Featured Philosop-her: Gina Schouten

Gina Schouten

Gina Schouten is Assistant Professor of Philosophy at Illinois State University. Before coming to Illinois State, Gina completed her PhD at the University of Wisconsin-Madison in 2013. Her research interests include political legitimacy, educational justice, gender in the family, and diversity problems within the discipline of philosophy. She is currently working on a paper that extends her previous work on stereotype threat in academic philosophy, in which she argues for the expansion of pre-collegiate philosophy instruction as a possible remedy for the underrepresentation of women in the field. Other projects in progress include a series of papers concerning the legitimacy of political interventions to alter the gendered division of labor.

What do we owe the violinist? Some musings on the ethics and politics of abortion

Gina Schouten

Though abortion is a profoundly controversial ethical issue among the population at large, it seems to be fairly decisively settled among feminists. Feminists who endorse women’s full equality in workplaces, politics, and intimate relationships have generally regarded strong protections for reproductive freedoms as essential to securing that equality. I agree that efforts to achieve women’s social and political equality are likely to be frustrated by restrictions on abortion. My sense is that these facts have been taken by many feminists to settle at least the politics of abortion, if not the ethics as well: Women’s equality is an urgent requirement of justice, and that equality depends upon women having the capacity to decide whether and when to have children. Thus, we must assure women access to the tools necessary to choose freely whether and when to become pregnant; and, at least so long as that capacity cannot perfectly be assured, we must assure their access to the tools necessary to end pregnancies that they do not want.

But the urgency of securing women’s equality, and the fact that abortion restrictions frustrate that goal, do not suffice to settle the ethics or politics of abortion.

There are, of course, many different kinds of people who think of themselves as feminists, and some so called “pro-life feminists” argue that women’s interests are actually furthered by restrictions on abortion.[1] These arguments are unpersuasive. But it seems to me that there are some genuine feminist commitments that challenge the moral permissibility of abortion, and that challenge the impermissibility of policies that aim to restrict it.

I assume that restrictions on abortion frustrate the cause of women’s equality. Even so, I want to suggest, tentatively, that such restrictions may nonetheless be justified, all-things-considered. Judith Thomson’s now iconic defense of abortion asks us to assume that the fetus is a person.[2] Still, she argues, this does not suffice to show that it is impermissible to kill it: If the fetus is a person, then its interest in the use of the woman’s body to sustain its life is a morally relevant interest. But according to Thomson, that interest is, in many cases, decisively outweighed by the interests of the woman whose body it is.

On what grounds is this weighting so decisive?

Some of our most basic feminist commitments entail that, if the fetus becomes a member of the moral community at some point during fetal development, then at that point its interests become morally very weighty indeed. Feminists have powerfully drawn attention to the ubiquity of dependence, and the implications of dependence for our moral and political theorizing. We all rely on the care we receive from others to meet our basic needs and to flourish, and our dependence does not lessen our moral claim to have our interests respected and considered in moral decision-making. Moral theorizing is flawed, for example, insofar as it lacks the resources to secure the status of children, people with disabilities, or other dependents as direct and unambiguous moral subjects. This commitment of feminists also makes vivid the fact that moral obligations can compel us even when those obligations are not voluntarily undertaken. Thus are we owed care during times of dependency even if we have no intimate relations who are intrinsically motivated to provide that care.

Because they have so compellingly drawn attention to these implications of our common need for care, feminists are especially well-positioned to recognize a crucial, if contingent, point about the ethics of abortion: Whether or not fetuses are members of the moral community whose interests must be taken into account, their neediness does not suffice to exclude them from the moral community; nor, if fetuses have morally relevant interests, are those interests rendered less weighty by virtue of the fetuses’ reliance on others to have them met. Presumably, the fetal interest implicated in the abortion debate is something like the interest in receiving the care necessary for survival. That seems, prima facie, to be a strong interest. If that interest is not weakened by the fetus’s dependence, then we have some presumptive reason—conditional on Thomson’s assumption that the fetus’s interests are morally relevant to begin with—to think that interest is morally weighty indeed.

Women have a morally weighty interest in reproductive freedom. But as Thomson rightly points out, very morally weighty interests can be in tension with other very morally weighty interests. Under some conceivable circumstances, then, very morally weighty interests can justifiably be frustrated. If this is right, then the fact that abortion restrictions are very bad for women does not yet suffice to show that those restrictions are unjustified, all-things-considered. I am genuinely unsure whether the fetus’s interests are morally relevant, and if so, at what point during the pregnancy they become so. But contra Thomson, I think that answering these questions is of paramount importance. And if the fetus does have moral status, then one initially appealing strategy for discounting the weight of its claims is ruled out by feminist commitments: Dependency does not lessen one’s moral status.

