Samuel Director

Josh is a typical 27-year-old in a career that he enjoys and a successful marriage. Josh begins to exhibit the symptoms of a manic episode. He is soon diagnosed with bipolar disorder. While non-manic, Josh’s preferences are typical. While manic, his preferences change dramatically. He quits his job, cheats on his partner, and squanders his savings. These are behaviors that Josh, when non-manic (euthymic), would never agree to. When Josh returns to a euthymic state, he regrets these decisions. Should those close to Josh have prevented him from making these decisions, or does his competence to decide persist despite his acute mania? In this paper, I examine the connections be-tween bipolar disorder and consent. I defend the view that many (although far from all) individuals with bipolar disorder are competent to consent to a wide variety of things when they are in a manic state. This means that mania should not be presumed to undermine competence in clinical settings. I have several goals in this paper. I want to bring philosophy to bear on the connection between consent and bipolar disorder. Additionally, I intend this paper to contribute to the general debate about the conditions of informed consent. Bipolar disorder presents novel challenges to existing conceptions of competence to consent which require stable core of values for an agent to be competent. For example, Buchanan and Brock endorse such a view. In showing that shifting values do not undermine the competence of a person experiencing acute mania, I show that the aforementioned views of competence are false. Overall, this paper makes substantive contributions to the debate about competence to consent and presents the first sustained philosophical treatment of consent among people with bipolar disorder.

Suppose that a patient is receiving treatment options from her doctor. In one case, the doctor says, “the surgery has a 90% survival rate.” Now, suppose the doctor instead said, “the procedure has a 10% mortality rate.” Predictably, the patient is more likely to consent on the first description and more likely to dissent on the second. This is an example of a framing effect. A framing effect occurs when “the description of [logically-equivalent] options in terms of gains (positive frame) rather than losses (negative frame) elicits systematically different choices.” Framing effects are ubiquitous, but they are particularly troublesome in medicine. Many worry that there is tension between valuing informed consent and using framing effects in clinical settings. In this paper, I answer this question: if an individual is subject to a framing effect when she gives her consent, does this undermine the validity of her consent? I argue that framing effects do not undermine consent in general.

Philosophers have become newly interested in the ethics of sex. One promising feature of this new discussion is that it has been broadening our moral lens to include individuals whose sexual interests have historically been denied or ignored. One such group is the elderly. Contrary to popular belief, many elderly people want to have sex and see it as a regular part of their lives. If society harbors ignorance about or prejudice against elderly sexuality, it harbors stronger views against the sexual expression of elderly people with dementia. People with dementia are often prohibited by nursing‐home staff, sometimes in extreme ways, from having sex with their partners. This prohibition is at least partly motivated by the goal of protecting the vulnerable. However, cutting people with dementia off from sex has negative health effects and is a needless restriction of their autonomy. In this article, I argue that the expanding moral lens in sexual ethics should include the sexual expression of elderly individuals with dementia and that their sexual expression should be respected. Specifically, I argue that many people with dementia are competent to consent to sexual activity with their long‐term partners.

In the American medical system, patients do not know the final price of treatment until long after the treatment is given, at which point it is too late to say “no.” I argue that without price disclosure many, perhaps all, tokens of consent in clinical medicine fall below the standard of valid, informed consent. This is a sweeping and broad thesis. The reason for this thesis is surprisingly simple: medical services rarely have prices attached to them that are known to the patient prior to treatment. Yet, for many patients, knowledge of the price is relevant to whether they would give consent. If informed consent requires that patients know all information about their treatment that is relevant to their decision, then consent to a medical intervention in the absence of the price is not informed consent.

