There are many debates surrounding the proper usage of the word "disability." In this paper, we argue that it is a mistake to attempt to diagnose such debates in a vacuum, but rather that we should assess the truth of specific attributions based on context. This is a familiar move from the literature on epistemic contextualism about knowledge. We thus briefly describe how the maneuver is used in that literature. We then formulate two versions of Disability Contextualism (DC)-a weak version that merely asserts that the context is relevant for assessing the truth of affirmations and denials regarding particular models of disability, and a stronger version that says a bit more about what elements of the context might be relevant. We then argue for why contextualism is the appropriate option for "disability" by looking at some of the major competitors of its epistemic counterpart.

This paper argues for two intertwined theses. The first is that the nature of autism is such that it sometimes presents with corresponding benefits that make it the case that on some legitimate understandings of the concept of disability some autistic individuals might not count as disabled. The second is that the concept of disability can itself be deconstructed into medical, social, legal, and identity components in a manner similar (though not identical) to the concept of gender, as deconstructed in Lindqvist et al. (2021). I explore the notions of medical, social, legal, and identity disability, and argue that some autistics qualify as disabled on some but not others. I suggest that, given the lack of a definitive answer, the default approach should be to defer to individuals’ self-identifications.

Philosophers have argued that stakes affect knowledge: a given amount of evidence may suffice for knowledge if the stakes are low, but not if the stakes are high. By contrast, empirical work on the influence of stakes on ordinary knowledge ascriptions has been divided along methodological lines: "evidence-fixed" prompts rarely find stakes effects, while "evidence-seeking" prompts consistently find them. We present a cross-cultural study using both evidence-fixed and evidence-seeking prompts with a diverse sample of 17 populations in 11 countries, speaking 14 languages. Our study is the first to use an evidence-seeking prompt cross-culturally, and includes several previously untested populations (including indigenous populations). Across cultures, we do not find evidence of a stakes effect with our evidence-fixed prompt, but do with our evidence-seeking prompt. We argue that the divergent results reveal a tension within folk epistemology: people's beliefs about when it is appropriate to ascribe knowledge differ significantly from their actual practice in ascribing knowledge.

Abstract Nursing ethics educators (and educators more generally) frequently find value in presenting and discussing with students tragic historical events in clinical practice or medical research. In this chapter, the authors argue that the use of images of victims in these cases is ethically problematic. Specifically, they argue that it is not acceptable in a classroom setting to use identifiable photographs of people in a heightened vulnerable state without at least their implied consent, even for otherwise laudable goals. While there is undoubtedly consequentialist value in utilizing such tools, the authors ultimately argue that doing so violates deontological constraints (e.g., with regard to autonomy and respect for persons). If one grants (as is largely assumed) that ends do not typically justify means, this provides grounds for revising current practice.

This paper, in a nutshell, is a plea for community participation in research along with an adapted idea for how such participation should be shaped and understood. I will give varied examples of the ways in which scientists viewing a perceived problem solely from an external perspective has led to mistakes. If we do not properly take into account the knowledge and values of people with a condition, we are liable to pursue the wrong sorts of treatments. In particular, I provide examples of three ways (exemplified in the cases of “female hysteria”, autism, and chronic fatigue syndrome) scientists are liable to pursue treatment of what they perceive to be at least partially mental illnesses that they/we shouldn't. I present the idea of deliberative research—the concept is based on that of deliberative democracy. The idea of deliberative democracy is that decisions should be made on the basis of reasons that would be acceptable to the target population. I similarly argue that research decisions should be made on the basis of reasons that would be acceptable to the target population, even if it requires other experts to determine how those reasons are best to be respected in the context of a particular project.

In this paper, I consider the relationship between coming to understand why something must be the case and coming to understand why it actually is the case in some particular instance. Peter Lipton uses the possibility of coming to understand a phenomenon via a necessity proof as an argument that there can be understanding with no explanation. Lipton's argument has come under criticism, at least partially because one might think that understanding why something must be the case has a different object from understanding the actual phenomenon. In this paper, I argue that that under certain circumstances it is fairly straightforward to come to understand an actual phenomenon on the basis of knowing why it had to be the case. Rather than relying on brute intuitions, my primary strategy will be to show that on least some modern accounts of understanding we can validate Lipton's general point with respect to a variety of possible necessity relations.

