Ronald Munson is Professor of Philosophy of Science and Medicine at University of Missouri-St. Louis.  His new book, The Woman Who Decided to Die: Challenges and Choices at the Edges of Medicine, takes readers to the very edges of medicine, where treatments fail and where people must cope with helplessness, mortality, and doubt. In the excerpt below Munson takes us to the crux of medical ethics, with questions about the right to die.

I think the case can be made that the world of American medicine changed decisively at two in the morning on April 14, 1975, when Julie Quinlan of Landing, New Jersey, was awakened by a telephone call.

She was crying when she hung up the phone. “Karen is very sick,” she said to her husband, Joseph. “She’s unconscious, and we have to go to Newton Hospital right away.”

…Karen was in a comatose state for unknown reasons and was being given oxygen through a mask taped over her nose and mouth. It wasn’t clear that she would live.

…Blood and urine tests indicated that Karen hadn’t consumed what would usually be considered a dangerous amount of alcohol. But she had been on a very strict diet and had eaten nothing that day before having two gin-and-tonics at the party. The tests also detected the presence in her blood of .6 milligrams of aspirin combined with the tranquilizer Valium. Two milligrams would have been toxic, five lethal. So why she had stopped breathing was a mystery, yet it was during the brief period she was alone in the bedroom that part of her brain died, apparently from oxygen depletion.

About a week after Karen failed to regain consciousness, her parents moved her to St. Clare’s Hospital… Dr. Robert J. Morse, a neurologist, and Dr. Arshad Javed, a pulmonary internist, became her physicians. They conducted additional studies to rule out several possible causes of her coma… The neurological tests and X-ray studies confirmed, however, that Karen’s brain had undergone extensive damage.

…By early July, Karen’s physicians and her mother, sister, and brother had come to believe that Karen would never regain consciousness…

THE PRIEST AND THE LAWYERS

The Quinlans’ parish priest, Father Thomas Trapasso, assured the Quinlans that the ethical principles of the Roman Catholic Church didn’t require the continuation of extraordinary measures to support a life after any realistic hope of recovery was gone.

…On July 31, 1975, after Karen had been in a coma for three and a half months, Julie and Joseph Quinlan gave Drs. Morse and Jared their permission to take their daughter off the ventilator. They signed a letter authorizing the discontinuance of all extraordinary procedures and absolving the hospital from all legal liability that might result from Karen’s death. “I think you have come to the right decision,” Dr. Morse told them.

But the next morning Dr. Morse called Joseph Quinlan and said, “I have a moral problem about what we agreed on last night…” The next day, Dr. Morse called again. “I find I will not do it,” he said. “And I’ve informed the administrator at the hospital that I will not do it.”

The Quinlans were upset and bewildered… They talked with the hospital’s attorney, and he told them that, because Karen was over twenty-one, they were no longer her legal guardians. They would have to go to court and be appointed to guardianship. After that, they would have the standing to ask the hospital to remove Karen from the respirator, and the hospital might or might not comply…

Joseph Quinlan consulted attorney Paul Armstrong…

…Paul Armstrong filed a plea with Judge Robert Muir of the New Jersey Superior Court on September 12, 1975. He requested that Joseph Quinlan be appointed Karen’s guardian so that he would have “the express power of authorizing the discontinuance of all extraordinary means of sustaining her life.”

Armstrong argued the case on three constitutional grounds. First, he claimed (following the lead of the 1973 U.S. Supreme Court decision in Roe v. Wade) that there is an implicit right to privacy guaranteed by the Constitution and that this right permits individuals or others
acting for them to terminate the use of extraordinary medical measures, even when death may result…

Second, Armstrong argued that the First Amendment guarantee of religious freedom extended to the Quinlan case. If the court didn’t allow them to act in accordance with the doctrines of their church, their religious liberty would be infringed.

Finally, Armstrong appealed to the “cruel and unusual punishment” clause of the Eighth Amendment. He claimed that “for the state to require that Karen Quinlan be kept alive, against her will and the will of her family, after the dignity, beauty, promise and meaning of earthly life have vanished, is cruel and unusual punishment.”…

…On November 10, Judge Muir ruled against Joseph Quinlan…

APPEAL
Paul Armstrong immediately filed an appeal with the New Jersey Supreme Court. On January 26, 1976, the court convened to hear arguments…

This time the court’s ruling was favorable…the court stated, if Karen’s doctors believed she would never emerge from her coma, they should consult an ethics committee that should be established by St. Clare’s Hospital. If the committee accepted their prognosis, then the ventilator could be removed. If Karen’s present physicians were then unwilling to take her off the respirator, Mr. Quinlan was free to find a physician who would.

