ArticlePDF Available

Abstract

There is a rich tradition in bioethics of gathering empirical data to inform, supplement, or test the implications of normative ethical analysis. To this end, bioethicists have drawn on diverse methods, including qualitative interviews, focus groups, ethnographic studies, and opinion surveys to advance understanding of key issues in bioethics. In so doing, they have developed strong ties with neighboring disciplines such as anthropology, history, law, and sociology. Collectively, these lines of research have flourished in the broader field of “empirical bioethics” for more than 30 years (Sugarman & Sulmasy 2010). More recently, philosophers from outside the field of bioethics have similarly employed empirical methods—drawn primarily from psychology, the cognitive sciences, economics, and related disciplines—to advance theoretical debates. This approach, which has come to be called experimental philosophy (or x-phi), relies primarily on controlled experiments to interrogate the concepts, intuitions, reasoning, implicit mental processes, and empirical assumptions about the mind that play a role in traditional philosophical arguments (Knobe et al. 2012). Within the moral domain, for example, experimental philosophy has begun to contribute to long-standing debates about the nature of moral judgment and reasoning; the sources of our moral emotions and biases; the qualities of a good person or a good life; and the psychological basis of moral theory itself (Alfano, Loeb, & Plakias 2018). We believe that experimental philosophical bioethics—or “bioxphi”—can similarly contribute to bioethical scholarship and debate. Here, we introduce this emerging discipline, explain how it is distinct from empirical bioethics more broadly construed, and attempt to characterize how it might advance theory and practice in this area.
1
Experimental Philosophical Bioethics
Brian D. Earp (a,b,c,d), Joanna Demaree-Cotton (a), Michael Dunn (e), Vilius Dranseika
(f,g), Jim A. C. Everett (d,h), Adam Feltz (i), Gail Geller (j), Ivar R. Hannikainen (k), Lynn
A. Jansen (l), Joshua Knobe (a,b), Julia Kolak (m), Stephen Latham (n), Adam Lerner (o),
Joshua May (p), Mark Mercurio (q), Emilian Mihailov (r,s), David Rodríguez-Arias (t),
Blanca Rodríguez López (u), Julian Savulescu (d), Mark Sheehan (e), Nina Strohminger (v),
Jeremy Sugarman (j), Kathryn Tabb (w), Kevin Tobia (a,x)
a. Department of Philosophy, Yale University, New Haven, Connecticut, USA
b. Department of Psychology, Yale University, New Haven, Connecticut, USA
c. Yale-Hastings Program in Ethics and Health Policy, The Hastings Center, Garrison, New York, USA
d. Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
e. Ethox Centre, University of Oxford, Oxford, UK
f. Institute of Philosophy, Vilnius University, Vilnius, Lithuania
g. Faculty of Social Sciences, Arts and Humanities, Kaunas University of Technology, Kaunas, Lithuania
h. School of Psychology, University of Kent, Canterbury, UK
i. Department of Psychology, University of Oklahoma, Norman, Oklahoma, USA
j. Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland, USA
k. Department of Law, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
l. Center for Ethics, Oregon Health and Sciences University, Portland, Oregon, USA
m. Department of Philosophy, The Graduate Center, CUNY, New York, New York, USA
n. Interdisciplinary Center for Bioethics, Yale University, New Haven, Connecticut, USA
o. Center for Bioethics, New York University, New York, USA
p. Department of Philosophy, University of Alabama at Birmingham, Alabama, USA
q. Program for Biomedical Ethics, Yale Medical School, Yale University, New Haven, Connecticut, USA
r. Faculty of Philosophy, University of Bucharest, Bucharest, Romania
s. Institute of Biomedical Ethics, University of Basel, Basel, Switzerland
t. Facultad de Filosofía, Universidad de Granada, Granada, Spain
u. Facultad de Filosofía, Universidad Complutense de Madrid, Madrid, Spain
v. Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania, USA
w. Department of Philosophy, Bard College, New York, USA
x. Yale Law School, Yale University, New Haven, Connecticut, USA
Key words: empirical bioethics, experimental bioethics,
experimental philosophy, bioxphi
This is the authors’ copy of an published manuscript. It may be cited as:
Earp, B. D., Demaree-Cotton, J., Dunn, M., Dranseika, V., Everett, J. A. C., Feltz, A., Geller, G., Hannikainen, I.
