How Should Free Will Skeptics Pursue Legal Change?
AbstractFree will skepticism is the view that people never truly deserve to be praised, blamed, or punished for what they do. One challenge free will skeptics face is to explain how criminality could be dealt with given their skepticism. This paper critically examines the prospects of implementing legal changes concerning crime and punishment derived from the free will skeptical views developed by Derk Pereboom and Gregg Caruso. One central aspect of the changes their views require is a concern for reducing the severity of current forms of punishment. The paper considers two strategies for pursuing such a reduction. By tak...
Source: Neuroethics - May 30, 2017 Category: Medical Ethics Source Type: research
Deep Brain Stimulation: Inducing Self-Estrangement
AbstractDespite growing evidence that a significant number of patients living with Parkison ’s disease experience neuropsychiatric changes following Deep Brain Stimulation (DBS) treatment, the phenomenon remains poorly understood and largely unexplored in the literature. To shed new light on this phenomenon, we used qualitative methods grounded in phenomenology to conduct in-depth, semi- structured interviews with 17 patients living with Parkinson’s Disease who had undergone DBS. Our study found that patients appear to experience postoperative DBS-induced changes in the form of self-estrangement. Using the insights fro...
Source: Neuroethics - May 20, 2017 Category: Medical Ethics Source Type: research
Q: Is Addiction a Brain Disease or a Moral Failing? A: Neither
This article uses Marc Lewis ’ work as a springboard to discuss the socio-political context of the brain disease model of addiction (BDMA). The claim that promotion of the BDMA is the only way the general public can be persuaded to withhold blame and punishment from addicts is critically examined. After a discussion of public understandings of the disease concept of addiction, it is pointed out that it is possible to develop a scientific account of addiction which is neither a disease nor a moral model but which the public could understand. Evidence is reviewed to suggest that public acceptance of the disease concept is ...
Source: Neuroethics - May 18, 2017 Category: Medical Ethics Source Type: research
Adam Smith ’s Theory of Prudence Updated with Neuroscientific and Behavioral Evidence
This article proposes a philosophical interpretation of these cognitive processes that is elaborated in the updated theory of Adam Smith ’s prudence (UTSP). The UTSP is inspired by Smith’s account of prudence and is in line with the neuroscientific and behavioral studies on OPT, distancing, time discounting as well as risk and loss aversion. The UTSP represents a framework aiming to interpret and connect these cognitive processes and providing a consistent and empirically sound account of a “Smithianly” prudent style of decision-making. The two pillars of the UTSP are the shift of perspective in space and time (fro...
Source: Neuroethics - May 15, 2017 Category: Medical Ethics Source Type: research
Enough Comparing! Addiction is Its own Thing. Reply to Matthews
AbstractBoth Matthews and I see addiction as the outcome of developmental processes that arrive at diverse levels of dysfunction for different individuals at different stages. Matthews characterizes"late-stage" addiction in terms of lost control and extreme automaticity, a degree of dysfunction he calls a"disorder" and compares to another disorder -- depersonalization. I don't mind the label"disorder." Yet addiction is no morelike depersonalization than it is like other conditions, most notably obsessive-compulsive disorder. Automaticity is never pure or total. My dual focus on the phenomenolo...
Source: Neuroethics - May 10, 2017 Category: Medical Ethics Source Type: research
A Morass of Musings on Moralization. Reply to Frank and Nagel
AbstractFrank and Nagel are very interested in the causes and consequences of moralizing about addiction. If addiction is a disease, moralistic concerns are sidelined. If it's a choice, we'd better identify clear reasons to absolve addicts from blame. While these are interesting considerations, they don't have much to do with the model of addiction I put forward in the target article. (Source: Neuroethics)
Source: Neuroethics - May 10, 2017 Category: Medical Ethics Source Type: research
Once More, with Feeling! Reply to Ainslie
AbstractAinslie ’s contribution offers a useful refinement of his powerful model of intertemporal bargaining. However, he focuses mostly on the cognitive mechanisms of choice. I suggest that these interact with emotional, personality, and developmental dynamics that cannot be ignored, either psychologically or ne urally. (Source: Neuroethics)
Source: Neuroethics - May 6, 2017 Category: Medical Ethics Source Type: research
Searching for Norms to Violate. Reply to Henden & amp; Gjelsvik
AbstractAlthough I reject neuronormativity -- an idea central to the Brain Disease Model of Addiction (BDMA) -- Henden and Gjelsvik argue that the disease definition might refer to normativity in nonneural domains. They profess that a cognitive dysfunction (e.g., impaired response inhibition), or a mismatch of evolutionary intentions, could also qualify as norm violations, thus legitimizing the disease label. The need for dividing lines is questioned as well. I rebut these criticisms in turn, but I must admit they are thought provoking. (Source: Neuroethics)
Source: Neuroethics - May 6, 2017 Category: Medical Ethics Source Type: research
Brains are Important Too: Reply to Hall, Carter, and Barnett
AbstractThe authors and I agree on many features of addiction, such as its developmental (versus pathological) nature. But because I rely on much of the same data as the Brain Disease Model of Addiction (BDMA), they seem to conflate my work with that of my opponents. Indeed they are generally skeptical of the use of neuroscientific data to help understand addiction, calling it"immature." Thus my work is also suspect. Hall and colleagues believe that it is impossible to look at neural and social processes at the same time, yet that is exactly what I do. I suggest that interdisciplinary approaches to addiction are ...