NOT IN THIS HOSPITAL
…The Quinlans expected Karen to die once she was off the machine, but she was soon breathing on her own without mechanical assistance…

TEN YEARS
Karen Quinlan continued to breathe on her own. She was given high nutrient feedings through a surgically implanted gastric tube, and she received regular doses of antibiotics to ward off bacterial infections…

…On June 11, 1985…Karen Quinlan finally died. She was thirty-one years old.

To most people in 1975, the case of Karen Quinlan seemed both astonishing and disturbing, and the whole country followed reports of the medical, moral, and legal issues as months passed and Karen neither died nor recovered consciousness. Most of us had never heard the phrase persistent vegetative state, which the neurologists used to describe her condition, and we were puzzled about its implications.

If Karen was trapped in some indefinite, ambiguous territory between life and death, how should we treat her? Were we duty-bound to keep her body functioning, even when she had no hope of recovery?

Today I am pleased to be able to bring you a new video from our friends at Meet the Author. Nigel Warburton is the author of Free Speech: A Very Short Introduction, and here he is explaining what inspired him to write the book, and what the key arguments in free speech are.

He has previously written for OUPblog here, and an excerpt from his book can be found here.  Check out the video after the break.

Click here to view the embedded video.

Leslie Francis is Professor of Philosophy, Professor of Law, and Adjunct Professor of Internal Medicine in the Division of Medical Ethics and Humanities at the University of Utah.  Margaret P. Battin is Distinguished Professor of Philosophy and Adjunct Professor of Internal Medicine in the Division of Medical Ethics and Humanities at the University of Utah.  Together with Jay A. Jacobson and Charles B. Smith, they wrote The Patient as Victim and Vector: Ethics and Infectious Disease which explores how traditional and new issues in clinical medicine, research, public health, and health policy might look different if infectious disease were treated as central. The authors argue that both practice and policy must recognize that a patient with a communicable infectious disease is not only a victim of that disease, but also a potential vector- someone who may transmit an illness that will sicken or kill others.  In the post below Francis and Battin look specifically at the H1N1 outbreak.

The recent outbreak of H1N1 influenza in Mexico has been greeted with great concern to prevent spread. Trips have been cancelled, travelers have been quarantined, schools have been closed, and sporting events will go uncontested. Preventing spread is important, to be sure, especially of a novel agent with unknown infectivity and lethality. But there is a down side to all the worry about spread: it encourages us to think of each other as vectors, sources of disease to be feared.

We are all vectors or potential; that’s a biological fact. But it’s only one side of our biology. We’re “way-station” selves, breeding grounds and launching pads for literally trillions of microorganisms, all the time—but we’re also recipients of them too. In short: we’re all victims,
just as we are vectors. We live in a state of perpetual uncertainty about whether we’re victims, vectors, or both, at any given time.

As we are caught up in the fear of pandemic spread, we need to remember our victim-side, too. There’s been some discussion of this in the press reports: stories of empty hotels, the cancelled U-17 Concacaf tournament, travelers quarantined in airports, workers without
childcare, or pigs slaughtered unnecessarily in Egypt. But there have been no comprehensive reminders that people stricken with the flu or suspected as vectors are victims as well and in need of support: medical care if they are ill, economic consideration if their livelihoods are
lost, and just plain concern when events that are important to them must be cancelled to enforce the social distancing that is hoped to prevent spread.

In pandemic planning, much effort has been devoted to preventing disease spread. We are seeing the importance of these measures in the current situation. As fears wane, or refocus on later, perhaps more virulent phases of an epidemic or on future emergences of new infectious diseases, however, it is equally important for us to plan for victims and to ask what we owe them. Such planning efforts may be particularly important to encourage the sharing of epidemiological data in the future, if the economic impacts on Mexico are dire and left unattended, where data sharing and international cooperation is crucial in disease control. That’s a prudential imperative, but it’s an ethical one, too. After all, we’re all in this together,working together not only to prevent the spread of infectious disease but also to mitigate the impact of disease where it strikes.

Nigel Warburton is a Senior Lecturer in Philosophy at the Open University, as well as the author of a number of bestselling books on the subject. Below is an excerpt from his latest book, Free Speech: A Very Short Introduction, on liberty versus licence to say what you want. His previous blog for OUP is here.