R., Jansen, L., Knobe, J., Kolak, J., Latham, S., Lerner, A., May, J., Mercurio, M., Mihailov, E., Rodriguez-Arias,
D., Rodriguez Lopez, B., Savulescu, J., Sheehan, M., Strohminger, N., Sugarman, J., Tabb, K., & Tobia, K.
(2020). Experimental philosophical bioethics. AJOB Empirical Bioethics, 11(1), 30-33.
2
Introduction
There is a rich tradition in bioethics of gathering empirical data to inform, supplement, or test
the implications of normative ethical analysis. To this end, bioethicists have drawn on diverse
methods, including qualitative interviews, focus groups, ethnographic studies, and opinion
surveys to advance understanding of key issues in bioethics. In so doing, they have developed
strong ties with neighboring disciplines such as anthropology, history, law, and sociology.
Collectively, these lines of research have flourished in the broader field of “empirical
bioethics” for more than 30 years (Sugarman & Sulmasy 2010).
More recently, philosophers from outside the field of bioethics have similarly employed
empirical methods—drawn primarily from psychology, the cognitive sciences, economics,
and related disciplines—to advance theoretical debates. This approach, which has come to be
called experimental philosophy (or x-phi), relies primarily on controlled experiments to
interrogate the concepts, intuitions, reasoning, implicit mental processes, and empirical
assumptions about the mind that play a role in traditional philosophical arguments (Knobe et
al. 2012). Within the moral domain, for example, experimental philosophy has begun to
contribute to long-standing debates about the nature of moral judgment and reasoning; the
sources of our moral emotions and biases; the qualities of a good person or a good life; and
the psychological basis of moral theory itself (Alfano, Loeb, & Plakias 2018).
We believe that experimental philosophical bioethics—or “bioxphi”—can similarly
contribute to bioethical scholarship and debate.
1
Here, we introduce this emerging discipline,
explain how it is distinct from empirical bioethics more broadly construed, and attempt to
characterize how it might advance theory and practice in this area.
1
On October 4th and 5th, 2019, an international, interdisciplinary workshop on “experimental
philosophical bioethics” was held at Yale University. One aim of the workshop was to produce a short
position statement outlining the distinctive features of this emerging field (the meeting schedule and
presentation abstracts showing representative new work are available at www.bioxphi.org). We are
the workshop organizers and presenters, including experimental philosophers and moral psychologists
engaged in research on bioethical topics, and (empirical) bioethicists interested in experimental
philosophy and moral psychology. Some of the material in this statement has been adapted from Earp,
B. D. (2019, August 2). Introducing bioxphi. The New Experimental Philosophy Blog, available at
https://xphiblog.com/introducing-bioxphi/.
3
What is experimental philosophical bioethics?
In simplest terms, bioxphi is experimental moral philosophy as applied to topics in bioethics.
It is thus a species of experimental philosophy. It is also a species of empirical bioethics: one
which relies primarily on controlled experiments rather than descriptive studies to make
sense of normatively charged phenomena of interest to bioethicists, with the aim of
contributing to associated substantive debates. In this way, bioxphi aims not only to establish
what people believe about matters of bioethical concern (for example, how various opinions,
attitudes, or preferences are distributed in the general population or among specific
stakeholders), but to uncover and explain why or how people arrive at certain normative
beliefs, judgments, or decisions, largely by probing the relevant situational factors and
proximate psychological mechanisms.
For example, what do ordinary people take informed consent to require—and what cognitive
processes and contextual cues contribute to judgments about whether such consent has in fact
been given (Sommers forthcoming)? How do doctors determine what constitutes a harm or
benefit when conflicting values are at stake, and what factors affect the weights they assign to
each in terms of magnitude or importance (Earp and Shaw 2017)? When policymakers decide
about fair distribution of resources, what shapes their intuitions about what justice demands?
