My research draws on a background in philosophy of emotion and experience in clinical ethics consultation to address questions in bioethics and related fields, with special attention to questions of justice in medicine. I am currently at work on two major projects.
Fittingness and Its Implications in Medicine and Psychiatry: Emotions and moods are rationally evaluable, i.e., they can be justified by reasons, just as beliefs and actions can. In fact, philosophers have identified a type of normative reason distinctive of affective responses: a fitting reason. In recent work, I argue that this framework can help elucidate the boundary conditions of certain mental disorders. Specifically, it can help us to recognize that affective syndromes superficially identical to pathologies such as Major Depressive Disorder can be rational responses to extreme circumstances, especially those characterized by oppression and structural injustice. This framework can prevent psychiatrists from inappropriately, and therefore unjustly, representing an individual's appropriate response to their circumstances as a pathological response. Future work will examine the role of fittingness judgments in assessments of decision-making capacity, especially for end-of-life decision-making.
Belief, Trust, and Decision-Making Capacity: In work currently under review, I investigate whether disbelieving one's diagnosis and/or prognosis can or should result in being found incapable of making decisions regarding the management of one's health condition. Although I think disbelief of this sort renders a patient incapable under circumstances, this draws out serious questions about the ethics of capacity assessments, particularly when disbelief issues from, or is representative of, a patient's justified distrust of medical practitioners (e.g., because of past experiences of racist treatment in the health care system).
In addition, I am interested in ethical issues related to rationality and decision-making capacity in individuals with delusional and psychotic disorders, the moral justification(s) for withholding and/or withdrawing medically inappropriate treatment, and the role of empathy in medical and psychiatric practice.
Upon request, I am happy to share my work on any of these topics, insofar as it is at a shareable stage.
Q&A for my talk, "Moral Anger, Empathy, and Solidarity" at Political Role of Moral Emotions, University of Geneva, June 2022. Credit to Andrew I. Cohen.
What use is empathy if we can only muster it for those to whom we are similar? This is the challenge posed by mounting evidence of intergroup empathy bias and has led some moral psychologists to suggest that we are better off without empathy altogether, morally speaking. I present a picture of empathy, as well as the class of fellow feelings to which it belongs, as essentially connected to patterns of caring attitudes. Although this may not vindicate it as a lodestone of an impartialist moral theory, I argue that it does help us to understand the reasons that bear most prominently on empathy and the circumstances in which it is demanded. These are, respectively, the reasons we have to care about others -- which do not direct us to privilege others on the basis of mere similarity -- and the context of loving relationships, which I argue we would necessarily give up in any recognizable form of we were to get rid of empathy. Also discussed are the parallels between empathy and Schadenfreude, with which it is argued that the latter can be not only appropriate but positively demanded by relationships marked by enmity, and the relevance of affective identification to an accurate understanding of grief.
Committee: Mark Timmons (co-chair), Jonathan Weinberg (co-chair), Michael McKenna, Shaun Nichols (external).
Depressed, not disordered: Fittingness and pathologies of emotion (Forthcoming in Journal of Medicine and Philosophy). I introduce the normative concept of fittingness to philosophy of psychiatry, arguing it is essential to discriminating pathological from non-pathological patterns of affective response. This in turn permits a recongition of the limits of psychiatric practice and helps to avoid potential disciplinary injustices.
Grief as identity crisis (Forthcoming in Philosophy, Psychiatry, & Psychology). I note an apparent tension between prominent philosophical and psychiatric views about the proper (fitting vs. non-pathological) duration of grief. Then I develop a conception of grief as an affective response to an identity-crisis-generating loss. Although this does not directly resolve the interdisciplinary dispute it does permit a more productive characterization thereof as well as orienting questions for working toward a resolution.
The perceived morality of love drugs: Why mechanisms might (and should) matter (AJOB Neuroscience 15(4): 234-236). A reply to Lantian, Boudesseul, and Cova highlighting the relevance of experimental philosophy results concerning bypassing and the comprehension of determinism.
