The risk that direct-to-consumer advertising of prescription pharmaceuticals (DTCA) may increase inappropriate medicine use is well recognized. The U.S. Food and Drug Administration addresses this concern by subjecting DTCA content to strict scrutiny. Its strictures are, however, heavily focused on the explicit claims made in commercials, what we term their “propositional content.” Yet research in social psychology suggests advertising employs techniques to influence viewers via nonpropositional content, for example, images and music. We argue that one such technique, evaluative conditioning, is (...) operative in DTCA. We further argue that evaluative conditioning fosters unjustified beliefs about drug safety and efficacy, antagonising the autonomy of viewers’ choices about advertised medicines. We conclude that current guidelines are deficient in failing to account for evaluative conditioning, and that more research and debate are needed to determine the permissibility of this and other forms of nonpropositional persuasion. (shrink)

Although the value of health is universally agreed upon, its definition is not. Both the WHO and the UN define health in terms of well-being. They advocate a globally shared responsibility that all of us — states, international organizations, pharmaceutical corporations, civil society, and individuals — bear for the health (that is, the well-being) of the world's population. In this paper I argue that this current well-being conception of health is troublesome. Its problem resides precisely in the fact that the (...) well-being conception of health, as an all-encompassing label, does not properly distinguish between the different realities of health and the different demands of justice, which arise in each case. In addressing responsibilities related to the right to health, we need to work with a more differentiated vocabulary, which can account for these different realities. A crucial distinction to bear in mind, for the purposes of moral deliberation and the crafting of political and legal institutions, is the difference between basic and non-basic health needs. This distinction is crucial because we have presumably more stringent obligations and rights in relation to human needs that are basic, as they justify stronger moral claims, than those grounded on non-basic human needs. It is important to keep this moral distinction in mind because many of the world's problems regarding the right to health relate to basic health needs. By conflating these needs with less essential ones, we risk confusing different types of moral claims and weakening the overall case for establishing duties regarding the right to health. There is, therefore, a practical need to reevaluate the current normative conception of health so that it distinguishes, within the broad scope of well-being, between what is basic and what is not. My aim here is to shed light onto this distinction and to show the need for this differentiation. I do so, first, by providing, on the basis of David Miller's concept of basic needs, an account of basic health needs and, secondly, by mounting a defense of the basic needs approach to the right to health, arguing against James Griffin who opposes the basic needs approach. (shrink)

The standard view holds that the degree to which an individual's preferences are satisfied is simply the degree to which the individual prefers the prospect that is realized to the other prospects in her preference domain. In this article, I reject the standard view by showing that it violates one fundamental intuition about degrees of preference satisfaction.

Many questions concerning health involve values. How well is a health system performing? How should resources be allocated between the health system and other uses or among competing healthrelated uses? How should the costs of health services be distributed among members of a population? Who among those in need of transplants should receive scarce organs? What is the best way to treat particular patients? Although many kinds of expertise bear on these questions, values play a large role in answering them. (...) These values are of many kinds – judgments about how health states contribute to the well-being of individuals depend on views about what is good for a person, whereas judgments about how to share the costs of health care or about how to distribute scarce organs among those in need of transplants depend on theories of fairness. The value judgments that need to be made are not only multifaceted and heterogeneous; they are also controversial. Both the understanding of the questions and the substance of the answers may vary widely from individual to individual and among different groups within countries and across national boundaries. How are these many complicated, difficult and controversial evaluative questions to be answered? This could be a question about who should answer them as well as a question about how they should be answered. There are various possible mechanisms, and there is no reason why the same method should be employed to answer every question. Among the possible methods are (1) moral argument, (2) political deliberation and (3) eliciting preferences or judgments from some group. Included in the third method lie many different techniques of elicitation. For example, one could study attitudes by the use of deliberative (focus) groups, by permitting individual choice in some sort of market or quasi-market, by polling or by voting. These methods of answering evaluative questions are not always incompatible with one another. Moral argument can play a role within political deliberation, deliberation by focus groups, individual market choice, or voting.. (shrink)

People condemn inequalities for many reasons. For example, many who have no concern with distribution per se criticize inequalities in health care, because these inequalities lessen the benefits provided by the resources that are devoted to health care. Others who place no intrinsic value on distribution believe that a just society must show a special concern for those who are worst off. Some people, on the other hand, do place an intrinsic value on equality of distribution, regardless of its contribution (...) to other goals. Derek Parfit and Larry Temkin call these people "egalitarians." I shall always employ quotation marks when referring to "egalitarians" in this special sense, because, as I shall argue, this terminology is misleading. One of its unhappy implications is that almost all egalitarians are not "egalitarians.". (shrink)