And how do proxy decision-makers characterize respect for persons in the face of contested
intuitions about personhood, as in cases of fetuses or individuals with advanced dementia?
By attempting to empirically address these and other similar questions, the long-term goal of
bioxphi is to build cumulative, explanatory models of moral attitudes and behavior as these
relate to bioethical issues, ideally grounded in nuanced, real-life examples. Insofar as
abstract, theoretical principles or normative arguments emerge from bioxphi, they will
hopefully be enriched by having been formulated or tested in a manner that takes into account
the moral psychology of ordinary people.
Some illustrative examples
A common method in experimental philosophy is the so-called contrastive vignette technique
(CVT), wherein certain stimuli or aspects of a situation are systematically manipulated to
identify the particular factors and processes that shape moral concepts, intuitions, judgments,
and decisions (Reiner 2019). Here, we share some illustrative examples of this technique in
bioxphi, leaving questions about potential normative implications to the following section.
4
Consider an early bioxphi study by Jansen, Fogel, and Brubaker (2013). They asked a group
of physicians to judge the intentions of a doctor who, depending on the experimental
condition, was described as bringing about either a harmful or a helpful patient outcome as a
consequence of enrolling them in a pharmaceutical trial. Consistent with classic work on the
“side-effect effect” in experimental philosophy (Knobe 2003), participants judged the doctor
to have behaved more intentionally with respect to the outcome when patients were harmed
than when they were helped as a side-effect of participating in the study.
More recently, Earp and colleagues (2019) used the CVT to study folk intuitions about
perceived discontinuity in personal identity as a consequence of addiction. In this study, the
characteristics of an agent and their drug of addiction were systematically manipulated across
a set of vignettes. Participants were then asked to judge the extent to which the addicted agent
was the “same person as” the agent prior to addiction. The researchers found that becoming
addicted to a drug can lead to the strong impression that one is not the same person as before,
and that this perception may be driven by perceived negative changes in the drug user’s
moral character. This work builds on previous studies exploring the intuitive basis for
judgments about altered identity in the context of neurodegeneration (Strohminger &
Nichols, 2014; Tobia, 2016). Such studies in turn may be relevant to debates about, for
example, the validity of advance directives.
As a final example, Mihailov, Hannikainen and Rodríguez López (under review) described a
series of agents who take cognitive enhancing medications while engaged in various
competitive and non-competitive activities. Through the combined effects of effort and
enhancement, each agent succeeds in their activity. Even though procedural fairness was
stipulated across all cases, only participants who scored high on a baseline psychological
measure of personal investment in fairness attributed the agent’s success more to the “pill”
than to “skill” and judged the enhancement to be impermissible. These findings might
suggest that concerns about fairness in the cognitive enhancement debate could depend in
part upon the psychological attributes of the debater.
Normative implications
Given that bioxophi—in contrast to, say, moral psychology—is situated within bioethics, one
might ask whether or how the descriptive empirical evidence generated by bioxphi studies
5
can help in drawing normative moral conclusions. Within the broader field of empirical
bioethics, a large number of complex methods have been employed toward this end. These
include normative-empirical reflective equilibrium, grounded moral analysis, reflexive
balancing (Davies, Ives, and Dunn 2015) and practical reflective equilibrium (Savulescu,
Kahane and Gyngell 2019).
Such strategies often take the context-specific moral judgments of stakeholders at face value
to shape normative arguments or inform the future development of practice. A different
approach, based on insights from experimental philosophy, is to trace the underlying sources
of such moral judgments, treating them as objects of investigation in their own right.
Depending on what is discovered about the situational factors or psychological processes
involved in producing such judgments, their role in a given normative argument might be
affirmed or called into question.
In debates about palliative care for terminally ill patients, for example, it is sometimes argued
that a high dose of pain medication that will foreseeably cause the patient’s death may
nevertheless permissibly be administered if the doctor’s intention is to relieve suffering, but
not if their intention is to cause death. Yet if judgments about what a doctor actually intended
may be influenced by such factors as whether their actions led to a positive or negative
outcome—as the study by Jansen et al. (2013) described earlier seems to suggest—this may
require fresh thinking about how to determine whether such actions are indeed permissible on
standard models.
