Whereas most moral philosophers believe that the facts as to what we’re morally required to do are grounded by the facts about our moral reasons, which in turn are grounded by non-normative facts, I propose that moral requirements are directly grounded by non-normative facts. This isn’t, however, to say that there is no place in the picture for moral reasons. Moral reasons exist, and they’re grounded by moral requirements. Arguing for this picture of the moral sphere requires playing both offense (...) and defense; this article provides the defense. I defend this view against the objections that it must deny that one is generally blameworthy for having violated a moral requirement, that it implies the existence of genuine moral dilemmas, that it runs counter to an obviously true view of how moral deliberation should work, and that it cannot explain why it feels as though figuring about what one is morally required to do often takes the form of thinking about what one’s moral reasons are. (shrink)

The traditional debate about moral dilemmas concerns whether there are circumstances in which an agent is subject to two obligations that cannot both be fulfilled. Realists maintain there are. Irrealists deny this. Here I defend an alternative, methodologically-oriented position wherein the denial of genuine moral dilemmas functions as a regulative ideal for moral deliberation and practice. That is, moral inquiry and deliberation operate on the implicit assumption that there are no genuine moral dilemmas. This view is superior to both realism (...) and irrealism in accounting for moral residue and other crucial phenomenological dimensions of our experience of moral dilemmas. (shrink)

This paper examines what managers ought to do when confronted with apparent moral conflicts between their managerial responsibilities and the general requirements of morality, specifically when those conflicts are driven by the institutional environment. I examine Google’s decision to enter the Chinese search engine market as an example of such a conflict. I consider the view that Google’s managers engaged in justifiable moral compromise in making the choice to engage in self-censorship and show how this view depends on the idea (...) of genuine moral dilemmas or irresolvable moral conflicts. I argue that there are serious reasons to doubt the existence of genuine moral dilemmas both in the abstract, as well as in the context of managerial responsibility. I propose an alternative account for what Google’s managers ought to do, as well as others who face relevantly similar situations. The account contains two conditions for permissibly contributing to another party’s failure to live up to their moral responsibilities. The first condition is that the manager must intend and act in such a way as to minimize the firm’s complicity in the other entity or actor’s failure, which in most cases will imply a duty for the manager to take actions that aim towards changing the institutional context. Under the second condition, managers ought to communicate to the firm’s constituents that they take seriously the importance of the interests at stake. (shrink)

The purpose of this article is to demonstrate that there are ample resources in the English-speaking academic community to enable philosophers who cannot read Chinese to work with material from the Western Han dynasty in their research or teaching. It discusses three kinds of resources, with the aim of developing a community of philosophers engaged in a sustained conversation about Western Han thought. These resources are histories that describe various aspects of the Han dynasty, translations of key texts, and intellectual (...) histories that examine specific thinkers or texts from the Han. This article also provides a detailed example of one way in which Western Han texts demonstrate the diversity of Chinese philosophy with regard to value conflicts. (shrink)

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 alleged problem of the dirty hands of politicians has been much discussed since Michael Walzer’s original piece (Walzer 1974). The discussion has concerned the precise nature of the problem or sought to dissolve the apparent paradox. However there has been little discussion of the putative complicity, and thus also dirtying of hands, of a democratic public that authorizes politicians to act in its name. This article outlines the sense in which politicians do get dirty hands and the degree to (...) which a democratic public may also get dirty hands. It separates the questions of secrecy, authorisation, and wrongfulness in order to spell out the extent of public complicity. Finally it addresses the ways in which those who do and those who do not acknowledge the problem of dirty hands erroneously discount or deny the problem of complicity by an appeal to the nature of democracy, a putatively essential need for political openness or to the scope of ideal theory. (shrink)