Advances in technology have made it possible for us to take actions that affect the numbers and identities of humans and other animals that will live in the future. Effective and inexpensive birth control, child allowances, genetic screening, safe abortion, in vitro fertilization, the education of young women, sterilization programs, environmental degradation and war all have these effects. Although it is true that a good deal of effort has been devoted to the practical side of population policy, moral theory has (...) not dealt adequately with the new possibilities. The dilemma faced by moral theory is that traditional theories cannot answer moral questions involving the creation of people. Two related problems arise. The first concerns numbers: how many people should there be? The second asks what sort of people should live and what their levels of well-being should be. Conventional social-contract theories, including the work of Rawls (1971), are restricted to situations with a fixed number of individuals. Sumner (1978) attempts to extend a Rawlsian veil-of-ignorance approach to possible people but is aware of the difficulties involved. The main problem is that possible people must be thought to benefit when they move from non-existence to existence, a view that we reject (see Section 1, Heyd, 1992, Chapter 1; McMahan, 1996a; Parfit, 1984, Appendix G). Rights-based and duty-based theories suffer from a similar problem; there must be a person who has the right or a person to whom the duty is owed (see McMahan, 1981). (shrink)

This paper argues that the standard account of posthumous harm is untenable. The standard account presupposes the desire-fulfillment theory of welfare, but I argue that no plausible version of this theory can allow for the possibility of posthumous harm. I argue that there are, at least, two problems with the standard account from the perspective of a desire-fulfillment theorist. First, as most desire-fulfillment theorists acknowledge, the theory must be restricted in such a way that only those desires that pertain to (...) one’s own life count in determining one’s welfare. The problem is that no one has yet provided a plausible account of which desires these are such that desires for posthumous prestige and the like are included. Second and more importantly, if the desire-fulfillment theory is going to be at all plausible, it must, I argue, restrict itself not only to those desires that pertain to one’s own life but also to those desires that are future independent, and this would rule out the possibility of posthumous harm. If I’m right, then even the desire-fulfillment theorist should reject the standard account of posthumous harm. We cannot plausibly account for posthumous harm in terms of desire fulfillment (or the lack thereof). (shrink)

One of the biggest problems in applications of animal welfare science is our ability to make comparisons between different individuals, both within and across species. Although welfare science provides methods for measuring the welfare of individual animals, there’s no established method for comparing measures between individuals. In this paper I diagnose this problem as one of underdetermination—there are multiple conclusions given the data, arising from two sources of variation that we cannot distinguish: variation in the underlying target variable (welfare experience) (...) and in the relationship of measured indicators to the target. I then describe some of the possible methods of making comparisons, based on the use of similarity assumptions that will have greater or lesser justification in different circumstances, and the alternative methods we may use when direct comparisons are not possible. In the end, all our available options for making welfare comparisons are imperfect, and we need to make explicit context-specific decisions about which will be best for the task at hand while acknowledging their potential limitations. Future developments in our understanding of the biology of sentience will help strengthen our methods of making comparisons. (shrink)

ABSTRACT What kind of basic minimum do we owe to others? This paper defends a new procedure for answering this question. It argues that its minimally good life account has some advantages over the main alternatives and that neither the first-, nor third-, person perspective can help us to arrive at an adequate account. Rather, it employs the second-person perspective of free, reasonable, care. There might be other conditions for distributive justice, and morality certainly requires more than helping everyone to (...) secure a basic minimum. Still, if the minimally good life account is correct, and we owe everyone a basic minimum, we must ensure that everyone lives well enough. (shrink)

I aim to show that the common idea according to which we can assess how bad death is for the person who dies relies on numerous dubious premises. These premises are intuitive from the point of view of dominant views regarding the badness of death. However, unless these premises have been thoroughly justified, we cannot measure the badness of death for the person who dies. In this paper, I will make explicit assumptions that pertain to the alleged level of badness (...) of death. The most important assumption I will address is the assignment of a quantitative value of zero to death, which leads to the conclusion that there are lives not worth living for the affected person. Such a view interprets the idea of a live worth living in quantitative terms. It is in conflict with actual evaluations of relevant people of their lives. (shrink)

