Christopher Masciari

In their article, Pope and colleagues examine the ethical, legal, and practical complexities associated with the use of advance directives (ADs) to pursue voluntarily stopping eating and drinking (VSED) in the context of patients with advanced dementia. The authors detail the shortcomings of current VSED ADs, and they review a new VSED AD that they argue addresses these shortcomings and provides a better solution to the complexities associated with implementing VSED ADs. While the authors make a robust argument for the overall need and supportability of VSED ADs, this commentary highlights a problem that still persists even with the new VSED AD, specifically the absence of a robust ethical justification for continuing to honor the VSED AD even when the advanced dementia patient is requesting to eat or drink in the context of distress and suffering. Without this robust ethical justification, moral distress of family and caregivers is likely to occur, which could jeopardize the larger implementation of the VSED AD. Rather than pursue this more extreme measure without robust ethical justification, the commentary argues that the authors’ alternative proposal of minimal comfort feeding is the more practical and ethical strategy that best balances the patient’s longer- and shorter-term interests.

This dissertation provides a defense of reductive representationalism about consciousness. After an introductory chapter, chapter 2 provides a representationalist account of olfaction. In the literature, Burge’s (2010) account of representation is widely endorsed. According to his account, perceptual representation represents “objectually”, that is, it represents features of the world, as objective. This depends on perceptual constancies. Many authors attempt to defend representationalism about olfaction by showing that there are olfactory constancies. I argue that there are none. Instead, I show that representationalism regarding olfaction is correct by showing that olfaction represents minimally. I then argue that representations in Burge’s sense are constructed when minimal olfactory content is embedded in object-files that contain other non- olfactory properties that meet Burge’s criteria for representation. In chapter 3, I defend a particular reductive representationalist account of consciousness—the global workspacetheory—against an alternative which suggests that consciousness is richer than the global workspace theory claims. I argue that experience is richer than is standardly suggested by proponents of the global workspace theory, but less rich than the alternative theory suggests. I argue that there are additional resources available to defenders of the global workspace theory in accommodating intuitions of richness that have yet to be fully appreciated by participants in the debate. In chapter 4, I defend reductive representationalism against a new objection presented by Adam Pautz (20172020). He recently suggested that there are several constraints on experience, known as “The Laws of Appearance,” that put pressure on the representationalist thesis about conscious experience because they suggest that experience is constrained in ways that representations are not. Since the representationalist claims that experience just is a matter of representing the world to be a certain way, the representationalist owes us an explanation, or else representationalism is false. I argue that the laws are not genuine laws, but that we have the intuition that they are because of the limits of imagination. As a consequence, I show that representationalism is not threatened.

This chapter examines how telehealth’s rapid and widespread deployment into medical practice offers valuable insights for understanding the ethical dimensions of implementing new technologies in healthcare, particularly artificial intelligence. We argue that telehealth is not merely a tool for improving healthcare accessibility and clinical effectiveness; it serves as a critical case study for understanding how technology reshapes medicine and affects non-medical domains in unexpected ways. Through analysis of telehealth’s impact on medical adherence, provider-patient relationships, and the medicalization of personal spaces, we identify three key lessons for the ethical deployment of healthcare technologies: First, while benefits are often readily quantifiable, risks to normative aspects of medicine—such as patient autonomy and identity—are subtler and harder to measure. Second, technologies affect different populations and specialties in varying and unexpected ways, demanding context-sensitive implementation strategies rather than universal solutions. Third, new technologies shape not just what we can do but who we become as healthcare providers and patients. As healthcare becomes increasingly technology-dependent, we must balance innovation with the preservation of human values and relationships that lie at the foundation of good care. These insights are particularly relevant for the ongoing integration of AI systems into healthcare practice.

Here I defend representationalism against an important objection: the laws of appearance. The problem is that the laws seem necessary, but representationalist explanations of the laws give us no reason to think that they are. In the first part, I argue that the laws only seem necessary but are not. I argue that the laws seem necessary because we cannot imagine violations of them, and we cannot explain this inability. Since we have an explanation of why the laws seem necessary, we have no reason to posit a modal fact. In the second part, I argue that even if one establishes the metaphysical necessity of the laws by restricting them to normal humans, representationalism is not undermined either since the metaphysical necessity of the laws will be explained by contingent facts about normal human vision.

In this paper I argue that by using methods of encouragement, derived from the fields of social psychology, cognitive neuroscience, and behavioral economics, healthcare workers can potentially provide their patients with tools for increasing adherence to their treatment plans. I claim that the shared decision-making model can, and should, be enriched to include a component that encourages patients to follow through with their plans. It is commonsense that it is one thing to decide on a plan, and quite another to stick to it. Even if a plan is one’s own, people often backslide with respect to their prior commitments. I appeal to the extensive literatures on decision-making, delay discounting, and willpower to provide some empirically verified tools for motivating patients. Importantly, I argue that contrary to appearances, motivating others to act with respect to their commitments expresses a respect for autonomy and is non-paternalistic.

There are many accounts of representation in the philosophical literature. However, regarding olfaction, Burge’s (2010) account is widely endorsed. According to his account, perceptual representation is always of an objective reality, that is, perception represents objects as such. Many authors presuppose this account of representation and attempt to show that the olfactory system itself issues in representations of that sort. The present paper argues that this myopia is a mistake and, moreover, that the various arguments in favor of olfactory objects fail. Yet, by taking seriously a minimal notion of representation, adopted from Shea (2018), we can see that the olfactory system is representational after all even if it doesn’t represent objects as such. That is, olfaction issues in minimal representations. Crucially, however, this paper will conclude with an argument to the effect that olfactory object files (objectual representations of olfactory objectual properties) are constructed by interactions between various mental systems. The claim to be defended is that objectual representations of olfactory objects are constructed when minimal olfactory content is embedded in object-files that contain other non-olfactory properties that meet Burge’s criteria for representation. Some extant work on feature-binding, attention, and object-files will be introduced to support the suggestion.

The phenomenal overflow debate is a debate about the richness of phenomenal consciousness. There are two candidate views: the rich view and the sparse view. The rich view says phenomenal consciousness outstrips access consciousness and the contents of working memory. The sparse view denies this. Moreover, according to some conceptions of the sparse view, the subjective impression of richness depends on scene statistics and the refrigerator-light illusion. The purpose of this paper is to show there are additional resources available to the sparse view in accommodating intuitions of richness that have yet to be fully appreciated by participants in the debate. To this end, research pertaining to feature binding and activity-silent working memory will be discussed.

We present Birch and colleagues with a dilemma. On one interpretation, they aim to chart the distribution of a sort of minimal perceptual awareness across the animal kingdom, where that awareness can be fully characterized in third-person psychological terms. On this interpretation, the project is worthy but dull, since it doesn’t touch the question that has excited most people: whether other animals are phenomenally conscious. On an alternative interpretation, in contrast, they hope to resolve this latter question, arguing that phenomenal consciousness is extremely widespread. But if this is their intention, then their argument begs the question.