The slogan “the personal is political” captures another paradigmatic commitment of feminism. The personal is political because intimate relationships can give rise to profound vulnerabilities, and these vulnerabilities can generate claims of justice that are no less urgent in virtue of arising in intimate relationships. On these grounds, feminists have rightly resisted those who would classify the family as a “private” realm and afford families presumptive immunity against political intervention. The vulnerabilities of unpaid caregivers, we argue, generate demands of justice even when those receiving care are intimates whom the caregiver loves, and even when the resulting inequalities occur between intimates, such as between the caregiver and her spouse. Because the personal is political, we endorse political protections to secure women’s equality not only in the workplace but in the home as well.

It is tempting to treat abortion as a personal issue. But the personal becomes political when the choices we make have profound implications regarding others’ lives. I have suggested that even the strongest and most compelling interests—such as the interest in securing women’s bodily integrity through reproductive freedom—can conflict with others that are similarly strong and compelling. If fetuses’ interests are morally relevant, then it is difficult to see how we could avoid classifying reproductive choices as political.

Of course, even assuming that fetuses are members of the moral community whose interests must be accorded weight in moral and political calculations, women’s quite strong interest in exercising control over their bodies may be decisive. The importance of reproductive control in securing women’s most basic equality might render their interest sufficiently strong and fundamental to override any countervailing considerations. But even if women’s reproductive freedom is overridingly important, there are nonetheless reasons to keep track of morally important trade-offs that we make in securing it. The difference between a moral calculus in which the fetus’s interests do not matter and one in which they matter but are outweighed might have relevance for both our rhetoric and our policy endorsements.

If we recognize the fetus’s interests as morally important, though, is it so obvious that they are outweighed, even by the extraordinarily strong interest in protecting rights to reproductive freedom? I worry that we might, after all, have some obligation to stay plugged into the violinist. The needs and vulnerabilities of others generate powerful moral obligations, and feminists have long been banner-carriers in the recognition of those obligations. Moreover, if the vulnerability of the fetus is morally important, then it has many of the hallmarks of the personal and yet still political vulnerabilities that feminists have been particularly adept at theorizing.

In considering this possibility, we must remember that ubiquitous dependency generates ubiquitous moral obligations as well: There are serious costs to doing the socially necessary and morally obligatory work of caregiving. We must develop policies to share the costs of discharging such obligations fairly, and to compensate those who incur costs that cannot be shared. If fetuses are morally significant, then the vulnerabilities of those who care for them are particularly urgent, since the most serious harms are entirely non-transferrable. If fetuses’ interests generate moral imperatives, and if pregnant women are uniquely in a position to provide the care they need, the rest of us have obligations to share the costs of providing care insofar as sharing them is possible, and to take other steps to ease resultant vulnerabilities when sharing is not possible. If sustaining fetuses turns out, under some circumstances, to be morally obligatory care, then feminists should endorse protections and social supports for those who perform it and call for new social and medical technologies to share its costs more broadly.

Thomson was right that the fetus’s having morally relevant interests does not suffice to show that abortion is morally impermissible. But we must also recognize a corresponding—if far less welcome—insight: The moral relevance of women’s very strong interest in reproductive freedom does not suffice to show that abortion is morally permissible, or that restricting it is always illegitimate. If we assume with Thomson that the fetus is a person, then our obligations to care for it are weighty indeed. Even if we acknowledge that restrictions on abortion would frustrate profoundly worthy feminist goals, we should consider whether, after all, the ethics and politics of abortion crucially depend on the moral status of the fetus and the moral weight of its interests.

Because I believe that restrictions on abortion are likely to undermine women’s equality, I want for the ethics of abortion to be settled decisively in favor of the woman’s right to choose, and for the politics of abortion to be settled in favor of strong protections for that right. But when I scrutinize my conviction that abortion is permissible and that robust protections for access to abortion are desirable, I am dismayed to find that conviction in tension with other commitments I have that I take to be distinctly feminist. I welcome any thoughts about whether the tension is genuine or merely apparent, and, if it is genuine, how it is best resolved.

[1] I set aside questions about what views are properly regarded as “feminist.”

[2] Thomson Judith J. (1971). “A Defense of Abortion,” Philosophy and Public Affairs 1(1): 47-66.

Featured Philosop-her: Lisa Bortolotti

lisa for blog

Lisa Bortolotti is Professor of Philosophy at the University of Birmingham. She works in the philosophy of cognitive sciences and in biomedical ethics. Her main research interests lie in irrational beliefs. From September 2013 to September 2014 she held an AHRC Fellowship. In October 2014 she started a new project, Pragmatic and Epistemic Role of Factually Erroneous Cognitions and Thoughts (PERFECT), funded by a European Research Council Consolidator Grant. Her monograph on delusions, Delusions and Other Irrational Beliefs (OUP 2009), won the American Philosophical Association Book Prize in 2011. Her new book, Irrationality (Polity 2014), has just been released.