One of the lessons of the COVID-19 pandemic is that the lay public relies immensely on the knowledge of public health officials. At every phase of the pandemic, the testimony of public health officials has been crucial for guiding public policy and individual behavior. The reason is simple: public health officials know a lot more than you and I do about public health. As lay people, we rely on experts. This seems straightforward. But the COVID-19 pandemic has shown that public health officials seem undecided as to what, precisely, their role is; are they providing the public information as it presents itself, or are they informing the public in a way that produces a desired or optimal outcome? In this article, I answer the following question: what are public health officials morally obligated to tell the public? As I see it, these are the main options: (1) public health officials should tell the full truth, regardless of outcome; or (2) they should tell partial truths or lies that are aimed to promote a socially optimal outcome. My answer to this question is that public health officials are only allowed to lie under very narrow and rare conditions.

Many people believe that our thoughts can be morally wrong. For example, many regard rape and murder fantasies as morally wrong. In a provocative recent essay, George Sher disagrees with this and argues that “the realm of the purely mental is best regarded as a morality-free zone,” wherein “no thoughts or attitudes are either forbidden or required”. Ultimately, Sher argues that “each person’s subjectivity is a limitless, lawless wild west in which absolutely everything is permitted”. Sher calls this view the Wild West of the Mind. I argue against Sher’s position. In section I, I summarize Sher’s view. In section II, I criticize Sher’s argument for the Wild West of the Mind. In section III, I outline additional objections to Sher’s view.

Individuals suffering from anorexia-nervosa experience dysmorphic perceptions of their body and desire to act on these perceptions by refusing food. In some cases, anorexics want to refuse food to the point of death. In this paper, I answer this question: if an anorexic, A, wants to refuse food when the food would either be life-saving or prevent serious bodily harm, can A’s refusal be valid? I argue that there is compelling reason to think that anorexics can validly refuse food, even in these extreme circumstances

In response to the spread of COVID-19, governments across the world have, with very few exceptions, enacted sweeping restrictive lockdown policies that impede citizens’ freedom to move, work, and assemble. This paper critically responds to the central arguments for restrictive lockdown legislation. We build our critique on the following assumption: public policy that enjoys virtually unanimous support worldwide should be justified by uncontroversial moral principles. We argue that that the virtually unanimous support in favor of restrictive lockdowns is not adequately justified by the arguments given in favor of them. Importantly, this is not to say that states ought not impose restrictive lockdown measures, but rather that the extent of the acceptance of these measures is not proportionate to the strength of the arguments for lockdowns. We begin by exploring the case for restrictive lockdowns. We first argue that several of the principles that are used to justify the lockdowns yield unexpectedly revisionary implications for other political problems that many would be unwilling to accept. We then outline what we consider the strongest argument for a lockdown—namely, that its net welfare benefits are great enough to defeat the moral presumption against restricting citizens’ civil liberties to move, work, and assemble. However, we give a number of reasons for doubting that the lockdown’s net welfare benefits are, in fact, sufficiently high to defeat the presumption against it.

Peter Singer famously argues that speciesism, like racism and sexism, is based on a preju-dice. As Singer argues, since we reject racism and sexism, we must also reject speciesism. Since Singer articulated this line of reasoning, it has become a widespread argument against speciesism. Shelly Kagan has recently critiqued this argument, claiming that one can endorse speciesism with-out doing so on the basis of a prejudice. In this paper, I defend Kagan’s conclusion (that one can endorse speciesism without being prejudiced). However, many philosophers have found Kagan’s argument deeply unsatisfactory; so, I advance an alternative argument, different from Kagan’s, in support of his conclusion. My argument runs as follows: I argue that, if there is epistemic peer dis-agreement about a view, then the parties to this disagreement cannot reasonably label each other as prejudiced in their beliefs about this view. Then, I argue that there is epistemic peer disagreement about the truth of speciesism, from which it follows that the parties to this disagreement cannot rea-sonably label each other as prejudiced. Thus, one can affirm speciesism without being prejudiced. If I am correct that one can affirm speciesism without being prejudiced, then Singer’s argument (that if one rejects racism, one must reject speciesism) is unsound.