Defenders of free speech almost without exception recognize the need for some limits to the freedom they advocate. In other words, liberty should not be confused with licence. Complete freedom of speech would permit freedom to slander, freedom to engage in false and highly misleading advertising, freedom to publish sexual material about children, freedom to reveal state secrets, and so on. Alexander Meiklejohn, a thinker who was particularly concerned to nurture the sorts of debates that are fruitful for a democracy made this point:

When self-governing men demand freedom of speech they are not saying that every individual has an unalienable right to speak whenever, wherever, however he chooses. They do not declare that any man may talk as he pleases, when he pleases, about what he pleases, about whom he pleases, to whom he pleases.

This is important. The kind of freedom of speech worth wanting is freedom to express your views at appropriate times in appropriate places, not freedom to speak at any time that suits you. Nor should it be freedom to express any view whatsoever: there are limits.

John Stuart Mill, the most celebrated contributor to debates about the limits of individual freedom, despite advocating considerably more personal freedom than most of his contemporaries were comfortable with, set the boundary at the point where speech or writing was an incitement to violence. He was also clear that his arguments for freedom only applied to ‘human beings in the maturity of their faculties’. Paternalism – that is, coercing someone for their own good – was in his opinion appropriate towards children, and, more controversially, towards ‘those backward states of society in which the race itself may be considered in its nonage’. But it was not appropriate towards adult members of a civilised society: they should be free to make their own minds up about how to live. They should also be free to make their own mistakes.

Judge Oliver Wendell Holmes Jr’s memorable observation that freedom of speech should not include the freedom to should ‘Fire!’ in a crowded theatre captures an important point that is easily ignored when rhetoric about freedom takes over: defenders of freedom of speech need to draw a line somewhere. The emotive connotations of the word ‘freedom’ should not blinker us to the extent that we forget this. Allowing someone to shout ‘fire’ in a crowded theatre might cause a stampede resulting in injury of even death, and a hoax might also undermine theatregoers’ reactions to a genuine cry of ‘fire’. Holmes made his comment in a Supreme Court judgement (Schenck v United States) relating to the First Amendment. He gave this judgement in 1919, but the offending act, printing and circulating 15,000 anti-war leaflets to enlisted soldiers during wartime, took place in 1917. The pamphlets declared that the drafting of soldiers was a ‘monstrous wrong against humanity in the interest of Wall Street’s chosen few’. For Holmes the context of any expression in part determined whether it could justifiably be censored. While this expression of ideas night have had First Amendment protection in peacetime, the same ideas expressed during a war should be treated differently and did not merit that protection. Here the war effort could have been seriously undermined, so Holmes declared these special circumstances justified a special restriction on freedom:

The question in every case is whether the words are used in such circumstances and are of such a nature as to create a clear and present danger that they will bring about the substantive evils that Congress has a right to prevent. It is a question of proximity and degree. When a nation is at war many things that might be said in time of peace are such a hindrance to its effort that their utterance will not be endured so long as men fight, and that no court could regard them as protected by any constitutional right.

Holmes, like Mill, was committed to defending freedom of speech in most circumstances, and, explicitly defended the value of a ‘free trade in ideas’ as part of a search for truth: ‘the best test of truth,’ he maintained, ‘is the power of the thought to get itself accepted in the competition of the market’. Holmes wrote passionately about what he called the ‘experiment’ embedded in the US Constitution arguing that we should be ‘eternally vigilant’ against any attempt to silence opinions we despise unless they seriously threaten the country – hence the ‘clear and present danger’ test outlined in the quotation above. Holmes as a judge was specifically concerned with how to interpret the First Amendment; his was an interest in the application of the law. Mill in contrast was not writing about legal rights, but about the moral question of whether it was ever right to curtail free speech whether by law, or by what he described as the tyranny of majority opinion, the way in which those with minority views can be sidelined or even silenced by social disapproval.

Both Mill and Holmes, then, saw that there had to be limits to free speech and that other considerations could on occasion defeat any presumption of an absolute right (legal or moral) to freedom of speech. Apart from the special considerations arising in times of war, most legal systems which Bradley preserve freedom of speech still restrict free expression where, for example, it is libellous or slanderous, where it would result in state secrets being revealed, where it would jeopardize a fair trial, where is involves a major intrusion into someone’s private life without good reason, where it results in copyright infringement (e.g. using someone else’s words without permission), and also in cases of misleading advertising. Many countries also set strict limits to the kinds of pornography that may be published or used. These are just a selection of the restrictions on speech and other kinds of expression that are common in nations which subscribe to some kind of free speech principle and whose citizens think of themselves as free.