Sometimes physicians lie to third-party payers in order to grant their patients treatment they would otherwise not receive. This strategy, commonly known as gaming the system, is generally condemned for three reasons. First, it may hurt the patient for the sake of whom gaming was intended. Second, it may hurt other patients. Third, it offends contractual and distributive justice. Hence, gaming is considered to be immoral behavior. This article is an attempt to show that, on the contrary, gaming may sometimes (...) be a physician's duty. Under specific circumstances, gaming may be necessary from the viewpoint of the internal morality of medicine. Moreover, the objections against gaming are examples of what we call the idealistic fallacy, that is, the fallacy of passing judgments in a nonideal world according to ideal standards. Hence, the objections are inconclusive. Gaming is sometimes justified, and may even be required in the name of beneficence. (shrink)

Whereas most moral philosophers believe that the facts as to what we’re morally required to do are grounded by the facts about our moral reasons, which in turn are grounded by non-normative facts, I propose that moral requirements are directly grounded by non-normative facts. This isn’t, however, to say that there is no place in the picture for moral reasons. Moral reasons exist, and they’re grounded by moral requirements. Arguing for this picture of the moral sphere requires playing both offense (...) and defense; this article provides the defense. I defend this view against the objections that it must deny that one is generally blameworthy for having violated a moral requirement, that it implies the existence of genuine moral dilemmas, that it runs counter to an obviously true view of how moral deliberation should work, and that it cannot explain why it feels as though figuring about what one is morally required to do often takes the form of thinking about what one’s moral reasons are. (shrink)

Background The edge metaphor is ubiquitous in describing the present situation in the world, and nowhere is this as clearly visible as in medicine. “The edge of medicine” has become the title of books, scholarly articles, media headlines, and lecture series and seems to be imbued with hype, hope, and aversion. In order better to understand what is at stake at “the edge of medicine” this article addresses three questions: What does “the edge of medicine” mean in contemporary debates on (...) modern medicine? What are the challenges “on the edge of medicine” (in these various meanings of “on the edge”)? How can philosophy and ethics contribute with addressing these challenges? Methods Literature searches in PubMed and Google Scholar are used to identify uses of the phrase “the edge of medicine” while conventional content analysis is used to analyze meanings of and challenges with “the edge of medicine.” These results are then investigated with respect to how philosophy and ethics can address the identified challenges. Results The literature reveals that “the edge of medicine” has many meanings, such as: Border; Margin (of life); Frontier; Forefront; Fringes; Plunge (abyss); Brink (verge); Conflict; and Balancing. In general, the various meanings address four basic challenges: setting limits, keeping control, make meaning, and handling conflicts or aporias. The analysis of each of the meanings of “the edge of medicine” identifies a wide range of important and urgent tasks for the humanities in general, and for philosophy and ethics in particular: 1) clarifying concepts; 2) clarifying assumptions and premises of arguments, methods, advice, and decisions; 3) elaborate new concepts and new theories; 4) conceptualize and handle uncertainty, moral regret, and residue; 5) reveal “the emperor’s new clothes;” 6) identify trends and reflect on their implications; 7) demarcation; and 8) reflecting on goodness in medicine. Conclusion The phrase “the edge of medicine” expresses a wide range of challenges for modern health care. Together with other disciplines philosophy and ethics can and should make crucial contributions at “the edge of medicine,” which is where the future of human beings and societies is created and formed. (shrink)

Recent medical and bioethics literature shows a growing concern for practitioners’ emotional experience and the ethical environment in the workplace. Moral distress, in particular, is often said to result from the difficult decisions made and the troubling situations regularly encountered in health care contexts. It has been identified as a leading cause of professional dissatisfaction and burnout, which, in turn, contribute to inadequate attention and increased pain for patients. Given the natural desire to avoid these negative effects, it seems to (...) most authors that systematic efforts should be made to drastically reduce moral distress, if not altogether eliminate it from the lives of vulnerable practitioners. Such efforts, however, may be problematic, as moral distress is not adequately understood, nor is there agreement among the leading accounts regarding how to conceptualize the experience. With this article I make clear what a robust account of moral distress should be able to explain and how the most common notions in the existing literature leave significant explanatory gaps. I present several cases of interest and, with careful reflection upon their distinguishing features, I establish important desiderata for an explanatorily satisfying account. With these fundamental demands left unsatisfied by the leading accounts, we see the persisting need for a conception of moral distress that can capture and delimit the range of cases of interest. (shrink)