Drunken sex is common. Despite how common drunken sex is, we think very uncritically about it. In this paper, I want to examine whether drunk individuals can consent to sex. Specifically, I answer this question: suppose that an individual, D, who is drunk but can still engage in reasoning and communication, agrees to have sex with a sober individual, S; is D’s consent to sex with S morally valid? I will argue that, within a certain range of intoxication, an individual who is drunk can give valid consent to have sex with an individual who is sober.

It seems that intuitions are indispensable in philosophical theorizing. Yet, there is evidence that our intuitions are heavily influenced by biases. This generates a puzzle: we must use our intuitions, but we seemingly cannot fully trust those very intuitions. In this paper, I develop a methodology for philosophical theorizing which attempts to avoid this puzzle. Specifically, I develop and defend a methodology that I call Extra-Wide Reflective Equilibrium. I argue that this method allows us to use intuitions, while also providing a mechanism to check the influence of bias on our intuitions. In section I, defend the claim that intuitions are indispensable in philosophical theorizing. In section II, I outline recent arguments against the reliability of intuitions. In section III, I explain and defend my account of Extra-Wide Reflective Equilibrium.

In this paper, I answer the following question: suppose that two individuals, C and D, have been in a long-term committed relationship, and D now has dementia, while C is competent; if D agrees to have sex with C, is it permissible for C to have sex with D? Ultimately, I defend the view that, under certain conditions, D can give valid consent to sex with C, rendering sex between them permissible. Specifically, I argue there is compelling reason to endorse the following thesis: Prior Consent Thesis: D, when competent, can give valid prior consent to sex with her competent partner (C) that will take place after she has dementia, assuming that D is the same person as she was when she gave prior consent, meaning that, if D, when competent, gave prior consent to sex with C, then C may permissibly have sex with D. In section I, I explain both the background and the existing literature on this issue. In section II, I outline relevant stipulations about the kinds of cases I will be examining. In section III, I defend the Prior Consent Thesis. And, in section IV, I address objections to the Prior Consent Thesis.

In this paper, I examine global public reason as a method of justifying a global state. Ultimately, I conclude that global public reason fails to justify a global state. This is the case, because global public reason faces an unwinnable dilemma. The global public reason theorist must endorse either a hypothetical theory of consent or an actual theory of consent; if she endorses a theory of hypothetical consent, then she fails to justify her principles; and if she endorses a theory of actual consent, her theory will lead to a highly unstable political system. On either side of the dilemma, global public reason faces untenable implications. Although similar criticisms have been advanced against domestic public reason, my argument is not repeating points made before me. My argument is new, in that it raises these objections specifically against global public reason, and in that it shows how, due to increased diversity of belief in the global arena, these problems are more pressing for global public reason than they are for domestic public reason.

In the Laws, Plato argues that the legislator should attempt to persuade people to voluntarily obey the laws. This persuasion is accomplished through use of legislative preludes. Preludes (also called preambles) are short arguments written into the legal code, which precede laws and give reasons to follow them. In this paper, I argue that Plato’s use of persuasive preludes shows that he endorses the core features of a public reason theory of political justification. Many philosophers argue that Plato’s political philosophy is deeply at odds with contemporary liberal political philosophy. While Plato certainly does not affirm (and even rejects) some of the main features of liberalism, if it could be shown that he endorses some account of public reason (which is a liberal idea to its core), this would suggest that there is more in common between Plato and liberalism than many philosophers think. Furthermore, if combined with the work of philosophers, like C.C.W. Taylor, this could form a cumulative case against those who argue that there is little in common between Plato’s political philosophy and liberalism. In short, by showing that Plato endorses the core features of public reason, I endeavor to show that there is more in common between Plato and liberalism than is often thought.

I argue that perfect being theologians cannot endorse the Principle of Alternative Possibilities. On perfect being theology, God is essentially morally perfect, meaning that He always acts in a morally perfect manner. I argue that it is possible that God is faced with a situation in which there is only one morally perfect action, which He must do. If this is true, then God acts without alternative possibilities in this situation. Yet, unless one says that this choice is not free, one must say that God has acted freely without alternative possibilities.