Increasing emphasis on patient self-management, including having patients advocate for their needs and priorities, is generally a good thing, but it is not always wanted or attainable by patients. The aim of this critical ethical review is to deepen the current discourse in patient self-advocacy by exposing various situations in which patients struggle to self-advocate. Using examples from oncology patient populations, we disambiguate different notions of self-advocacy and then present limits to the more demanding varieties (i.e., health-related, trust-based, and psychological); we argue that these limits create ethical dilemmas with respect to whether it is always desirable to encourage patients to self-advocate. We conclude that self-advocacy can be both under and overrated with respect to how much it benefits the patient with cancer, with many instances being indeterminate. Ultimately, providers must understand the patient's perspective relative to the challenges they are experiencing and work with them to meet their needs.

Autism research frequently seeks to evaluate interventions or inform their development. Unfortunately, researchers often assume that autism intervention should reduce autistic traits, effectively setting as a goal of treatment that autistic people attempt to "pass" as nonautistic. A growing body of evidence highlights serious potential harms from passing demands. We discuss why it is important for institutional review boards (IRBs) to scrutinize autism research for clinical passing demands, and we document the existence of such demands in outcome measures commonly employed in autism research. We propose an ethical framework for IRBs and others to make use of in evaluating the ethical appropriateness of particular treatment goals in autism intervention or intervention-adjacent research, emphasizing that treatment goals should be in pursuit of a beneficial nonpassing purpose and be the least burdensome means of accomplishing such a purpose. We also highlight potential promising practices for IRBs, investigators, and other stakeholders seeking to address these issues in autism research.

The way in which one understands information and concepts, and the way a student works to develop this, is an individual aspect of learning that cannot be universally defined as (at least manifested) the same for everyone. 'Understanding' is a broad term, and the way one achieves understanding is dependent on the way that material is presented. In this article, we argue that the philosophy of science can be important to nursing education-in particular, by showing that the way we imbue understanding might depend on the meaning of 'understanding'. Diagrams and concept maps are meant to guide newly formed knowledge and connections to develop proper thinking (e.g., the order in which nursing students must prioritize data) that a student requires in the field. We argue that whether or not an image/diagram/concept map confers understanding will depend on both what the object is and what we mean by 'understanding'.

Metaphors are found all throughout science: in published papers, working hypotheses, policy documents, lecture slides, grant proposals, and press releases. They serve different functions, but perhaps most striking is the way they enable understanding, of a theory, phenomenon, or idea. In this paper, we leverage recent advances on the nature of metaphor and the nature of understanding to explore how they accomplish this feat. We attempt to shift the focus away from the epistemic value of the content of metaphors, to the epistemic value of the metaphor's consequences. Many famous scientific metaphors are epistemically good, not primarily because of what they say about the world, but because of how they cause us to think. Specifically, metaphors increase understanding either by improving our sets of representations (by making them more minimal or more accurate), or by making it easier for us to encode and process data about complex subjects by changing how we are disposed to conceptualize those subjects. This view hints towards new positions concerning testimonial understanding, factivity, abilities, discovery via metaphor, and the relation between metaphors and models.

We provide two programmatic frameworks for integrating philosophical research on understanding with complementary work in computer science, psychology, and neuroscience. First, philosophical theories of understanding have consequences about how agents should reason if they are to understand that can then be evaluated empirically by their concordance with findings in scientific studies of reasoning. Second, these studies use a multitude of explanations, and a philosophical theory of understanding is well suited to integrating these explanations in illuminating ways.

This article will focus on the ethical issues of vaccine mandates and stake claim to the relatively extreme position that outright requirements for people to receive the vaccine are ethically correct at both the governmental and institutional levels. One novel strategy employed here will be to argue that deontological considerations pertaining to consent rights cut as much in favor of mandating vaccines as against them. The presumption seems to be that arguments from consent speak semi-definitively against forcing people to inject something into their bodies, and so any argument in favor of mandates must produce different and overriding logical and ethical considerations. Our central claim will be that the same logic that might seem to prohibit vaccine mandates as violations of consent actually supports such mandates when viewed from the perspective of the potential bystander who might otherwise be exposed to COVID-19.

The generally agreed upon principle that legality and ethics can come apart is frequently overlooked in our professional ethics education and decision-making procedures. The crux of the issue is that we teach in our philosophy classes that the law can sometimes be unethical, but then clearly state in nursing codes of ethics that students should always follow the law. The law could no doubt give us some reason to choose action A over action B, but in professional contexts we frequently treat the law as a side-constraint that limits the logical space of choices to exclude even consideration of action B. If B is the mandatory action, this in effect forces professionals to do something unethical by preventing them from ever seeing the ethical action as an option. This is a problem. Ultimately we concede that there might be an irresolvable tension in competing normative interests in ethics and the law, though we suggest that a more nuanced approach to ethical code formation could help alleviate the issue somewhat.

