Walter Glannon

Free will consists in the capacity to initiate and execute plans of action. It involves the capacity to respond to reasons and control how our motivational states issue in our actions. Neurological and psychiatric disorders can diminish this capacity by causing dysfunction in the neural networks that mediate it. But brain abnormalities do not necessarily compromise free will. Pharmacological, surgical, and psychological interventions can restore the relevant capacity to varying degrees. The most difficult questions regarding free will involve conscious and unconscious aspects of our mental states and their role in self-control. I discuss violent impulses, addiction, and psychopathy and consider whether or to what extent individuals with these conditions can control their behavior and be responsible for it. Certain drugs might enhance the will and responsibility by increasing choices and strengthening responsiveness to reasons. While we should be open to this idea, it can have counterintuitive consequences.

The ethics of human enhancement has been a hotly debated topic in the last 15 years. In this debate, some advocate examining science fiction stories to elucidate the ethical issues regarding the current phenomenon of human enhancement. Stories from science fiction seem well suited to analyze biomedical advances, providing some possible case studies. Of particular interest is the work of screenwriter Andrew Niccol (Gattaca, S1m0ne, In Time, and Good Kill), which often focuses on ethical questions raised by the use of new technologies. Examining the movie In Time (2011), the aim of this paper is to show how science fiction can contribute to the ethical debate of human enhancement. In Time provides an interesting case study to explore what could be some of the consequences of radical life-extension technologies. In this paper, we will show how arguments regarding radical life-extension portrayed in this particular movie differ from what is found in the scientific literature. We will see how In Time gives flesh to arguments defending or rejecting radical life-extension. It articulates feelings of unease, alienation and boredom associated with this possibility. Finally, this article will conclude that science fiction movies in general, and In Time in particular, are a valuable resource for a broad and comprehensive debate about our coming future.

This work is an analysis of the metaphysical, psychological, and normative conditions that are necessary and sufficient for individual persons to be morally responsible. It takes the content of responsibility, that is, what persons are responsible for, to include mental states as well as actions, omissions, and the consequences of actions and omissions. I hold that moral responsibility entails causal responsibility. A person is causally responsible for mental states, actions, and states of affairs just in case he has the capacity to respond to practical reasoning, to translate reasons into action, and to respond to theoretical reasoning concerning the likely consequences of what he does or fails to do. He is morally responsible if, in addition to these capacities, he has the normative capacity to respond to moral reasons for the right sorts of action. ;In Chapters One and Two, I examine the three psychological capacities necessary for moral responsibility. In Chapter Three, I challenge three principles that have figured prominently in the debate on moral responsibility. I argue that persons may be responsible for actions they are forced to perform, for failing to perform actions they are unable to perform, and for consequences that are not directly sensitive to their actions. In Chapter Four, I show how causal determinism is compatible with the notion that persons can act freely and responsibly. Three main theses distinguish this work from other work on the subject. First, the mental basis on which we act is at least as important as our actions themselves in explaining why we are responsible. Second, normative competence involves the capacity to have certain emotions, together with the capacity for practical and theoretical reasoning. Third, it is not the ability to do otherwise but rather the autonomy and causal efficacy of our motivational states and actions which can make us responsible even in a deterministic world.

This book is a discussion of the most timely and contentious issues in the two branches of neuroethics: the neuroscience of ethics; and the ethics of neuroscience. Drawing upon recent work in psychiatry, neurology, and neurosurgery, it develops a phenomenologically inspired theory of neuroscience to explain the brain-mind relation. The idea that the mind is shaped not just by the brain but also by the body and how the human subject interacts with the environment has significant implications for free will, moral responsibility, and moral justification of actions. It also provides a better understanding of how different interventions in the brain can benefit or harm us. In addition, the book discusses brain imaging techniques to diagnose altered states of consciousness, deep-brain stimulation to treat neuropsychiatric disorders, and restorative neurosurgery for neurodegenerative diseases. It examines the medical and ethical trade-offs of these interventions in the brain when they produce both positive and negative physical and psychological effects, and how these trade-offs shape decisions by physicians and patients about whether to provide and undergo them.

