Mark Alfano

Placebo Effects and Informed Consent

The concepts of placebos and placebo effects refer to extremely diverse phenomena. I recommend dissolving the concepts of placebos and placebo effects into loosely related groups of specific mechanisms, including (potentially among others) expectation-fulfillment, classical conditioning, and attentional-somatic feedback loops. If this approach is on the right track, it has three main implications for the ethics of informed consent. First, because of the expectation-fulfillment mechanism, the process of informing cannot be considered independently from the potential effects of treatment. Obtaining informed consent influences the effects of treatment. This provides support for the authorized concealment and authorized deception paradigms, and perhaps even for outright deceptive placebo use. Second, doctors may easily fail to consider the potential benefits of conditioning, leading them to misjudge the trade-off between beneficence and autonomy. Third, how attentional-somatic feedback loops play out depends not only on the content of the informing process but also on its framing. This suggests a role for libertarian paternalism in clinical practice.

Outlining the field – a research program for empirically informed ethics

Replace with:“What is the right thing to do?” This question echoes through the centuries and millennia of human history. It alludes to the sometimes disturbing moral dilemmas humans face, and it has produced elaborate ethical theories of the virtues people should foster, the norms societies should promote, and the states of affairs at which people should aim. It is therefore unsurprising that human behavior in moral contexts has become a topic of empirical research. The last two decades have witnessed a substantial increase in empirical research on morality—in particular using psychological and neuroscientific methods. But the endeavor of promoting an empirically informed ethics raises various questions. This chapter structures them with respect to the subject-matter, the kinds of empirical methodologies and data that could be useful for ethics, and the types of problems and fundamental questions of ethics for which an empirical approach could be particularly fruitful. It also outlines what is at stake when empirical insights are taken seriously by normative theorists. Furthermore, this chapter serves as an introduction to the other contributions in this book, as it arranges them into a general framework of empirically informed ethics, which can be called a “research program”. Section 1.2 presents the phenomenon that empirically informed ethics tackles, which is, we propose, a thorough explanation of ‘moral agency’ in all its facets. In this section, we also discuss how the understanding of ethics itself influences the role of empirical knowledge for ethics. In Sect. 1.3, we draw some important methodological distinctions, in order to help clarify the kinds of empirical research that may be relevant to ethics. In Sect. 1.4, we provide an overview of the different kinds of data that can inform ethics in various ways. Finally, in Sect. 1.5, we present several problems that we consider particularly important for an empirical approach to ethics.

Expanding the Situationist Challenge to Reliabilism About Inference

The last few decades have witnessed the birth and growth of both virtue epistemology and the situationist challenge to virtue ethics. It seems only natural that eventually we would see the convergence of the twain: the situationist challenge to virtue epistemology. Virtue epistemologists divide into three camps: reliabilists, for whom the intellectual virtues are cognitive capacities, processes, or dispositions; responsibilists, for whom the intellectual virtues are conative traits of intellectual character related to the love of truth and aversion to error; and mixed theorists, who countenance the virtues of both reliabilism and responsibilism. For all three, justification and knowledge are analyzed in terms of intellectual character: someone is justified in believing that p just in case her belief was acquired and retained through the exercise of intellectual virtue, and she knows that p just in case her justified belief that p is true. Empirical research on cognitive dispositions spells trouble for reliabilist accounts of justification and knowledge. The trouble can be framed as an inconsistent triad: (inferential non-skepticism) Most people know a lot inferentially; (inferential reliabilism) Inferential knowledge is true belief acquired and retained through inferential reliabilist intellectual virtue; (inferential cognitive situationism) People acquire and retain most of their inferential beliefs through heuristics rather than intellectual virtues. Inferential non-skepticism is an unrevisable Moorean platitude. I muster evidence from cognitive psychology to argue for inferential cognitive situationism. If my argument is correct, inferential reliabilism must be rejected.

The Most Agreeable of All Vices: Nietzsche as Virtue Epistemologist

It has been argued with some justice by commentators from Walter Kaufmann to Thomas Hurka that Nietzsches positive ethical position is best understood as a variety of virtue theory – in particular, as a brand of perfectionism. For Nietzsche, value flows from character. Less attention has been paid, however, to the details of the virtues he identifies for himself and his type. This neglect, along with Nietzsches frequent irony and non-standard usage, has obscured the fact that almost all the virtues he praises are intellectual rather than moral. The vices he most despises include dogmatism, intellectual partisanship, faith, boredom, the desire for certainty and pity. The virtues he most appreciates include curiosity, honesty, scepticism, creativity, the historical sense, intellectual courage and intellectual fastidiousness. These tables of values place Nietzsche squarely among so-called responsibilist virtue epistemologists, such as Lorraine Code and Linda Zagzebski, who emphasize that knowledge is infused with desire and affect. I argue that curiosity construed as the specification of the will to power in the domain of epistemology is the cardinal Nietzschean virtue, and that the others – especially intellectual courage and honesty – are presupposed by curiosity. Thus, Nietzsche turns out to accept his own peculiar brand of the thesis of the unity of virtue.