Prospects for engineering personhood (AJOB 24(1): 69-71). I propose that Jennifer Blumenthal-Barby's critique of the concept of personhood is reason to engineer the concept, rather than eliminate it from the bioethicist's toolkit.
Teaching drunk: Work, the online economy, and uncertainty in action (Philosophy 96(3): 387-408). I offer a teleological account of work, thereby illuminating the many ways in which one can attempt and fail to work. I argue that person-oriented service work runs the risk of substantially alienating workers when it is digitized--that is, when person-oriented service workers are forced to work online. This is because digitization places workers under conditions of persistent uncertainty as to whether their efforts are successful or not. *Runner-up, 2020 Royal Institute of Philosophy Essay Prize*
What it might be like to be a group agent (Neuroethics 14: 437-447). I respond to Christian List's recent work on the possibility of group phenomenal consciousness. Relying on the same Integrated Information Theory that List does, I argue that groups experience bouts of subjective experience that arise from their members integrating task-specific information. I also discuss the way in which the defender of group consciousness faces a version of the Combination Problem for panpsychists.
Fittingness as a Framework for Affective Psychopathology (UCLA Semel Institute Grand Rounds, March 2025, and UCSD Ethics Grand Rounds, February 2025)
Fittingness is a normative property distinctive of affective states. Given this, it is reasonable to see it as bearing significantly on the proper functioning of the affective system, and therefore to the delineation of pathological versus non-pathological emotional responses (and moods). This has important consequences for mental health care.
Two Types of Empathy and their Relevance to Clinical Practice (UCLA Health Palliative Care Service Monthly Meeting, February 2024)
I propose a view about the distinction between cognitive and emotional empathy and propose, in line with previous critiques of empathy, that the emotional form carries risk of impairment in clinical practice. However, there remains an important role for it insofar as patients sometimes require more humanity from their providers than clinical expertise.
Not Your Death to Grieve (APA Central, Denver, February 2023).
Death elicits strong responses. The most familiar of these are grief responses, but equally important are evaluative judgments of others’ grief. In particular, we sometimes judge the grief of others to be inappropriate. Here I distinguish between two types of inappropriate grief: grieving unfittingly, which occurs when one lacks a considerable interest in the deceased, and grieving without standing, which occurs when one has taken a genuine interest in the deceased, even loved them, but that interest is ill-founded. Recognition of the latter phenomenon helps to expand our conception of the normative considerations involved in grieving practices.
Grief: A Social Identity Approach (Meeting of the International Social Ontology Society, Vienna (but participated virtually), August 2022).
Some authors have recently argued that grief is 'forever fitting' as a response to a loved one's death. I argue against what I see as a highly counter-intuitive conclusion by presenting an alternative, identity-based view of grief that is grounded in social psychological theory and recent neuroscience evidence on the neural/mental representation of social closeness. On my view, grief is a kind of identity crisis -- specifically, a crisis in which one's self-concept, which prominently features one's closest relationships, is made suddenly impracticable by a loved one's death. The process of reckoning with this crisis and eventually overcoming it is what is commonly understood as the 'processing' of a loss. If the fit-making features of a death are what makes it precipitate and sustain such a crisis, grief will cease to be fitting, as expected, once one has fully 'processed' the loss.
Moral Anger, Empathy, and Solidarity (Political Role of Moral Emotions, Geneva, June 2022).
When we blame someone for wronging us, part of what we aim to do is elicit their empathy because it provides an involved and affective comprehension of the wrong that has been done to us. If I can get you to understand and experience how I feel as a result of your actions, you may better come to appreciate their normative significance. Despite some assuming to the contrary, anger is especially well suited to procuring the empathy of (perceived) wrongdoers. However, this anger-eliciting-empathy mechanism is frustrated when wrongs take place across gulfs of power and privilege; individuals who enjoy a superior position in a hierarchy are insulated from facing the experiences of those they harm. I argue that, in a limited range of such cases, moral anger remains an effective tool because it solicits the interest and the empathy of bystanders, which in turn generates circumstances conducive for the collective action that is necessary for breaking down oppressive hierarchies.