One prominent welfarist axiology, critical-level utilitarianism, says that individual lives must surpass a specified ‘critical level’ in order to make a positive contribution to the comparative status of a given population. In this article I develop a new dilemma for critical-level utilitarians. When comparatively evaluating populations composed of different species, critical-level utilitarians must decide whether the critical level is a universal threshold or whether the critical level is a species-relative threshold. I argue that both thresholds lead to a range of (...) axiological puzzles and objections as yet undiscussed within the literature, and therefore conclude that critical-level utilitarianism should not be taken as a morally plausible welfarist axiology. I show that certain competitive formulations of critical range utilitarianism are subject to the argument too, and that further attempts to relativise critical levels to a particular group or category of welfare bearer are unsustainable. (shrink)

The central claim of this paper is that American states’ use of so-called “triggering conditions” to regulate surrogate decision-making authority in end-of-life care leaves unresolved a number of important ethical and legal considerations regarding the scope of that authority. The paper frames the issue with a case set in a jurisdiction in which surrogate authority to withdraw life-sustaining treatment is triggered by two specific clinical conditions. The case presents a quandary insofar as the clinical facts do not satisfy the triggering (...) conditions, and yet both the appropriate surrogates and the care team agree that withdrawal of life-sustaining treatment is in the best interest of the patient. The paper surveys applicable law across the 50 states and weighs the arguments for and against the inclusion of such triggering conditions in relevant legal regimes. The paper concludes by assessing the various legal and policy options states have for regulating surrogate decision-making authority in light of the moral considerations, and notes the possibility for conflict within ethics teams arising from the potential tension between prudence, risk-aversion, and moral obligation. (shrink)

This article brings together two debates in bioethics more substantively than has been the case until now. One is the methodological debate over "principlism," i.e., the theoretical framework for analyzing and solving ethical problems proposed by Beauchamp and Childress in Principles of Biomedical Ethics. The other is the normative debate about reproductive ethics, i.e., procreative rights and obligations in a time of pervasive opportunities for making detailed choices about the properties and capacities of future people. The obvious point of bringing (...) the debates together is to show how they can illuminate each other in fruitful ways consistent with the method of reflective equilibrium endorsed in PBE. Furthermore, discussions of reproductive ethics is almost absent in PBE, making it an interesting "test case" on how principlist theory can have an impact on and be affected by confrontations with new practices and considerations in biomedicine. Reproductive ethics is especially interesting due to the so-called non-identity considerations, which pose a challenge to common morality views on harm to and respect for persons. My focus is mainly on some methodological points about the import of concrete normative discussions for formulating basic normative principles. However, I unfold a number of substantial points in order to demonstrate this. It is my impression that most writers on principlism underestimate the effect of engaging with concrete problems. Specifically, I conclude that reflecting on procreative obligations provides strong reasons for specifying the basic principles in ways that uncover new dimensions of them and not just new applications. _Key words: _principlism, reproductive ethics, non-identity problem, nonmaleficence, respect for persons. (shrink)

The well-being account of sacrifice says that sacrifices are gross losses of well-being. This account is attractive because it explains the relationship between sacrifice and moral obligation. However, sacrifices made on behalf of loved ones may cause trouble for the account. Loving sacrifices occur in a context where the agent’s well-being and the beneficiary’s well-being are intertwined. They present a challenge to individualism about well-being. Drawing inspiration from feminist philosophers and bioethicists, I argue that a notion of ‘relational well-being’, analogous (...) to ‘relational autonomy’, can help account for loving sacrifices without either undermining the well-being theory of sacrifice or minimizing the very real sacrifices made in caregiving situations. (shrink)

This paper raises an objection to two important arguments for reductive ethical naturalism. Reductive ethical naturalism is the view that ethical properties reduce to the properties countenanced by the natural and social sciences. The main arguments for reductionism in the literature hold that ethical properties reduce to natural properties by supervening on them, either because supervenience is alleged to guarantee identity via mutual entailment, or because non-reductive supervenience relations render the supervenient properties superfluous. After carefully characterizing naturalism and reductionism, we (...) will present, explain, and raise objections against each of the main reductionist arguments: that supervenience does not support the claim that ethical properties and their subvenient natural properties are mutually entailing; that reductive views undermine the claim that ethical properties yield resemblance; and that supervenience does not entail that non-descriptive ethical properties are superfluous in the most fundamental sense. (shrink)

Velleman, MacIntyre, and others have argued for the compositional view that lives can be other than equally good for the person who lives them even though they contain all and only the same moments, and that this is explained by their narrative structure. I argue instead for explanation by self-realization, partly by interpreting Siegfried Sassoon’s exemplary life-narrative. I decide between the two explanations by distinguishing the various features of the radial concept of narrative, and showing, for each, either that self-realization (...) is just as good an account, or that we should prefer the self-realization account, of the composition it is supposed to explain. I conclude that, if the shape of a life matters, it matters because some shapes are self-realizations, not because they are narratives. (shrink)

