Research

Areas of Specialization: 

Bioethics, Sexual Ethics, Philosophy of Medicine, Feminist Philosophy

Areas of Competence: 

Epistemology, Digital Ethics

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My interests in Applied Ethics are united by three complementary notions: autonomy, personhood, and consent. In the Philosophy of Medicine, I focus on the social ontology of medical categories (e.g. disability, race, gender, placebo). I approach each of these topics with a feminist philosophical lens. My publications have appeared in Bioethics, Philosophers’ Imprint, The Journal of Medicine and Philosophy, with a reviewed public philosophy piece in the Institute of Art and Ideas (IAI News), and book review in The Journal of Philosophy of Disability. In the following, I present a detailed description of my research and its future development, abstracts of my publications, and abstracts for my works-in-progress (chronologically indexed to their most recent presentation at academic colloquia, conferences, or workshops).

a.     Research Summary

Autonomy

I argue that autonomy requires social support, and that we can cultivate our network of support to transform settings that are hostile to our autonomy into ones that are helpful for us. Thus far, I have focused on interpersonal instances of this phenomenon—e.g. when weak-willed patients can practice self-management by asking their doctors to withhold unwanted information—and examined the way the disclosure of information can promote or inhibit our autonomy. Most notably, I have challenged the near-universal assumption that having more information about a decision automatically translates into more or greater autonomy with regards to that decision. In future work, I will also focus on self-directed evaluative attitudes: what role does self-love and self-regard play in promoting our autonomy? Our self-regarding attitudes are deeply shaped and affected by our social environment, just as our epistemic states are. I also plan to extend my research to examine the way institutional structures (rather than inter-personal relationships) can impact our autonomy. In the next year I hope to develop and publish work on a phenomenon I call agential corrosion: a kind of harm wherein an individual’s autonomy is diminished or subverted in a way that is not proximally caused by the will of a bad actor, but rather, originates from environmental or structural factors.

Consent

In Biomedical and Sexual Ethics there is a near-exclusive focus on consent-based explanations for harms and wrongs. I believe this is a mistake generated by the systematic conflation of three distinct questions: (i) what conditions are required for the validity of consent? (ii) what conditions are required for an intervention to be permissible? (iii) what conditions are required for culpability for harm? Most importantly, my research drives a wedge between our answers to (i) and (ii)—I argue that in many cases, the conditions for consent are met, and the intervention is impermissible nevertheless. In future work, I will pay special attention to medical mechanisms—the causal chain that generates the therapeutic benefit—and their relevance to the duties of disclosure and the conditions necessary for consent.

Personhood

My interests in personhood are informed by my commitments in social ontology—that many identity-based categories (race, gender, disability) are at least partially socially constituted. Contrary to some approaches in social metaphysics, I am not gripped by the questions “what does it take to be me?” or “what is required to be the very person that I am?” when they are asked in a purely metaphysical register, with minimal reference to one’s phenomenology and self-regarding attitudes. This is most focally reflected by my approach to personhood and disability, a project that will moreover bring historical debates in the sub-fields of phenomenology and existentialism into a new contemporary context.

Philosophy of Medicine

I am currently interested in I call the ethics of grouping. The central question in this approach has to do with how our personhood is regarded by others—whether we are recognized as an individual, or as a ‘mere’ member of a group. This is particularly relevant for the running of Randomized Controlled Trials (RCTs). RCTs are quantitative studies in which research participants are randomly allocated into different groups, or ‘arms,’ that receive different interventions (sometimes, but not always, incorporating a placebo control). The outcomes of these different interventions are then measured and compared. RCTs are interested in aggregate values across groups, not individuals. Furthermore, in the course of biomedical research, individuals are sometimes grouped according to age, race, and gender, prior to being randomized (this is called ‘stratified randomization’). Focusing on the ethics of grouping in biomedical research reveals potential harms that might arise from prescinding away from the individual in lieu of group-membership. I pay particular attention to the role of racial grouping in the practice of medicine and argue that social constructivist theories of race are compatible with the way racial concepts are deployed in medicine.

b.     Academic Publications

Rees, M. (2024). The social epistemology of clinical placebos. In The Journal of Medicine and Philosophy: (Vol. 49, No. 3, pp. 233-245). US: Oxford University Press.

Many extant theories of placebo focus on their causal structure wherein placebo effects are those that originate from select features of the therapy (e.g., client expectations or “incidental” features like size and shape). Although such accounts can distinguish placebos from standard medical treatments, they cannot distinguish placebos from everyday occurrences, for example, when positive feedback improves our performance on a task. Providing a social-epistemological account of a treatment context can rule out such occurrences, and furthermore reveal a new way to distinguish clinical placebos from standard medical treatments.

Rees, M., & Ichikawa, J. (2024). Sexual agency and sexual wrongs: A dilemma for consent theory. Philosophers' Imprint, 24.

