Joanna Demaree-Cotton

Suppose that a person is asked for consent. However--either due to cognitive disability, or because she is intoxicated, or because she is a child--she is not able to think through this question in the way most of us would. When this person says ‘yes,’ does she thereby consent? We suggest intuitions about such cases can reflect two different senses of consent--one more superficial sense of consent, and one deeper sense. We provide empirical evidence that apparent disagreement or ambivalence about such cases in fact reflects complex reactions of simultaneously thinking that there is a sense in which the agent consents (superficial sense), but also thinking that there is an important sense in which she did not consent at all (deeper sense). We argue that these findings carry important implications for researching and discussing consent in philosophy and public discourse.

This chapter evaluates arguments that findings from experimental studies into our moral psychology debunk moral intuitions i.e. show that they cannot, in fact, provide a basis for justified moral belief. After offering an overview of different types of psychological debunking arguments, the rest of the chapter focuses on analysing so-called “Irrelevant Factors Debunking”. I highlight some important recent developments in the debate. This includes recent scientific evidence that certain irrelevant factors are much less likely to influence moral intuitions than philosophers have previously thought. I also discuss recent attempts to provide more reliable estimates of how strong the influence of irrelevant factors on moral intuitions really is. Ultimately, I argue that the influence of irrelevant factors like “framing” may not be strong enough to defeat epistemic justification. Moreover, I argue, even strong dependence on irrelevant factors may not be troubling so long as those intuitions are sensitive to good reasons.

Medical predictions, for example, concerning a patient's likelihood of survival, can be used to efficiently allocate scarce resources. Predictions of patient behaviour can also be used—for example, patients on the liver transplant waiting list could receive lower priority based on a high likelihood of non‐adherence to their immunosuppressant medication regimen or of drinking excessively. But is this ethically acceptable? In this paper, we will explore arguments for and against behavioural predictions, before providing novel empirical evidence on this question. Firstly, we note that including behavioural predictions would lead to improved transplant outcomes. Fairness could also require prioritising those predicted to engage in healthier behaviours: consistent with using behavioural predictions in other contexts such as psychiatry and substance misuse. Conversely, behavioural predictions may be judged too inaccurate or discriminatory, or it may be thought unfair to deprioritise based on future behaviour. In part two, we performed an online survey of 172 UK adults. When presented with possible factors relevant to liver allocation, most thought predictions of higher medication adherence (78.6%) and lower future alcohol use (76.5%) should be used but not predictions of lower future criminality (24.7%) and higher societal contribution (21.2%). Randomising participants into two groups, 69.8% of participants found deprioritising a patient based on their predicted medication adherence acceptable (91.9% found a nonbehavioural prediction acceptable). We did not identify an ethically relevant difference between behavioural predictions and other medical predictions already used in organ allocation. Our sample of participants also appeared to support behavioural predictions in this context.

Background: Allocation of scarce organs for transplantation is ethically challenging. Artificial intelligence (AI) has been proposed to assist in liver allocation, however the ethics of this remains unexplored and the view of the public unknown. The aim of this paper was to assess public attitudes on whether AI should be used in liver allocation and how it should be implemented. Methods: We first introduce some potential ethical issues concerning AI in liver allocation, before analysing a pilot survey including online responses from 172 UK laypeople, recruited through Prolific Academic. Findings: Most participants found AI in liver allocation acceptable (69.2%) and would not be less likely to donate their organs if AI was used in allocation (72.7%). Respondents thought AI was more likely to be consistent and less biased compared to humans, although were concerned about the “dehumanisation of healthcare” and whether AI could consider important nuances in allocation decisions. Participants valued accuracy, impartiality, and consistency in a decision-maker, more than interpretability and empathy. Respondents were split on whether AI should be trained on previous decisions or programmed with specific objectives. Whether allocation decisions were made by transplant committee or AI, participants valued consideration of urgency, survival likelihood, life years gained, age, future medication compliance, quality of life, future alcohol use and past alcohol use. On the other hand, the majority thought the following factors were not relevant to prioritisation: past crime, future crime, future societal contribution, social disadvantage, and gender. Conclusions: There are good reasons to use AI in liver allocation, and our sample of participants appeared to support its use. If confirmed, this support would give democratic legitimacy to the use of AI in this context and reduce the risk that donation rates could be affected negatively. Our findings on specific ethical concerns also identify potential expectations and reservations laypeople have regarding AI in this area, which can inform how AI in liver allocation could be best implemented.