This thesis is a contribution to the ethical justification for clinical research with children. A research subject’s participation in a trial is usually justified, in part, by informed consent. Informed consent helps to uphold the moral principle of respect for persons. But children’s limited ability to make informed choices gives rise to a problem. It is unclear what, if anything, justifies their participation in research. Some research ethicists propose to resolve this problem by appealing to social utility, proxy consent, arguments (...) explaining why it is permissible to expose children to some harm, and an argument concerning the appropriate balance between research harms and benefits. I argue that each of these is a necessary part of the justification for research with children, but that the argument concerning harms and benefits is under-developed. It relies on the concept of minimal risk, but minimal risk is inadequately justified. I propose an interpretation of minimal risk. I defend the idea that minimal risk should be interpreted according to the risks of daily life. I reject the most prominent defense of daily life, which claims that daily risks are morally relevant because they replace, rather than add to, the risks a child would ordinarily face. Instead, I propose that these risks are part of a reasonable trade-off between personal safety and our ability to pursue meaningful lives. I then examine whose daily life should be captured in the concept of minimal risk. I reject arguments that minimal risk should refer to healthy children or the subjects of the research and propose instead that the referent should be children who are not unduly burdened by their lives. I argue that children are not unduly burdened when they fare well and defend the idea that children fare well when they possess sufficiently high degrees of the substantive goods of childhood. I conclude by analyzing a controversial case study using my interpretation of minimal risk. I draw on this case to argue that my interpretation offers clear guidance for research ethics review and contributes to a determination that is more plausible than its rivals. (shrink)

1. Brian Hedden, in this impressively learned and ingenious, if somewhat maddening book,1 1 defends a view he calls Time-slice Rationality, a view comprising two central claims. They are: Synchronicity : All requirements of rationality are synchronic. Impartiality : In determining how you rationally ought to be at a time, your beliefs about what attitudes you have at other times play the same role as your beliefs about what attitudes other people have.

This essay responds to the helpful criticisms of Valuing Health: Well-Being, Freedom, and Suffering, which have been offered by Elselijn Kingma, Adam Oliver, Anna Alexandrova, Alex Voorhoeve, Erik Nord and James Wilson. I am extremely grateful to Jonathan Wolf and especially James Wilson for arranging a one-day conference on my book, Valuing Health: Well-Being, Freedom, and Suffering [Hausman, D.. Valuing Health: Well-Being, Freedom, and Suffering. Oxford: Oxford University Press.], and for publishing this symposium. I am also grateful to the wonderful (...) six scholars who took the time to study my work and to offer perceptive and helpful criticisms. Without unduly trying the patience of readers, I cannot respond to all their remarks, but I hope that in what follows I have replied to the most important of their comments on the arguments and conclusions of Valuing Health. Before I begin these replies, a brief synopsis of Valuing Health may be helpful to the reader. (shrink)

This essay criticizes the proposal recently defended by a number of prominent economists that welfare economics be redirected away from the satisfaction of people's preferences and toward making people happy instead. Although information about happiness may sometimes be of use, the notion of happiness is sufficiently ambiguous and the objections to identifying welfare with happiness are sufficiently serious that welfare economists are better off using preference satisfaction as a measure of welfare. The essay also examines and criticizes the position associated (...) with Daniel Kahneman and a number of co-authors that takes welfare to be ‘objective happiness’ – that is, the sum of momentary pleasures. (shrink)

The psychological condition of happiness is normally considered a paradigm subjective good, and is closely associated with subjectivist accounts of well-being. This article argues that the value of happiness is best accounted for by a non-subjectivist approach to welfare: a eudaimonistic account that grounds well-being in the fulfillment of our natures, specifically in self-fulfillment. And self-fulfillment consists partly in authentic happiness. A major reason for this is that happiness, conceived in terms of emotional state, bears a special relationship to the (...) self. These arguments also point to a more sentimentalist approach to well-being than one finds in most contemporary accounts, particularly among Aristotelian forms of eudaimonism. (shrink)