On a version of consent theory that tempts many, predatory sexual relations involving significant power imbalances (e.g. between professors and students, adults and teenagers, or employers and employees) are wrong because they violate consent-centric norms. In particular, the wronged party is said to have been incapable of consenting to the predation, and the sexual wrong is located in the encounter’s nonconsensuality. Although we agree that these are sexual wrongs, we resist the idea that they are always nonconsensual. We argue instead that it is possible for students, teenagers, employees, etc. to fully consent to sexually predatory encounters; denying as much renders survivors of predation vulnerable to compounding harms. Survivors face a dilemma: give up either their understanding of their experience as wrong, or their self-conception as an agent capable of consenting. We call the latter phenomenon agential demotion.

Rees, M. (2023). Patient autonomy and withholding information. Bioethics, 37(3), 256-264.

Disclosure in clinical practice is aimed at promoting patient autonomy, usually culminating in patient choice (e.g., to consent to an operation or not, or between different medications). In medical ethics, there is an implicit background assumption that knowing more about (X) automatically translates to greater, or more genuine, autonomy with respect to one's choices involving (X). I challenge this assumption by arguing that in rare cases, withholding information can promote a patient's autonomy (understood as the capacity for rational choice in alignment with one's values and goals)

Review of Disability, Health, Law and Bioethics. Edited by Cohen, Shachar, Silvers, and Stein. Cambridge University Press. The Journal of Philosophy of Disability 1 (2021) 231-235

c.  Public-Facing Articles

Rees, M. Ichikawa, J. (2025). The limits of consent. IAI News. /articles/the-limits-of-consent-auid-3082

Consent is of central importance in many areas of our lives, from sex to healthcare. But, argue Melissa Rees and Jonathan Ichikawa, consent should not become the only thing we care about in our relations with others. Many wrongdoings involving power imbalances resist explanation in terms of consent, and wrongs can take place even when consent is present. We must avoid seeing consent as the only ethical concept that matters in sexual relations and other areas of life. Consent matters, but it is not the only thing that matters. 

d. Works-in-Progress

“Personhood and Psychological Disability” American Philosophical Association Pacific Division, San Francisco (April 2025).

There is significant variation in how people relate to their psychological disabilities. In this paper I focus on two: one in which the disability is felt as core to one’s person, and one in which it is peripheral. On the former, one’s disability is experienced as a vital part of one’s personhood—one could not meaningfully be oneself in absence of the disability. On the latter, one’s disability is felt as a contingent feature that one bears; the disability is inessential to being the very person that one is. This is a phenomenological distinction that, when recognized, has a few interesting consequences. First, it casts certain disagreements between the “mere difference” and “bad difference” views of disability in a different light. Second, it offers an opportunity to reframe theories of disability more broadly, and perhaps even invites new ways to structure disability activist coalition-making.

“Are Medical Mechanisms Relevant to Medical Ethics?” History and Philosophy of Science and Medicine Colloquium Series, Washington University St. Louis (Spring 2024)

In clinical practice, it is widely assumed that the causal mechanisms which generate therapeutic outcomes are irrelevant for medical ethics. That is, when a therapy’s causal pathway is known, such information is neither: (i) covered by a medical practitioner’s duty of disclosure, (ii) nor is understanding a therapy’s causal pathway a condition for valid consent to either accept or abstain from treatment. I begin this talk by motivating and reconstructing what I take to be the best argument for this exclusion. However, I am unconvinced that it is the right account of disclosure and consent. I conclude by defending the opposing claim: in select cases, medical mechanisms are important for both disclosure and consent.

“Self-Love and Self-Loathing: Feminist Philosophy and Internalized Oppression”—Departmental Colloquium, Marist College (Spring 2024)

This project articulates three ways self-love (and self-loathing) relates to social justice: (i) self-love constitutes social justice when it directly mitigates internalized oppression, (ii) self-love causally contributes to social justice when it disrupts some of the causal mechanisms of social injustice, and (iii) pursuing social justice activism can generate self-love. I offer a specification of (iii) that entails self-love is not governed by the widely endorsed particularity constraint; for some expressions of self-love, the particularity of the loved one is not important for explaining the loving attitude or commitment.

“Agential Corrosion and the Business of Medicine” Marc Sanders Foundation Mentoring Workshop, University of Missouri (Columbia Missouri, 2023)

The business of medicine threatens the ethical integrity of medical practice. Although the high cost of medical procedures and the lack of transparency in medical billing may not at first appear to be medical concerns, divorcing the business of medicine from the art of medicine fundamentally misunderstands the ethical landscape of healthcare. In this article I will argue that—as it is currently set up—the business of medicine is corrosive to patient agency. I introduce the notion of agential corrosion as a genus of wrongs that are unified by the explanation of their harm: the patient’s agency is diminished or subverted by structural features of a society, industry, or bureaucracy. Consequently, structural features of medical billing threaten the ethical good standing of doctor-patient interactions and patient lives more broadly.