Daniel Moseley

Psychopathy is best understood as a specific deficit in moral understanding and not merely as a cluster of antisocial behaviors. Psychopathy is the absence of conscience. While popular culture depicts psychopaths as remorseless serial killers, many psychopaths never commit homicide, and conversely some killers (e.g., soldiers acting on moral convictions) retain a functioning conscience. What unites all psychopaths is their incapacity to grasp moral reasons for actions. In this paper, we clarify psychopathy’s conceptual contours; distinguish it from related conditions, such as, legal insanity, pragmatic criminality, and volitional disorders. We also critique the Hare Psychopathy Checklist–Revised (PCL-R) for its behavioral rather than motivational focus. We argue that psychopathy amounts to a congenital moral blindness, with signifi cant implications for diagnosis, treatment, and moral psychology.

As military institutions explore the use of enhancement technologies to improve combat readiness and operational effectiveness, critical ethical and policy questions emerge about the long-term consequences of these interventions. This paper examines the reintegration challenges facing enhanced veterans—those who undergo cognitive, neurological, genetic, or physiological modifications during service—and explores the military’s obligations to support their post-service lives. We analyze how enhancements, though often framed as temporary or mission-specific, may result in lasting changes to cognition, emotion, and identity that complicate veterans’ ability to rejoin civilian life. Drawing from military ethics, bioethics, and neuroethics literature, we examine issues of autonomy, informed consent, and structural coercion within the hierarchical nature of military service. We argue that enhancement may not only exacerbate existing barriers to healthcare, employment, and social belonging but also generate novel forms of stigma and challenge existing systems of support. To address these challenges, we recommend policy interventions including the establishment of an enhanced veteran registry, expanded research funding, and the development of tailored long-term care strategies. We conclude that protecting the rights and dignity of enhanced service members requires proactive ethical and institutional planning—before, during, and long after their time in uniform.

We examine whether non-invasive brain stimulation (NIBS), particularly transcranial magnetic stimulation (TMS) and transcranial alternating current stimulation (tACS), can address a decline in standardized measures of creativity that is often referred to as the “creativity crisis.” We review empirical studies that suggest these interventions yield modest, yet meaningful, gains in creative thinking. By targeting key brain networks underlying creative cognition, NIBS provide researchers with a novel avenue for probing the neurological foundations of creativity. However, the prospect of using NIBS for creativity enhancement raises challenging ethical and social questions. We discuss how this technology challenges traditional distinctions between treatment and enhancement, as well as concerns surrounding authenticity, autonomy, and justice. We highlight debates about whether such interventions undermine core aspects of human nature or compromise individuals’ cognitive liberty. We also address potential concerns about inequities, including disparities in access and the broader implications for global health. We conclude that NIBS provide a powerful tool for advancing our understanding of the neuroscience of creativity.

Joshua May’s Neuroethics: Agency in the Age of Brain Science is a landmark achievement in the field. I discuss May’s chapter on the topic of moral enhancement. May examines whether it is morally permissible to go beyond treatment and enhance our moral capacities and character via direct brain interventions. May argues for a permissive stance in which the safe experimentation by individuals of some currently available forms of direct brain interventions are permissible. I contend that May’s discussion overlooks some central distinctions and arguments in the literature on moral enhancement. Specifically, I argue that the discussion would benefit from: a closer look at the Bioethics literature on the treatment/enhancement distinction, the relevant sense of ‘moral’ in this debate, arguments in favor of a moral duty to develop and widely deploy neurotechnologies that could be used for moral enhancement, and examining how radical enhancements, transhumanism and moral status issues are central to the topic.

Psychiatric disorders usually do not have characteristic physical exam findings, imaging, or lab values. Psychiatrists therefore diagnose and treat patients largely based on reported or observed behavior, which makes collateral information from a patient’s close contacts especially pertinent to an accurate diagnosis. The American Psychiatric Association considers communication with patients’ supports a best practice when the patient provides informed consent or does not object to the communication. However, situations arise in which a patient’s objection to such communication is the product of impaired decision-making and the benefits of obtaining collateral information represent best practice. In this article a framework for addressing these situations is proposed using a full decisional capacity evaluation, followed by an alternate decision-making process by concurrence from a second physician. It is recommended that a patient’s refusal to allow the gathering of collateral information should be addressed exactly like refusals for other diagnostic or treatment interventions.