I defend a methodology for theorizing about happiness. I reject three methods: conceptual analysis; scientific naturalism; and the “pure normative adequacy” approach, where the best conception of happiness is the one that best fills a role in moral theory. The concept of happiness is a folk notion employed by laypersons who have various practical interests in the matter, and theories of happiness should respect this fact. I identify four such interests in broad terms and then argue for a set of (...) desiderata that theories of happiness ought to satisfy. The theory of happiness falls within the province of ethics. It should, however, be viewed as autonomous and not merely secondary to moral theory. (shrink)

In this thesis I am going to explore the relationship between happiness and imprisonment. I will discuss three theories of happiness - hedonism, life satisfaction theories and emotional states theories. I will argue that the main problem of these theories is that they take happiness to consist only of psychological states. Because of this, I will turn my attention towards those theories that evaluate happiness in terms of how well life is going for the person who is living it. I (...) will argue that my Aristotelian account is the most plausible way to understand the relationship between happiness and imprisonment. This is because it takes into account both the external circumstances and the psychological and emotional life of pnsoners. Through this thesis, I will show that my account of happiness in prison accomplishes three tasks: i) it solves the problems encountered by the other theories of happiness in the evaluation of prisoners' happiness, ii) it does not suffer from two of the main objections to the other objectivist theories of happiness, and iii) it can help us to investigate the happiness of prisoners empirically more accurately. (shrink)

To protect children in research, procedures that are not administered in the medical interests of a child must be restricted. The risk threshold for these procedures is generally measured according to the concept of minimal risk. Minimal risk is often defined according to the risks of “daily life.” But it is not clear whose daily life should serve as the baseline; that is, it is not clear to whom minimal risk should refer. Commentators in research ethics often argue that “minimal (...) risk” should refer to healthy children or the subjects of the research. I argue that neither of these interpretations is successful. I propose a new interpretation in which minimal risk refers to children who are not unduly burdened by their daily lives. I argue that children are not unduly burdened when they fare well, and I defend a substantive goods account of children’s welfare. (shrink)

ABSTRACT:To have a virtue is to possess a certain kind of trait of character that is appropriate in pursuing the moral good at which the virtue aims. Human beings are assumed to be capable of attaining those traits. Yet, a number of scholars are skeptical about the very existence of such character traits. They claim a sizable amount of empirical evidence in their support. This article is concerned with the existence and explanatory power of character as a way to assess (...) the possibility of achieving moral virtue, with particular attention paid to business context. I aim to unsettle the so-called situationist challenge to virtue ethics. In the course of this article, I shall defend four claims, namely, that virtues are more than just behavioral dispositions, that at least some virtues may not be unitary traits, that psychologists cannot infer virtues from overt behavior, and that the situationist data do not account for the observational equivalence of traits. Since it rests on a misconception of what virtue is, the situationist objection remains unconvincing. (shrink)

The concept of well-being is central to the subject matter of moral philosophy as well as economics. According to some moral theorists morality is about the maximization of social well-being. According to others, notably John Rawls we ought to give particular priority to the worst off members in society. Both these and other moral positions, whatever the priority they attach to different members of society in arriving at moral judgements, require an account of well-being or advantage. The concern with well-being (...) is thus of foundational importance in moral philosophy, even if well-being is not thought of as all that matters. Furthermore, those who want to distinguish ‘morality’ from ‘self-interest’ must furnish us with an account of human interests, so that we can distinguish the moral realm from that of self-interest or prudence. The concerns of moral philosophers, here, clearly overlap with those of economists. Economists are much concerned with questions of how well people are doing, with their ‘standard of living’ or ‘quality of life’. However, there are very different ways of thinking about each of these ideas. Indeed, we need to discriminate between different views of the quality of life and to decide which is the most appropriate for the purposes of moral theory and the normative parts of economics. (shrink)

The economics of happiness is an influential research programme, the aim of which is to change welfare economics radically. In this paper I set out to show that its foundations are unreliable. I shall maintain two basic theses: (a) the economics of happiness shows inconsistencies with the first person standpoint, contrary claims on the part of the economists of happiness notwithstanding, and (b) happiness is a dubious concept if it is understood as the goal of welfare policies. These two theses (...) are closely related and lead to a third thesis: (c) happiness should be replaced by autonomy as the fundamental goal of welfare economics. To defend my claims I shall show that a hedonic approach to happiness leads to an awkward trilemma. Furthermore, I shall clarify the meaning of and , along with their conceptual relationships. (shrink)

