In healthcare priority settings, early access to treatment before reimbursement decisions gives rise to problems of whether negative decisions for cost‐effectiveness reasons should result in withdrawing treatment, already accessed by patients. Among professionals there seems to be a strong attitude to distinguish between withdrawing and withholding treatment, viewing the former as ethically worse. In this article the distinction between withdrawing and withholding treatment for reasons of cost effectiveness is explored by analysing the doing/allowing distinction, different theories of justice, consequentialist and (...) virtue perspectives. The authors do not find any strong reasons for an intrinsic difference, but do find some reasons for a consequentialist difference, given present attitudes. However, overall, such a difference does not, all things considered, provide a convincing reason against withdrawal, given the greater consequentialist gain of using cost‐effective treatment. As a result, patients should be properly informed when given early access to treatment, that such treatment can be later withdrawn following a negative reimbursement decision. (shrink)

A powerful argument against the counterfactual comparative account of harm is that it cannot distinguish harming from failing to benefit. In reply to this problem, I suggest a new account of harm. The account is a counterfactual comparative one, but it counts as harms only those events that make a person occupy his level of well-being at the world at which the event occurs. This account distinguishes harming from failing to benefit in a way that accommodates our intuitions about the (...) standard problem cases. In laying the groundwork for this account, I also demonstrate that rival accounts of harm are able to distinguish harming from failing to benefit only if, and because, they also appeal to the distinction between making upshots happen and allowing upshots to happen. One important implication of my discussion is that preserving the moral asymmetry between harming and failing to benefit requires a commitment to the existence of a metaphysical and moral distinction between making and allowing. (shrink)

According to the Standard View, a doctor who withdraws life-sustaining treatment does not kill the patient but rather allows the patient to die—an important distinction, according to some. I argue that killing can be understood in either of two ways, and given the relevant understanding, the Standard View is insulated from typical criticisms. I conclude by noting several problems for the Standard View that remain to be fully addressed.

The anti-doping policies of the World Anti-Doping Agency (WADA) aim to promote a level playing field and protect the health of the athlete. Anti-doping policy discourages research using performance enhancing drugs (PEDs) or methods and prohibits athlete support personnel, including healthcare providers, from providing advice, assistance, or aid to an athlete or others seeking to use, or using PEDs until harm has occurred. Athletes are individually responsible for the presence of a prohibited substance in their bodies and face sanction regardless (...) of knowledge or intent. I will argue (i) that WADA policies fail to meet the epistemic and control conditions needed to adequately assign individual responsibility and (ii) that transferring responsibility for use of PEDs solely to the athlete results in harm. WADA is drifting perilously close to the morally impermissible ‘doing of harm’ to athletes by initiating or sustaining a causal sequence of events that can result in harm. (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)

It is widely believed to be permissible for a physician to discontinue any treatment upon the request of a competent patient. Many also believe it is never permissible for a physician to intentionally kill a patient. I argue that the prospect of deactivating a patient’s artificial heart presents us with a dilemma: either the first belief just mentioned is false or the second one is. Whichever horn of the dilemma we choose has significant implications for contemporary medical ethics.

Alon Harel defines extreme cases as those in which the only way to avert a destructive threat is to harm innocent people. He rejects traditional consequentialist and non-consequentialist approaches because of the type of reasoning they both employ. I interpret Harel as making two central objections to this form of reasoning. First, traditional approaches require comparisons to be made about the value of human life. Second, decisions in extreme cases, even if permissible, should not be made under the guidance of (...) rules. I argue that these objections, though prima facie plausible, are on reflection relatively weak, and I offer instead a more moderate argument that vindicates Harel’s general thesis that deliberation is morally relevant. More specifically, I argue that whether one acts on certain conditions affects both the moral permissibility of one’s actions and the duties owed by others. (shrink)

