Ezio Di Nucci

I analyse an argument according to which medical artificial intelligence represents a threat to patient autonomy—recently put forward by Rosalind McDougall in the Journal of Medical Ethics. The argument takes the case of IBM Watson for Oncology to argue that such technologies risk disregarding the individual values and wishes of patients. I find three problems with this argument: it confuses AI with machine learning; it misses machine learning’s potential for personalised medicine through big data; it fails to distinguish between evidence-based advice and decision-making within healthcare. I conclude that how much and which tasks we should delegate to machine learning and other technologies within healthcare and beyond is indeed a crucial question of our time, but in order to answer it, we must be careful in analysing and properly distinguish between the different systems and different delegated tasks.

In this paper I refute an apparently obvious objection to Frankfurt-type counterexamples to the Principle of Alternate Possibilities according to which if in the counterfactual scenario the agent does not act, then the agent could have avoided acting in the actual scenario. And because what happens in the counterfactual scenario cannot count as the relevant agent's actions given the sort of external control that agent is under, then we can ground responsibility on that agent having been able to avoid acting. I illustrate how this objection to Frankfurt's famous counterexample is motivated by Frankfurt's own 'guidance' view of agency. My argument consists in showing that even if we concede that the agent does not act in the counterfactual scenario, that does not show that the agent could have avoided acting in the actual scenario. This depends on the crucial distinction between 'not φ-ing' and 'avoiding φ-ing'

According to the Simple View of intentional action, I have intentionally switched on the light only if I intended to switch on the light. The idea that intending to is necessary for intentionally -ing has been challenged by Bratman (1984, 1987) with a counter-example in which a videogame player is trying to hit either of two targets while knowing that she cannot hit both targets. When a target is hit, the game finishes. And if both targets are about to be hit simultaneously, the game shuts down. The player knows that she cannot hit both targets, but still she concludes that, given her skills, the best strategy is to have a go at each target at the same time. Suppose she hits target 1. It seems obvious that she has hit target 1 intentionally. But, Bratman argues, she could not have intended to hit target 1. Since the scenario is perfectly symmetrical, had the player intended to hit target 1, she would have also had to intend to hit target 2. But the player knows that she cannot hit both targets.

Frankfurt sets out to refute the principle according to which ‘a person is morally responsible for what he has done only if he could have done otherwise’ . Frankfurt devises a counterexample in which an agent is intuitively responsible even though she could not have done otherwise: Suppose someone – Black, let us say – wants Jones to perform a certain action. Black is prepared to go to considerable lengths to get his way, but he prefers to avoid showing his hand unnecessarily. So he waits until Jones is about to make up his mind what to do, and he does nothing unless it is clear to him that Jones is going to decide to do something other than what he wants him to do. If it does become clear that Jones is going to decide to do something else, Black takes effective steps to ensure that Jones decides to do, and that he does do, what he wants him to do. Whatever Jones's initial preferences and inclinations, then, Black will have his way … Now suppose that Black never has to show his hand because Jones, for reasons of his own, decides to perform and does perform the very action Black wants him to perform. In that case, it seems clear, Jones will bear precisely …

Is the wish to be biologically related to your children legitimate? Here, I respond to an argument in support of a negative answer to this question according to which a preference towards having children one is biologically related to is analogous to a preference towards associating with members of one’s own race. I reject this analogy, mainly on the grounds that only the latter constitutes discrimination; still, I conclude that indeed a preference towards children one is biologically related to is morally illegitimate because, in the context of parental love, biological considerations are normatively irrelevant.