As another example, consider that a recurring objection to cognitive bioenhancement is that it
is, in one way or another, unfair. In the previously mentioned study by Mihailov et al. (under
review), it turned out that judgments about fairness were strongly influenced by participants’
individual psychological attributes, even when procedural fairness was explicitly not at issue
in the vignettes used. One might think, then, that the normative force of such judgments, at
least when procedural fairness has been accounted for, may deserve a more skeptical look in
the context of objections to cognitive bioenhancement.
In essence, the approach we are describing asks whether a given influence debunks or
vindicates the relevant judgments, or their role in a normative argument (Kumar & May
2019). Consider the following simplified schema for such debunking (or vindicating):
6
1. Moral judgment M is mainly influenced by factor/process F/P. [empirical
premise]
2. F/P is an unreliable (reliable) or morally irrelevant (relevant) factor/process.
[normative premise]
3. So, moral judgment M is unjustified (vindicated/not defeated).
Such a schema makes clear that a normative premise is still required to reach a normative
conclusion. Yet experimental results derived from bioxphi studies, we claim, can provide
crucial support for the empirical premise.
Concluding thoughts
A flourishing bioxphi movement envisages empirically-oriented philosophers and ethicists
and normatively-minded clinicians and cognitive scientists coming together to study deep
questions in bioethics. This is at heart, then, a collaborative project, which aims to integrate
experimental study and normative analysis. In particular, the experimental approach can
illuminate factors and processes underlying real-life bioethical judgments, which can in turn
be assessed for their normative significance. By helping us understand why and how people
make certain moral judgments, bioxphi aims to encourage a new perspective on traditional
bioethical questions, affecting how these questions are studied, taught, and perhaps
ultimately, addressed in public policy.
7
References
Alfano, M., Loeb, D. and Plakias, A. (2018). Experimental moral philosophy. In E. N. Zalta
(ed.)., The Stanford Encyclopedia of Philosophy.
https://plato.stanford.edu/archives/win2018/entries/experimental-moral/
Davies, R., Ives, J., & Dunn, M. (2015). A systematic review of empirical bioethics
methodologies. BMC Medical Ethics, 16(15), 1-13.
Earp, B. D., Skorburg, J. A., Everett, J. A., & Savulescu, J. (2019). Addiction, identity,
morality. AJOB Empirical Bioethics, 10(2), 136-153.
Earp, B. D., & Shaw, D. M. (2017). Cultural bias in American medicine: the case of infant
male circumcision. Journal of Pediatric Ethics, 1(1), 8-26.
Jansen, L. A., Fogel, J. S., & Brubaker, M. (2013). Experimental philosophy, clinical
intentions, and evaluative judgment. Cambridge Quarterly of Healthcare Ethics, 22(2), 126-
135.
Knobe, J. (2003). Intentional action and side-effects in ordinary language. Analysis 63, 190-
194.
Knobe, J., Buckwalter, W., Nichols, S., Robbins, P., Sarkissian, H., & Sommers, T. (2012).
Experimental philosophy. Annual Review of Psychology, 63, 81-99.
Kumar, V., & May, J. (2019). How to debunk moral beliefs. In J. Suikkanen & A. Kauppinen
(eds.), Methodology and Moral Philosophy (pp. 25–48). New York: Routledge.
Reiner, P. B. (2019). Experimental neuroethics. In S. Nagel (ed.) Shaping Children (pp. 75-
83), Cham, Switzerland: Springer.
Savulescu, J., Kahane, G., & Gyngell, C. (2019). From public preferences to ethical policy.
Nature Human Behaviour, published online, August 26, 1-3. https://doi.org/10.1038/s41562-
019-0711-6.
Sommers, R. (forthcoming). Commonsense consent. Yale Law Journal, forthcoming.
Available at http://dx.doi.org/10.2139/ssrn.2761801
Strohminger, N., & Nichols, S. (2015). Neurodegeneration and identity. Psychological
Science, 26(9), 1469-1479.
Sugarman, J., & Sulmasy, D. P. (Eds.). (2010). Methods in Medical Ethics. Georgetown:
Georgetown University Press.
Tobia, K. P. (2016). Personal identity, direction of change, and neuroethics. Neuroethics,
9(1), 37-43.
... For instance, descriptive ethics studies explore stakeholders' responses to bioethical questions and try explain how people arrive at certain moral opinions Open Access *Correspondence: emilian.mihailov@filosofie.unibuc.ro and reasoning patterns [13][14][15][16][17][18][19][20][21][22]. Empirical research can investigate whether people and healthcare professionals comply with ethical guidelines and how ethical solutions are translated into practice [13-15, 18, 23-29]. ...
... All participants accepted the lowest ambitious objective: identification of ethical issues in practice. It was not viewed as an important objective mainly because empirical research was assumed to be hypothesis driven, in line with experimental strands of empirical bioethics [16,19,21]. Therefore, this objective was not considered a driving force of empirical research. ...
... At the same time, debates in bioethics often involve controversies about how to define concepts, what concepts are relevant or appropriate [57][58][59], and for that identifying theoretical issues is also needed. Empirical work on theoretical goals is increasingly being carried out in the field of experimental philosophy (x-phi) and experimental bioethics (bio-xphi) [19,20,[60][61][62][63][64]. Drawing on x-phi and bio-xphi literature, there are pleas to use of empirical methods to inform our understanding of concepts like health and disease [65,66]. ...
Article
Full-text available
Background: This is the first qualitative study to investigate how researchers, who do empirical work in bioethics, relate to objectives of empirical research in bioethics (ERiB). We explore reasons that make some objectives more acceptable, while others are deemed less acceptable. Methods: Using qualitative exploratory study design, we interviewed bioethics researchers, who were selected to represent different types of scholars working in the field. The interview data of 25 participants were analyzed in this paper using thematic analysis. Results: From the eight objectives presented to the study participants, understanding the context of a bioethical issue and identifying ethical issues in practice received unanimous agreement. Participants also supported other objectives of ERiB but with varying degrees of agreement. The most contested objectives were striving to draw normative recommendations and developing and justifying moral principles. The is-ought gap was not considered an obstacle to ERiB, but rather a warning sign to critically reflect on the normative implications of empirical results. Conclusions: Our results show that the most contested objectives are also the more ambitious ones, whereas the least contested ones focus on producing empirical results. The potential of empirical research to be useful for bioethics was mostly based on the reasoning pattern that empirical data can provide a testing ground for elements of normative theory. Even though empirical research can inform many parts of bioethical inquiry, normative expertise is recommended to guide ERiB. The acceptability of ambitious objectives for ERiB boils down to finding firm ground for the integration of empirical facts in normative inquiry.
... Though, somewhat surprisingly, the authors do not discuss their work in the context of the growing field of experimental bioethics (see Earp, et al. 2020;Mihailov et al. 2021), we see this work as a welcome sign that the neuroethics community is embracing the experimental philosophy or "x-phi" movement, as envisioned by Reiner (2019) when he coined the term "experimental neuroethics". In part, this positive uptake by neuroethicists of the quantitative tools of experimental philosophy can be explained by the distinctive status of bioethics within philosophy . ...
... Nevertheless, there have been several criticisms brought forward against experimental philosophy within the more traditional philosophical fields, and it is worth examining whether these criticisms may also apply in the case of experimental neuroethics. The two primary critiques of experimental philosophy are: (i) that the field only describes how ordinary people think about philosophical concepts, and (ii) that such descriptive work cannot be used to make normative assessments (see Earp, et al 2020;Veit forthcoming). The challenge can be reformulated as follows: even if it is true that experimental philosophy succeeds at giving us accurate data about the philosophical intuitions and values of the public, why should such data be considered relevant to the work of philosophers (or in our case, neuroethicists)? ...