The demands of morality can seem straightforward. Be kind to others. Do not lie. Do not murder. But moral life is not so simple. We are often confronted with difficult situations in which someone is going to get hurt no matter what we do, in which we cannot meet all of our obligations, in which loyalties come into conflict, in which we cannot help everyone who needs it, or in which we must compromise on important values. It is natural to describe such situations as moral dilemmas. This chapter is about the psychology of how we represent, process, and make decisions about what to do when moral life is difficult in this way. Our first aim is to provide some conceptual clarity on what exactly turns a choice situation into a moral dilemma. Here, we propose a normative account of moral dilemmas in terms of moral appropriate feelings of conflict in response to strongly conflicting reasons. Our second aim is to critically survey existing psychological work, providing an overview of some important findings, while raising questions for future research.

This entry summarizes an emerging subdiscipline of both empirical bioethics and experimental philosophy (“x-phi”) which has variously been referred to as experimental philosophical bioethics, experimental bioethics, or simply “bioxphi”. Like empirical bioethics, bioxphi uses data-driven research methods to capture what various stakeholders think (feel, judge, etc.) about moral issues of relevance to bioethics. However, like its other parent discipline of x-phi, bioxphi tends to favor experiment-based designs drawn from the cognitive sciences – including psychology, neuroscience, and behavioral economics – to tease out why and how stakeholders think as they do.

Why do we find agents less blameworthy when they face mitigating circumstances, and what does this show about philosophical theories of moral responsibility? We present novel evidence that the tendency to mitigate the blameworthiness of agents is driven both by the perception that they are less normatively competent—in particular, less able to know that what they are doing is wrong—and by the perception that their behavior is less attributable to their deep selves. Consequently, we argue that philosophers cannot rely on the case strategy to support the Normative Competence theory of moral responsibility over the Deep Self theory. However, we also outline ways in which further empirical and philosophical work would shift the debate, by showing that there is a significant departure between ordinary concepts and corresponding philosophical concepts, or by focusing on a different type of coherence with ordinary judgments.

Consent governs innumerable everyday social interactions, including sex, medical exams, the use of property, and economic transactions. Yet little is known about how ordinary people reason about the validity of consent. Across the domains of sex, medicine, and police entry, Study 1 showed that when agents lack autonomous decision-making capacities, participants are less likely to view their consent as valid; however, failing to exercise this capacity and deciding in a nonautonomous way did not reduce consent judgments. Study 2 found that specific and concrete incapacities reduced judgments of valid consent, but failing to exercise these specific capacities did not, even when the consenter makes an irrational and inauthentic decision. Finally, Study 3 showed that the effect of autonomy on judgments of valid consent carries important downstream consequences for moral reasoning about the rights and obligations of third parties, even when the consented-to action is morally wrong. Overall, these findings suggest that laypeople embrace a normative, domain-general concept of valid consent that depends consistently on the possession of autonomous capacities, but not on the exercise of these capacities. Autonomous decisions and autonomous capacities thus play divergent roles in moral reasoning about consent interactions: while the former appears relevant for assessing the wrongfulness of consented-to acts, the latter plays a role in whether consent is regarded as authoritative and therefore as transforming moral rights.

I address Sinnott-Armstrong's argument that evidence of framing effects in moral psychology shows that moral intuitions are unreliable and therefore not noninferentially justified. I begin by discussing what it is to be epistemically unreliable and clarify how framing effects render moral intuitions unreliable. This analysis calls for a modification of Sinnott-Armstrong's argument if it is to remain valid. In particular, he must claim that framing is sufficiently likely to determine the content of moral intuitions. I then re-examine the evidence which is supposed to support this claim. In doing so, I provide a novel suggestion for how to analyze the reliability of intuitions in empirical studies. Analysis of the evidence suggests that moral intuitions subject to framing effects are in fact much more reliable than perhaps was thought, and that Sinnott-Armstrong has not succeeded in showing that noninferential justification has been defeated.