BackgroundEuthanasia can be thought of as being either active or passive; but the precise definition of “passive euthanasia” is not always clear. Though all passive euthanasia involves the withholding of life-sustaining treatment, there would appear to be some disagreement about whether all such withholding should be seen as passive euthanasia.Main textAt the core of the disagreement is the question of the importance of an intention to bring about death: must one intend to bring about the death of the patient in (...) order for withholding treatment to count as passive euthanasia, as some sources would indicate, or does withholding in which death is merely foreseen belong to that category? We may expect that this unclarity would be important in medical practice, in law, and in policy. The idea that withholding life-sustaining treatment is passive euthanasia is traced to James Rachels’s arguments, which lend themselves to the claim that passive euthanasia does not require intention to end life. Yet the argument here is that Rachels’s arguments are flawed, and we have good reasons to think that intention is important in understanding the moral nature of actions. As such, we should reject any understanding of passive euthanasia that does not pay attention to intent.Short conclusionJames Rachels’s work on active and passive euthanasia has been immensely influential; but this is an influence that we ought to resist. (shrink)

In recent years, there has been a great deal of philosophical discussion about the alleged moral right to die. If there is such a moral right, then it would seem to imply a moral duty on others to not interfere with the exercise of the right. And this might have important implications for public policy insofar as public policy ought to track what is morally right.

I argue that, according to ordinary morality, there is moral inertia, that is, moral pressure to fail to intervene in certain circumstances. Moral inertia is manifested in scenarios with a particular causal structure: deflection scenarios, where a threatening or benefiting process is diverted from a group of people to another. I explain why the deflection structure is essential for moral inertia to be manifested. I argue that there are two different manifestations of moral inertia: strict prohibitions on interventions, and constraints (...) on interventions. Finally, I discuss the connection between moral inertia and the distinction between killing and letting die (or doing and allowing harm). (shrink)

The criminal law presently distinguishes between actions and omissions, and only rarely proscribes failures to avert consequences that it would be an offense to bring about. Why? In recent years it has been persuasively argued by both Glover and Bennett that, celeris paribus, omissions to prevent a harm are just as culpable as are actions which bring that harm about. On the other hand, and acknowledging that hitherto “lawyers have not been very successful in finding a rationale for it,” Tony (...) Honoré has sought to defend the law's differential treatment. He proposes a “distinct-duties theory” that in addition to the general duties we owe to everyone, we also owe distinct duties to a more limited collection of people and associations, specified by features of our relationship with them. Where a distinct duty holds, breach by omission may well be no better than breach by positive action. But absent a distinct duty, omissions, per Honoré, are less culpable. They are mere failures to intervene and improve or rectify things, whereas actions are positive interventions which make things worse. And, thus, the law has good reason to differentiate between them. (shrink)

Western ethics and law have been slow to come to conclusions about the right to choose the time and manner of one's death. However, policies, practices, and legal precedents have evolved quickly in the last quarter of the twentieth century, from the forgoing of respirators to the use of Do Not Resuscitate (DNR) orders, to the forgoing of all medical technologies (including hydration and nutrition), and now, in one U.S. state, to legalized physician-assisted suicide. The sweep of history—from the Quinlan (...) case in New Jersey to legislation in Oregon that allows physician-assisted suicide—has been as rapid as it has been revolutionary. (shrink)

I present and defend (1) an account of ethical judgments as judgments about our reasons to feel specific motivationally laden attitudes, (2) an account of what an agent should do in terms of what would achieve ends that she has reason to be motivated to pursue, and (3) an account of an agent’s reasons for motivation (and thus action) in terms of the prescriptions of the most fundamental principles that guide her deliberations. Using these accounts, I explain the connection between (...) ethics and reasons for action, how ethical judgments are both descriptive and intrinsically motivating, and how ethical facts arise from facts about agents’ deliberations. (shrink)

According to a simple form of consequentialism, we should base decisions on our judgments about their consequences for achieving our goals. Our goals give us reason to endorse consequentialism as a standard of decision making. Alternative standards invariably lead to consequences that are less good in this sense. Yet some people knowingly follow decision rules that violate consequentialism. For example, they prefer harmful omissions to less harmful acts, they favor the status quo over alternatives they would otherwise judge to be (...) belter, they provide third-party compensation on the basis of the cause of an injury rather than the benefit from the compensation, they ignore deterrent effects in decisions about punishment, and they resist coercive reforms they judge to be beneficial. I suggest that nonconsequentialist principles arise from overgeneralizing rules that are consistent with consequentialism in a limited set of cases. Commitment to such rules is detached from their original purposes. The existence of such nonconsequentialist decision biases has implications for philosophical and experimental methodology, the relation between psychology and public policy, and education. (shrink)