I defend the argument that if embryo loss in stem cell research is morally problematic, then embryo loss in in vivo conception is similarly morally problematic. According to a recent challenge to this argument, we can distinguish between in vivo embryo loss and the in vitro embryo loss of stem cell research by appealing to the doctrine of double effect. I argue that this challenge fails to show that in vivo embryo loss is a mere unintended side effect while in vitro embryo loss is an intended means and that, even if we refine the challenge by appealing to Michael Bratman's three roles of intention, the distinction is still unwarranted

I show that Pickard’s argument against the irresistibility of addiction fails because her proposed dilemma, according to which either drug-seeking does not count as action or addiction is resistible, is flawed; and that is the case whether or not one endorses Pickard’s controversial definition of action. Briefly, we can easily imagine cases in which drug-seeking meets Pickard’s conditions for agency without thereby implying that the addiction was not irresistible, as when the drug addict may take more than one route to go meet her dealer

In this paper I argue that there is an important anomaly to the causalist/compatibilist paradigm in the philosophy of action and free will. This anomaly, which to my knowledge has gone unnoticed so far, can be found in the philosophy of Harry Frankfurt. Two of his most important contributions to the field – his influential counterexample to the Principle of Alternate Possibilities and his ‘guidance’ view of action – are incompatible. The importance of this inconsistency goes far beyond the issue of coherence within Frankfurt’s philosophy. I shall argue that this inconsistency represents an important anomaly within the causalist/compatibilist framework; so that we should start to seriously consider having to move on from the established paradigm.

I argue that so-called automatic actions – routine performances that we successfully and effortlessly complete without thinking such as turning a door handle, downshifting to 4th gear, or lighting up a cigarette – pose a challenge to causalism, because they do not appear to be preceded by the psychological states which, according to the causal theory of action, are necessary for intentional action. I argue that causalism cannot prove that agents are simply unaware of the relevant psychological states when they act automatically, because these content-specific psychological states aren’t always necessary to make coherent rational sense of the agent’s behaviour. I then dispute other possible grounds for the attribution of these psychological states, such as agents’ own self-attributions. In the final section I introduce an alternative to causalism, building on Frankfurt’s concept of guidance.

The argument for the moral permissibility of killing newborns is a challenge to liberal positions on abortion because it can be considered a reductio of their defence of abortion. Here I defend the liberal stance on abortion by arguing that the argument for the moral permissibility of killing newborns on ground of the social, psychological and economic burden on the parents recently put forward by Giubilini and Minerva is not valid; this is because they fail to show that newborns cannot be harmed and because there are morally relevant differences between fetuses and newborns

I argue against various versions of the ‘attitude’ view of consent and of the ‘action’ view of consent: I show that neither an attitude nor an action is either necessary or sufficient for consent. I then put forward a different view of consent based on the idea that, given a legitimate epistemic context, absence of dissent is sufficient for consent: what is crucial is having access to dissent. In the latter part of the paper I illustrate my view of consent by applying it to the case of consenting to being an organ donor.

This paper argues against Appel's recent proposal—in this journal—that there is a fundamental human right to sexual pleasure, and that therefore the sexual pleasure of severely disabled people should be publicly funded—by thereby partially legalising prostitution. An alternative is proposed that does not need to pose a new positive human right; does not need public funding; does not need the legalisation of prostitution; and that would offer a better experience to the severely disabled: charitable non-profit organisations whose members would voluntarily and freely provide sexual pleasure to the severely disabled.

How does the use of military drones affect the legal, political, and moral responsibility of different actors involved in their deployment and design? This volume offers a fresh contribution to the ethics of drone warfare by providing, for the first time, a systematic interdisciplinary discussion of different responsibility issues raised by military drones. The book discusses four main sets of questions: First, from a legal point of view, we analyse the ways in which the use of drones makes the attribution of criminal responsibility to individuals for war crimes more complicated and what adjustments may be required in international criminal law and in military practices to avoid ’responsibility gaps’ in warfare. From a moral and political perspective, the volume looks at the conditions under which the use of military drones by states is impermissible, permissible, or even obligatory and what the responsibilities of a state in the use of drones towards both its citizens and potential targets are. From a socio-technical perspective, what kind of new human machine interaction might drones bring and which new kinds of shared agency and responsibility? Finally, we ask how the use of drones changes our conception of agency and responsibility. The book will be of interest to scholars and students in ethics and to those in law, politics and the military involved in the design, deployment and evaluation of military drones.

