It is sometimes said that certain hard moral choices constitute tragic moral dilemmas in which no available course of action is justifiable, and so the agent is blameworthy whatever she chooses. This paper criticizes a certain approach to the debate about moral dilemmas and considers the metaethical implications of the criticisms. The approach in question has been taken by many advocates as well as opponents of moral dilemmas who believe that analysing the emotional response of the agent is the key (...) to the debate about moral dilemmas. The metaethical position this approach is most naturally associated with is sentimentalism. Sentimentalists claim that evaluation, and in particular moral evaluation, crucially depends on human sentiment. This paper is not concerned with the question whether moral dilemmas exist, but rather with emotion-based arguments used on both sides of the debate. The first aim of the paper is to show that emotion-based arguments by friends or foes of moral dilemmas cannot garner support from sentimentalism. The second aim is to show that this constitutes a serious problem for sentimentalism. (shrink)

The literature on conscience in medicine has paid little attention to what is meant by the word ‘conscience.’ This article distinguishes between retrospective and prospective conscience, distinguishes synderesis from conscience, and argues against intuitionist views of conscience. Conscience is defined as having two interrelated parts: (1) a commitment to morality itself; to acting and choosing morally according to the best of one’s ability, and (2) the activity of judging that an act one has done or about which one is deliberating (...) would violate that commitment. Tolerance is defined as mutual respect for conscience. A set of boundary conditions for justifiable respect for conscientious objection in medicine is proposed. (shrink)

Debates about the ethics of health care and medical research in contemporary pluralistic democracies often arise partly from competing religious and secular values. Such disagreements raise challenges of balancing claims of religious liberty with claims to equal treatment in health care. This paper proposes several mid-level principles to help in framing sound policies for resolving such disputes. We develop and illustrate these principles, exploring their application to conscientious objection by religious providers and religious institutions, accommodation of religious priorities in biomedical (...) research, and treatment of patients’ religious views in doctor–patient encounters. Given that no sound set of guiding principles yields precise solutions for every policy dispute, we explore how morally sound democracies might deliberatively resolve such policy issues, following our proposed principles. Taken together and carefully interpreted, these principles may help in guiding difficult decision making in the indefinitely large realm where government, medical providers, and patients encounter problems concerning religion and medicine. (shrink)

That we are morally responsible for what we do willingly and knowingly is a commonplace. That our moral responsibility extends as far as to cover at least the intended consequences of our voluntary actions and perhaps also the ones we did not intend, but could or did foresee, is equally beyond dispute. But what about omissions? Are we, or can we be, (equally) morally responsible for the harm that has occured because we did not prevent it, even though we could (...) have done so? Say, for all the enormous suffering, caused daily by famine, deprivation and curable diseases in the Third World countries? Moral intuitions and practices that one could consult in this matter seem to leave us in the dark. We regularly ascribe responsibility to people for harms resulting from their negligence or failure to fulfill professional duties. On the other hand, we tend to think that unless there is some evidence of the causal contribution that agents made to a harmful event and/or state, it is not really fair to blame it on them. And finally, to complicate things even more, most of us deny that omissions could effect anything (any change) in the world and consequently regard them as causally impotent (as well as possibly harmless). (shrink)

Means-based harms are frequently seen as forbidden, even when they lead to a greater good. But, are there mitigating factors? Results from five experiments show that judgments about means-based harms are modulated by: 1) Pareto considerations (was the harmed person made worse off?), 2) the directness of physical contact, and 3) the source of the threat (e.g. mechanical, human, or natural). Pareto harms are more permissible than non-Pareto harms, Pareto harms requiring direct physical contact are less permissible than those that (...) do not, and harming someone who faces a mechanical threat is less permissible than harming someone who faces a non-mechanical threat. These results provide insight into the rich representational structure underlying folk-moral computations, including both the independent and interacting roles of the inevitability, directness and source of harm. (shrink)

Several philosophers argue that individuals have an interest-protecting right to parent; specifically, the interest is in rearing children whom one can parent adequately. If such a right exists it can provide a solution to scepticism about duties of justice concerning distant future generations and bypass the challenge provided by the non-identity problem. Current children - whose identity is independent from environment-affecting decisions of current adults - will have, in due course, a right to parent. Adequate parenting requires resources. We owe (...) duties of justice to current children, including the satisfaction of their interest-protecting rights; therefore we owe them the conditions for rearing children adequately in the future. But to engage in permissible parenting they, too, will need sufficient resources to ensure their own children's future ability to bring up children under adequate conditions. Because this reasoning goes on ad infinitum it entails that each generation of adults owes its contemporary generation of children at least those resources that are necessary for sustaining human life indefinitely at an adequate level of wellbeing. (shrink)