Professor Aaron Ben-Ze’ev is the President of the University of Haifa, and Professor of Philosophy. Ruhama Goussinsky, Ph.D is a lecturer in the Human Service Department in Emek Yisreel College and University of Haifa in Israel. Together they wrote In The Name of Love: Romantic Ideology and Its Victims which looks at how the idealization of love arms it with a destructive power. A major case study of the book concerns men who have murdered their wives or partners allegedly ‘out of love’.  In the excerpt below the authors look at the common assumption in wife killing; that it is rooted in masculine possessiveness.

If you leave me now, you’ll take away the very heart of me - Chicago

My heart would break in two if I should lose you - Elvis Presley

The various explanations offered for the phenomenon of the murder of wives share one common assumption, according to which the motivation for violence against wives in all its forms, including murder, is rooted in masculine possessiveness. Although the existing explanations disagree about the acquired or inborn essence of male possessiveness, they share the view that an act of murder is the embodiment of the murderer’s personality (as if to say: tell me who the man is, and I will tell you what the woman’s chances of survival are).  Sexual jealousy and anger are two emotions that, according to the common view, trigger wife killing.

Another assumption that unites most of the explanations is that in terms of motives and emotional dynamics, murderous violence is not distinguishable from other manifestations of violence against women.  The prevalent view considers murder the end of a path and the climax of a history of violence that preceded it, not a separate phenomenon.  However, unlike violence that is not connected to as specific behavioral stimulus on the woman’s part, 20 years of research has pointed systematically to the fact that many cases of wife killing are connected to the threat of abandonment, and they take place in response to the woman’s effort to end her relationship with the man.

Theories that refer to male possessiveness but overlook the context of potential abandonment cannot answer the question of why certain men murder their wives instead, they lead one to ask: ‘how is it that so few men kill their wives?’

Our conclusions support the consistent pattern of findings that have demonstrated that the phenomenon of wife killing often revolves around the woman threatening to or actually separating from her dating or marital partner.  However, they also led us to diverge from the assumption that the murder of female partners is a phenomenon that can be explained by a single, central variable such as male possessiveness. The findings point to the need to understand the murder of women partners as a phenomenon anchored in a certain constellation of factors that combine and create the ‘conditions for murder’. From this point of view, the murder of the woman cannot be explained only as the embodiment of the murderer’s possessive personality; rather, it must be seen as the result of an interaction between the specific person and the specific context.  Conditions of murder may be created when a relationship characterized by deep emotional dependence of the man on his wife, when love is experienced in terms of paternalism and shared identity, when separation is seen as loss of personal continuity, when masculine identity is defined in terms f power and control, and when a rigid personal disposition accompanies the dangerous realization of Romantic Ideology’s central theme- ‘without you I am nothing’.

Deciphering the context in which the idea of murder ripens until it is carried out illustrates that understanding the motivations behind the act in terms of ’sexual jealousy’ or ‘masculine possessiveness’ is extremely simplistic and partial.  Although conceptions of ownership and paternalism, and emotions such as jealousy and anger all play a role in the full range of factors that produce a readiness to take the life of a conjugal partner, it is more accurate to consider the motive for murder in terms of conditions that are propitious for the development of murderous violence, rather than in terms of one central personality variable.

The basis of the potential for murder can be characterized in dimensions of space and time.  In the spatial dimension, in terms of content, the murder of wives is, as noted, the result of a combination of factors.  A certain infrastructure gives rise to the potential for murderous violence.  There are conditions of risk, many of which are part and parcel of Romantic Ideology, that combine and act together: when the woman is the man’s whole world; when separation from her is conceived of as a loss of identity, of self; when reality is emptied of other sources of significance; when the conception of masculinity, which dictates power, honor, and control, turns one’s dependence on the woman into an experience of weakness and impotence, grasped as a humiliating blow to masculine pride; when the feeling of need is joined to rigidity of personality; when rigidity is combined with aggression; when aggression is justified by Romantic Ideology; and when love legitimizes the worst sort of actions, in the guise of a desirable social ideal.  When all of these combine, conditions of high risk are present.

In the temporal dimension, the murder must be seen as the climax of a dynamic process, during which a psychological readiness matures, specifically, the willingness to take the wife’s life.  Our findings point to a dynamics of progress toward the deed over a period of weeks and months.  That period is marked by continued affective states such as jealousy, anger, fear, depression, and despair, which shape a very powerful emotional framework for grasping reality.  In this emotional context, the idea of murder ripens, gathers a feeling of realism, and advances toward implementation.  That advancement involves certain or vague knowledge about what is going to happen, anxiety about the anticipated end, a feeling of sitting on a barrel of explosives, predicting imminent danger.  Something horrible is about to happen.