The purpose of this paper is to offer an account of ‘flourishing’ that is relevant to health care provision, both in terms of the flourishing of the individual patient and carer, and in terms of the flourishing of the caring institution. It is argued that, unlike related concepts such as ‘happiness’, ‘well-being’ or ‘quality of life’, ‘flourishing’ uniquely has the power to capture the importance of the vulnerability of human being. Drawing on the likes of Heidegger and Nussbaum, it is (...) argued that humans are at once beings who are autonomous and thereby capable of making sense of their lives, but also subject to the contingencies of their bodies and environments. To flourish requires that one engages, imaginatively and creatively, with those contingencies. The experience of illness, highlighting the vulnerability of the human being, thereby becomes an important experience, stimulating reflection in order to make sense of one’s life as a narrative. To flourish, it is argued, is to tell a story of one’s life, realistically engaging with vulnerability and suffering, and thus creating a framework through which one can meaningful and constructively go on with one’s life. (shrink)

In the paper, I aim to reconstruct a charitable interpretation of Durkheimian utilitarianism, a normative theory of public morality proposed by well-recognised American moral psychologist – Jonathan Haidt, which might provide reasons to justify particular legal regulations and public policies. The reconstruction contains a coherent theory that includes elements of rule-utilitarianism, value pluralism, objective list theory and perfectionism, as well as references to Emile’s Durkheim views on human nature. I also compare Durkheimian utilitarianism with two similar theories – Brad Hooker’s (...) rule consequentialism and Krzysztof Saja’s institutional function consequentialism. (shrink)

The aim of the article is to give an outline of a value theory suitable for climate ethics, based on a perfectionist account on the convergence between prudential values and moral responsibility. I claim that such a convergence may generate a system of values that specify norms and obligations and attribute responsibility towards future generations, and thereby provides us with a measure of acceptable political action.

Welfare in economics is generally conceived of in terms of the satisfaction of preferences, but a general, comparable index measure of welfare is generally not taken to be possible. In recent years, in response to the usage of measures of subjective well-being as indices of welfare in economics, a number of economists have started to develop measures of welfare based on preference-satisfaction. In order to evaluate the success of such measures, I formulate criteria of policy-relevance and theoretical success in the (...) context of preference-satisfaction measures of welfare. I present a detailed case study of the methodological choices put forward in a prominent generalized proposal for measuring welfare through preferences recently published in the American Economic Review. I contrast this with an alternative welfare measure which also uses preferences to weight aspects of welfare: the ICECAP-A measure. I assess the methodology of both approaches in detail and argue that the two goals of a preference... (shrink)

In her excellent and comprehensive article, Friesen argues that utilising personal responsibility in healthcare is problematic in several ways: it is difficult to ascribe responsibility to behaviour; there is a risk of prejudice and bias in deciding which behaviours a person should be held responsible for; it may be ineffective at reducing health costs. In this short commentary, I will elaborate the critique of personal responsibility in health but suggest one way in which it could be used ethically. In doing (...) so, I will introduce the concepts of reasonable risk and golden opportunity. I previously argued that it is both difficult to disentangle responsibility and that we risk prejudice and bias in singling out behaviours that are socially disapproved of.1 So I am sympathetic to Friesen’s concerns. I also discussed another way in which ascribing personal responsibility for health is problematic which Friesen does not discuss and which, in my view, is the most concerning and further supports her arguments. It represents a back door assault on liberalism and neutrality towards concepts of the good life. Even if one were to accurately and in an unbiased way divine the personal contribution to disease, the greatest problem would remain: those who voluntarily take on risk would be penalised. That is, such a system would be risk-averse. Those lives which avoided risk would be prioritised, while those who chose to take on risky activities in their conception of the good life would be penalised. Yet risk is necessary, both for the good life, and social progress. Columbus, Edmund Hilary, Florence Nightingale, Ernest Hemingway and countless monumental figures in human history took risks in order to achieve something great. Should we aim for a society of trembling, teetotalling health nuts? Surely that prospect is horrific. It is horrific because it elevates health …. (shrink)

In the Global Burden of Disease study, disease burden is measured as disability-adjusted life years (DALYs). The paramount assumption of the DALY is that it makes sense to aggregate years lived with disability (YLDs) and years of life lost (YLLs). However, this is not smooth sailing. Whereas morbidity (YLD) is something thathappens toan individual, loss of life itself (YLL) occurs when that individual’s life has ended. YLLs quantify something that involves no experience and does not take place among living individuals. (...) This casts doubt on whether the YLL is an individual burden at all. If not, then YLDs and YLLs are incommensurable. There are at least three responses to this problem, only one of which is tenable: a counterfactual account of harm. Taking this strategy necessitates a re-examination of how we count YLLs, particularly at the beginning of life. (shrink)

In Reasons Without Persons, Brian Hedden argues that a theory of rationality need not provide diachronic norms for reasoning, since we can explain all we need to explain about rationality using purely synchronic norms. This article argues that a theory of rationality should contain at least one diachronic norm for reasoning, namely a norm to fill in the details of one's coarse-grained or partial plans. It also explores a possible synchronic approach to this aspect of rationality.

