Shen Pan

This article explores the potential of supported decision-making for helping individuals with intellectual or cognitive disabilities to make value-aligned or authentic decisions with respect to participation in clinical research. We argue that supported decision-making is valuable in this context not merely because it promotes self-determination, but also because it increases the likelihood that individuals’ decisions align with what matters to them. To realize this potential, it is important to recognize and address situations in which individuals with intellectual or cognitive disabilities are at increased risk of making decisions that are contrary to their values. We focus on two such situations in particular: when the individual must integrate multiple, potentially competing values, and when the relevant values are insufficiently specified and require unpacking. These challenges can be met, we propose, by integrating dialectical support — a form of structured, dialogue-based assistance designed to help individuals explore and apply their values — into supported decision-making practices.

One proposed explanation for a particular kind of temporal preference lies in a disparity between the emotional intensity of memory compared to anticipation. According to the memory/anticipation disparity explanation, the utility of anticipation of a particular event if that event is future, whether positive or negative, is greater than the utility of retrospection of that same event if it is past, whether positive or negative, and consequently, overall utility is maximised when we prefer negative events to be located in the past rather than the future, and positive ones in the future rather than the past. To have this preference is to be (at least apparently) future biased. If this explanation is correct, it would tend to confer rational justification upon these preferences. This paper empirically investigates this explanation. Our results suggest that, at most, this explanation might be a partial one of some people’s preferences some of the time, rather than a general explanation of future bias. In turn, this lends some indirect support to a competing explanation that appeals to temporal asymmetries in emotion and attention. Since that explanation would arguably tend not to confer rational justification upon (apparently) future-biased preferences, we argue that our findings provide some reason to be sceptical that these preferences are, in general, rationally justified.

Compared to other forms of memory, episodic memory is commonly viewed as special for being distinctively metarepresentational and, relatedly, uniquely human. There is an inherent ambiguity in these conceptions, however, because “episodic memory” has two closely connected yet subtly distinct uses, one designating the recollective experience and the other designating the underlying neurocognitive system. Since experience and system sit at different levels of theorizing, their disentanglement is not only necessary but also fruitful for generating novel theoretical hypotheses. To show this, I first argue that accepting the phenomenally conscious contents of episodic remembering as metarepresentational does not necessitate a metarepresentational conception of the episodic memory system. In its stead, I sketch an alternative account on which the metarepresentational character of episodic remembering is generated through the interaction of first-order outputs of the episodic memory system with other neurocognitive components of the brain. Complemented with a first-order account of the memory system, the system-experience distinction further supplies a novel understanding of the human uniqueness of episodic recollection, one that is compatible with there being an evolutionarily conserved episodic memory system. Overall, by distinguishing the two equivocal senses of “episodic memory” in our theorizing, we unearth an opportunity to understand how the distinctive phenomenology of our episodic recollection is related to and implemented in the cognitive architecture.