Responding to recent concerns about the reliability of the published literature in psychology and other disciplines, we formed the X-Phi Replicability Project (XRP) to estimate the reproducibility of experimental philosophy (osf.io/dvkpr). Drawing on a representative sample of 40 x-phi studies published between 2003 and 2015, we enlisted 20 research teams across 8 countries to conduct a high-quality replication of each study in order to compare the results to the original published findings. We found that x-phi studies – as represented in our sample – successfully replicated about 70% of the time. We discuss possible reasons for this relatively high replication rate in the field of experimental philosophy and offer suggestions for best research practices going forward.

This article examines ethical issues associated with the return of AD neuroimaging results to cognitively symptomatic individuals. Following a review of research on patient and study partner reactions to learning the results of biomarker testing for AD, we examine ethical issues that will be of increasing significance as the field transitions to an era wherein disease-modifying treatments for AD become available. We first review the ethical justification for returning AD biomarker results to individuals who desire them. We then address a more novel question: whether, and to what extent, clinicians or clinical researchers should influence the decisions of individuals who are potentially reluctant to learn their AD imaging results. We argue that in many cases, it is ethically correct to explore, and sometimes alter, factors that may be inhibiting one’s desire to know these test results. Our argument is grounded in the premise that having more complete information about changes that may be happening in one’s brain will generally yield more informed participation in decisions about one’s own care, thereby promoting autonomy. Finally, on the assumption that we have established that it is frequently ethically correct to try to communicate testing information, we examine considerations regarding (not whether but) how this is best accomplished, discussing the concept of responsible transparency. We suggest that both (1) explorations of why one may or may not want to learn results of AD biomarker imaging and (2) the responsible return of such test results is best accomplished using a transactional model of communication.

From a legal perspective, before a physician engages in a serious medical intervention they must obtain informed consent. In this paper, we argue that there are serious deficits in our processes of obtaining informed consent; it is often seen as just a bureaucratic hurdle, and people agree to interventions without being in an appropriate epistemic state. We explore some possible reasons for this, including ignorance, trust in physicians' authority, and the minimal time physicians spend with patients. We trace many of these issues to one central cause, which is that in the United States obtaining informed consent is the purview of physicians. We argue that a simple shift in how we obtain informed consent can help to ameliorate these issues. Specifically, we argue that obtaining informed consent should be the responsibility of nurses rather than physicians. While there are several reasons for this, the central ideas are that (1) since nurses are the ones who know the patient, they will be in better position to tell when patients are genuinely informed, and (2) patients will be more comfortable asking questions and admitting ignorance to nurses rather than physicians. While we focus on US law, our conclusions are more broadly applicable.

The central claim of this paper is that people who ignore recherche cases might actually understand ethics better than those who focus on them. In order to establish this claim, I employ a relatively new account of understanding, to the effect that one understands to the extent that one has a representation/process pair that allows one to efficiently compress and decode useful information. I argue that people who ignore odd cases have compressed better, understand better, and so can be just as ethical (if not more so) as those who focus on such cases. The general idea is that our intuitive moral judgments only imprecisely track the moral truth—the function that maps possible decisions onto moral valuations—and when we try to specify the function precisely we end up overfitting what is basically a straightforward function to accommodate irrelevant data points.

In this paper, I explore the possibility that the point Kripke (1982) made about understanding meaning also applies to understanding social interaction. This understanding involves extending what one has learned from a finite number of past observations to provide normative guidance for an indefinitely complicated future. Kripke argues (to my mind correctly) that what one should do in the future is inevitably underdetermined by the infinite possible interpretations of the past. Moreover, no matter how much one attempts to make the rules explicit, they will always be underspecified. I then explore the speculative hypothesis that having different tacit dispositions made manifest in one’s understanding of the rules of social engagement would look remarkably similar to tendencies exhibited by many autistic individuals. The analogy will say something substantive about how neurotypicals (and other autists) should treat the behavior of autistic individuals—if we are not even doing anything incorrect, then society should not be criticizing our means of engagement.

Our goal in this paper is to experimentally investigate whether folk conceptions of explanation are psychologistic. In particular, are people more likely to classify speech acts as explanations when they cause understanding in their recipient? The empirical evidence that we present suggests this is so. Using the side-effect effect as a marker of mental state ascriptions, we argue that lay judgments of explanatory status are mediated by judgments of a speaker’s and/or audience’s mental states. First, we show that attributions of both understanding and explanation exhibit a side-effect effect. Next, we show that when the speaker’s and audience’s level of understanding is stipulated, the explanation side-effect effect goes away entirely. These results not only extend the side-effect effect to attributions of understanding, they also suggest that attributions of explanation exhibit a side-effect effect because they depend upon attributions of understanding, supporting the idea that folk conceptions of explanation are psychologistic.