We describe the legal practice of using civil court orders to mandate outpatient mental health treatment for adults with serious mental illness. After briefly placing the practice in historical context, we discuss the traditional clinical rationale and assumptions underlying outpatient commitment and its legal variants, as well as how the predominant and controversial preventive form of outpatient commitment emerged in the U.S. to address limitations of earlier versions of these laws, such as "conditional release." We then consider whether, and under what conditions, outpatient commitment may be ethical, and we provide a conceptual framework for deciding such questions at the policy and individual-case levels.

John Harris's influential work on human enhancement has advocated the development, use, and exchange of human enhancement technologies. The types of enhancements that are of interest are biomedical interventions that are used to improve human capacities beyond what is necessary to achieve or maintain health or "normal functioning". This new book is unique in Harris's body of work in that it takes a more cautious stance regarding moral enhancements than he has taken toward other forms of human enhancement, such as cognitive enhancements. I examine and evaluate Harris's main arguments for this cautious stance. Two of the main issues that are discussed are: (1) whether it would be unethical for someone to use biomedical technologies to become less racist and (2) whether it would be unethical for someone to use biomedical technologies to reduce impulsive violent aggression.

Following Kahneman and Tversky, I examine the term ‘bias’ as it is used to refer to systematic errors. Given the central role of error in this understanding of bias, it is helpful to consider what it is to err and to distinguish different kinds of error. I identify two main kinds of error, examine ethical issues that pertain to the relation of these types of error, and explain their moral significance. Next, I provide a four-level explanatory framework for understanding biases: personal, sub-personal, situational, and systemic levels. Finally, I examine some of the ethical complexities involved in attributing biases to oneself and to others.

We examine a set of debates in Practical Ethics commonly labeled “the ethics of human enhancement.” Our essay focuses on (1) conceptual concerns about the limits of legitimate health care—the treatment vs. enhancement distinction, (2) moral considerations about fairness, authenticity, and human nature that are common in discussing the use of medical technologies in competitive institutions like sports and academia, and (3) broader issues that pertain to science policy and the distribution and regulation of medical technologies.

Decisional capacity evaluations (DCEs) occur in clinical settings where it is unclear whether a consumer of medical services has the capacity to make an informed decision about the relevant medical options. DCEs are localized interventions, not the global loss of competence, that assign a surrogate decision maker to make the decision on behalf of the medical consumer. We maintain that one important necessary condition for a DCE to be morally justified, in cases of medical necessity, is that the health care consumer under evaluation is incapable of expressing a preference for a certain outcome.

This groundbreaking volume of original essays presents fresh avenues of inquiry at the intersection of philosophy and psychiatry. Contributors draw from a variety of fields, including evolutionary psychiatry, phenomenology, biopsychosocial models, psychoanalysis, neuroscience, neuroethics, behavioral economics, and virtue theory. Philosophy and Psychiatry’s unique structure consists of two parts: in the first, philosophers write five lead essays with replies from psychiatrists. In the second part, this arrangement is reversed. The result is an interdisciplinary exchange that allows for direct discourse, and a volume at the forefront of defining an emerging discipline. Philosophy and Psychiatry will be of interest to professionals in philosophy and psychiatry, as well as mental health researchers and clinicians

I reconstruct Bernard Williams’ integrity-based critique of Act-Utilitarianism (AU). I contend that Williams presents a compelling argument against AU, but the argument does not generalize to all impartial moral theories. I argue that Williams’ conception of personal integrity as the pursuit of one’s projects presents a strong objection to AU and it reveals the importance of widening the scope of morality to include considerations of partial inter-personal relations. I also contend that Williams’ conception of integrity can withstand the scrutiny brought upon it by the self-indulgence objection. However, defenders of his conception of integrity must admit that personal integrity does place one in the danger of having evil projects.