships shape such judgments? Here we provide new theory and evidence to address this question. In a pre- registered study of U.S. participants (n = 423, nationally representative for age, race and gender), we show that particular social relationships (like those between romantic partners, housemates, or siblings) are normatively expected to serve distinct cooperative functions – including care, reciprocity, hierarchy, and mating – to different degrees. In a second pre- registered study (n = 1,320) we show that these relationship-specific norms, in turn, influence the severity of moral judgments concerning the wrongness of actions that violate cooperative expectations. These data provide evidence for a unifying theory of relational morality that makes highly precise out-of-sample predictions about specific patterns of moral judgments across relationships. Our findings show how the perceived morality of actions depends not only on the actions themselves, but also on the relational context in which those actions occur.
In recent years, diminished belief in free will or increased belief in determinism have been associated with a range of antisocial or otherwise negative outcomes: unjustified aggression, cheating, prejudice, less helping behavior, and so... more
In recent years, diminished belief in free will or increased belief in determinism have been associated with a range of antisocial or otherwise negative outcomes: unjustified aggression, cheating, prejudice, less helping behavior, and so on. Only a few studies have entertained the possibility of prosocial or otherwise positive outcomes, such as greater willingness to forgive and less motivation to punish retributively. Here, five studies (open data, materials, and pre-print at https://osf.io/hmy39/) explore the relationship between belief in determinism and another positive outcome or attribute, namely, humility. The reported findings suggest that relative disbelief in free will is reliably associated in our samples with at least one type of humility—what we call ‘Einsteinian’ humility—but is not associated with, or even negatively associated with, other types of humility described in the literature.
Societies invest in scientific studies to better understand the world, and attempt to harness such improved understanding to address pressing medical and social problems. Scientific findings, however, can only justifiably inform theory or... more
Societies invest in scientific studies to better understand the world, and attempt to harness such
improved understanding to address pressing medical and social problems. Scientific findings, however, can only justifiably inform theory or applied problems if they are at minimum internally and externally provisionally trustworthy. Internal trustworthiness is gauged by quantifying the analytic reproducibility and robustness of a study's results; external trustworthiness is gauged by quantifying the replicability and generalizability of published effects and phenomena. The following paper outlines a unified curation framework to quantify the reproducibility, robustness, replicability, and generalizability of scientific findings, categorically addressing all forms of researcher and publication bias. Five major challenges are addressed by the proposed framework: (1) a standardized workflow and principled metric to quantify the analytic reproducibility and robustness of reported results from primary, auxiliary, and secondary analyses; (2) a flexible workflow and replication taxonomy to categorize (i) sufficiently methodologically similar replications that can speak to replicability and (ii) eligible generalizations of an original effect that can speak to generalizability; (3) a principled meta- analytic approach to synthesizing replicability and generalizability evidence; (4) accounting for variations in study characteristics of replications and generalizations; and (5) a viable crowd- sourced web platform to allow the community of scientists to quantify the provisional trustworthiness of published findings in an incremental and ongoing basis. Ultimately, the framework will accelerate investigations into the validity of such trustworthy findings, and consequently accelerate our understanding of the world and development of applied solutions to societal problems.
Research Interests:
Frederick (2021) offers a critique of my writing tips aimed at undergraduate students in philosophy, arguing that my tips will lead to papers that say “next-to-nothing.” Here, I offer some thoughts in reply.
I wrote up the following tips a couple of years ago when I was teaching assistant for an introductory philosophy class at Yale led by Daniel Greco called “Problems in Philosophy.” The tips were intended, then, for college students, many... more
I wrote up the following tips a couple of years ago when I was teaching assistant for an introductory philosophy class at Yale led by Daniel Greco called “Problems in Philosophy.” The tips were intended, then, for college students, many of them right out of high school, and most of whom had never written a philosophy paper before. So the focus is on clarity and mastering the basics. With that in mind, I hope you will find these tips helpful for teaching or writing in philosophy (or any other relevant field or discipline).
Lecture by me (Brian D. Earp), delivered at the University of Oxford on November 30, 2012. The material from this lecture was eventually published in a paper: Earp, B. D., Wudarczyk, O. A., Sandberg, A., & Savulescu. J. (2013). If I could... more
Lecture by me (Brian D. Earp), delivered at the University of Oxford on November 30, 2012. The material from this lecture was eventually published in a paper: Earp, B. D., Wudarczyk, O. A., Sandberg, A., & Savulescu. J. (2013). If I could just stop loving you: Anti-love biotechnology and the ethics of a chemical breakup. American Journal of Bioethics, Vol. 13, No. 11, 3–17. Available here http://www.tandfonline.com/doi/full/10.1080/15265161.2013.839752. For more information on the topic of love and anti love drugs, visit http://enhancinglove.weebly.com/.
Research Interests:
Business Ethics, Pharmacology, Evolutionary Biology, Neuroscience, Sociology, and 54 more
What is love? A loaded question with the potential to lead us down multiple rabbit holes (and, if you grew up in the 90s, evoke memories of the Haddaway song). In episode #95, Jesse welcomes Brian D. Earp on board for a thought-provoking... more
What is love? A loaded question with the potential to lead us down multiple rabbit holes (and, if you grew up in the 90s, evoke memories of the Haddaway song). In episode #95, Jesse welcomes Brian D. Earp on board for a thought-provoking conversation about the possibilities and ethics of making biochemical tweaks to this most celebrated of human emotions. With a topic like “manipulating love,” the discussion moves between the realms of neuroscience, psychology and transhumanist philosophy.
Interview with Brian D. Earp on open access publishing and problems with peer review.
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Interview with Brian D. Earp on John Ioannidis's claim that most published research is false.
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Interview with Brian D. Earp on the successes and failures of science.
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Interview with Brian D. Earp on the limitations of thinking about being pro-science versus anti-science.
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Interview with Brian D. Earp on the future of peer review
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Interview with Brian D. Earp on sloppy science at the CDC and WHO.
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Interview with Brian D. Earp on "fake news" in the New York Times science section
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Interview with Brian D. Earp on skepticism and scientific expertise. When should we be skeptical about scientific claims, and when should we defer to experts?
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Interview with Brian D. Earp on publication bias in science and the need to publish negative results.
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Interview with Brian D. Earp on mindless statistics and using scales to measure mental states.
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Interview with Brian D. Earp on politics in science and the problems of expertise.
Research Interests:
Interview with Brian D. Earp on dogmas in science.
Research Interests:
Interview with Brian D. Earp on Sam Harris's "The Moral Landscape." Additional thoughts on free will, the replication crisis in science, and more.
Research Interests: