ABSTRACT In his paper ‘The Survival Lottery’John Harris suggested that there could be situations where the rational thing to do would be to kill a healthy person and harvest his organs for transplantation, thereby saving several lives at the cost of one. Anne Maclean claims that such a proposal, far from being rational, does not qualify as a moral proposal at all since what it suggests is ‘plain murder’. I argue that she is correct to claim that the proposal is (...) not uniquely rational and that doctors could quite rationally reject it, but that she overreaches herself when she holds it not to be a moral proposal at all. (shrink)

“The Trolley Problem” is the name Judith Jarvis Thomson has given to a difficult problem in moral philosophy and legal theory. The problem arises by considering a series of cases, all of which involve a choice of evils. Many, but not all of these cases, involve an out-of-control trolley about to run over a group of five people. In each case we are asked for our intuitive judgment as to whether it would be permissible to save the five people at (...) risk when doing so would require the death of, or the imposition of a high risk of death on, another human being. (shrink)

This paper argues that, if one thinks that the needy have a right to the material resources they need in order to lead decent lives, one must be committed, in some cases, to conferring on the sick a right that the healthy give them some of the body parts they need to lead such a life. I then assess two objections against that view, to wit: to confer on the sick a right to the live body parts of the healthy (...) violates the bodily integrity of the latter; and constitutes too much of an interference in their life. I conclude that although the sick sometimes have a right to some of the body parts of the healthy, the latter still retain a considerable degree of autonomy. (shrink)

The demand for bodily parts such as organs is increasing, and individuals in certain circumstances are responding by offering parts of their bodies for sale. Is there anything wrong in this? Kant had arguments to suggest that there is, namely that we have duties towards our own bodies, among which is the duty not to sell parts of them. Kant's reasons for holding this view are examined, and found to depend on a notion of what is intrinsically degrading. Rom Harré's (...) recent revision of Kant's argument, in terms of an obligation to preserve the body's organic integrity, is considered. Harré's view does not rule out all acts of selling, but he too ultimately depends on a test of what is intrinsically degrading. Both his view and Kant's are rejected in favour of a view which argues that it does make sense to speak of duties towards our own bodies, grounded in the duty to promote the flourishing of human beings, including ourselves. This provides a reason for opposing the sale of bodily parts, and the current trend towards the market ethic in health care provision. (shrink)

The standard problem with many slippery slope arguments is that they fail to provide us with the necessary evidence to warrant our believing that the significantly morally worse circumstances they predict will in fact come about. As such these arguments have widely been criticised as ‘scare-mongering’. Consequentialists have traditionally been at the forefront of such criticisms, demanding that we get serious about guiding our prescriptions for right action by a comprehensive appreciation of the empirical facts. This is not surprising, since (...) consequentialism has traditionally been committed to the idea that right action be driven by empirical realities, and this hard-headed approach has been an especially notable feature of Australian consequentialism. But this apparent empirical hard-headedness is very selective. While consequentialists have understood their moral outlook and commitments as guided by a partnership with empirical science – most explicitly in their replies to the arguments of their detractors – some consequentialists have been remarkably complacent about providing empirical support for their own prescriptions. Our key example here is the consequentialist claim that our current practises of partiality in fact maximise the good, impartially conceived. This claim has invariably been made without compelling support for the large empirical claims upon which it rests, and so, like the speculative empirical hand-waving of weak slippery slope arguments, it seems similarly to be undermined. While these arguments have presented us with ‘wishful thinking’ rather than ‘scare-mongering’, we argue in this paper that their complacency in meeting the relevant empirical justificatory burden remains much the same. (shrink)

This paper analyzes the inconsistency of Mill’s utilitarianism in moral philosophy and his liberalism in political philosophy, the efforts of Ten and Dworkin for their consistency and the distinction that Leob and Driver use for reconciling them‌. The distinction is between decision-procedure and criterion of evaluation or the metaphysics and epistemology of right‌. In the next step, it shows a new inconsistency between Mill’s moral and political philosophy‌. It seems that Mill cannot accept the non-consequentialist ‘doing/allowing harm’ distinction in moral (...) philosophy because he himself is a consequentialist‌. The rejection of this distinction makes it inconsistent with his harm principle and his main distinction in political philosophy: the distinction between ‘self-regarding’ and ‘other-regarding’ actions‌. These criticisms show the difficulty of reconciling Mill’s utilitarianism with his liberalism and his moral philosophy with his political philosophy in the framework of the classic triple in normative ethics‌. Therefore, in order to solve this problem, I combined the classic triple with the modern triple in normative ethics. In this way, we can regard Mill as a consistent utilitarian who regards liberty as the essential condition for personal development and maximization of the good, and tries to raise a moderate and sophisticated version of utilitarianism by decreasing its pervasiveness‌‌. (shrink)

My aim in this paper is to provide an effective counterexample to consequentialism. I assume that traditional counterexamples, such as Transplant (A doctor should kill one person and transplant her organs to five terminal patients, thereby saving their lives) and Judge (A judge should sentence to death an innocent person if he knows that an outraged mob will otherwise kill many innocent persons), are not effective, for two reasons: first, they make unrealistic assumptions and, second, they do not pass the (...) rule‐consequentialist institutional test. My example (The Moral Murderer), instead, assumes a realistic empirical framework and the relevant action does not undermine basic social institutions. On the contrary, it reinforces them. In The Moral Murderer, Tom (an adult male) is morally allowed to murder a person (preferably a woman) in order to be punished to death. (shrink)

Nach Parfit konvergieren die systematisch stärksten Versionen von Kantianismus, Regel-Konsequentialismus und Kontraktualismus in einer Triple Theory. Ich konzentriere mich auf eine der zentralen Schwierigkeiten, Kantianismus und Konsequentialismus zusammenzubringen: die Rolle von Zustimmung, welche ihren deutlichsten Ausdruck in Kants Zweck-an-sich-Formel findet. Ich zeige zunächst, wie die Einführung unparteilicher, nichtmoralischer Gründe, auf der viel Gewicht in Parfits Zustimmungsprinzip liegt, in einigen Fällen die Zweck-an-sich-Formel zu dem intuitiv richtigen Ergebnis führen kann. Anschließend wende ich mich kritisch gegen Parfit. Ich diskutiere zwei Einwände gegen (...) Parfits Zustimmungsprinzip: Das Zustimmungsprinzip ist unterbestimmt und daher nicht relevant für die Fälle, die Kantianismus und Konsequentialismus unterscheiden. Zudem lässt das Zustimmungsprinzip, wie Parfit es versteht, mehr Instrumentalisierung zu, als Parfit selbst bereit ist einzuräumen. (shrink)

In this article I show that the argument in John Harris's famous "Survival Lottery" paper cannot be right. Even if we grant Harris's assumptions—of the justifiability of such a lottery, the correctness of maximizing consequentialism, the indistinguishability between killing and letting die, the practical and political feasibility of such a scheme—the argument still will not yield the conclusion that Harris wants. On his own terms, the medically needy should be less favored (and more vulnerable to being killed), than Harris suggests.

This thesis will utilise the literature on the distinction between doing harm and allowing harm to develop a novel system of moral sequencing that can be applied to general moral problems to decide if, when, and how an agent should intervene to prevent harm from occurring to another agent. Off the back of this discussion, this thesis will offer a way of determining the responsibility of certain agents for their actions within a moral sequence. These motivations will be at the (...) centre of the discussions in this thesis and will be accomplished by ultimately updating the system of moral sequencing so that it makes sense of practical cases of inner-agent change, which itself provides a justification for intervening earlier, and potentially diminishing the responsibility for agents who have experienced an inner-agent change, in a moral sequence. (shrink)

Utilitarianism focuses on the optimization of personal well being in ways that seems to make the practice of medicine irrelevant to the well being of the practitioners, unless given external incentives such as money or honor. Care based on indirect incentives is considered inferior to care motivated internally. This leads to the paradox of utilitarian care. Following Nozick's conceptual Pleasure Machine it is argued that in addition to the promotion of personal well being, people care about fulfilling their well being (...) in a world which is real, just, good, and beautiful. Complete mechanization of social and personal life in accordance with a strict utilitarian regime is also incompatible with the kind of world people desire, even if it promises more fulfillments in terms of personal well being. This explains the so-called Taurek-Parfit paradox, according to which sometimes ethics seems “to count the numbers” and sometimes not. The very pursuit of utilitarianism does not contribute to any personal life plan. The helping professions make the world a better place for us to live in, even though they do not necessarily bear directly on the well being of any individual other than the recipients of care. This resolves the paradox of utilitarian care. (shrink)

The Principle of Double Effect has served as a guide for both statesmen and soldiers since the middle ages in determining which acts in war are morally permissible and which are not. It is used, in particular, by those who make their moral decisions on the basis of certain moral rules that concern the moral consequences of action. This Principle of Double Effect (hereafter referred to as PDE) comes into play in situations where an agent has the option of performing (...) an act with both good and bad consequences. Advocates of PDE believe that it is morally significant whether a bad consequence is intended by the agent or merely forseen as incidental to an act that is in all other respects morally acceptable.^ Of great interest to moral philosophers discussing acts of war is how this principle applies to the deaths of persons not directly involved in the prosecution of the war. Proponents of the PDE claim that while it is morally impermissible to intentionally bring about the deaths of innocent people during combat, either as a means to a military objective or as a goal in itself, it is permissible under certain circumstances for an agent to choose a course of action which may bring about the deaths of innocent people as a forseeable consequence. (shrink)

Whereas indirect euthanasia is a common clinical practice, active euthanasia remains forbidden in most countries. The reason for this differentiation is usually seen in the principle of double-effect (PDE). PDE states that there is a morally relevant difference between the intended consequences of an action and merely foreseen, unintended side-effects. This article discloses the fundamental assumptions presenting the basis for this application of the PDE and examines whether these assumptions are compatible with the PDE. It is shown that neither a (...) liberal nor a utilitarian point of view makes the utilization of the PDE possible. In accordance with philosophical tradition, only within the doctrine of the sanctity of life does the PDE seem to be applicable. By analysing the premises of this doctrine, and comparing them with those of the PDE, the inconsistency of this idea is demonstrated. It is suggested that the role of the PDE in the current discussion on euthanasia is largely exaggerated. (shrink)

Chester Barnard's classic, The Functions of the Executive, is premised on an Aristotelean conception of human nature. This reliance ramifies throughout his analysis of the cooperative basis of human organizations. Perhaps its most important manifestation appears in his definition of willing cooperation as self-abnegation. For by so removing cooperation from its utilitarian and contractarian assumptions, he avoids the well known criticisms of those assumptions while retaining his fundamental liberalism. Put positively, self-abnegation informs Barnard's liberalism with an heroic dimension. This, in (...) turn, enables him to provide an account of organizational effectiveness which is at once realistic and optimistic and which values its unique human participants. (shrink)

Despite the prominence of healthcare-relatedconcerns in public debate, the ground remainsinfertile for the idea of conscripting citizensinto medical research. Reluctance to entertainthe thought of a system where nearly everyonecould be selected for service might reflectuncertainty about what the project wouldinvolve. There might also be a fear that themore crucial issue is how to protect researchsubjects within current, voluntary systems. Nodoubt reluctance to explore a system ofuniversal service results from the common hopethat each of us might avoid research in anycapacity besides (...) researcher. A system of fullcivic participation might, however, avoid manyof the usual objections. Ethics regulations,including informed-consent guidelines, couldfor the most part remain in force. Though thesystem would compel people to serve, it couldremain responsive to principles of autonomy andjustice if it centered on broad publiceducation, community representation, and alottery-type selection process. The systemcould draw from the largest possiblecross-section of society, and offer conscriptsthe widest possible range of service. In thisway, a compulsory system might reconcile theexpectations about healthcare with researchneeds. (shrink)

For the majority of scholars concerned with the ethics of living organ donation, inflicting moderate harms on competent volunteers in order to save the lives or increase the life chances of others is held to be justifiable provided certain conditions are met. These conditions tend to include one, or more commonly, some combination of the following: The living donor provides valid consent to donation. Living donation produces an overall positive balance of harm–benefit for donors and recipients which cannot be obtained (...) in a less harmful manner. Donation is not liable to cause significant and long-term morbidity to, or the death of, the donor. This paper critically examines the suggestion that these criteria are not sufficient to offer a general account of justified living organ donation in the context of competent volunteers and that key to justified living organ donation is that donors receive sufficient benefits from their donation that these outweigh the harms they suffer. However, although this view—termed here ‘The Donor Benefit Standard’—directs welcome attention to the many and complex motives which may underlie living organ donation, this paper ultimately concludes that given the threats this position poses to individual autonomy and the lives of those in need of organ transplants ‘The Donor Benefit Standard’ should ultimately be rejected. (shrink)

We can enjoy and suffer many kinds of human goods and evils. The goods include not only experiences and enjoyments but also the having and exercise of various talents and abilities, the receipt of recognitions and rewards, successes, employments, opportunities. The evils include not only pains and frustrations but also defects such as ugliness, disabilities such as paralysis or retardation, lack of standard opportunities such as unemployment, financial loss, failure, disgrace. It is tempting to say that wherever a person has (...) a good he has an advantage and when he suffers an evil he is, in that respect, disadvantaged. However this usage can make it look as if all human goods and evils are subject matter for distributive justice. In fact that is not the conventional view. (shrink)

ABSTRACT This paper takes issue with the idea that there is a variety of moral theories available which can in some way usefully be applied to problems in ethics. The idea is reflected in the common view that those favouring a systematic approach would do well to abandon consequentialist thinking and turn to some alternative theory. It is argued here that this is not an option, since each of the usual supposed alternatives lacks the independent resources to meet the minimal (...) requirements of being a moral theory at all. The aim is to demonstrate that virtue ethics, rights theory and deontology lack the different forms of explanation that would make them genuinely alternative theories. The conclusion is that this part of ethics is much more of a unity than is standardly assumed and that, far from our being able to move on from consequentialism, certain problems that arise from its very nature are bound to remain central to any attempt at moral theory. (shrink)

A well-known thought experiment has us ponder a lottery system that selects one person as the source of transplantable organs for two others. The organs are forcibly harvested and the “donor” dies, whereas the other two patients live. The Survival Lottery is supposed to get at the distinction between killing and letting die, but it is also a challenge to beliefs about moral duties: what are my obligations if my life could be used to save yours and another person's as (...) well? A less extreme version of this thought experiment might have us imagining that officials of the public healthcare system would devise a similar lottery in the aftermath of a large-scale medical emergency. We could imagine that a natural disaster or an attack using biological weapons, for example, has so diminished the ability to provide public health care that in some communities, officials might consider implementing a lottery. To avoid the concerns about outright killing of selectees, officials might offer a wide range of participation in medical practice and research, not just organ allocation. Officials could ensure that no significant risks are involved, and selectees could in various ways be compensated. Would it be possible to ethically justify this “Healthcare Lottery” on the grounds that it was a temporary, yet necessary, infringement on autonomy? (shrink)

Modern utilitarianism has largely abandoned the view that human well-being consists solely in pleasurable sensations. Too much was wanting in that view for it to withstand the critique of a more refined philosophical psychology than was available to Bentham and Mill. The objections are by now familiar and need no detailed rehearsal. The older view failed to characterize adequately the structure of human satisfactions, forgetting that we can care about things that will happen after we are dead, that we generally (...) prefer to be told a distasteful truth to a comforting lie, and that we wish to be actors in our own lives and not merely passive recipients of pleasures from external sources. The extent to which a life is a flourishing one cannot be determined by summing the pleasures and pains, and calculating the balance. Nor, indeed, can it be determined by summing anything else. A life that is happy or eudaimon in the Aristotelian sense is an organic unity in which the significance of its parts rests on their contribution to the meaning of the whole. Nur im Zusammenhange eines Lebens hat ein Erlebnis Bedeutung. Utilitarianism needs to find a way of incorporating an organic view of human satisfaction. (shrink)