Agent-centered constraints on harming hold that some harmful upshots of our conduct cannot be justified by its generating equal or somewhat greater benefits. In this paper I argue that all plausible theories of agent-centered constraints on harming are undermined by the likelihood that our actions will have butterfly effects, or cause cascades of changes that make the world dramatically different than it would have been. Theories that impose constraints against only intended harming or proximally caused harm have unacceptable implications for (...) choices between more and less harmful ways of securing greater goods. This leaves as plausible only theories that impose constraints against causing some unintended distal harms. But, I argue, given the distal harms our actions are likely to cause through their butterfly effects, these theories entail that any way of sustaining our lives is overwhelmingly likely to involve unjustified killing, and that we are therefore morally required either to allow ourselves to waste away or kill ourselves. (shrink)

The Doctrine of Double Effect [DDE] states roughly that it is harder to justify causing or allowing harm as a means to an end than it is to justify conduct that results in harm as a side effect. This chapter argues that a theory of deontological constraints on harming needs something like the DDE in order to avoid the charge that it reflects a narcissistic obsession with the cleanliness of our own hands. Unfortunately, the DDE is often interpreted as maintaining (...) that we must avoid acting with certain intentions, which, this chapter contends, embodies an equally narcissistic obsession with the purity of our own hearts. The chapter argues that the DDE is better interpreted as a denial of the Machiavellian idea that beneficial ends justify harmful means. On this view, the objective fact that our conduct will secure benefits for some individuals at the expense of other individuals weakens the extent to which those benefits count as reasons to engage in that conduct. The chapter argues that this version of the DDE provides a plausible, non-narcissistic foundation for deontological constraints. (shrink)

Fiona Woollard presents an original defence of the Doctrine of Doing and Allowing, according to which doing harm seems much harder to justify than merely allowing harm. She argues that the Doctrine is best understood as a principle that protects us from harmful imposition, and offers a moderate account of our obligations to offer aid to others.

Traditionally, moral philosophers have distinguished between doing and allowing harm, and have normally proceeded as if this bipartite distinction can exhaustively characterize all cases of human conduct involving harm. By contrast, cognitive scientists and psychologists studying causal judgment have investigated the concept ‘enable’ as distinct from the concept ‘cause’ and other causal terms. Empirical work on ‘enable’ and its employment has generally not focused on cases where human agents enable harm. In this paper, we present new empirical evidence to support (...) the claim that some important cases in the moral philosophical literature are best viewed as instances of enabling harm rather than doing or allowing harm. We also present evidence that enabling harm is regarded as normatively distinct from doing and allowing harm when it comes to assigning compensatory responsibility. Moral philosophers should be exploring the tripartite distinction between doing harm, allowing harm, and enabling harm, rather than simply the traditional bipartite distinction. Cognitive scientists and psychologists studying moral judgment, who have so far largely adopted the bipartite distinction in this area of research, should likewise investigate the tripartite distinction. (shrink)

I defend the Doctrine of Doing and Allowing: the claim that doing harm is harder to justify than merely allowing harm. A thing does not genuinely belong to a person unless he has special authority over it. The Doctrine of Doing and Allowing protects us against harmful imposition – against the actions or needs of another intruding on what is ours. This protection is necessary for something to genuinely belong to a person. The opponent of the Doctrine must claim that (...) nothing genuinely belongs to a person, even his own body. (shrink)

According to the Doctrine of Doing and Allowing, the distinction between doing and allowing harm is morally significant. Doing harm is harder to justify than merely allowing harm. This paper is the first of a two paper critical overview of the literature on the Doctrine of Doing and Allowing. In this paper, I consider the analysis of the distinction between doing and allowing harm. I explore some of the most prominent attempts to analyse this distinction:. Philippa Foot’s sequence account, Warren (...) Quinn’s action/ inaction account, and counterfactual test accounts put forward by Shelly Kagan and Jonathan Bennett. I also discuss Jeff McMahan’s account of the removal of barriers to harm. I argue that analysis of the distinction has often been made more difficult by two mistaken assumption: (1) the assumption that when an agent does or allows harm his behaviour makes the difference to whether or not the harm occurs (2) the assumption that the distinction between doing and allowing and the distinction between action and inaction are interchangeable. I suggest that Foot’s account is the most promising account of the doing/allowing distinction, but that it requires further development. (shrink)