I argue that the right to sexual satisfaction of severely physically and mentally disabled people and elderly people who suffer from neurodegenerative diseases can be fulfilled by deploying sex robots; this would enable us to satisfy the sexual needs of many who cannot provide for their own sexual satisfaction; without at the same time violating anybody’s right to sexual self-determination. I don’t offer a full-blown moral justification of deploying sex robots in such cases, as not all morally relevant concerns can be addressed here; rather, I put forward a plausible way of fulfilling acute sexual needs without thereby violating anybody’s sexual rights.

I argue that it is possible for prospective mothers to wrong prospective fathers by bearing their child; and that lifting paternal liability for child support does not correct the wrong inflicted to fathers. It is therefore sometimes wrong for prospective mothers to bear a child, or so I argue here. I show that my argument for considering the legitimate interests of prospective fathers is not a unique exception to an obvious right to procreate. It is, rather, part of a growing consensus that procreation can be morally problematic and that generally talking of rights in this context might not be warranted. Finally, I argue that giving up a right to procreate does not imply nor suggest giving up on women’s absolute right to abort, which I defend.

I argue that we should give up the fight to rescue causal theories of action from fundamental challenges such as the problem of deviant causal chains; and that we should rather pursue an account of action based on the basic intuition that control identifies agency. In Section 1 I introduce causalism about action explanation. In Section 2 I present an alternative, Frankfurt’s idea of guidance. In Section 3 I argue that the problem of deviant causal chains challenges causalism in two important respects: first, it emphasizes that causalism fails to do justice to our basic intuition that control is necessary for agency. Second, it provides countless counterexamples to causalism, which many recent firemen have failed to extinguish – as I argue in some detail. Finally, in Section 4 I argue, contra Al Mele, that control does not require the attribution of psychological states as causes.

We think less than we think. My thesis moves from this suspicion to show that standard accounts of intentional action can't explain the whole of agency. Causalist accounts such as Davidson's and Bratman's, according to which an action can be intentional only if it is caused by a particular mental state of the agent, don't work for every kind of action. So-called automatic actions, effortless performances over which the agent doesn't deliberate, and to which she doesn't need to pay attention, constitute exceptions to the causalist framework, or so I argue in this thesis. Not all actions are the result of a mental struggle, painful hesitation, or the weighting of evidence. Through practice, many performances become second nature. Think of familiar cases such as one's morning routines and habits: turning on the radio, brushing your teeth. Think of the highly skilled performances involved in sport and music: Jarrett's improvised piano playing, the footballer's touch. Think of agents' spontaneous reactions to their environment: ducking a blow, smiling. Psychological research has long acknowledged the distinctiveness and importance of automatic actions, while philosophy has so far explained them together with the rest of agency. Intuition tells us that automatic actions are intentional actions of ours all the same (I have run a survey which shows that this intuition is widely shared): not only our own autonomous deeds for which we are held responsible, but also necessary components in the execution and satisfaction of our general plans and goals. But do standard causal accounts deliver on the intentionality of automatic actions? I think not. Because, in automatic cases, standard appeals to intentions, beliefs, desires, and psychological states in general ring hollow. We just act: we don't think, either consciously or unconsciously. On the reductive side, Davidson's view can't but appeal to, at best, unconscious psychological states, the presence and causal role of which is, I argue, inferred from the needs of a theory, rather than from evidence in the world. On the non-reductive side, Bratman agrees, with his refutation of the Simple View, that we can't just attach an intention to every action that we want to explain. But Bratman’s own Single Phenomenon View, appealing to the mysterious notion of 'motivational potential', merely acknowledges the need for refinement without actually providing one. So I propose my own account of intentional action, the 'guidance view', according to which automatic actions are intentional: differently from Davidson and Bratman, who only offer necessary conditions in order to avoid the problem of causal deviance, I offer a full-blown account: E's phi-ing is intentional if and only If phi-ing is under E's guidance. This account resembles one developed by Frankfurt, with the crucial difference that Frankfurt – taking 'acting with an intention' and 'acting intentionally' to be synonymous – thinks that guidance is sufficient only for some movement being an action, but not for some movement being an intentional action. I argue that, on the other hand, Frankfurt's concept of guidance can be developed so that it is sufficient for intentional action too. In Chapter One I present and defend my definition of ‘automatic action’. In Chapter Two I show that such understanding of automatic actions finds confirmation in empirical psychology. In Chapter Three I show that Davidson's reductive account of intentional action does not work for automatic actions. In Chapter Four I show that the two most influential non-reductive accounts of intentional action, the Simple View and Bratman's Single Phenomenon View, don't work either. And in Chapter Five I put forward and defend my positive thesis, the 'guidance view'. Also, in the Appendix I present the findings of my survey on the intentionality of automatic actions.