The day of the murder is the day on which a spark ignites the explosive mass. As mentioned, the psychological willingess was already in place, and therfore neither the cirucmstance surrounding the day of the murder, nor the emotions accompanying the act can offer insight into the reason for the murder or shed light on the place from which it emerged.  The traces of anger, as well as the traces of the murder, lead backwards in time…

Robert M. Veatch is the director and Professor of Medical Ethics at the Kennedy Institute of Ethics. His new book, Patient, Heal Thyself: How the New Medicine Puts the Patient in Charge, uses a range of fascinating contemporary and historical examples to reveal how values underlie almost all medical procedures.  He makes a strong case that patients must take a more active role in their treatments, so that their values are met. In the excerpt below Veatch uses the example of a broken arm to demonstrate value judgments in treatment.

Phil was a sophomore in his state’s premier university in a city some hundred miles from his home.  Playing “severe Frisbee” one fall afternoon, he dove for the dis and landed on his right wrist.  He knew instantly that it was broken.  His buddies drove him to the school clinic, where the arm was set.  In a few weeks he was as good as new - almost.

The arm was left with a slight distortion that concerned the orthopedist but did n ot appear to require surgical correction.  The next summer when Phil was skating at a roller rink with his friends, he fell on the arm and rebroke it.  This time the orthopedic surgeon said pins would have to be placed to reconstruct the bone.  The surgery was uneventful.  The surgeon instructed Phil and his parents that he would have to return for the removal of the pins in about a year when the bone was mended.

The following summer the procedure was scheduled for Phil as an outpatient.  Everything went fine.  His now-screwless arm was placed once again in a cast so the screw holes could mend.

In the conversation with Phil and his parents after the successful events, the surgeon made a statement that was rather remarkable, even though neither he nor Phil as first realized all its implications.  He said, “Most surgeons would leave this cast on for about seven weeks, but I found that if you are careful, I can remove it in about four weeks, so schedule an appointment in a month and we’ll get if off.”

Phil and his parents here encounter an amazing array of value judgments made by the surgeon.  Pass over all the judgments not to place the pins after the first break and to place them after the second.  Forget about the techniques used in setting the arm each time, the type of surgery, the anesthesia, the decision to remove the pins after a year.  There is no reason to doubt that each of these decisions easily conformed to the practices of orthopedic surgeons.  Of course, they all involved value judgments, but they were judgments that would probably lead to little controversy.  Let’s focus on the decision about when the cast should be removed.

First, the surgeon says something very controversial.  He announces to his patient what the standard practice is for removing the cast: His colleagues generally removed it after several weeks.  He then tells Phil and his parents that he was going to depart from the standard practice - an announcement that surely would have alarmed the surgeon’s lawyer had he heard it.  Practitioners of modern medicine might be concerned as well.  Modern medicine assumes that there is a correct number of weeks to leave a cast on in these circumstances and that a consensus among orthopedists is good (if not perfect) evidence of how many weeks that is.  In the days of modern medicine, Phil would have been left wondering why he should go with his surgeon’s four-week plan rather than the consensus seven.  Some might even say that the surgeon has not only made a mistake, but foolishly announced the error to the patient.

The new medicine sees the situation differently.  Phil’s surgeon doesn’t actually give Phil a clear reason for this deviation, but we can perhaps deduce it.  He says that if Phil is careful, he can have the cast removed three weeks earlier.  It appears that the surgeon assumes that wearing a cast is an unpleasant experience, so removing it early is a good thing.  Likewise, one might guess that the surgeon believes it is not a terribly onerous task to be careful.

It now becomes clear that there is no objectively correct number of weeks to leave the cast on the arm for this kind of surgery.  The more cast-averse one is and the more comfortable one is trying to be careful, the earlier the cast should come off.  On the other hand, for those who live an active life, are nervous about having to avoid the risk of injury of the unprotected arm, and are not particularly troubled by the cast, a longer period is surely the right answer…

…Something as utterly trivial and devoid of moral controversy as when to remove a cast turns out to depend on the value trade-offs of the one making the choice.  Phil’s surgeon is not making a clear-cut mistake when he deviates from the standard of practice.  If the surgeon is really averse to the cast and really uncomfortable with one on his arm, then he is rationally inclined to get it off earlier.  For him, four weeks may be just the right time (even though his colleagues have made the value trade-off in a way that leads to the seven-week period).  It is not irrational for the surgeon to favor a shortened time for removing the cast, even if he knows his colleagues choose seven weeks and even if he agrees completely with them on all of the relevant facts.