Numerous grounds have been offered for the view that healthcare workers have a duty to treat, including expressed consent, implied consent, special training, reciprocity (also called the social contract view), and professional oaths and codes. Quite often, however, these grounds are simply asserted without being adequately defended or without the defenses being critically evaluated. This essay aims to help remedy that problem by providing a critical examination of the strengths and weaknesses of each of these five grounds for asserting that (...) healthcare workers have a duty to treat, especially as that duty would arise in the context of an infectious disease pandemic. Ultimately, it argues that none of the defenses is currently sufficient to ground the kind of duty that would be needed in a pandemic. It concludes by sketching some practical recommendations in that regard. (shrink)

We are pleased to have received such a varied set of commentaries on our target article, “Pox Parties for Grannies? Chickenpox, Exogenous Boosting, and Harmful Injustices,” and we are thankful for the opportunity to respond to some of them here. We regret that space limitations preclude us from responding to each. In what follows we will begin by addressing commentaries that expand the application of our arguments. We will then correct some seeming misunderstandings about our distinctions, arguments and thesis. We (...) will conclude by showing, pace our critics, that our view does not entail a rejection of COVID-19 related “lock-downs,” duties of “easy rescue” for children, nor loving relationships between children and their (elderly) family members. (shrink)

Recent results from two different studies show evidence of strong emotional engagement in moral dilemmas that require personal involvement or ethical problems that involve significant inter-personal issues. This empirical evidence for a connection between emotional engagement and moral or ethical choices is interesting because it is related to a fundamental survival mechanism rooted in human evolution. The results lead one to question when and how emotional engagement might occur in a professional ethical situation. However, the studies employed static dilemmas or (...) problems that offered only two choices whose outcome was certain or nearly so, whereas actual problems in professional ethics are dynamic and typically involve considerable uncertainty. The circumstances of three example cases suggest that increasing personal involvement and uncertainty could have been perceived as changes, threats, or opportunities and could therefore have elicited an emotional response as a way to ensure the reputation, integrity or success of oneself or a group to which one belongs. Such emotional engagement is only suggested and more studies and experiments are required to better characterize the role of emotional engagement in professional ethics. (shrink)

What makes killing morally wrong? And what makes killing morally worse than letting die? Standard answers to these two questions presuppose that killing someone involves shortening that person's life. Yet, as I argue in the first two sections of this article, this presupposition is false: Life-prolonging killings are conceivable. In the last two sections of the article, I explore the significance of the conceivability of such killings for various discussions of the two questions just mentioned. In particular, I show why (...) the conceivability of life-prolonging killings renders Frances M. Kamm's attempt to provide an answer to the second question problematic. (shrink)

RESUMEN Los defensores del liberalismo político sostienen que el ejercicio del poder político es legítimo solo cuando es justificado por razones públicas que todos los ciudadanos pueden aceptar con independencia de la doctrina religiosa, filosófica o moral a la que se adhieren. Según John Rawls, satisfacer esa concepción de la legitimidad exige apelar, en la justificación pública de la acción del Estado, a "concepciones políticas de la justicia". Se busca elaborar un nuevo tipo de argumento a favor de la posición (...) de Rawls. ABSTRACT The supporters of political liberalism hold that the exercise of political power is legitimate only when it is justified by public reasons acceptable to all citizens, independently of the religious, philosophical, or moral doctrine they adhere to. In John Rawls' view, satisfying this conception of legitimacy makes it necessary to appeal to "political conceptions of justice" when attempting to publicly justify actions by the State. The article sets forth a new type of argument in favor of Rawls' position. RESUMO Os defensores do liberalismo político sustêm que o exercício do poder político é legítimo só quando é justificado por razões públicas que todos os cidadãos podem aceitar com independência da doutrina religiosa, filosófica ou moral à qual se aderem. Segundo John Rawls, satisfazer essa concepção da legitimidade exige apelar, na justificativa pública da ação do Estado, a "concepções políticas da justiça". Procura-se elaborar um novo tipo de argumento a favor da posição de Rawls. (shrink)

According to a simple form of consequentialism, we should base decision on our judgments about their consequences for achieving out goals. Our goals give us reason to endorse consequentialism as a standard of decision making. Alternative standards invariably lead to consequences that are less good in this sense. Yet some people knowingly follow decision rules that violate consequentialism. For example, they prefer harmful omissions to less harmful acts, they favor the status quo over alternatives they would otherwise judge to be (...) better, they provide third-party compensation on the basis of the cause of an injury rather than the benefit from the compensation, they ignore deterrent effects in decisions about punishment, and they resist coercive reforms they judge to be beneficial. I suggest that nonconsequentialist principles arise from overgeneralizing rules that are consistent with consequentialism in a limited set of cases. Commitment to such rules is detached from their original purposes. The existence of such nonconsequentialist decision biases has implications for philosophical and experimental methodology, the relation between psychology and public policy, and education. (shrink)