 

Reverse Othello Syndrome and Epistemic Innocence

Lisa Bortolotti

Can delusions playing a defensive function (hereafter, motivated delusions) have epistemic benefits? Arguably, they can prevent loss of self-esteem and help manage strong negative emotions. The claim that delusions are psychologically adaptive was recently discussed in the psychological literature (McKay and Kinsbourne 2010; McKay and Dennett 2009).

Without denying that delusions are typically false and irrational, and that they compromise good functioning, my goal here is to ask whether the psychological benefits attributed to motivated delusions can translate into epistemic benefits. Thinking about delusions in terms of potential epistemic benefits invites a reflection on the relevance of contextual factors in epistemic evaluation.

 

Motivated delusions

Clinical delusions are symptoms of psychiatric disorders such as schizophrenia, dementia, and delusional disorders. Motivated delusions can be characterised as irrational beliefs, in that they are implausible, they do not accurately represent reality, they do not respond to evidence, and they may not be consistently reflected in behaviour. An example of a monothematic delusion with a defensive function that emerged as a result of brain damage is the case of Reverse Othello syndrome (Butler 2000). A man, BX, delusionally believed that he was in a happy relationship, when in fact his partner had left him.

Butler’s patient was a talented musician who had sustained severe head injuries in a car accident. The accident left him quadriplegic, unable to speak without reliance on an electronic communicator. One year after his injury, the patient developed a delusional system that revolved around the continuing fidelity of his partner (who had in fact severed all contact with him soon after his accident). The patient became convinced that he and his former partner had recently married, and he was eager to persuade others that he now felt sexually fulfilled. (McKay et al. 2005)

BX’s belief in the fidelity of his previous partner and the continued success of his relationship was very resistant to counterevidence. BX believed that his relationship was going from strength to strength, even though his former partner did not want to communicate with him and was in a relationship with someone else.

The delusion seemed to protect BX from an undesirable truth while he was coping with the consequences of permanent disability. Gradually BX developed the delusion that his former romantic partner was still in a relationship with him, and also that they had recently married. While still in hospital, he often asked to go home so that he could see his wife. Butler argues that the delusion relieved the sense of loss that BX was feeling at the time.

[A]ppearance [of delusions] may mark an adaptive attempt to regain intrapsychic coherence and to confer meaning on otherwise catastrophic loss or emptiness (Butler 2000).

As gradually as it had appeared, BX’s delusional system dissolved, and by the end of the process BX realised that his former partner had moved on, was not married to him, and had no intention to go back to him. This happened roughly at the time when BX had completed his physical rehabilitation and was ready to return home.

Butler argues that a psychological defence against depression contributed to the fixity and elaboration of BX’s delusional system. The delusion kept BX’s depression at bay at a very critical time. Acknowledging the end of his romantic relationship might have been disastrous at a time when he was coping with the realisation of his new disability and its effects on his life.

 

Delusions as a shear pin

According to the “shear-pin” account developed by McKay and Dennett, some false beliefs that help manage negative emotions and avoid low self-esteem and depression can count as psychologically adaptive. McKay and Dennett suggest that, in situations of extreme stress, motivational influences are allowed to intervene in the process of belief evaluation, causing a breakage.

What might count as a doxastic analogue of shear pin breakage? We envision doxastic shear pins as components of belief evaluation machinery that are “designed” to break in situations of extreme psychological stress (analogous to the mechanical overload that breaks a shear pin or the power surge that blows a fuse). Perhaps the normal function (both normatively and statistically construed) of such components would be to constrain the influence of motivational processes on belief formation. Breakage of such components, therefore, might permit the formation and maintenance of comforting misbeliefs – beliefs that would ordinarily be rejected as ungrounded, but that would facilitate the negotiation of overwhelming circumstances (perhaps by enabling the management of powerful negative emotions) and that would thus be adaptive in such extraordinary circumstances. (McKay and Dennett 2009)

Could motivated delusions be adaptive misbeliefs? The mechanism that inhibits motivational influences on belief evaluation is compromised, and as a result of this motivated delusions emerge, making negative emotions easier to manage and depression less likely to ensue. McKay and Dennett consider the possibility that motivated delusions count as adaptive misbeliefs, but interestingly argue that the extent to which desires are allowed to influence belief formation in the case of delusions is pathological. Delusions are the result of the maladaptive version of a psychologically adaptive mechanism.

According to the shear-pin account, the situation in which adaptive misbeliefs emerge is already seriously compromised. The premise is that the person is already experiencing high levels of distress, and can come to more serious harm unless her negative emotions are managed. Thus, the benefit here amounts to the prevention of more serious harm than the one the person is already experiencing. In other words, the adaptive misbelief is equivalent to an emergency response.

