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.

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.

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

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 analyse the relationship between the Doctrine of Double Effect and the Trolley Problem: the former offers a solution for the latter only on the premise that killing the one in Bystander at the Switch is permissible. Here I offer both empirical and theoretical arguments against the permissibility of killing the one: firstly, I present data from my own empirical studies according to which the intuition that killing the one is permissible is neither widespread nor stable; secondly, I defend a normative principle according to which killing the one in Bystander at the Switch is not permissible. In conclusion, there just is no trolley problem.

I distinguish between 'hard nudges' and 'soft nudges', arguing that it is possible to show that the latter can be compatible with informed consent - as Cohen has recently suggested; but that the real challenge is the compatibility of the former. Hard nudges are the more effective nudges because they work on less than conscious mechanisms such as those underlying our habits: whether those influences - which are often beyond the subject's awareness - can be reconciled with informed consent in health care is the more challenging question. I suggest two directions for possible answers: on the one hand, looking at the growing empirical literature on mindless judgement and behaviour; and on the other hand considering a more diversified conception of consent, which I sketch.

In a previous paper, I had argued that Strong’s counterexamples to Marquis’s argument against abortion—according to which terminating fetuses is wrong because it deprives them of a valuable future—fail either because they have no bearing on Marquis’s argument or because they make unacceptable claims about what constitutes a valuable future. In this paper I respond to Strong’s criticism of my argument according to which I fail to acknowledge that Marquis uses "future like ours" and "valuable future" interchangeably. I show that my argument does not rely on not acknowledging that "future like ours" and "valuable future" are interchangeable; and that, rather, it is exactly by replacing "future like ours" with "valuable future" that I construct my argument against Strong. I conclude with some remarks on how Marquis’s concept of "future like ours" should be interpreted.

Thinking is overrated: golfers perform best when distracted and under pressure; firefighters make the right calls without a clue as to why; and you are yourself ill advised to look at your steps as you go down the stairs, or to try and remember your pin number before typing it in. Just do it, mindlessly. Both empirical psychologists and the common man have long worked out that thinking is often a bad idea, but philosophers still hang on to an intellectualist picture of human action. This book challenges that picture and calls on philosophers to wake up to the power of mindlessness: it is our habits, skills and conventions that help us cope with a world way too diverse for us to hope to always reinterpret it. The book presents the empirical evidence that has been accumulating over the last few decades and offers a philosophical analysis of mindless phenomena such as habits, skilled activity, automatic actions, emotional and spontaneous reactions and social conventions, arguing that traditional philosophical theories of action should be revised to do justice to this forgotten but important part of our lives: when we act mindlessly, we are free and fully rational even though we neither deliberate nor are aware of what we are doing.

I argue against the Doctrine of Double Effect’s explanation of the moral difference between terror bombing and strategic bombing. I show that the standard thought-experiment of Terror Bomber and Strategic Bomber which dominates this debate is underdetermined in three crucial respects: (1) the non-psychological worlds of Terror Bomber and Strategic Bomber; (2) the psychologies of Terror Bomber and Strategic Bomber; and (3) the structure of the thought-experiment, especially in relation to its similarity with the Trolley Problem. (1) If the two worlds are not identical, then it may be these differences between the two worlds and not the Doctrine of Double Effect to explain the moral difference; (2a) if Terror Bomber and Strategic Bomber have the same causal beliefs, then why does Terror Bomber set out to kill the children? It may then be this unwarranted and immoral choice and not the Doctrine of Double Effect that explains the moral difference; (2b) if the two have different causal beliefs, then we can’t rule out the counterfactual that, had Strategic Bomber had the same beliefs as Terror Bomber, she would have also acted as Terror Bomber did. Finally, (3) the Strategic Bomber scenario could also be constructed so as to be structurally equivalent to the Fat Man scenario in the Trolley Problem: but then the Doctrine of Double Effect would give different answers to two symmetrical cases.

There are some interesting similarities between Aristotle’s ‘mixed actions’ in Book III of the Nicomachean Ethics and the actions often thought to be justifiable with the Doctrine of Double Effect. Here I analyse these similarities by comparing Aristotle’s examples of mixed actions with standard cases from the literature on double effect such as, amongst others, strategic bombing, the trolley problem, and craniotomy. I find that, despite some common features such as the dilemmatic structure and the inevitability of a bad effect, Aristotle’s mixed actions do not count as cases justifiable through application of the Doctrine of Double Effect because they fail to meet the crucial necessary condition of the Doctrine according to which the bad effect can only be a merely foreseen side-effect and not an intended means.