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.3 (2002) 265-269 [Access article in PDF] The Psychology and Physiology of Depression Walter Glannon Trauma and stressful events can disrupt the physiologic homeostasis of our bodies and brains. The physiologic stress response consists of neural and endocrine mechanisms whose function is to reestablish homeostasis. These mechanisms include the secretion of glucocorticoids (cortisol) and catecholemines (epinephrine and norepinephrine). Once an external event has ceased to be a stressor or threat to a human organism, an integrated system of negative feedback loops inhibits the continued production of these hormones and effectively shuts down the stress response. These mechanisms are adaptive in the sense that they ensure the survival of the organism by reestablishing homeostasis. But prolonged exposure to real or perceived stressors can trigger prolonged secretion of stress hormones, thereby disrupting the feedback systems and causing a cascade of pathogenic events. The stress response is a double-edged sword. An acute stress response can protect an organism from external threats and reestablish homeostasis. But a chronic stress response can cause the body's defenses to become damaging rather than protective and to result in various disorders. Acute stress responses are adaptive. Chronic stress responses are often maladaptive and pathogenic.In "Depression as a Mind-Body Problem," I characterized major clinical depression as a disorder resulting from a maladaptive chronic stress response (Glannon 2003). Specifically, I argued that depression often results when our beliefs and emotions are out of proportion to the true nature of external events. The mind prolongs rather than constrains the physiologic stress response. Depression is not a disorder of the brain alone or the mind alone, however. Endocrine and immune dysfunction can contribute to the dysfunction in the brain and central nervous system that are involved in depression. Moreover, the contents of the mental states that initiate the sequence of events leading to depression are reflections of the person's natural and social environment. Thus, a satisfactory account of depression requires an analysis of the interconnections among the central nervous, endocrine, and immune systems, as well as the mind and the environment. All of these factors support the description of depression as a psychoneuroimmunologic disorder.Mike Martin (Martin 2003) and Thomas Fuchs (Fuchs 2003) discuss important aspects of depression that I did not elaborate in my paper. Martin argues that I fail to distinguish between depression as a mood and depression as a disorder. This is pertinent to the distinction evolutionary psychiatrists draw between moods that are adaptive and moods that are maladaptive. In contrast to my negative characterization of depression, Martin also makes a case for the positive [End Page 265] contributions of depression to meaningful life. Fuchs explores the notion of the brain as an organ of translation enabling patients to have meaningful subjective experience. The emphasis on subjectivity has important implications for potential preventive and therapeutic interventions for depression. For whether a person perceives an external event as a stressor may play a crucial role in the physiologic stress response. I will address the main points of these two authors in turn.Contrary to what Martin claims, I explicitly defined chronic depression as an affective (mood) disorder. My focus was on the clinical definition of major depression as a moderately severe to severe chronic disorder. It consists of affective, cognitive, and even physical dysfunction that interferes with a person's ability to carry out the normal tasks of daily life. This characterization of major chronic depression distinguishes it from milder forms of depression, such as dysthymia. Because these milder forms do not involve the same type or degree of dysfunction as more severe forms, they are not appropriately characterized as pathologies. For this reason, I focused on Nesse's (2000) discussion of depression rather than on his discussion of low mood. In fairness to Nesse and Stevens and Price (2000), not all forms of depression are pathologic according to the evolutionary view they defend. Some passive aspects of mild depression may be useful in alerting us to dangerous or wasteful behavior. It does seem plausible to describe depressed moods as falling along a continuum from those that...

In a recent set of papers, Aaron Spital has proposed conscription or routine recovery of cadaveric organs without consent as a way of ameliorating the severe shortage of organs for transplantation. Under the existing consent requirement, organs can be taken from the bodies of the deceased if they expressed a wish and intention to donate while alive. Organs may also be taken when families or other substitute decisionmakers decide on behalf of the deceased to allow organ procurement for the purpose of transplantation. When patients or families do not consent to organ procurement, many transplantable organs are lost. This is a tragic yet avoidable situation. The dead are beyond any benefit or harm, and their organs could be used to prevent harm by saving and improving the lives of many people suffering and dying from end-stage organ failure

In a provocative 1991 paper, Alvin Moss and Mark Siegler argued that it may be fair to give individuals with alcohol-related end-stage liver disease lower priority for a liver transplant than those who develop end-stage liver disease from other factors. Like other organs, there is a substantial gap between the available livers for transplantation and the number of people who need liver transplants. Yet, unlike those with end-stage renal disease, who can survive for some time on dialysis before receiving a kidney transplant, those with liver failure will die without a liver transplant

In 1999, a case was described on national television in which a woman had enlisted onto an international bone marrow registry with the altruistic desire to offer her bone marrow to some unidentified individual in need of a transplant. The potential donor then was notified that she was a compatible match with someone dying from leukemia and gladly donated her marrow, which cured the recipient of the disease. Years later, though, the recipient developed end-stage renal disease, a consequence of the high-dose chemotherapy she received earlier to destroy her stem cells and prepare her for the bone marrow transplant. Finding a suitable donor for a kidney transplant proved extremely difficult. Desperate, she requested that the donor registry personnel help her locate the individual who earlier was determined to be a compatible donor and asked this now-identifiable individual to consider donating one of her two normally functioning kidneys for a kidney transplant