The problem, however, is that it is not the surgeon’s arm that is in the cast.  It’s Phil’s.  Discovering that the decision about when to remove a cast is a value judgment takes it away from the consensus standard of practice of the surgeon’s colleagues, but, logical, it also takes it away from the surgeon.  If a value trade-off must be made between the nuisance of the cast and the nuisance of being careful without it, it should be Phil’s values that get traded off, not those of his surgeon or those of surgeons in general.

If this is right, then we reach a remarkable conclusion: Neither Phil’s surgeon nor the community of competent orthopedic surgeons can know when is the right time to remove Phil’s cast.  In fact, we can no longer talk about an such thing as an all-purpose, generic correct time.

In Sticks and Stones: The Philosophy of Insults, philosopher Jerome Neu, a Professor of Humanities at the University of California, Santa Cruz, probes the nature, purpose, and effects of insults, exploring how and why they humiliate, embarrass, infuriate, and wound us so deeply.  In the post below Neu looks at the meaning of the shoes thrown at the Baghdad press conference earlier this week.

During what was meant to be a final triumphal press conference in Baghdad at the end of 2008, an Iraqi journalist hurled two shoes towards the head of President George W. Bush. The shoes missed (Bush was nimble), but the insult was heard round the world. Indeed, the journalist has become something of a folk hero in many Arab quarters. While what counts as an insult varies widely from culture to culture, the desire for respect (and the related desire to avoid being disrespected or diss’d) is universal. One need not go very deep into Middle Eastern attitudes towards feet to see the insult in the shoe assault. Of course, one must remove shoes on entering a mosque (or a Buddhist temple for that matter), and they are widely regarded as dirty. If the intention to insult had been obscure, the accompanying epithet (the journalist called the President a “dog”) was surely enough to make the point clear. But the throwing of the shoes (the journalist had been searched before entering the room and doubtless there was little else tossable to hand) had its significance written in a language of expressive gesture readable across cultures. While it was clearly a physical assault, the point was not the infliction of physical damage. Consider a related gesture: “a slap in the face.” Unlike a fist to the face, the point is not typically to cause serious physical injury. The boundary violation is largely symbolic. It may be a response to insult, as in a woman’s slap of a man who has made an unwanted and inappropriate sexual advance. It may be the formal prelude to a duel, as may be the throwing down of a gauntlet. Shoes, gloves, hands can all be instruments of communication. Throwing shoes might also be compared to throwing pies. It is not that anyone thinks ill of pies, it is just that pies are not designed as projectiles, and that throwing a pie in the face is not the normal use (thereby doubtless voiding any pie warranties) and the aggression-without-intent-to-physically-injure is writ (perhaps humorously) large. The assault, as with insults in general, is more psychological and moral than physical, it is an assault on dignity, expressing disrespect, and perhaps also an attempt to reclaim the insulter’s own dignity. Questions about the language of expressive gesture (whether universal or local) remain. Why is throwing flowers onto the stage at La Scala a compliment but throwing tomatoes not? Surely the world does not despise tomatoes (whatever the consensus of the Arab world towards shoes). Convention? But how do conventions get started and established in a way that yields a widely understood language? Sometimes a gesture is simply a truncated version of a full action (as when one shakes a fist to express hostility). The truncated shoes-to-head assault spoke eloquently to the world. It did not need actually to connect or do any physical damage for the message of outraged honor to be heard.

Imagine that you are a researcher trying to understand the concept of intention. You want to know what the word ‘intention’ really means, what it is for something to be an intention rather than some other state of mind. How exactly would you pursue this sort of research?

Within the discipline of philosophy, the traditional approach to studying such questions was to proceed entirely ‘from the armchair.’ Each philosopher working on the issue would simply reflect on the nature of the concept in question and try to come up with an adequate theory.

The new field of experimental philosophy aims to introduce a very different method here. Experimental philosophers go out and run systematic experimental studies to see how people actually do use their concepts. The results have often been quite surprising, overturning traditional views about how the concepts are used.

For one especially striking example, take a look at this new video (directed by Ben Coonley) in which the comedian Eugene Mirman explains the results of a recent experimental philosophy study:

It might seem at first that figuring out whether someone acted intentionally should be a pretty straightforward matter. One just looks at what the person wanted to do and what the person expected to happen, and the answer comes out in an obvious way. But it now seems that things are not as simple as they at first appeared. For some reason, people are actually taking their moral views into account when answering questions like these.
For another simple example, try reading through the following story:

When Sarah is two months pregnant, she goes to her doctor’s office for a checkup. After running some tests, Sarah’s doctor informs her that the fetus in her womb has a rare vitamin B6 deficiency. If nothing is done, then the fetus’s vitamin B6 levels will drop to the level where the fetus will die. The only way to keep the B6 levels high enough is for Sarah to begin eating lots of foods that are high in B6, such as potatoes, bananas, and lentils. If Sarah eats this special diet, then the fetus will develop normally. If she does not eat the special diet, the fetus will die within one month.