Ethics Without Intention tackles the questions raised by difficult moral dilemmas by providing a critical analysis of double effect and its most common ethical and political applications. The book discusses the philosophical distinction between intended harm and foreseen but unintended harm. This distinction, which, according to the doctrine of double effect, makes a difference to the moral justification of actions, is widely applied to some of the most controversial ethical and political questions of our time: collateral damages in wars and acts of terrorism; palliative care, euthanasia, abortion, and embryo research; self-defence, suicide, and self-sacrifice. It is also crucial to the now notorious theoretical cases of the trolley problem and the knobe effect. Di Nucci approaches the doctrine of double effect from four key directions: its historical origins, which can be traced further back than the classic attribution to Aquinas; its theoretical coherence, which is the subject of a lively contemporary debate in philosophy; its moral intuitiveness, which has always been taken for granted but has recently begun to be questioned; and finally its relevance to the difficult moral and political decisions of our time. An engaging and comprehensive introduction to the doctrine of double effect.

David Shoemaker has claimed that a binary approach to moral responsibility leaves out something important, namely instances of marginal agency, cases where agents seem to be eligible for some responsibility responses but not others. In this paper we endorse and extend Shoemaker’s approach by presenting and discussing one more case of marginal agency not yet covered by Shoemaker or in the other literature on moral responsibility. Our case is that of Kenneth Parks, a Canadian man who drove a long way to his mother-in-law’s and killed her in a state of somnambulism. We support our claim about Parks’ marginal responsibility in three steps: we first deny that Parks acts involuntarily as traditionally claimed in the legal literature; we then propose to extend Shoemaker’s analysis of marginal responsibility based on quality of will so as to include two other dimensions: the moral status of the agent and the actual causal effects of their actions; finally, we distinguish Parks’ marginal responsibility from four other existing concepts: “tracing”, diminished responsibility, causal responsibility, and moral disapproval without responsibility.

Ought parents, in general, to value being biologically tied to their children? Is it important, in particular, that both parents be biologically tied to their children? I will address these fundamental questions by looking at a fairly new practice within IVF treatments, so-called IVF-with-ROPA ( Reception of Oocytes from Partner ), which allows lesbian couples to „share motherhood‟ with one partner providing the eggs while the other becomes pregnant. I believe that IVF-with-ROPA is, just like other IVF treatments, morally permissible; but here I argue that the increased biological ties which IVF-with-ROPA allows for do not have any particular value beside the satisfaction of a legitimate wish, because there is no intrinsic value in a biological tie between parents and children; further, I argue that equality within parental projects cannot be achieved by redistributing biological ties.

On Don Marquis’s future of value account of the wrongness of killing, ‘what makes it wrong to kill those individuals we all believe it is wrong to kill, is that killing them deprives them of their future of value’. Marquis has recently argued for a narrow interpretation of his future of value account of the wrongness of killing and against the broad interpretation that I had put forward in response to Carson Strong. In this article I argue that the narrow view is problematic because it violates some basic principles of equality and because it allows for some of the very killing that Marquis sets out to condemn; further, I argue that the chief reason why Marquis chooses the narrow view over the broad view – namely that the broad view would take the killing of some nonhuman animals to be also wrong – should rather be considered a welcome upshot of the broad view.

I argue that the empirical literature on priming effects does not warrant nor suggest the conclusion, drawn by prominent psychologists such as J. A. Bargh, that we have no free will or less free will than we might think. I focus on a particular experiment by Bargh – the ‘elderly’ stereotype case in which subjects that have been primed with words that remind them of the stereotype of the elderly walk on average slower out of the experiment’s room than control subjects – and I show that we cannot say that subjects cannot help walking slower or that they are not free in doing do. I then illustrate how these cases can be reconciled and normalized within a Davidsonian theory of action to show that, in walking slower, subjects are acting intentionally. My argument applies across various experiments, including those of goal priming. In the final section I argue that the only cases in which priming effects are efficacious are so-called Buridan cases.