Editor's Note, December 2022

All four of the articles in this issue of the Kennedy Institute of Ethics Journal concern questions of identity and its ethical significance; all four frame and study identity in different ways, using different methodologies and literatures. The pieces by Emma Gordon and by Neşe Devenot and their colleagues both explore how artificially induced shifts in identity, from drugs or technology, can open up new ethical possibilities and worries. Anne-Marie Gagné-Julien's essay looks at mad identity, and the value of taking the mad community as a source of sense-making and self-interpretation that is robustly independent from medical sense-making. Finally, Megan Dean and Nabina Liebow examine how identities based upon race, class, region, fatness, and thinness intersect in complex ways.

In "Virtual Reality and Technologically Mediated Love," Emma Gordon examines and assesses the debates over whether the pharmacological enhancement of love is ethically and politically risky, and whether it generates states and relationships less valuable than 'natural,' unenhanced love. She then shifts these arguments to the domain of technologically enhanced love, for instance, love relationships cultivated and sustained through virtual reality interactions. She argues that technologically mediated love avoids most of the moral pitfalls that people have suggested might plague chemically mediated love. This is an important paper, because as our embodiment becomes more and more complexly intertwined with technology, myths of purity and of 'natural' agency and emotions become harder and harder to maintain. We routinely use technology to sustain relationships: we might use social media to keep in touch with our beloved and establish a joking repertoire with them; we might take drugs that enhance our libido; and so forth. Given that we are inevitably technologically embedded beings, it is worth asking whether there are special kinds of technological dependence that are distinctively ethically or existentially troubling.

Neşe Devenot, et. al.'s essay, "Psychedelic Identity Shift: A Critical Approach to Set and Setting," presents results from an exciting qualitative study, which explored how patients in a smoking cessation program experienced therapy using psilocybin. The authors explore the phenomenological and ethical complexities and the therapeutic potential of the kinds of identity shifts and ego dissolutions that psychedelic drugs enable. On the one hand, the authors argue that the power of identity reconfiguration can be harnessed to increase agency and treat addiction. On the other hand, they point out the ways in which this type of radical intervention raises distinctive ethical issues around autonomy and consent. Psychedelic drugs are enjoying a renaissance right now. Some of the moral panic surrounding them has dulled, regulation is easing somewhat, and many people are discovering their intellectual, emotional, and medical potential. As these drugs make their way out of the shadows, we need high-quality empirical and ethical studies like this one, that take seriously both their potential benefits and their distinctive, identity-engaging risks.

In "Medicalization, Contributory Injustice, and Mad Studies," Anne-Marie Gagné-Julien brings together three academic discourses: social studies of medicalization; philosophical studies of epistemic injustice; and interdisciplinary, politically engaged mad studies. She argues that the medicalization of psychiatric conditions, as currently practiced, perpetrates "contributory injustice." That is, it serves to hide and devalue the conceptual and other hermeneutic resources that mad communities are already building. Whereas classic hermeneutic injustice prevents the formation of hermeneutic resources that serve the purposes of a vulnerable group, contributory injustice excludes and devalues these resources once they exist. The mad community, she argues, is in fact a rich and fertile source of self-understanding, but these self-understandings are suppressed within a biomedical framework. She advocates more than mere inclusiveness or acceptance of these sense-making resources; she wants active support for institutional spaces and infrastructure that would allow mad folks to come together to build and disseminate their own hermeneutic strategies.

Finally, Megan Dean and Nabina Liebow's challenging article, "'White, Fat, and Racist': Racism and Environmental Accounts of Obesity" argues that environmental accounts of obesity--that is, accounts that see obesity as produced not by individual choices or failures of willpower but by 'obesogenic environments'--often frame themselves as anti-racist but in fact can be...