Wilde heuristics and Rum Tum Tuggers: preference indeterminacy and instability

Models in decision theory and game theory assume that preferences are determinate: for any pair of possible outcomes, a and b, an agent either prefers a to b, prefers b to a, or is indifferent as between a and b. Preferences are also assumed to be stable: provided the agent is fully informed, trivial situational influences will not shift the order of her preferences. Research by behavioral economists suggests, however, that economic and hedonic preferences are to some degree indeterminate and unstable, which in turn suggests that other sorts of preferences may suffer the same problem. Even fully informed agents do not always determinately prefer a to b, prefer b to a, or feel indifferent as between a and b. Seemingly trivial situational influences rearrange the order of their preferences. One could respond that decision theory and game theory are not meant to describe actual behavior, and that they instead adumbrate an ideal of rationality from which human action diverges in various ways. When the divergences are small and systematic, they help us identify the heuristics that conspire to help people approximate rationality. One such heuristic, dubbed the Wilde heuristic, is explored. However, the divergences documented by behavioral economists threaten to be too large to handle through idealization. The Rum Tum Tugger Model, in which indifference is intransitive, is spelled out as one promising way for decision and game theory to retrench. Preferences may be locally unstable and indeterminate, but when the differences between options are sufficiently large, they approximate stability and determinacy.

The topology of communities of trust

Hobbes emphasized that the state of nature is a state of war because it is characterized by a fundamental and generalized distrust. Exiting the state of nature and the conflicts it inevitably fosters is therefore a matter of establishing trust. Extant discussions of trust in the philosophical literature, however, focus either on isolated dyads of trusting individuals or trust in large, faceless institutions. In this paper, I begin to fill the gap between these extremes by analyzing what I call the topology of communities of trust. Such communities are best understood in terms of interlocking dyadic relationships that approximate the ideal of being symmetric, Euclidean, reflexive, and transitive. Few communities of trust live up to this demanding ideal, and those that do tend to be small (between three and fifteen individuals). Nevertheless, such communities of trust serve as the conditions for the possibility of various important prudential epistemic, cultural, and mental health goods. However, communities of trust also make various problematic phenomena possible. They can become insular and walled-off from the surrounding community, leading to a distrust of out-groups. They can lead their members to abandon public goods for tribal or parochial goods. These drawbacks of communities of trust arise from some of the same mechanisms that give them positive prudential, epistemic, cultural, and mental health value, and so can, at most, be mitigated, not eliminated.

Toward an ethics of digital government: a first discussion

In this panel, scholars discuss involving data, computational analysis, and information technology that has the potential to present ethical quandaries in the course of decision making related to digital government. More specifically, the presentations focus on algorithm-based decision making, personally identifiable information, and the manipulation of public opinion in social media channels. Discussion following the presentations will focus on how ethical guidelines should be formulated or what their specific content should be.

Ethics, Morality, and Game Theory

Ethics is a field in which the gap between words and actions looms large. Game theory and the empirical methods it inspires look at behavior instead of the lip service people sometimes pay to norms. We believe that this special issue comprises several illustrations of the fruitful application of this approach to ethics.

Development and validation of a multi-dimensional measure of intellectual humility

This paper presents five studies on the development and validation of a scale of intellectual humility. This scale captures cognitive, affective, behavioral, and motivational components of the construct that have been identified by various philosophers in their conceptual analyses of intellectual humility. We find that intellectual humility has four core dimensions: Open-mindedness (versus Arrogance), Intellectual Modesty (versus Vanity), Corrigibility (versus Fragility), and Engagement (versus Boredom). These dimensions display adequate self-informant agreement, and adequate convergent, divergent, and discriminant validity. In particular, Open-mindedness adds predictive power beyond the Big Six for an objective behavioral measure of intellectual humility, and Intellectual Modesty is uniquely related to Narcissism. We find that a similar factor structure emerges in Germanophone participants, giving initial evidence for the model’s cross-cultural generalizability.

A cross-cultural assessment of the semantic dimensions of intellectual humility

Intellectual humility can be broadly construed as being conscious of the limits of one’s existing knowledge and capable of acquiring more knowledge, which makes it a key virtue of the information age. However, the claim “I am (intellectually) humble” seems paradoxical in that someone who has the disposition in question would not typically volunteer it. Therefore, measuring intellectual humility via self-report may be methodologically unsound. As a consequence, we suggest analyzing intellectual humility semantically, using a psycholexical approach that focuses on both synonyms and antonyms of ‘intellectual humility’. We present a thesaurus-based methodology to map the semantic space of intellectual humility and the vices it opposes as a heuristic to support analysis and diagnosis of this disposition. We performed the mapping both in English and German in order to test for possible cultural differences in the understanding of intellectual humility. In both languages, we find basically the same three semantic dimensions of intellectual humility (sensibility, unpretentiousness, and knowledge dimensions) as well as three dimensions of its related vices (self-overrating, other-underrating and dogmatism dimensions). The resulting semantic clusters were validated in an empirical study with English (n = 276) and German (n = 406) participants. We find medium-to-high correlations (0.54–0.72) between thesaurus similarity and perceived similarity, and we can validate the three dimensions identified in the study. But we also find limitations of the thesaurus methodology in terms of cluster plausibility. We conclude by discussing the importance of these findings for constructing psychometric measures of intellectual humility via self-report vs. computer models.