Totalism is the view that one distribution of well-being is better than another just in case the one contains a greater sum of well-being than the other. Many philosophers, following Parfit, reject totalism on the grounds that it entails the repugnant conclusion: that, for any number of excellent lives, there is some number of lives that are barely worth living whose existence would be better. This paper develops a theory of welfare aggregation—the lexical-threshold view—that allows totalism to avoid the repugnant (...) conclusion, as well as its analogues involving suffering populations and the lengths of individual lives. The theory is grounded in some independently plausible views about the structure of well-being, identifies a new source of incommensurability in population ethics, and avoids some of the implausibly extreme consequences of other lexical views, without violating the intuitive separability of lives. (shrink)

„Medizinische Notwendigkeit“ (MedN) ist der zentrale Steuerungsbegriff für die Finanzierung medizinischer Versorgung in der deutschen Gesetzlichen Krankenversicherung. Trotz seiner scheinbaren Objektivität und Bestimmtheit durch ärztliche Expertise ist der Begriff alles andere als eindeutig definiert. In diesem ersten von fünf geplanten Aufsätzen zur Begriffsklärung von MedN aus medizintheoretischer, -ethischer, rechtlicher und (sozial)medizinischer Perspektive geht es um eine Systematisierung der aktuellen Kontroversen. Damit soll eine Fundierung für Detaildebatten gelegt werden, die bisher fehlt. Geklärt werden sollen die begriffliche Struktur, Funktion, Kontextualität und Missverständlichkeit (...) von MedN sowie die grundsätzlichen Grenzen einer Begriffsanalyse für die anstehenden normativen Fragen medizinischer Leistungssteuerung. (shrink)

Values are incommensurable when they cannot be measured on a single cardinal scale. Many philosophers suggest that incommensurability can help us solve the problems of population ethics. I agree. But some philosophers claim that populations bear incommensurable values merely because they contain different numbers of people, perhaps within some range. I argue that mere differences in how many people exist, even within some range, do not suffice for incommensurability. I argue that the intuitive neutrality of creating happy people is better (...) captured by a version of average utilitarianism. But this view is problematic. So I suggest a version of total utilitarianism that avoids the repugnant conclusion by appealing to incommensurable dimensions of wellbeing. (shrink)

:A good deal of contemporary moral nonconsequentialism assumes that agents have perfect knowledge about the various features and consequences of their options. This assumption is unrealistic. More often than not, moral agents can only assess with a certain degree of probability the factual circumstances that are morally relevant for their decision making. My aim in this essay is to discuss the problem of moral decisions under risk from the point of view of nonconsequentialism. Basically, I analyze how objective moral principles (...) can be transformed into subjective, decisional prescriptions, and argue that the standard nonconsequentialist approach to moral decision making, which focuses on probability thresholds, is wrong. In accordance with the fundamental postulates of nonconsequentialism, I seek to solve the problem of risk in moral choice by proposing a theory about the marginal moral value of various options. Actions can vary along various dimensions, and each of these dimensions can offer a different moral value function. Nonconsequentialist marginalism can level the playing field with consequentialism. Whereas consequentialism can simply borrow the notion of expected utility from economics, nonconsequentialism must introduce the notion of expectational obligation to formulate a general principle of moral choice under risk. I finally suggest that further empirical work is needed to delineate the shape of various moral value functions that are critical for applying the general principle of moral decision making under risk to well-known cases. View HTML Send article to KindleTo send this article to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle. Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service.DECISIONAL NONCONSEQUENTIALISM AND THE RISK SENSITIVITY OF OBLIGATIONVolume 32, Issue 2Horacio Spector DOI: https://doi.org/10.1017/S0265052516000121Your Kindle email address Please provide your Kindle [email protected]@kindle.com Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Dropbox To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Dropbox. DECISIONAL NONCONSEQUENTIALISM AND THE RISK SENSITIVITY OF OBLIGATIONVolume 32, Issue 2Horacio Spector DOI: https://doi.org/10.1017/S0265052516000121Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Google Drive To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive. DECISIONAL NONCONSEQUENTIALISM AND THE RISK SENSITIVITY OF OBLIGATIONVolume 32, Issue 2Horacio Spector DOI: https://doi.org/10.1017/S0265052516000121Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Export citation Request permission. (shrink)

Justificatory defenses apply to actions that are generally wrong and illegal—mainly since they harm people—when they are justified—usually since they prevent harm to others. A strict conception of justification limits justificatory defenses to actions that reflect all pertinent principles in the optimal manner. A more relaxed conception of justification applies to actions that do not reflect all pertinent principles optimally due to mistake but are not too far from this optimum. In the paper, I consider whether justificatory defenses should reflect (...) the strict conception of justification or a more relaxed conception of justification. This question is important since often the relevant actions are not strictly justified, while the alternative of an excuse is frequently irrelevant or does not provide an appropriate solution. Reflection on this question raises the following dilemma: On the one hand, the strict interpretation seems too harsh, especially with regard to legal liability. On the other hand, it is difficult to explain the basis for a more relaxed conception of justification. I conclude, first, that justification—and accordingly wrongfulness—is a matter of degree and that the strictly justified action is merely the peak of a continuum, and, second, that a practical reaction is in place only with regard to actions whose wrongness is above a minimal threshold. (shrink)

I come to grips with the deontological critique of constitutional proportionality that asserts that this doctrine ignores rights and slips into the utilitarian maximisation of societal interests. I...