Article
Full-text available
In recent years we have seen an explosion of scholarship within the field of neuroethics – a subdiscipline of bioethics concerned with the ethical challenges raised by advances in neuroscience and the development of new neurotechnologies. While some, such as Parens and Johnston (2007), have challenged the idea that neuroethics is a unique sub-discipline with its own special problems, we see neuroethics as made importantly distinct from the general questions of bioethics through the complex relationship of our brains to our personal identity, making us who we are. New neurotechnologies can thus not only substantially improve wellbeing, but radically change our cognitive limitations and even our personalities themselves. It is therefore unsurprising that much of neuroethics is concerned with determining the ethical challenges new technologies raise for considerations such as autonomy, privacy, and equality, and how to weigh these against one another.
... In closing, we would like to draw on two examples from the published literature, which serve as a template for what an exercise in empirically-informed normative ethics could entail. These studies-which belong to a growing body of research in Experimental philosophical bioethics (Earp et al. 2020(Earp et al. , 2021)-blur the traditional distinction between descriptive and normative bioethics. They raise questions in normative bioethics, whether theoretical ("How should we 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 distinguish between killing and letting die?") or practical ("Does the irreversible cessation of an individual's brain function mark their death?"); ...
... However, as the fields of psychology, neuroscience, and social sciences have enjoyed substantial methodological advancements and experimentation -including digital games and virtual realities (Lange and Pauli 2019),empirical bioethics has largely stayed within the safe fold of traditional methods: surveys, interviews, vignettes and case studies. While such methods are sufficient for many research purposes, in other cases the research questions and researchers' epistemological and theoretical commitments require methods typically outside of this range (Earp et al. 2020;Pavarini et al. 2021). ...
Article
Full-text available
Background Over the last decades, the neurosciences, behavioral sciences, and the social sciences have all seen a rapid development of innovative research methods. The field of bioethics, however, has trailed behind in methodological innovation. Despite the so-called “empirical turn” in bioethics, research methodology for project development, data collection and analysis, and dissemination has remained largely restricted to surveys, interviews, and research papers. We have previously argued for a “Design Bioethics” approach to empirical bioethics methodology, which develops purpose-built methods for investigation of bioethical concerns. In this paper we compare a research tool created using a design bioethics approach to a “methods-as-usual” approach in empirical bioethics. Methods Our study compared dimensions of engagement with a digital game we created, called “Tracing Tomorrow,” to a standard vignette survey. The two tools investigated the same subject matter, digital phenotyping for mental health, in a sample of 301 UK adolescents. Results Participants who played the game reported a greater sense of presence, emotional engagement, cognitive absorption, and mental health ethics insight, compared to participants who completed the vignette survey. Perceived authenticity and curiosity/motivation to learn more was equivalent for both methods. Conclusion The results of this study highlights the importance of purpose-built methodology for empirical bioethics research.
Chapter
Full-text available
This chapter summarizes an emerging sub-discipline of both empirical bioethics and experimental philosophy (“x-phi”) which has variously been referred to as experimental philosophical bioethics, experimental bioethics, or simply “bioxphi” (Earp, Latham and Tobia, 2020; Earp et al., 2020; Lewis, 2020; Mihailov, Hannikainen and Earp, 2021). 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 (Knobe, 2016)—including psychology, neuroscience, and behavioral economics—to tease out why and how stakeholders think as they do.
Chapter
Full-text available
The question of what makes someone the same person through time and change has long been a preoccupation of philosophers. In recent years, the question of what makes ordinary or lay people judge that someone is—or isn’t—the same person has caught the interest of experimental psychologists. These latter, empirically oriented researchers have sought to understand the cognitive processes and eliciting factors that shape ordinary people’s judgments about personal identity and the self. Still more recently, practitioners within an emerging discipline, experimental philosophical bioethics or “bioxphi”—the focus of this chapter—have adopted a similar aim and employed similar methodologies, but with two distinctive features: (a) a special concern for enhanced ecological validity in the examples and populations studied; and (b) an interest in contributing to substantive normative debates within the wider field of bioethics. Our aim in this chapter is to sample illustrative work on personal identity in bioxphi, explore how it relates to studies in psychology covering similar terrain, and draw out the implications of this work for matters of bioethical concern. In pursuing these issues, we highlight recent work in bioxphi that includes the perceived validity of advance directives following neurodegeneration, the right of psychologically altered study participants to withdraw from research, how drug addiction may cause one to be regarded by others as “a completely different person,” the effect of deep-brain stimulation on perceptions of the self, and the potential influence of moral enhancement interventions on intuitive impressions of a person’s character.