In a recent article in this journal, we argued that living organ donation from a parent to a child should be described as a beneficent rather than an altruistic act. Emotional relationships can generate an obligation of beneficence to help those with whom we have these relationships. This may involve an obligation for a parent to donate an organ to a child, even though it entails some risk to the parent. The parent's donation is not altruistic because altruistic acts are not obligatory but optional, and they are motivated solely or primarily by other-regarding concerns. In contrast, donor parents' other-regarding concerns are inseparable from their own self-regarding concerns. An individual who donates to a stranger is acting altruistically. She may choose to help others to whom she is not emotionally related for a variety of reasons—sympathy, compassion, generosity, or a desire to give something back to humanity. But she does not have an obligation to do so. Although she may benefit as a consequence of donating, this is not her reason for donating. Instead, her action is motivated by a concern for the recipient's own sake. This is what makes the donation altruistic, and it can be justified without any expectation of benefit to the donor. However, although the potential competent donor decides whether the donation is in her best interests, physicians have the right to refuse to perform a transplant if the risks to the donor are too great or the potential benefits to the recipient are too small

Major depression is a disorder of the mind caused by dysfunction of both the body and the brain. Because it is a psychiatric illness and psychiatry is a branch of medicine, the question of how mind and body interact in depression should be treated as a medical rather than metaphysical mind-body problem. The relation between mind and body as it pertains to this illness should be construed in teleological rather than causal terms. Mental states like beliefs and emotions serve an adaptive purpose by constraining the physiologic systems involved in the body's stress response, thus preserving homeostasis and protecting us from various disorders. Depression results when the mind fails it its constraining role.

Endophenotypes are an exciting and important area of research in genetically complex psychiatric diseases. They are biological markers between genotype and external phenotype that may indicate susceptibility to or manifest as early signs of a wide range of mental disorders. Identifying endophenotypes can enable researchers to tease apart the biological components of psychiatric diseases and thereby gain a better understanding of them. They may lead to more accurate prediction and to more effective prevention and treatment. Endophenotypes also have implications for the philosophy of mind and the ethics of informed consent.

In lieu of an abstract, here is a brief excerpt of the content:Walter Glannon WHAT LITERARY THEORY MISSES IN WITTGENSTEIN Wittgenstein's stock is rising in literary criticism. The market value of expressions such as "language games" and "form oflife" is increasing in that they seem to lend themselves to the notion of interpretive communities endorsed by diose of reader-response persuasion.1 Wittgenstein's style is also apparently at a premium, in light of a recent attempt by a proponent of deconstruction to relate the philosopher's writing to that movement's use of rhetorical strategies in dealing with texts.2 There are affinities between Wittgenstein's repudiation (in the Investigations and the Remarks on the Foundations of Mathematics) of the metaphysical realism in the Tractatus and die arguments from reader-response critics against the notion of unmediated facts, as well as the rejection of the metaphysics of presence by deconstructionists. All diree oppose the idea that truth and falsity are conferred on our statements about the world by properties independent of diese statements. Insofar as these two critical schools are concerned primarily with language, they share Wittgenstein's aspiration to "bring words back from their metaphysical to their everyday use" (PI, I, § 116), for we can arrest the tendency to postulate objective, unmediated facts by "looking into the workings of our language" (PI, I, § 109). Moreover, Wittgenstein avoids psychology which involves the mental faculties. Presumably, this puts him at one with die concerted effort of many critics to rid texts of die author and with it the problem of intentionality. At first blush, then, the relation between Wittgenstein and literary criticism appears to be an attractive one. Yet Wittgenstein's antirealism does not militate against his passion for truth, that is, his intense desire to achieve complete understanding in the areas ofphilosophy that vexed him most.3 Nor does it debar him from thinking about the inexpressible realm 263 264Philosophy and Literature of the mystical, since, despite his concern for language, Wittgenstein never ceased being attracted to "things that cannot be put into words" (TLP, 6.522). This is not at all congenial to die purpose ofliterary theory, which admits ofno such shadowy domain beyond words and our linguistic practices. Indeed, I shall illustrate that Wittgenstein's resdess search for truth, spiritual concerns, and the dialectical structure of his works for the most part put him radically at odds with a critical enterprise whose aversion to truth and penchant for rhetorical analysis and conventions blinds it to both his view of literature and his aim in doing philosophy. I Since die advent of the New Criticism, literary theory has in great measure addressed itself to die discourse ramer than the story in texts. With the focus on literature as a rhetorical construct, more traditional humanistic interpretations have been excised. A more recent development of this shift to the discursive side of diings has been the effort to blur the distinction between literature and philosophy.4 With neidier discipline having a privileged status, both have been reduced to a textual discourse with no lines ofdemarcation, a reduction diat is at variance with Wittgenstein on two counts. First, he compartmentalized literature and philosophy as having distinct purposes: the literary works that interested him were stories ofmoral import; philosophy was to be practiced for the sake of clarity in thought. To the extent diat such clarity, if attainable, pointed toward an ethical dimension that lay beyond the bounds of language, literature and philosophy for him did have a common goal; but the paths leading to it were distinct. Second, and more importantly, Wittgenstein had no concern for the discourse of the literature diat he read. Rather, it was the moral import of the stories that attracted him. Most noteworthy on this score were the writings of Tolstoy, who had a profound influence on Wittgenstein's view oflife, and Dostoevsky.5 Wittgenstein often recommended Tolstoy's Twenty-three Tales to his friends, and while a schoolmaster in Lower Austria from 1920 to 1926, he constantly read The Brothers Karamazov, doing so aloud on one occasion in die presence of the village priest. He was especially impressed with Dostoevsky's character the Elder Zossima, "who could see into people's hearts and direct diem" (Rhees...

