Luke Allen

Philosophers often appeal to Bayesian confirmation theory to render speculative metaphysical arguments more rigorous. But can a probabilistic framework designed for empirical data decide questions of metaphysics? This paper argues that Huemer’s Bayesian “existence → immortality” inference fails on two independent grounds. First, the comparison tacitly shifts the content of the evidence across the competing identity theories: treating “I exist now” as a different event under a restrictive view than under a permissive view. So, the Bayesian evidence is ill-defined. Second, if we hold the evidence fixed as the single indexical proposition E = “I exist now”, the key question is the relative likelihoods of E under each hypothesis. Once standard constraints on background verses evidence and on self-locating information are respected, there is no non-question-begging route to a Bayes factor that favors the permissive view of personal identity. Thus, mere existence does not confirm reincarnation. I remain agnostic on the correct theory of personal identity.

We respond to a Letter to the Editor regarding "Principlism and contemporary ethical considerations for providers of transgender health care." We address criticisms by Castle & Klein (2024) of blatant fatphobia related to the ethical elements concerning BMI restrictions for gender-affirming surgery. Our response corrects several mischaracterizations of the article and clarifies our position. My co-authors and I remain focused on advocating for patient-centered, ethically sound, evidence-based, and equitable healthcare policies.

Background: Transgender health care is a subject of much debate among clinicians, political commentators, and policy-makers. While the World Professional Association of Transgender Health (WPATH) Standards of Care (SOC) establish clinical standards, these standards contain implied ethics but lack explicit focused discussion of ethical considerations in providing care. An ethics chapter in the SOC would enhance clinical guidelines. Aims: We aim to provide a valuable guide for healthcare professionals, and anyone interested in the ethical aspects of clinical support for gender diverse and transgender people of all ages. Recognizing that the WPATH is a global association, we address broad challenges. We offer a reflection on general ethical principles, providing conceptual tools for healthcare providers, patients, and families to navigate the specific challenges they might encounter in transgender health care, in line with WPATH’s worldwide mission and scope. Method: This article employs a descriptive analysis, and our framework of reference is the four principles of biomedical ethics: respect for autonomy, beneficence, nonmaleficence, and justice. Results: The article presents a discussion on the four ethical principles as applied to transgender health care. We address issues such as respect for patient autonomy in decision-making, the role of beneficence and nonmaleficence in clinical interventions, and the importance of justice in equitable treatment and access to care. Some of the ethical concerns we address in this article pertain to the current sociopolitical climate, where there has been increasing legal interference, internationally, for transgender and nonbinary people, particularly youth, seeking medical care. Discussion: We highlight the interplay between ethical principles and clinical practice, underscoring the need for ethical guidance in addressing the diverse challenges faced by healthcare providers and patients in transgender health care. We advocate for continuous refinement of ethical thinking to ensure that transgender health care is not only medically effective but also ethically sound.

In the United States, prohibitionist policies are used as the primary approach to combat the negative effect of substance use on society. An extensive academic literature spanning the disciplines of economics, political science, and multiculturalism documents the great social costs of the United States’ “War on Drugs” both nationally and internationally. These costs come with at best marginal effect on substance abuse and other crimes linked to the drug trade. In many cases, there is a reason to believe that these policies exacerbate the problems they aim to address. This article explores psychologists’ ethical commitments to social change concerning such drug policy, given the field of psychology’s expanding commitment to social justice. We examine arguments regarding the boundaries between psychologists’ personal and professional ethics with regard to political participation. Using drug prohibition as an exemplar, we suggest that many psychologists’ political actions and professional ethics may be misaligned. Ultimately, we conclude that the endorsement of prohibitionist drug policies is in direct conflict with the guiding ethical principles put forth by the American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct.