基于期望值最大化的理论何时失效：风险决策中为自己-为所有人决策差异的眼动研究

主流的风险决策理论专家发展了一系列基于期望值最大化(expectation-maximization)的理论, 以期捕获所有人的风险决策行为。然而大量证据表明, 这些基于期望值最大化的理论并不能如同描述性理论那样理想地描述单一个体的决策行为。本研究采用眼动追踪技术, 系统考察了个体在为所有人决策与为自己决策时的风险决策行为及信息加工过程的差异。本研究发现, 基于期望值最大化的理论可捕获为所有人决策或为自己多次决策时的情况, 却不能很好捕获个体为自己进行单次决策时的情况。本研究结果有助于理解基于期望值最大化的理论与启发式/非基于期望值最大化的理论的边界, 为风险决策理论的划分和发展提供实证参考。     

“[No] Doctor but My Master”: Health Reform and Antislavery Rhetoric in Harriet Jacobs’s Incidents in the Life of a Slave Girl

This essay examines Harriet Jacobs’s Incidents in the Life of a Slave Girl (1861) in light of new archival findings on the medical practices of Dr. James Norcom (Dr. Flint in the narrative). While critics have sharply defined the feminist politics of Jacobs’s sexual victimization and resistance, they have overlooked her medical experience in slavery and her participation in reform after escape. I argue that Jacobs uses the rhetoric of a woman-led health reform movement underway during the 1850s to persuade her readers to end slavery. This essay reconstructs both contexts, revealing that Jacobs links enslaved women’s physical and sexual vulnerability with her female readers’ fears of male doctors’ threats to modesty and of their standard bleed-and-purge treatments. Jacobs illustrates that slavery damages women’s health as much as heroic medicine, and thus merits the political activism of her readers. Specifically, Jacobs dramatizes her conflicts with the rapacious physician-master at moments that are crucial to women’s health: marriage, pregnancy, childbirth, and motherhood. Ultimately, this essay advances a new understanding of the role of health reform in social change: it galvanized other movements such as women’s rights and abolition, particularly around issues of bodily autonomy for women and African Americans.     

Impossible obligations and the non-identity problem

In a common example of the non-identity problem (NIP), a person (call her Wilma) deliberately conceives a child (call her Pebbles) who she knows will have incurable blindness but a life well worth living. Although Wilma’s decision seems wrong, it is difficult to say why. This paper develops and defends a version of the “indirect strategy” for solving the NIP. This strategy rests on the idea that it is wrong to deliberately make it impossible to fulfill an obligation; consequently, it is wrong for Wilma to create Pebbles because doing so makes it impossible to fulfill her obligation to protect her child from harms like blindness. A challenge for the indirect strategy is the well-known “rights waiver problem”: Since Pebbles’s very existence depends on Wilma’s having made herself unable to fulfill an obligation to Pebbles, Pebbles is likely to waive that obligation. I address this problem by recasting the indirect strategy in terms of a non-grievance evil. I argue that deliberately making it impossible to fulfill a moral obligation manifests a defective attitude toward morality—an attitude which sees moral obligations as things to be dodged whenever they are inconvenient. Next, I argue that acting on this attitude is a wrong-making feature that is independent of any wrong that might be done to Pebbles. I conclude that Wilma’s decision remains wrong even if Pebbles waives any objection to it.

     

Blessed are the peacemakers: Commentary on making peace in gestational conflicts

The purpose of this commentary on James Nelson's article [1] is to advocate introducing the ethics of care into the arena of gestational conflict. Too often the debate gets stalled in a maternal versus fetal rights headlock. Interventionists stress fetal over maternal rights: they believe education, post-birth prosecution or pre-birth seizure of pregnant women may be permissible. In contrast to interventionists, other philosophers stress that favoring fetal rights treats women like ‘fetal containers’. I question whether we should really consider issues of moral/parental obligations to children in terms of rights. Rather, the language of care should guide moral conduct vis-a-vis children/fetuses. The particularity of each woman's story — the particulars of her human relationships — inform her story. An individual's ability to care is largely a function of whether community cares for her. We must care for others to enable them to care for themselves and their loved ones — born or unborn.     

Child Welfare Versus Parental Autonomy: Medical Ethics,The Law,and Faith-Based Healing

Over the past three decades more than 200 children have died in the U.S. of treatable illnesses as a result of their parents relying on spiritual healing rather than conventional medical treatment. Thirty-nine states have laws that protect parents from criminal prosecution when their children die as a result of not receiving medical care. As physicians and citizens, we must choose between protecting the welfare of children and maintaining respect for the rights of parents to practice the religion of their choice and to make important decisions for their children. In order to make and defend such choices, it is essential that we as health care professionals understand the history and background of such practices and the legal aspects of previous cases, as well as formulate an ethical construct by which to begin a dialogue with the religious communities and others who share similar beliefs about spiritual healing. In this paper, we provide a framework for these requirements.     

The importance of what they care about

Many forms of contemporary morality treat the individual as the fundamental unit of moral importance. Perhaps the most striking example of this moral vision of the individual is the contemporary global human rights regime, which treats the individual as, for all intents and purposes, sacrosanct. This essay attempts to explore one feature of this contemporary understanding of the moral status of the individual, namely the moral significance of a subject’s actual affective states, and in particular her cares and commitments. I argue that in virtue of the moral significance of actual individuals, we should take actual cares and values very seriously—even if those cares and values are not expressions of the person’s autonomy—as partially constituting that individual as a concrete subject who is the proper object of our moral attention. In particular, I argue that a person’s actual cares and values have non-derivative moral significance. Simply because someone cares about something, that care is morally significant. In virtue of this non-derivative moral significance of cares, we ought to adopt of a commitment to accommodate others’ cares and a commitment not to frustrate their cares.     

Revisiting the Right to Do Wrong

Rights to do wrong are not necessary even within the framework of interest-based rights aimed at preserving autonomy (contra Waldron, Enoch, and Herstein). Agents can make morally significant choices and develop their moral character without a right to do wrong, so long as we allow that there can be moral variation within the set of actions that an agent is permitted to perform. Agents can also engage in non-trivial self-constitution in choosing between morally indifferent options, so long as there is adequate non-moral variation among the alternatives. The stubborn intuition that individuals have a right to do wrong in some cases can be explained as stemming from a cautionary principle motivated by the asymmetry between the risk of wrongly interfering and that of refraining from interfering.     

Getting Obligations Right: Autonomy and Shared Decision Making

Shared Decision Making (‘SDM’) is one of the most significant developments in Western health care practices in recent years. Whereas traditional models of care operate on the basis of the physician as the primary medical decision maker, SDM requires patients to be supported to consider options in order to achieve informed preferences by mutually sharing the best available evidence. According to its proponents, SDM is the right way to interpret the clinician-patient relationship because it fulfils the ethical imperative of respecting patient autonomy. However, there is no consensus about how decisions in SDM contexts relate to the principle of respect for autonomy. In response, I demonstrate that in order to make decisions about what treatment they will or will not receive, patients will be required to meet different conditions depending on the approach proponents of SDM take to understanding personal autonomy. Due to the fact that different conceptions of autonomy yield different obligations, I argue that if physicians and patients satisfied all the conditions described in standard accounts of SDM, then SDM would undermine patient autonomy.     

The gap between medical and monetary choices under risk persists in decisions for others

Decisions under risk in the medical domain have been found to systematically diverge from decisions in the monetary domain. When making choices between monetary options, people commonly rely on a decision strategy that trades off outcomes with their probabilities; when making choices between medical options, people tend to neglect probability information. In two experimental studies, we tested to what extent differences between medical and monetary decisions also emerge when the decision outcomes affect another person. Using a risky choice paradigm for medical and monetary decisions, we compared hypothetical decisions that participants made for themselves to decisions for a socially distant other (Study 1) and to recommendations as financial advisor or doctor (Study 2). In addition, we examined people's information search in a condition in which information about payoff distributions had to be learned from experiential sampling. Formal modeling and analyses of search behavior revealed a similarly pronounced gap between medical and monetary decisions in decisions for others as in decisions for oneself. Our results suggest that when making medical decisions, people try to avoid the worst outcome while neglecting its probability—even when the outcomes affect others rather than themselves.     

Olympia and Other O-Machines

Against Maudlin, I argue that machines which merely reproduce a pre-programmed series of changes ought to be classed with Turing’s O-Machines even if they would counterfactually show Turing Machine-like activity. This can be seen on an interventionist picture of computational architectures, on which basic operations are the primitive loci for interventions. While constructions like Maudlin’s Olympia still compute, then, claims about them do not threaten philosophical arguments that depend on Turing Machine architectures and their computational equivalents.     

From Maternal Impressions to Eugenics: Pregnancy and Inheritance in the Nineteenth-Century U.S.

This essay examines the theory of maternal impressions, the belief that a woman’s experiences or emotions during pregnancy could explain congenital disability or emotional/ behavior differences in her child and asks why this theory circulated as an explanation for disability seen at birth by both medical doctors and in literature for far longer than it did across the Atlantic. By presenting examples from nineteenth-century medical literature, popular fiction, maternal handbooks, and two canonical works of literature, Nathaniel Hawthorne’s The Scarlet Letter and Harriet Jacobs’ Incidents in the Life of a Slave, I argue that maternal impressions worked to maintain anxiety for women, and particular white women, to ensure they felt responsible if anything was “wrong” with their child. Ultimately, I show how maternal impressions was both an ableist and racialized understanding of inheritance that wouldn’t be discarded until the emergence of eugenics in the early twentieth century.

     

Respectful Lying

I argue that there are instances in which lying to an innocent and generally competent person respects her autonomy, contrary to arguments by Christine Korsgaard and Onora O’Neill. These authors say that respect for a person’s autonomy requires treating her in a way consistent with the possibility of consent, but I contend that the possibility of consent condition is unworkable. I maintain that lying can respect individual autonomy when being truthful to a person undermines her choices and lying gets her what she would reasonably see herself as having most reason to choose in the circumstances. I make my case by reflecting on lying invitations to a surprise party and on negotiation phenomena.     

Privacy,autonomy, and public policy: French and North American perspectives

This article raises the question of whether in both the United States and in France, an individual’s autonomy and private decision-making right(s) in matters of health care and access to reproductive technologies can be conciliated with the general interest, and more specifically, the role of the State. Can a full-fledged right to privacy, the ability to exercise one’s autonomy, exist alongside the general interest, and depend neither on financial resources like in the United States nor on centralised government decisions or the medical hierarchy like in France? The contrast between these two modern democracies justify the importance of comparing them. I will demonstrate that overlaps do exist: the free exercise of religion and opinion, freedom of expression, the inherent value of each individual. What differs, however, are the institutions and how they provide, protect, promote, or frame access to and expressions of these democratic principles. The impact of the global economy, the exposure of people around the world to each other via the internet, and the mirror effects of social media, blogs, and other such forums, have created new perspectives that countries project onto one another. For example, does France now seem to tout ‘autonomy’ as a new and important value because it appears to be an ‘American success story’? Does the United States now seem to value human rights and a social-democratic approach because of the ‘French model’? There seems to be some truth behind these assertions, but as this article will demonstrate, the portrayals of what the ‘right to privacy’ is in the United States and what ‘socialised medicine’ is in France are not necessarily fully accurate.     

Stability of choices in a risky decision‐making task: a 3‐year longitudinal study with children and adults

In a 3‐year follow‐up to Levin and Hart's ( 2003 ) study, we observed the same children, now 9–11 years old, and their parents in the same risky decision‐making task. At the aggregate level the same pattern of means was observed across time periods. At the individual level the key variables were significantly correlated across time periods for both children and adults. Taken together with the results from the original study and earlier studies, these results solidify the following conclusions: children utilize both probability and outcome information in risky decision‐making; the tendency to make more risky choices to avoid a loss than to achieve a gain of equal magnitude, which is a major tenet of the leading theories of risky decision‐making, occurs for children as well as adults; children make more risky choices than adults; temperamental predictors of risky choice are valid for children as well as for adults. Copyright © 2006 John Wiley & Sons, Ltd.     

Better Living Through Chemistry? A Reply to Savulescu and Persson on ‘Moral Enhancement’

In ‘Moral Enhancement, Freedom, and the God Machine’, Savulescu and Persson argue that recent scientific findings suggest that there is a realistic prospect of achieving ‘moral enhancement’ and respond to Harris's criticism that this would threaten individual freedom and autonomy. I argue that although some pharmaceutical and neuro‐scientific interventions may influence behaviour and emotions in ways that we may be inclined to evaluate positively, describing this as ‘moral enhancement’ presupposes a particular, contested account, of what it is to act morally and implies that entirely familiar drugs such as alcohol, ecstasy, and marijuana are also capable of making people ‘more moral’. Moreover, while Savulescu and Persson establish the theoretical possibility of using drugs to promote autonomy, the real threat posed to freedom by ‘moral bioenhancement’ is that the ‘enhancers’ will be wielding power over the ‘enhanced’. Drawing on Pettit's notion of ‘freedom as non‐domination’, I argue that individuals may be rendered unfree even by a hypothetical technology such as Savulescu and Persson's ‘God machine’, which would only intervene if they chose to act immorally. While it is impossible to rule out the theoretical possibility that moral enhancement might be all‐things‐considered justified even where it did threaten freedom and autonomy, I argue that any technology for biomedical shaping of behaviour and dispositions is much more likely to be used for ill rather than good.     

Choosing when to Die

What would make it the right time for you to die, or the wrong one? In particular, could it be the right time for you to die even if your loved ones want to make the sacrifices needed to prolong your life, because that would cost them too dearly? The worry is that it would be selfish to permit these sacrifies, and wrong for that reason. I think it matters that the sacrifies would occur within a relationship of mutual devotion, and I try to say how it matters. In particular, I argue against some fairly simple views of what constitutes impermissible selfishness in this context, and in favor of approaching such decisions in a different way.     

Family conflict shapes how adolescents take risks when their family is affected

Numerous studies have established that the social context greatly affects adolescent risk taking. However, it remains unexplored whether adolescents' decision‐making behaviors change when they take risks that affect other individuals such as a parent. In the current study, we sought to investigate how the social context influences risky decisions when adolescents' behavior affects their family using a formalized risk‐taking model. Sixty‐three early adolescents (M_age = 13.3 years; 51% female) played a risk‐taking task twice, once during which they could make risky choices that only affected themselves and another during which their risky choices only affected their parent. Results showed that adolescents reporting high family conflict made more risky decisions when taking risks for their parent compared to themselves, whereas adolescents reporting low family conflict made fewer risky decisions when taking risks for their parent compared to themselves. These findings are the first to show that adolescents change their decision‐making behaviors when their risks affect their family and have important implications for current theories of adolescent risk taking.