Brain implants, such as Deep Brain Stimulation (DBS), which are designed to improve motor, mood and behavioural pathology, present unique challenges to our understanding of identity, agency and free will. This is because these devices can have visible effects on persons' physical and psychological properties yet are essentially undetectable when operating correctly. They can supplement and compensate for one's inherent abilities and faculties when they are compromised by neuropsychiatric disorders. Further, unlike talk therapy or pharmacological treatments, patients need not ‘do’ anything for the treatment to take effect. If one accepts, as we argue here, that brain implants are unique among implantable types of devices, then this can have significant implications for what it means to persist as the same person and be the source of one's thoughts and actions. By examining two of the most common indications for DBS in current use, namely in the motor (Parkinson's Disease) and psychiatric (Major Depression) domains, we further argue that although DBS, as it is currently applied, does not necessarily represent a unique threat to personal identity and agency per se, it introduces an unprecedented ‘third party’ into the debate on these concepts. In this way, DBS can be used as a tool to begin probing, both conceptually and empirically, some of philosophy's most perennial metaphysical questions

In defending what he calls ‘full-blooded Epicureanism’, James Stacey Taylor argues that the dead cannot be harmed or wronged.1 This has implications for a range of bioethical issues pertaining to death, including posthumous organ procurement. Taylor claims that respecting the autonomy of persons requires that their desires regarding the treatment of their postmortem bodies be given due consideration while these persons are alive. It is not obvious what this means in practical terms, though Taylor says that respect for autonomy requires that these wishes be recorded with the intention that they be followed. Yet if respect for autonomy only applies to the wishes of premortem persons, and if there are no posthumous harms or wrongs, then it is not clear why it would matter morally whether one's wishes about what to do with one's organs were fulfilled or thwarted after one's death.Most of us have an interest in what happens to our bodies not just during our lives but also after our deaths. Personal sovereignty and autonomy give persons a right to control what happens to their bodies, and since the body …

Neuroimaging showing brain abnormalities is increasingly being introduced in criminal court proceedings to argue that a defendant could not control his behavior and should not be held responsible for it. But imaging has questionable probative value because it does not directly capture brain function or a defendant’s mental states at the time of a criminal act. Advanced techniques could transform imaging from a coarse-grained measure of correlations between brain states and behavior to a fine-grained measure of causal connections between them. Even if this occurs, bias and other attitudes may unduly influence jurors’ interpretation of the data. Moreover, judges’ decisions about whether neuroimaging data is legally relevant and admissible are normative decisions based on more than empirical evidence. Advanced neuroimaging will better inform assessments of criminal responsibility but will not supplant or explain away the psychological and normative foundation of the criminal law

All psychiatric disorders have a neurobiological basis. This has led to a better understanding of these disorders and a reduction in the social stigma associated with them. But the claim that mental states can be explained entirely in neurobiological terms may give us de-stigmatization at the cost of de-personalization. A holistic view of the mind as distributed among the brain, body and environment provides the best model to guide interventions that will have the most salutary ef ects on the brain and the mind