My research employs philosophical accounts of emotion and insights from moral psychology to inform how we might better understand ourselves and how we might better understand and engage with others — interpersonally, institutionally, and clinically. On the flip side, I also employ insights from clinical fields to inform moral psychology and philosophical accounts of emotion. Some of my work also touches on issues in epistemology, metaphysics, the philosophy of disability, clinical ethics, and philosophy of technology. I have a couple of more empirically-oriented clinical and biomedical ethics projects underway too.
Publications
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Crítica (2024)
Special issue on current themes in philosophy of psychiatry
Accessible hereAbstract:
This paper intervenes on recent debates about whether to include Prolonged Grief Disorder (PGD) as a diagnostic category in the DSM. Often when thinking about institutionalized social categories we tend to focus on negative looping effects – ways that classificatory processes like medicalization (treating something as a disorder) contribute to harmful social practices or distortions of self-conception. I call attention to beneficial looping effects that might be achieved by medicalizing (some) experiences of grief, which would in turn provide heavyweight reasons in favor of medicalization that have been overlooked in recent discussions. In arguing for this, I highlight the often-underappreciated role that medical institutions play in providing tools for self-understanding and fruitful engagement, as opposed to being (just) tools for treatment and recovery. -
(With Jennifer Blumenthal-Barby)
Forthcoming in The American Journal of Bioethics
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Journal of Medical Ethics (2023)
Accessible hereIt has been suggested that if considerations of autonomy and beneficence support deference to patients’ risk attitudes in medical decision-making, this deference should include the risk attitudes that individuals desire to have or reflectively endorse (Makins N. Patients, doctors and risk attitudes. J Med Ethics 2023;49:737–41.) I draw out a relevant and overlooked distinction between:
(1) deferring to patients’ higher-order attitudes that endorse the first-order risk-attitudes they currently hold
and
(2) deferring to patients’ higher-order attitudes that endorse risk attitudes that are at odds with the first-order risk attitudes they currently hold (which equates to a higher-order desire to change one’s first-order risk-attitudes).
Deferring to a patient’s higher-order desire to possess first-order risk attitudes other than those she in fact possesses is not equivalent to deferring to her endorsement of attitudes she already possesses. Though both instances of deference involve treating her as the person she aspires to be, only the first instance is responsive to the person she actually is. Failing to be thus responsive is problematic because autonomy requires assisting a patient to direct her life in accordance with her higher-order values—not treating her as if she already is the person she aspires to be. Deferring to the attitudes that an individual would like to, but does not in fact, hold, thus risks undermining her autonomy.
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My dissertation, “Grief, Health, and Medicalization” articulates the role that grief plays in human health and flourishing. Along the way, I develop an account of grief as constructive process that opens up new possibilities for living in ways that are responsive to value. I also contribute to debates about the recent controversial addition of Prolonged Grief Disorder (PGD) to the DSM.
Papers in Progress
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(Under Review)
Email me for a draftThis paper develops and defends an account of grief that diverges from other philosophical accounts in that it rejects a widespread background assumption that (I will go on to argue) pervades the latter:
Problematic Belief (PB)
Grievers do well to (and should) eventually overcome, or move on from, their grief.
PB is oftentimes implicitly assumed rather than explicitly argued for. Through subjecting it to scrutiny, I show that it is far less plausible than it may initially appear to be and, more importantly, that its acceptance has led grief-theorists astray. In particular, significant philosophical attention has recently been paid to some apparent – seemingly intractable – tensions surrounding our attitudes towards the diminution of grief[1]. I will go on to suggest that extant accounts are unable to resolve these tensions because they are committed to PB. In contrast to other philosophical accounts of grief, I argue that in some contexts continued – even endless – grief can be good for the griever.
[1]See, for example, Julius Schönherr (2021), Moller (2017), Marušić (2018) and Scheffler (ms).
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Email me for a draft
This paper identifies and explores the significance of two unappreciated features of grief:
(i) grief exhibits object plenitude:
in grief, there is never just one “object” of loss. These objects stand in intimate and overlapping relations to each other such that there are not always (clear) boundaries between them.
(ii) grief exhibits object generation:
grief is not merely a means of discovering new ways of responding to things that we value - it is also one of the means via which things come to have value for us. In other words, it is (partially) through the process of grieving that we construct the objects of our grief.Considering these two features of grief supports and supplements the claim that grief is not a solely backwards looking process. But it also does more than this: it highlights that the objects of any particular grieving process are spread across the past, present, and future. In other words: grief is diachronic in both form and object.
This insight helps us to see why both grief in response to the death of a loved one and other forms of grief are of a unified kind. Moroever, not fully appreciating the multi-directional temporality of grief is, I suggest, a place where many extant accounts of grief go wrong: they focus on identifying the object of grief and in turn try to explain the fittingness (or rationality or appropriateness) of continued grief in terms of this. Taking grief’s perdurance seriously helps to explain why focusing on the initial cause of grief (identifying the “object” of grief) will never give us a full picture of the phenomenon.
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One of the challenging things about thinking through the significance of transhumanist proposals and prospective human enhancements (loosely understood as interventions aimed towards improve human life beyond what is “normal”), is that we do not know whether (or which of) the things that are significant to us as beings of the kind that we are now will be significant to us once we are changed in different ways. In other words, when considering prospective changes to the human species or to our current ways of life, a number of important questions arise for which we cannot appeal to the mere weighing of pros and cons for answers: how do we knowwhat will be lost? Via which standards should we determine what counts as an improvement, a mere change, or a loss?
The structure of this challenge is familiar: it is a version of the more general problem that transformative experiences pose for rational choice.
I suggest that once we take seriously that it is partially through grieving that we construct meaning, this gives us new resources for thinking about how to approach these questions: anticipatory grief can be a rational response to transhumanism.
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This paper proposes incorporating Anderson’s concept of relational equality into clinical education as a potential mechanism for equipping healthcare providers with helpful conceptual resources for approaching the disentanglement of medicalization and pathologization and for minimizing the transmission of medical stigma.
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an empirical study conducted as part of my work with Michigan Medicine and the Center for Bioethics and Social Sciences in Medicine
Projects in Development
Within philosophy of emotion and moral psychology
In a new extension of my work on grief, I am developing an account of the role that positive repetition plays in our learning how to value in the context of other temporally extended emotional processes, with a focus on gratitude, shame, anger, and wonder.
Within philosophy of medicine
I have recently been thinking about how the arguments I have made about the looping effects of medicalizing grief might apply in the context of other psycho-socially complex diagnostic classifications.
For example, in the case of Prolonged Grief Disorder, I have argued that an institutional approach to medicalization would be beneficial: to what extent does this carry over in the case of other diagnostic classifications? Recent debates in both medical ethics and social metaphysics have raised difficult issues about the medicalization of diagnoses with significant cultural components (like autism and ADHD), mirroring similar questions about the medicalization of disability categories more broadly. I am working on extending this strand of my research by exploring how distinctive features of my approach to grief might fruitfully inform these and related discussions.