ABSTRACT: Can virtue ethics say anything worthwhile about laws? What would a virtue-ethical account of good laws look like? I argue that a plausible answer to that question can be found in Plato’s parent analogies in the Crito and the Menexenus. I go on to show that the Menexenus gives us a philosophical argument to the effect that laws are just only if they enable citizens to flourish. I then argue that the resulting virtue-ethical account ofjust laws is not viciously (...) paternalistic. Finally, I refute the objection that the virtue-ethical account I am proposing is not distinct from a consequentialist account.RÉSUMÉ: Peut-on construire une théorie de la loi à partir de l’éthique de la vertu? Qu’est ce qu’une bonne loi? Je dis que l’on trouvera une réponse à la question dans l’analogie entre les lois et les parents présentée par Platon dans le Criton et le Ménéxène. Dans §2, je montre que le Ménéxène apporte une défense philosophique de l’argument que les lois sont bonne seulement si elles amènent les citoyens a la vertu.Dans §3, je montre que celte théorie des lois selon la vertu n’est pas outre mesure paternaliste. Dans la dernière section, je réponds a l’objection suivante : que la théorie que je défend n’est ni plus ni moins qu’une théorie conséquentialiste. (shrink)

The brunt of my claim in this paper is that the notion expressed in the slogan, “incommensurability of values” is misleading at best, pernicious at worst, and that its implications for practical rhetoric—which is to say, arguments when they go to work— are especially unfortunate. The case is straightforward. There is nothing in the original mathematical metaphor or in the developments in philosophy of science that warrants the use of incommensurability as a technical term in ethics. Values are bigger, lumpier (...) things than the term incommensurability prototypically references, and the deployment of the word in philosophy of science also references markedly different issues than it does in the domain of values. Moreover, that domain flat-footedly misappropriates the term for duties it doesn’t serve elsewhere, comparison. Worst of all, the implications of the use of incommensurability as a technical term are to draw attention away from the valueholders, who might well reconcile discrepant values if given the chance, and to direct that attention generally towards reified values, and specifically towards some putative relationship between reified values that precludes reconciliation. (shrink)

If I lead a life of virtue, that may well be good for you. But will it also be good for me? The idea that it will—or even must—is an ancient one, and its appeal runs deep. For if this idea is correct then we can provide everyone with a good reason—arguably the best reason—for being virtuous. However, for all the effort which has been invested in defending the idea, by some of the best minds in the history of philosophy, (...) it remains unproven. Worse, in this skeptical age hardly anyone really believes it. I don't really believe it either, at least not in its strongest forms, but I think that the question is nonetheless worth examining. Even if we cannot show that virtue and self-interest coincide, we can at least measure the breadth of the gap between them. (shrink)

ABSTRACT:Employing utilitarian criteria, Jones and Felps, in “Shareholder Wealth Maximization and Social Welfare: A Utilitarian Critique” (Business Ethics Quarterly23[2]: 207–38), examined the sequential logic leading from shareholder wealth maximization to maximal social welfare and uncovered several serious empirical and conceptual shortcomings. After rendering shareholder wealth maximization seriously compromised as an objective for corporate operations, they provided a set of criteria regarding what a replacement corporate objective would look like, but do not offer a specific alternative. In this article, we draw (...) on neo-utilitarian thought to advance a refined version of normative stakeholder theory that we believe addresses a major remaining criticism of extant versions, their lack of specificity. More particularly, we provide a single-valued objective function for the corporation—stakeholder happiness enhancement—that would allow managers to make principled choices between/among policy options when stakeholder interests conflict. (shrink)

This paper builds upon, but substantially revises, John Harsanyi's concept of ‘extended preferences’. An individual ‘history’ is a possible life that some person (a subject) might lead. Harsanyi supposes that a given spectator, formulating her ethical preferences, can rank histories by empathetic projection: putting herself ‘in the shoes’ of various subjects. Harsanyi then suggests that interpersonal comparisons be derived from the utility function representing spectators’ (supposedly common) ranking of history lotteries. Unfortunately, Harsanyi's proposal has various flaws, including some that have (...) hitherto escaped scholarly attention. In particular, it ignores the limits of personal identity. If the subject has welfare-relevant attributes that the spectator cannot acquire without changing who she is, full empathetic identification of the latter with the former becomes impossible. This paper proposes instead to usesympathyas the attitude on a spectator's part that allows us to make sense of her extended preferences. Sympathy – an attitude of care and concern – is a psychological state quite different from empathy. We should also allow for hetereogeneity in spectators’ extended preferences. Interpersonal comparisons emerge from a plurality of sympathetic spectators, not (as per Harsanyi) from a common empathetic ranking. (shrink)

