Withholding and withdrawing treatment are widely regarded as ethically equivalent in medical guidelines and ethics literature. Health care personnel, however, widely perceive moral differences between withholding and withdrawing. The proponents of equivalence argue that any perceived difference can be explained in terms of cognitive biases and flawed reasoning. Thus, policymakers should clear away any resistance to accept the equivalence stance by moral education. To embark on such a campaign of changing attitudes, we need to be convinced that the ethical analysis (...) is correct. Is it? In this article, I take a closer look at the moral relation between withholding and withdrawing. My conclusion is that withholding and withdrawing are not in general ethically equivalent. Thus, medical guidelines should be rewritten, and rather than being “educated” away from their sound judgments, medical professionals and patients should have nuanced medico-ethical discussions regarding withholding and withdrawing treatment. (shrink)

Whether value is “additive,” that is, whether the value of a whole must equal the sum of the values of its parts, is widely thought to have significant implications in ethics. For example, additivity rules out “organic unities,” and is presupposed by “contrast arguments.” This paper reconsiders the significance of value additivity. The main thesis defended is that it is significant only for a certain class of “mereologies”, roughly, those in which both wholes and parts are “complete”, in the sense (...) that they can exist independently. For example, value additivity is significant in the case of a mereology of material objects, but not in the case of a mereology of propositions. (shrink)

In some medical cases there is a moral distinction between killing and letting die, but in others there is not. In this paper I present an original and principled account of the moral distinction between killing and letting die. The account provides both an explanation of the moral distinction and an explanation for why the distinction does not always hold. If these explanations are correct, the moral distinction between killing and letting die must be taken seriously in medical contexts. Defeasibly, (...) when an agent kills she takes responsibility, but when an agent lets die she does not take responsibility. Therein lies the moral distinction between killing and letting die. The distinction, however, is defeated when an agent is already responsible for the surrounding situation. In such cases, killing does not involve taking any further responsibility and letting die does not avoid taking any responsibility. Medical examples are frequently complicated because patients' autonomous choices impact upon medical practitioners' surrounding responsibility. (shrink)

Consumers’ engagement in morally-questionable behaviors poses a serious threat to firms. To further the understanding of consumers’ behavior, this study explores the association and conflicts between their ethical and legal judgments. In addition, it examines the way consumers’ judgments depend on their mind-sets and the legal liability criterion of action. In two experiments, participants were asked to judge the ethicality and legality of consumers’ morally-questionable behaviors. Behavior activity and participants’ mind-sets were manipulated. The results show that consumers are more likely (...) to judge a behavior to be legal when they consider it ethical than when they consider it unethical. Nevertheless, conflicts between ethical and legal judgments are prevalent. Furthermore, ethical judgments, legal judgments, and the occurrence of conflicts between them depend on activity and on consumers’ mind-sets. Finally, consumers report uncertainty about the ethicality and legality of a wide range of morally-questionable behaviors. Thus, the results paint a picture of individuals who perceive the law to be often beyond their reach or in conflict with their ethical principles. They portray both ethical and legal judgments as dynamically-changing, subjective, and context-dependent. Theoretical contribution and business applications are discussed. (shrink)

The moral significance of the distinction between killing and allowing to die has played a key role in debates about euthanasia and physician assisted suicide. Since the withdrawal of life-sustaining treatment is held as morally permissible in the medical community, it follows that if there is no morally significant difference between killing and allowing to die, then there is no morally significant difference between withdrawing life-sustaining treatment or administering a lethal injection to end a patient’s life. Consistency then requires that (...) voluntary active euthanasia is also morally permissible. The debates over whether the distinction is morally significant have carried on for decades with little hope of consensus. We begin by surveying the literature to identify common argumentative strategies used in defending or rejecting the distinction’s significance. We observe, based on our review, that many of these strategies operate in ways that are conceptually removed from the concrete clinical situation of physicians involved in practices that lead to patient death. We conclude by arguing for a novel way of moving the debate forward indicated by our reading of the literature, namely, by paying careful attention to the moral experience of physicians involved in end-of-life interventions to understand how they experience these practices. Exploring physician experience can reveal how the distinction may or may not be useful for moral deliberation and can provide the needed context to theorize about the distinction in a more empirically informed and practically useful way. (shrink)