 

Epistemic innocence

According to the legal notion of justification defence, an act does not constitute an offence when it prevents serious harm from occurring and other ways of preventing the harm were not available to the agent at the time. The act is seen as an acceptable response to an emergency. I want to apply this notion of innocence to the domain of epistemic evaluation. In some contexts, a misbelief may help avoid worse epistemic consequences, and thus qualifies as an acceptable response to an emergency. A delusion is epistemically innocent if adopting it delivers a significant epistemic benefit that could not be obtained otherwise.

If a belief helps manage negative emotions, protect self-esteem, and relieve anxiety and stress (e.g., “I am now severely disabled, but my girlfriend still loves me”), it will have positive effects not just on the agent’s wellbeing but also on her capacity to function well epistemically. By having the belief, a person will be more likely to engage with her surrounding physical and social environment in a way that is conducive to epistemic achievements. Consequences of stress and anxiety include lack of concentration, irritability, social isolation, and emotional disturbances. These in turn negatively affect socialisation, making interaction with other people less frequent and less conducive to useful feedback on existing beliefs, and to the fruitful exchange of relevant information. Due to reduced socialisation and engagement, the acquisition and retention of knowledge is compromised and intellectual virtues are not exercised.

Notice that the delusional belief may bring relief at the time when it is adopted, due to the person being already in an epistemically compromised situation, but it often increases rather than reduces stress and anxiety when it is maintained in the face of conflicting evidence and challenges from third parties. Stress and anxiety no longer come from the negative emotions associated with trauma or loss (e.g., “My girlfriend left me”), but from the fact that the content of the delusion clashes with aspects of the person’s experience, conflicts with other things she believes or feels, and alienates other people. For all of these reasons, anxiety and depression do not always lessen after a delusion is adopted, they can also heighten. My claim here is modest: delusions can be epistemically innocent when they are adopted; and their epistemic innocence does not mean that they are also epistemically justified, or epistemically good overall.

Cannot the person adopt a belief that has the same epistemic benefits as the delusional one but fewer costs? One suggestion emerging from the empirical literature is that, in the extraordinary circumstances in which the agent finds herself, no other belief with the relevant characteristics is available. A belief that is more tightly constrained by evidence (e.g., “My girlfriend left me”) than the delusional one may not be as well placed as the delusional one to play a defensive function, in terms of defusing the negative emotions caused by trauma and disability. The non-delusional belief lacking those psychological benefits may also lack the epistemic benefits associated with the delusional belief.

 

Conclusions and implications

I suggested that motivated delusions have obvious epistemic costs but can also have a significant epistemic benefit that would be otherwise unattainable. When we think about adaptive misbeliefs, we usually think in terms of there being a trade-off. Believing something false can make us feel better, but it leads us further away from the truth.

The case for the potential epistemic innocence of motivated delusions puts some pressure on the trade-off view. It would be misleading to believe that motivated delusions provide anxiety-relief and protect self-esteem by compromising access to the truth. Rather, in the account I have sketched, the delusion is adopted at a time when access to the truth is already compromised, and it would be further compromised unless negative emotions were effectively managed. As a temporary response to an emergency, motivated delusions play a useful epistemic function.

In the case of BX with Reverse Othello syndrome, the clinical team decided not to challenge the delusion after they realised that there were no other psychotic symptoms and the delusion was playing a defensive function.

Persistent attempts […] to challenge B.X.’s delusional beliefs were unsuccessful and usually led him to become tearful and agitated.

All members of the treating team were instructed not to aggressively B.X.’s delusional beliefs but were also cautioned not to become complicit in his elaboration of them. (Butler 2000)

A clinical team might decide not to challenge a delusion if they think that it will be ineffective or disruptive, or if there is a high risk of depression ensuing from the agent’s insight into her mental illness. My discussion suggests that, in these contexts, challenging the delusion would not be advisable from an epistemic point of view either. At the critical stage, motivated delusions may serve a useful epistemic function, allowing the agent to overcome negative feelings or low self-esteem that would prevent her from functioning as an epistemic agent.

 

References

Butler, P. (2000). Reverse Othello syndrome subsequent to traumatic brain injury. Psychiatry: interpersonal and biological processes 63 (1): 85–92.

McKay, R. and Dennett, D. (2009). The Evolution of Misbelief. Behavioral and Brain Sciences 32 (6): 493–561.

McKay, R. and Kinsbourne, M. (2010). Confabulation, delusions and anosognosia. Motivational factors and false claims. Cognitive Neuropsychiatry 15 (1): 288-318.

 

Acknowledgements

For the research on which this post is based, I acknowledge the support of the Arts and Humanities Research Council (The Epistemic Innocence of Imperfect Cognitions, grant number: AH/K003615/1). A more detailed argument will appear in an article entitled “The Epistemic Innocence of Motivated Delusions”, forthcoming in Consciousness & Cognition.