Article
Full-text available
In the present chapter, we seek to better understand how laypeople reason about the “true self" of a person with advancing dementia. We are also interested in how such reasoning bears on laypeople’s views about the validity or invalidity of an advance directive (AD) regarding that person’s treatment. Toward that end, we will report the results of two empirical studies we undertook to gain insights into this relationship: namely, between judgments about the true self and whether to follow an AD. To justify our empirical approach, we draw on arguments from the emerging literature on experimental philosophical bioethics, also known experimental bioethics or simply “bioxphi” (Earp, 2019; Lewis, 2020; Mihailov et al., 2021). Bioxphi describes an approach to normative theorizing in bioethics that employs evidence about laypeople’s moral judgments as derived from psychological experiments. In a recent publication, we proposed several means of drawing substantive normative conclusions from argumentative premises that include such evidence (see Earp et al., 2021). We will rehearse some of those proposals in a later section, where we explore potential implications of our findings for competing normative positions in the debate about advanced directives.
Article
There is an emerging experimental trend in bioethics and neuroethics. We briefly review several topics in this trend and discuss how the existing and future studies can have normative implications related to bioethical/neuroethical issues. Particularly, we consider three major ways to draw such implications; (1) contributing to conceptual analysis and philosophical (counter-)evidence, (2) figuring out the unreliability of moral thinking and thereby providing a debunking argument, and (3) estimating the feasibility of ethical norms and policies.
Experiment Findings
Full-text available
Article
Full-text available
Background: Recent literature on addiction and judgments about the characteristics of agents has focused on the implications of adopting a "brain disease" versus "moral weakness" model of addiction. Typically, such judgments have to do with what capacities an agent has (e.g., the ability to abstain from substance use). Much less work, however, has been conducted on the relationship between addiction and judgments about an agent's identity, including whether or to what extent an individual is seen as the same person after becoming addicted. Methods: We conducted a series of vignette-based experiments (total N = 3,620) to assess lay attitudes concerning addiction and identity persistence, systematically manipulating key characteristics of agents and their drug of addiction. Conclusions: In Study 1, we found that U.S. participants judged an agent who became addicted to drugs as being closer to "a completely different person" than "completely the same person" as the agent who existed prior to the addiction. In Studies 2-6, we investigated the intuitive basis for this result, finding that lay judgments of altered identity as a consequence of drug use and addiction are driven primarily by perceived negative changes in the moral character of drug users, who are seen as having deviated from their good true selves.
Chapter
Full-text available
Arguments attempting to debunk moral beliefs, by showing they are unjustified, have tended to be global, targeting all moral beliefs or a large set of them. Popular debunking arguments point to various factors purportedly influencing moral beliefs, from evolutionary pressures, to automatic and emotionally-driven processes, to framing effects. We show that these sweeping arguments face a debunker's dilemma: either the relevant factor is not a main basis for belief or it does not render the relevant beliefs unjustified. Empirical debunking arguments in ethics can avoid this predicament, but only if they are refocused on highly selective classes of moral belief. Experimental data can combine with familiar consistency reasoning to reveal that like cases are not being treated alike. Selective debunking arguments are unlikely to yield sweeping sceptical conclusions, but they can lead to rational moral change.
Article
Full-text available
In 2012 the American Academy of Pediatrics (AAP) released a policy statement and technical report stating that the health benefits of newborn male circumcision outweigh the risks. In response, a group of mostly European doctors suggested that this conclusion may have been due to cultural bias among the AAP Task Force on Circumcision, since their conclusion differed from that of international peer organizations despite relying on a similar evidence base. In this article, we evaluate the charge of cultural bias as well as the response to it by the AAP Task Force. Along the way, we discuss ongoing disagreements about the ethical status of nontherapeutic infant male circumcision, and draw some more general lessons about the problem of cultural bias in medicine.