Source: Neuroethics - May 5, 2017 Category: Medical Ethics Source Type: research
A Continuum is a Continuum, and Swans are Not Geese. Reply to Fenton & amp; Wiers
AbstractI applaud Fenton and Wiers' attempt to find a demarcation point between cases of addiction that fall within the range of normal function and those that may count as disease. However, I argue that continua don't offer demarcation points, the mechanisms involved are not demonstrably different, and trying to pin down subjectivity doesn't help. (Source: Neuroethics)
Source: Neuroethics - May 5, 2017 Category: Medical Ethics Source Type: research
Neurocentrism and Name-Calling: Let ’s Agree to Agree. Reply to Satel & amp; Lilienfeld
AbstractAlthough these authors sometimes resort to medical terminology, we strongly agree that addiction is not a disease and that the Brain Disease Model of Addiction (BDMA) captures only one part of the story and distorts the big picture. Yet Satel and Lilienfeld continue to conflate a neurobiological model (such as mine) with a disease model. They also complain that my modeling of addiction reveals a hidden “neurocentric” bias, despite my integration of multiple levels of analysis, exactly as they recommend. (Source: Neuroethics)
Source: Neuroethics - May 5, 2017 Category: Medical Ethics Source Type: research
What Evolution Intended? Reply to Wakefield
AbstractWakefield doesn't mind my focus on parallels between addiction and love. But love can fall outside the bounds of what evolution intended. So, he claims, comparing addiction with love does not preclude a naturally defined"disorder." I counter with the argument that evolution handed us such highly general response systems, the bounds of normality cannot be defined. (Source: Neuroethics)
Source: Neuroethics - May 5, 2017 Category: Medical Ethics Source Type: research
Resetting the Brain as Well as the Nomenclature. Reply to Szalavitz
AbstractSzalavitz ’s model and mine share a good many components. Foremost among them is the conviction that addiction is a developmental trajectory, not a disease. Szalavitz is correct that we should consider controlled substance use an acceptable outcome, though I would like her to shift her terminology away from the medical mainstream. Finally, I suggest that Szalavitz's important idea of a"reset" in brain development might best be addressed by the notion of kindling. (Source: Neuroethics)
Source: Neuroethics - May 5, 2017 Category: Medical Ethics Source Type: research
No Need for the Disease Label: Choice is Complicated. Reply to Heather
AbstractDespite its historical contribution, Heather sees the Brain Disease Model of Addiction (BDMA) as failing to relieve stigma, increasing fatalism, and fundamentally wrong. He also sees “choice” as partly volitional and partly unconscious, implying no moral violation. I agree on all counts. Heather then presents a disorder-of-choice (DOC) model of addiction, highlighting the failure of self-regulation with respect to immediate goals. Not only do I endorse such modeling, but the neural mechanisms I describe may help to explicate it more thoroughly. (Source: Neuroethics)
Source: Neuroethics - May 4, 2017 Category: Medical Ethics Source Type: research
Self-Efficacy: Now You See It, Now You Don ’t. Reply to Snoek
AbstractSnoek, like other commentators, conflates some of my neural claims with those of the Brain Disease Model of Addiction (BDMA). But she sees other details of my modeling with precision and depth. I welcome her emphasis on individual and developmental differences in addicts' capacity to recognize and deploy their personal agency. In fact we agree thatbelief in personal agency is a critical first step to cultivating it. Yet I wish to steer away from (an even softer version of) the disease nomenclature, to give that belief its best chance to flourish. (Source: Neuroethics)
Source: Neuroethics - May 4, 2017 Category: Medical Ethics Source Type: research
