•  3
    Conscientious Objection in Health Care: Pinning down the Reasonability View
    Journal of Medicine and Philosophy 46 (1): 37-57. 2021.
    Robert Card’s “Reasonability View” is a significant contribution to the debate over the place of conscientious objection in health care. In his view, conscientious objections can only be accommodated if the grounds for the objection meet a reasonability standard. I identify inconsistencies in Card’s description of the reasonability standard and argue that each version he specifies is unsatisfactory. The criteria for reasonability that Card sets out most frequently have no clear underpinning prin…Read more
  •  8
    The COVID-19 pandemic has created unusually challenging and dangerous workplace conditions for key workers. This has prompted calls for key workers to receive a variety of special benefits over and above their normal pay. Here, we consider whether two such benefits are justified: a no-fault compensation scheme for harm caused by an epidemic and hazard pay for the risks and burdens of working during an epidemic. Both forms of benefit are often made available to members of the armed forces for the…Read more
  •  28
    Healthcare systems around the world are struggling to maintain a sufficient workforce to provide adequate care during the COVID-19 pandemic. Staffing problems have been exacerbated by healthcare workers refusing to work out of concern for their families. I sketch a deontological framework for assessing when it is morally permissible for HCWs to abstain from work to protect their families from infection and when it is a dereliction of duty to patients. I argue that it is morally permissible for H…Read more
  •  15
  •  20
    The Importance of Self-Narration in Recovery from Addiction
    with Anke Snoek
    Philosophy, Psychiatry, and Psychology 25 (3): 31-44. 2018.
    Addiction involves a chronic deficit in self-governance that treatment aims to restore. We draw on our interviews with addicted people to argue that addiction is, in part, a problem of self-narrative change. Over time, agents come to strongly identify with the aspects of their self-narratives that are consistently verified by others. When addiction self-narratives become established, they shape the addicted person’s experience, plans, and expectations so that pathways to recovery appear implausi…Read more
  •  25
    Daniel Sulmasy has recently argued that good medicine depends on physicians having a wide discretionary space in which they can act on their consciences. The only constraints Sulmasy believes we should place on physicians’ discretionary space are those defined by a form of tolerance he derives from Locke whereby people can publicly act in accordance with their personal religious and moral beliefs as long as their actions are not destructive to society. Sulmasy also claims that those who would re…Read more
  •  348
    In this chapter we focus on the structure of close personal relations and diagnose how these relationships are disrupted by addiction. We draw upon Peter Strawson’s landmark paper ‘Freedom and Resentment’ (2008, first published 1962) to argue that loved ones of those with addiction veer between, (1) reactive attitudes of blame and resentment generated by disappointed expectations of goodwill and reciprocity, and (2) the detached objective stance from which the addicted person is seen as less bla…Read more
  •  549
    Reasons, reflection, and repugnance
    In Alberto Giubilini & Steve Clarke (eds.), The Ethics of Human Enhancement: Understanding the Debate, Oxford University Press. 2016.
    In this chapter we draw comparisons between Kass’ views on the normative authority of repugnance and social intuitionist accounts of moral judgement which are similarly sceptical about the role of reasoned reflection in moral judgement. We survey the empirical claims made in support of giving moral primacy to intuitions generated by emotions such as repugnance, as well as some common objections. We then examine accounts which integrate intuition and reflection, and argue that plausible accounts …Read more
  •  371
    Narrative Self-Constitution and Recovery from Addiction
    American Philosophical Quarterly 53 (3): 307-322. 2016.
    Why do some addicted people chronically fail in their goal to recover, while others succeed? On one established view, recovery depends, in part, on efforts of intentional planning agency. This seems right, however, firsthand accounts of addiction suggest that the agent’s self-narrative also has an influence. This paper presents arguments for the view that self-narratives have independent, self-fulfilling momentum that can support or undermine self-governance. The self-narrative structures of add…Read more
  •  52
    Explaining Addiction: How Far Does the Reward Account of Motivation Take Us?
    with Jeanette Kennett
    Inquiry: An Interdisciplinary Journal of Philosophy 56 (5). 2013.
    ABSTRACT Choice theorists such as George Ainslie and Gene Heyman argue that the drug-seeking behaviour of addicts is best understood in the same terms that explain everyday choices. Everyday choices, they claim, aim to maximise the reward from available incentives. Continuing drug-use is, therefore, what addicts most want given the incentives they are aware of but they will change their behaviour if and when better incentives become available. This model might explain many typical cases of addic…Read more
  •  47
    Narrative self-constitution and vulnerability to co-authoring
    Theoretical Medicine and Bioethics 37 (1): 29-43. 2016.
    All people are vulnerable to having their self-concepts shaped by others. This article investigates that vulnerability using a theory of narrative self-constitution. According to narrative self-constitution, people depend on others to develop and maintain skills of self-narration and they are vulnerable to having the content of their self-narratives co-authored by others. This theoretical framework highlights how vulnerability to co-authoring is essential to developing a self-narrative and, thus…Read more
  •  247
    DBS, Personal Identity, and Diachronic Value
    American Journal of Bioethics Neuroscience 4 (2): 47-49. 2013.
  •  292
    Narrating Truths Worth Living: Addiction Narratives
    with Anke Snoek
    American Journal of Bioethics Neuroscience 3 (4): 77-78. 2012.
    Self-narrative is often, perhaps primarily, a tool of self- constitution, not of truth representation. We explore this theme with reference to our own recent qualitative interviews of substance-dependent agents. Narrative self- constitution, the process of realizing a valued narrative projection of oneself, depends on one’s narrative tracking truth to a certain extent. Therefore, insofar as narratives are successfully realized, they have a claim to being true, although a certain amount of self-d…Read more