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Interesting, but I think the article ultimately makes the same kind of mistake it criticizes Feinberg in making when he attempts to draw a distinction between disorders of rationality and disorders of mood. In particular, the assumption that there is some accessible standard we can use to decide if someone is capable of making rational choices about continuing their life.

Supposedly, the case where Alice wants to kill herself because she is convinced that Martians have invaded the town and will inevitably kill her is a clear example of someone lacking the capability to make rational choices about continuing their life. Yet, nothing in this example requires that Alice make any false logical inference. Alice might calmly say that, "Yes, I could be wrong and if so I would be making a terrible mistake but nonetheless the behavior of individuals A, B and C convinces me that it is overwhelmingly likely they are Martian spies." She might agree with you about all factual details about these people's actions and simply insist that their actions (which are merely slight variations in schedule/mood) are sufficiently abnormal to justify her conclusion. Before you throw this out as absurd consider the documented cases where people suffer a disconnect between their visual and emotional system and, despite otherwise complete rationality, are unable to see their loved ones without concluding they are imposters.

Now consider Amy who, like Alice, wants to kill herself but because she has been diagnosed with an illness offering only a tiny chance of successful treatment and great suffering/humiliation if that treatment fails. Amy, however, readily admits that if she had to choose between ceasing to exist and enduring this risk for even a small chance at continued existence the later option is clearly preferable. But, like most Americans, Amy happens to believe that she will continue to exist in the afterlife after she dies (and doesn't think she will be punished for suicide). Like Alice, when questioned about her belief in the afterlife she is only able to point to fairly mundane events and insist that things like the experience of beauty or love are enough to justify her belief in a caring god and thus an afterlife.

What, if anything, is the difference between Amy and Alice. I can't think of any except that Amy socially conforms while Alice adopts a non-conformist view. I happen to think that it is much more likely that there really are Martians hiding under the surface of the planet and spying on us using their advanced technology than a caring god created this world. I tend to think it is Amy, not Alice, who shows a greater inability to evaluate the available evidence and reach appropriate conclusions (even though both may be perfect Bayesians differing only in their priors).


Now perhaps you might want to invest the fact that Amy accepts a widely held societal belief with some significance to distinguish the cases but I think this reaction shows the pragmatic inadequacy of the approach. Ultimately, if you are willing to lock up Alice you have to make brute choices about what kinds of things it is and isn't acceptable to assume and this means that `cult members' and other minority religious beliefs will be treated very differently than mainstream beliefs.

Without a bright line like a test of logical reasoning ability assessed purely on it's mathematical correctness inevitably judges will lean towards preventing the travesty they see in front of them when someone is trying to make a choice that society feels is deeply mistaken. Without any clear way to distinguish belief in UFOs from belief in Christ that lean will simply progress to the same status quo we have now where people ultimately reach the conclusion they feel is best for the person in their gut.

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