Items are incommensurate if it is false that one is better than the other or that they are exactly as or equally good. John Broome claims that there are no incommensurate items (in some domain), but that there is vagueness. Wlodek Rabinowicz casts doubt on this claim because he rejects a principle which Broome adopts in advancing it. I argue that Robert Sugden's discussion can be interpreted as advancing a version of this claim which does not depend on the relevant (...) principle and which can respond to certain objections. (shrink)

Call the proposition that the good life consists of excellent, distinctively human activity the Aristotelian Thesis. I think of a photograph I clipped from the New York Times as vividly depicting this claim. It shows a pianist, David Golub, accompanying two vocalists, Victoria Livengood and Erie Mills, at a tribute for Marilyn Home. All three artists are in fine form, exercising themselves at the height of their powers. The reason I saved the photo, however, is Mr. Golub's face. He is (...) positively grinning, as if saying to himself, “And they pay me to do this?”. (shrink)

A principal aim of the branch of ethics called ‘population theory’ or ‘population ethics’ is to find a plausible welfarist axiology, capable of comparing total outcomes with respect to value. This has proved an exceedingly difficult task. In this paper I shall state and discuss two ‘trilemmas’, or choices between three unappealing alternatives, which the population ethicist must face. The first trilemma is not new. It originates with Derek Parfit's well-known ‘Mere Addition Paradox’, and was first explicitly stated by Yew-Kwang (...) Ng. I shall argue that one horn of this trilemma is less unattractive than Parfit and others have claimed. The second trilemma, which is a kind of mirror image of the first, appears hitherto to have gone unnoticed. Apart from attempting to resolve the two trilemmas, I shall suggest certain features which I believe a plausible welfarist axiology should possess. The details of this projected axiology will, however, be left open. (shrink)

WHEN ONE ASSUMES, as I will, that death marks the irrevocable end to one’s existence, it is difficult to make sense of the idea that a person could be harmed or benefited by events that take place after her death. How could a posthumous event either enhance or diminish the welfare of the deceased, who no longer exists? Yet we find that many people have a prudential (i.e., self-interested) concern for what’s going to happen after their deaths.1 People are, for (...) instance, concerned that their reputations not be slandered, that their achievements not be undermined, and that their contributions not be forgotten, not even after their deaths. Of course, many philosophers would insist that such a concern for what’s going to happen after one’s death must be based on, or a remnant of, a false belief in an afterlife. I, however, will argue that even if death marks the unequivocal and permanent end to one’s existence, people have good reason to be prudentially concerned with what’s going to happen after their deaths, for, as I will show, a person’s welfare can indeed be affected by posthumous events. (shrink)

This article takes a critical look at the classic couplet of theories on the justification of rights, namely, the choice theory and the interest or benefit theory, where the two are understood to be in conflict. The argument is made that this couplet is best replaced with a new one, namely, a sophisticated rendering of the benefit theory coupled with the autonomy theory, such that any conflict is resolved. The latter two theories take different cases in justifying the attribution of (...) rights: The autonomy theory is concerned with justifying the attribution of rights to adult, rational, and competent subjects, arguing that this attribution requires a sufficiently autonomous claim by such subjects, while the benefit theory seeks to justify the attribution of rights to subjects who lack any of these three properties, meaning that they cannot be considered adult, rational, or competent. (shrink)

This article presents an approach to how to make reasonable social choices when independent criteria (e.g., prioritarianism, religious freedom) fail to fully determine what to do. The article outlines different explanations of why independent criteria sometimes fail to fully determine what to do and illustrates how they can still be used to eliminate ineligible alternatives, but it is argued that the independent criteria cannot ground a reasonable social choice in these situations. To complement independent criteria when they fail to fully (...) determine what to do, it is suggested that society must engage in public deliberation by way of generating new reasons that can determine how to rank the alternatives. It is suggested that the approach to social choice presented here reveals a way of accepting the relevance of independent criteria for social choice without letting go of the idea that the attitudes of affected parties matter. (shrink)