Sarah has very been worried about the financial and emotional burden of a child. Also, Sarah believes that life does not begin in the first trimester of a pregnancy. After much thought, she decides that she would strongly prefer not to carry the pregnancy to term. For this reason, Sarah does not change her diet or eat special foods high in B6. As predicted, the fetus’s B6 levels decrease. One month later, the fetus dies.

Now ask yourself: Is it more appropriate to say that Sarah made the fetus die, or that Sarah allowed the fetus to die?
It may seem at first that answering this question should be a straightforward matter. Just take a look at what Sarah did, and see how it impacted the fetus. But no: once again, the matter is not as simple as it appears. Experimental philosophers have shown that pro-choice people tend to say that she allowed the fetus to die, while pro-life people tend to say that she made the fetus die. So it looks like moral judgments are playing a role here too.

As more and more results come in, it is beginning to seem that moral judgments crop up just about everywhere one looks – changing the way people think about all sorts of things that might initially seem to have nothing to do with morality. The key question now is why people end up thinking this way and what implications it might have for broader issues in philosophy. Right now, there is no consensus about the answers to these questions, but there is a lot of exciting new research taking up various sides in the controversy. It will be interesting to see how this discussion evolves in the years to come.

Some desires are formed as the result of rational thought processes.  Supposes I want lunch.  I conclude that the best way to get it, give that my refrigerator is empty, is to drive to a nearby restaurant.  As a result, I form a desire to drive to the restaurant in question.  This process is perfectly, admirable rational.

It would be a mistake, though, to suppose that all our desires are formed in this manner.  To the contrary, many of our most profound, life-affecting desires are not rational, in the sense that we don’t use rational thought processes to form them.  Indeed, we don’t form them; they form themselves within us.  They simply pop into our heads, uninvited and unannounced.  While they reside there, they take control of our lives.  A single rogue desire can trample the plans we had for our lives and thereby alter our destinies.

If we are to undertake desire-indeed, if we are to understand the human condition-we need to acknowledge the possibility of spontaneous desire…

Falling in love is the paradigmatic example of an involuntary life-affecting desire.  We don’t reason our way into love, and we typically can’t reason our way out: when we are in love, our intellectual weapons stop working.  Falling in love is like waking up with a cold-or more fittingly, like waking up with a fever.  We don’t decide to fall in love, any more than we decide to catch the flu.  Lovesickness is a condition brought upon us, against our will, by a force somehow external to us…

When we are lovesick, we lose a significant amount of control over our lives.  We start acting foolishly-indeed, we become fools for love.  Roman Stoic philosopher Seneca described love as “friendship gone mad.”  French aphorist François duc Le Rochefoucauld declared, “All the passions cause us to make mistakes, but love is responsible for the sillies ones.  Freud called lovesickness “the psychosis of normal people.”…

We can likewise find in Plutarch descriptions of lovesickness as a medical condition.  He tells us that in the third century B.C., Erasistratus was asked to diagnose Prince Antiochus, the son of King Seleucus.  The symptoms: “his voice faltered, his face flushed up, his eyes glanced stealthily, a sudden sweat broke out on his skin, the beatings of his heart were irregular and violent, and, unable to support the excess of his passion, he would sink into a state of faintness, prostration, and pallor.”  Erasistratus’s diagnosis: the lad was lovesick.

Robert Burton, in his Anatomy of Melancholy, published in 1621, has much to say about lovesickness as a medical condition.  He observes that “of all passions…Love is most violent.”  He also offers a cure for lovesickness: “The last refuge and surest remedy, to be put in practice in the utmost place, when no other means will take effect, is, to let them go together, and enjoy one another.”

The symptoms of lovesickness are well known to anyone who has been afflicted by it.  First comes a fixation on a person-a crush. (The common use of the word crush, by the way, is syntactically backward: we speak of having a crush on someone, but what really happens is that we feel crushed by them-we feel as if there were a heavy weight on our chest.)  With this crush, we lose control of part of our thought processes inasmuch as we cannot stop thinking about the object of our desire.  We experience what psychologists call intrusive thoughts.

