Publications
Research
My research is focused on three broad themes: (1) studying depression in order to shed light on the perennial questions of philosophy, particularly questions to do with well-being and virtue; (2) using the tools of analytic philosophy in order to unravel puzzles concerning depression (and mental illness more broadly); and, (3) addressing issues at the intersection of psychiatry and biomedical ethics more broadly, especially those arising in mental health research.
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See below for my current list of published work. I also have work under review or in prep on, among other things, the role of negative emotions like sorrow in the virtuous agent's moral psychology, ethical issues in the treatment of depression, and the nature of moral attentiveness. Please contact me if you are interested in reading drafts of any of my work.
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7. "Fitting Anger and Patient Wrongdoing.” (2023) Clinical Ethics 18(4), 347-353.
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As a result of the stress of responding to the COVID-19 pandemic, nurses, doctors, and other healthcare workers have been expressing a great deal of frustration and anger, sometimes directed at patients who have chosen not to get vaccinated. This paper examines the moral status of such anger in light of philosophical treatments of anger's purpose, benefits, and drawbacks. A theory of appropriate anger is sketched, after which healthcare workers’ anger toward perceived patient wrongdoing is assessed in light of philosophical considerations for and against anger. Ultimately, it is argued that it would be better for nurses and doctors not to experience this kind of anger, and this conclusion is used to motivate a moral case for additional support for overtaxed healthcare workers.
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Research on mental health and illness presents a variety of unique ethical challenges. In this paper, it is argued that IRBs can improve their reviews of such research by including the perspectives of individuals with the condition under study either as members on the IRB or as consultants thereto. Several reasons for including the perspectives of these individuals are advanced, the discussion being organized around a hypothetical case study involving the assessment of a novel talk therapy modality. Having made this case, the paper goes on to explain how to implement the idea by building on a recent proposal by Rebecca Dresser, who argues in a number of areas for the inclusion of former research participants in the IRB review process. Finally, concerns about protecting reviewer/consultant confidentiality are addressed.
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In this paper I address the question of whether it is ever permissible to grant a request for physician-assisted suicide from an individual suffering from treatment-resistant depression. I assume for the sake of argument that physician-assisted suicide is sometimes permissible. There are three requirements for PAS: suffering, prognosis, and competence. First, an individual must be suffering from an illness or injury which is sufficient to cause serious, ongoing hardship. Second, one must have exhausted effective treatment options, and one’s prospects for recovery must be poor. Third, the individual must be judged competent to request PAS. I argue that many cases of treatment-resistant depression meet the first two requirements. Thus, the key question concerns the third. I consider four features of depression which might compromise a person’s decision-making capacity. Ultimately, I conclude that PAS requests from depressed patients can be permissibly granted in some circumstances.
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Recent changes to the Common Rule have helped reduce regulatory burden on researchers conducting minimal risk research. However, in this paper I propose a way of minimizing burden further, within the existing confines of the current regulations. I focus my discussion on the newly created “benign behavioral interventions” category of exempt research, arguing that this exemption from the federal regulations governing research with human subjects should be more expansively interpreted by SACHRP than is currently the case. Specifically, I argue against the restriction, advocated by SACHRP, that the exemption exclude “physical (bodily) tasks” unless they are “incidental to the behavioral intervention.” This restriction, I argue, is (1) problematically vague and (2) does no significant moral work. The result is, I hope, a significant reduction in regulatory burden for minimal risk research.
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3. "Demarcating Depression." (2019). Ratio, 32(2), 114-121.
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How to draw the line between depression-as-disorder and non-pathological depressive symptoms continues to be a contested issue in psychiatry. Relatively few philosophers have waded into this debate, but the tools of philosophical analysis are quite relevant to it. In this paper, I defend a particular answer to this question, the Contextual approach. On this view, depression is a disorder if and only if it is a disproportionate response to a justifying cause or else is unconnected to any justifying cause. I present four objections to this approach and then defend it from them. Along the way, I explain why it matters whether we get this question right.
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The view that pleasure's value might be merely instrumental has not received much support from philosophers. Indeed, few things seem more clearly to be of intrinsic value than pleasure. However, Matthew Pianalto has provided a sophisticated defense of the purely instrumental view. In this paper I respond to Pianalto's argument. I defend it from some recent criticism, while nevertheless ultimately concluding that it fails.
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I argue that consideration of certain cases of severe depression reveals a problem for desire-based theories of welfare. I first show that depression can result in a person losing her desires, and then identify a case wherein it seems right to think that, as a result of very severe depression, the individuals described no longer have any desires whatsoever. I argue that the state these people are in is a state of profound ill-being: their lives are going very poorly for them. Yet desire theories get this case wrong. Because no desires are being frustrated, the desire theorist has no grounds for ascribing ill-being; indeed, because the individuals described seem utterly without desire, the desire theorist has no grounds for treating these people as subjects of welfare ascription at all. I argue that these results are unacceptable; therefore, we should reject desire-based theories of well-being and ill-being.
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Dissertation: Parsing the Blues: What Depression Reveals About the Life Well-Lived
My dissertation explores the way depression illuminates –and is illuminated by – certain aspects of moral philosophy. I begin by defending, in chapter one, a cognitive theory of one important subtype of depression. The subsequent chapters then investigate what depression can teach us about the nature of well- (and ill-) being, and about the nature of moral virtue. In chapter two I ask ‘what makes depression bad for us?’ and go on to argue that reflection upon this question shows that desire-based theories of welfare are false. Then, in the next chapter, I provide a (partial) answer to that question, arguing that a central harm of depression is its undermining of the values or cares that constitute the core of a person’s self. This, in turn, vitiates effective agency and saps a person’s life of subjective meaningfulness. Given the results from the previous three chapters, I then ask, in chapter 4, whether it is ever permissible to allow those suffering from depression to choose physician-assisted suicide, and answer in the affirmative. Finally, in chapter five I take up the relationship between depression and virtue. Though the virtuous should never seek to become clinically depressed, I contend that morally virtuous people ought to preferentially attend to what it is fitting to feel negative attitudes towards, and thus, that they should be unhappy.