This paper shows that the counterexamples proposed by Strong in 2008 in the Journal of Medical Ethics to Marquis’s argument against abortion fail. Strong’s basic idea is that there are cases — for example, terminally ill patients — where killing an adult human being is prima facie seriously morally wrong even though that human being is not being deprived of a "valuable future". So Marquis would be wrong in thinking that what is essential about the wrongness of killing an adult human being is that they are being deprived of a valuable future. This paper shows that whichever way the concept of "valuable future" is interpreted, the proposed counterexamples fail: if it is interpreted as "future like ours", the proposed counterexamples have no bearing on Marquis’s argument. If the concept is interpreted as referring to the patient’s preferences, it must be either conceded that the patients in Strong’s scenarios have some valuable future or admitted that killing them is not seriously morally wrong. Finally, if "valuable future" is interpreted as referring to objective standards, one ends up with implausible and unpalatable moral claims.

This paper argues that we know the future by applying a recent solution of the problem of future contingents to knowledge attributions about the future. MacFarlane has put forward a version of assessment-context relativism that enables us to assign a truth value 'true' (or 'false') to future contingents such as There Will Be A Sea Battle Tomorrow. Here I argue that the same solution can be applied to knowledge attributions about the future by dismissing three disanalogies between the case of future contingents and the case of knowledge attributions about the future. Therefore none of the traditional conditions for knowledge can be utilized to deny that we know the future, as I argue in the last section.

I argue that, if drones make waging war easier, the reason why they do so may not be the one commonly assumed within the philosophical debate – namely the promised reduction in casualties on either side – but a more complicated one which has little to do with concern for one’s own soldiers or, for that matter, the enemy; and a lot more to do with the political intricacies of international relations and domestic politics; I use the example of the Obama Administration’s drone policies to illustrate this argument. My point is meant to have wider methodological significance: philosophy can make an important contribution to this and related applied debates; but it is not by artificially – and optimistically – simplifying realities on the ground that philosophers can be of help.

Greg Janzen has recently criticised my defence of Frankfurt’s counterexample to the Principle of Alternate Possibilities by arguing that Jones avoids killing Smith in the counterfactual scenario. Janzen’s argument consists in introducing a new thought-experiment which is supposed to be analogous to Frankfurt’s and where the agent is supposed to avoid A-ing. Here I argue that Janzen’s argument fails on two counts, because his new scenario is not analogous to Frankfurt’s and because the agent in his new scenario does not avoid A-ing

I argue against Appel's recent proposal – in this JOURNAL – that there is a fundamental human right to sexual pleasure, and that therefore the sexual pleasure of severely disabled people should be publicly funded – by thereby partially legalizing prostitution. I propose an alternative that does not need to pose a new positive human right; does not need public funding; does not need the legalization of prostitution; and that would offer a better experience to the severely disabled: charitable non-profit organizations whose members would voluntarily and freely provide sexual pleasure to the severely disabled