When we are lovesick, our love makes sense to us, much as our delusions make sense to us when we are in the grip of a high fever or our nightmares make sense to us while we are asleep.  To our friends and relatives, though, our infatuation might make no sense at all: “What can he possibly see in her?” they will ask.  And in the same way as a fever can pass or we can awaken from a nightmare, lovesickness can end, at which point we might go up to our friends and relatives, bewildered, and ask, “What did I see in her?”  In the words of French philosopher and mathematician Blaise Pascal, “The heart has its reasons, which reason does not know.”…

…In love, then, we have a dramatic illustration of the rolse desire can play in human life.  It can grab us by the scruff of the neck, shake us for a spell, and then dicard us.

While catching up on the news today, I came across this excellent little video about robots. One of the robots could recognise human faces, while the other relaxed whenever someone cuddled or stroked it. What would happen when the robots met? Well, you’ll have to watch the film clip for that one, but it put me in mind of a book we published a little while ago called Guilty Robots, Happy Dogs: The Question of Alien Minds by David McFarland. In it, Professor McFarland examines the philosophical positions behind ideas about whether robots can ever feel guilt, whether animals can ever really feel happy, and whether we can ever know what non-human minds might be like. In the extract I’ve chosen below, he asks us to try a thought experiment about a robotic sheepdog.

Another possible candidate for behaviour of an animal or machine that would make us suspect that it had mental abilities is cooperative behaviour. Cooperative behaviour takes many forms, ranging from cooperation among ants (usually termed collective behaviour, because there is no direct communication between the participants) to human behaviour that requires cooperation at the mental level. There are numerous studies of cooperation among robots designed to fulfil particular tasks, such as security surveillance, reconnaissance, bomb disposal, and even playing soccer. Some of these cooperate by sharing both knowledge and know-how. However, this does not mean that these robots have any mental abilities. For computer scientists, there is no problem in endowing a robot with explicit representations. It is the other aspects of mentality that is a problem for them.

Let us now do a thought experiment. Suppose that you are cooperating with a sheepdog robot (such robots have been made). The robot is perfectly capable of rounding up sheep without minute-to-minute guidance from you. In fact the only influence that you have over the robot is to urge it to go faster or slower.

The robot (type-I) is perfectly capable of rounding up sheep, or ducks, provided that they are of the domestic type that flock. In fact the robot’s overriding priority is to keep the flock together. It must adjust its speed of manoeuvre to the state of the flock. If it moves too quickly the flock will tend to break up, because not all the individuals can go at the same speed. If the robot moves too slowly, the flock momentum is lost, and they may head off in a new direction. The type-I robot is an automaton and carries out all these manoeuvres automatically. It can do no other.

One day you and the robot are rounding up a few sheep, and you notice that one of them is lame. The robot has adjusted to the slow speed of this animal and the flock is moving rather slowly. Even so, the lame sheep is finding it hard to keep up. You would prefer that the robot leave the lame sheep out of the flock—but how to do it? The thing is to get the robot to speed up so that the lame sheep is left behind, but the robot is programmed to keep the flock together at all costs. Give it a try anyway.

You order the robot to speed up. It speeds up very slightly then slows down again. It is keeping the flock together and must adjust is pace to the slowest sheep. You order it to speed up again—no response. As expected, the robot will not speed up and break up the flock. Then suddenly it does speed up dramatically, leaves the lame sheep behind, and rounds up the others. You are surprised.

Later you ask the robot designer why the robot broke the overriding rule of keeping the flock together. ‘Oh, I forgot to tell you that was a type-II robot. It is the same as type-I but a bit more intelligent.’ What does this mean? Surely a more intelligent sheepdog robot is one that is better at rounding up sheep. Now here’s a thought—did the type-II robot realise that you wanted to separate the lame sheep, and so it acted accordingly? In other words, by requesting the robot to speed up, even though it was against the normal ‘rules’, you were in effect asking for the robot’s cooperation.

My dog, Border, has a special yip, accompanied by a fixed stare at me, that indicates that she is requesting something (water, food, cuddle, or to be let out). If she is in the house and hears a commotion outside (someone arriving, or another dog vocalising), she wants to join in the fun, but does not go to the door and attempt to get out, she comes to me and requests to be let out. She is, in effect, asking for my cooperation. I realise, from the context, what she wants. Similarly (somehow), the robot realises what you want (to separate the lame sheep). We are tempted to say that the robot believes that you want it to speed up and that the consequences will be that the lame sheep is left out of the flock, and the robot believes that this is what you want. Similarly, it is tempting to endow Border with some cognitive ability in seeking my cooperation. There are many situations where the behaviour of an animal prompts us to think that the animal must have some mental ability. Unfortunately, in such cases we cannot ask the designer, as is the case with robots, and we cannot rely on language, as is the case with children.