Article
Full-text available
The personal identity relation is of great interest to philosophers, who often consider fictional scenarios to test what features seem to make persons persist through time. But often real examples of neuroscientific interest also provide important tests of personal identity. One such example is the case of Phineas Gage – or at least the story often told about Phineas Gage. Many cite Gage’s story as example of severed personal identity; Phineas underwent such a tremendous change that Gage “survived as a different man.” I discuss a recent empirical finding about judgments about this hypothetical. It is not just the magnitude of the change that affects identity judgment; it is also the negative direction of the change. I present an experiment suggesting that direction of change (improvement or deterioration) also affects neuroethical judgments. I conclude we should consider carefully the way in which improvements and deteriorations affect attributions of personal identity. This is particularly important since a number of the most crucial neuroethical decisions involve varieties of cognitive enhancements (improvements) or deteriorations.
Article
Full-text available
Background Despite the increased prevalence of bioethics research that seeks to use empirical data to answer normative research questions, there is no consensus as to what an appropriate methodology for this would be. This review aims to search the literature, present and critically discuss published Empirical Bioethics methodologies. Methods MedLine, Web of Science and Google Scholar were searched between 15/02/12 and 16/06/13 to find relevant papers. These were abstract reviewed independently by two reviewers with papers meeting the inclusion criteria subjected to data extraction. Results 33 publications (32 papers and one book chapter) were included which contained 32 distinct methodologies. The majority of these methodologies (n = 22) can be classed as either dialogical or consultative, and these represent two extreme ‘poles’ of methodological orientation. Consideration of these results provoked three central questions that are central to the planning of an empirical bioethics study, and revolve around how a normative conclusion can be justified, the analytic process through which that conclusion is reached, and the kind of conclusion that is sought. Conclusion When considering which methodology or research methods to adopt in any particular study, researchers need to think carefully about the nature of the claims they wish to generate through their analyses, and how these claims align with the aims of the research. Whilst there are superficial similarities in the ways that identical research methods are made use of, the different meta-ethical and epistemological commitments that undergird the range of methodological approaches adopted rehearse many of the central foundational disagreements that play out within moral philosophy and bioethical analysis more broadly. There is little common ground that transcends these disagreements, and we argue that this is likely to present a challenge for the legitimacy of the bioethical enterprise. We conclude, however, that this heterogeneity ought to be welcomed, but urge those involved in the field to engage meaningfully and explicitly with questions concerning what kinds of moral claim they want to be able to make, about normative justification and the methodological process, and about the coherence of these components within their work.
Article
Studies have provided rich data on global preferences for how autonomous vehicles should act in collisions. We describe a framework for incorporating such preferences in policy. Preferences should inform the design of autonomous vehicles only after being screened for bias and only to the degree to which they match major ethical theories.
Chapter
Ethical discourse draws upon information from various disciplines to promote normative conclusions. In this chapter, we review one particular method—the contrastive vignette technique (CVT)—that has been fruitfully used as a quantitative means of exploring public attitudes towards ethically challenging issues. The chapter serves as a practical guide to the design and use of CVT in neuroethical inquiry, a technique we term experimental neuroethics.
Article
There is a widespread notion, both within the sciences and among the general public, that mental deterioration can rob individuals of their identity. Yet there have been no systematic investigations of what types of cognitive damage lead people to appear to no longer be themselves. We measured perceived identity change in patients with three kinds of neurodegenerative disease: frontotemporal dementia, Alzheimer's disease, and amyotrophic lateral sclerosis. Structural equation models revealed that injury to the moral faculty plays the primary role in identity discontinuity. Other cognitive deficits, including amnesia, have no measurable impact on identity persistence. Accordingly, frontotemporal dementia has the greatest effect on perceived identity, and amyotrophic lateral sclerosis has the least. We further demonstrated that perceived identity change fully mediates the impact of neurodegenerative disease on relationship deterioration between patient and caregiver. Our results mark a departure from theories that ground personal identity in memory, distinctiveness, dispositional emotion, or global mental function. © The Author(s) 2015.