“What should we do with coerced People?”
What should happen if a patient with full decision-making capacity is coerced? It’s widely accepted that voluntariness is required for informed consent, and voluntariness is thwarted when a patient is coerced. In this talk, I survey the options and show that they are all unattractive. I argue that this causes a dilemma: either we must accept one of the unattractive options, or we have to reassess the importance of voluntariness in some cases.
Research
“Value Promotion as a Goal of Medicine,” Journal of Medical Ethics (2021). With Jeremy Davis.
We argue that promoting patient values is a legitimate goal of medicine. Our view offers a justification for certain current practices, including birth control and living organ donation, that are widely accepted but do not fit neatly within the most common extant accounts of the goals of medicine (i.e, those that focus on healing or best interests). Moreover, we argue that recognising value promotion as a goal of medicine will expand the scope of medical practice by including some procedures that are sometimes rejected as being outside the scope of acceptable medical practice, such as certain forms of physician-assisted death. We then rebut some common and possible objections to this view. Our aim is not to argue that other accounts are mistaken—except when they argue for a single goal that does not include patient values—but rather to show that value promotion should play a more central role in discussions about the goals of medicine.
“The Case for an Autonomy-Centred View of Physician-Assisted Death,” Journal of Bioethical Inquiry (2020). With Jeremy Davis.
Most people who defend physician-assisted death (PAD) endorse the Joint View, which holds that two conditions—autonomy and welfare—must be satisfied for PAD to be justified. In this paper, we defend an Autonomy Only view. We argue that the welfare condition is either otiose on the most plausible account of the autonomy condition or else is implausibly restrictive, particularly once we account for the broad range of reasons patients cite for desiring PAD, such as “tired of life” cases. Moreover, many of the common objections to an autonomy only view fail once we understand the extent of the autonomy condition’s requirements—in particular, the importance of one’s values for autonomous choices. If our view is correct, then the scope of permissible PAD is broader than is currently accepted in both the philosophical literature and the law and therefore poses an important challenge to the current consensus on justified PAD.
“Is There a Right to the Death of the Foetus?” Bioethics (2017). With Jeremy Davis.
This paper was mentioned in the New York Times and was a Top Downloaded Article for Bioethics.
At some point in the future—perhaps within the next few decades—it will be possible for foetuses to develop completely outside the womb. Ectogenesis, as this technology is called, raises substantial issues for the abortion debate. One such issue is that it will become possible for a woman to have an abortion, in the sense of having the foetus removed from her body, but for the foetus to be kept alive. We argue that while there is a right to an abortion, there are reasons to doubt that there is a right to the death of the foetus. Our strategy in this essay is to consider and reject three arguments in favour of this latter right. The first claims that women have a right not to be biological mothers, the second that women have a right to genetic privacy, and the third that a foetus is one's property. Furthermore, we argue that it follows from rejecting the third claim that genetic parents also lack a right to the destruction of cryopreserved embryos used for in vitro fertilization. The conclusion that a woman possesses no right to the death of the foetus builds upon the claims that other pro-choice advocates, such as Judith Jarvis Thomson, have made.
“Asymmetries and Ill-Being” (dissertation)
My doctoral dissertation examines the role that ill-being, or what is intrinsically prudentially bad, plays in theories of well-being. I argue that all theories of well-being must produce an account of ill-being and that theories that deny ill-being, including privation views and perfectionism, are implausible for this reason. Each of my chapters develops an account of the most plausible theory of ill-being for each major theory of well-being. The second focus of my dissertation is on the many asymmetries in value between the good and the bad. For example, I show that for hedonism, at equal intensities, a unit of pain is more bad than a unit of pleasure is good. In my chapter on objective theories, I argue that false beliefs when there is strong contrary evidence—e.g., believing that the Earth is flat—contribute more ill-being than true beliefs contribute well-being.
My research reveals an important new topic for well-being research. Except for hedonism, which holds that pain is the only intrinsic bad, all other major theories of well-being are silent on ill-being. I show that this is a mistake by appealing to two strong intuitions: that there are intrinsically bad things, such as pain, just as there are intrinsic goods; and that ill-being is required to make sense of the belief that people can be faring so badly that death would be a relief. A complete theory of well-being must explain all the ways that one can be made better or worse off.