Of great importance to many non-consequentialists is a claimed moral difference between doing and allowing harm. I argue that non-consequentialism is best understood, however, as consisting in three morally distinct categories where commentators typically identify two: standard doings of harm, standard allowings of harm, and denials of resources. Furthermore, the moral distinctness of denials of resources is independent of whether denials are doings or allowings of harm, I argue. I argue by way of matched examples, as well as by way (...) of two widely accepted features of non-consequentialism: stringent rights of persons, and the susceptibility of resources to distribution within political society. (shrink)

One often hears Catholic and non-Catholic politicians and private citizens claim “I am personally opposed to abortion . . . ” but add that it is morally permissible for others to accept abortion. We consider a Rawlsian defense of this position based on the recognition that one’s opposition to abortion stems from acomprehensive doctrine which is incompatible with Public Reason. We examine a second defense of this position based upon respecting the autonomy of others and a third grounded in the (...) harm to the unwilling mother overriding that to the aborted fetus. We look at a fourth and fifth defense based upon our epistemic ignorance regarding the burdens on others of unwanted pregnancies and the ontological and moral status of embryo. We find most versions of these defenses to be wanting and conclude that only if the proponents of the position are subjectivist about morals, which few are, can they offer a coherent defense. (shrink)

According to the Doctrine of Doing and Allowing, it is more difficult to justify doing harm than it is to justify allowing harm. Enabling harm consists in withdrawing an obstacle that would, if left in place, prevent a pre-existing causal sequence from leading to foreseen harm. There has been a lively debate concerning the moral status of enabling harm. According to some (e.g. McMahan, Vihvelin and Tomkow), many cases of enabling harm are morally indistinguishable from doing harm. Others (e.g. Foot, (...) Hanser) support the Equivalence Hypothesis, according to which enabling harm is morally equivalent to allowing harm. Here I argue that there is every reason to embrace, and no reason to reject, the Equivalence Hypothesis. (shrink)

The distinction between doing and allowing appears to have moral significance, but the very nature of the distinction is as yet unclear. Philippa Foot's ‘pre-existing threats’ account of the doing/allowing distinction is highly influential. According to the best version of Foot's account an agent brings about an outcome if and only if his behaviour is part of the sequence leading to that outcome. When understood in this way, Foot's account escapes objections by Warren Quinn and Jonathan Bennett. However, more analysis (...) is required to show what makes a relevant condition part of a sequence. Foot's account is promising, but incomplete. (shrink)

Throw: Harry throws a stone at Dick, hitting him. Intuitively, there is a moral difference between the first and the second case of each of these pairs.1 In the second case, the agent’s behavior is morally worse than his behavior in the first case. But in each pair, the agent’s behavior has the same outcome: in No Check and Shoot, the outcome is that a child dies, and Jim saves $40; in No Catch and Throw, the outcome is that Dick (...) is hit by a stone. Let us call these pairs of cases “the paradigm pairs.” The paradigm pairs, and others like them, provide evidence that common sense morality is not consequentialist: common sense morality does not judge the moral worth of actions just in terms of their consequences. But it has proved extremely difficult to provide an account of a morally relevant difference between the members of pairs like the ones above. One hypothesis about the difference that has received a lot of attention in the literature is that in the first kind of case the agent allows the outcome to occur, while in the second the agent makes the.. (shrink)

This paper examines the absolutist grounds for denying an agent's responsibility for what he allows to happen in 'keeping his hands clean' in acute circumstances. In defending an agent's non-prevention of what is, viewed impersonally, the greater harm in such cases, absolutists typically insist on a difference in responsibility between what an agent brings about as opposed to what he allows. This alleged difference is taken to be central to the absolutist justification of non-intervention in acute cases: the agent's obligation (...) not to do harm is held to be more stringent than his obligation to prevent (comparable) harm, since as agents we are principally responsible for what we ourselves do. The paper's central point is that this representation of the absolutist response to acute cases- as grounded in a difference in responsibility for what we do as opposed to what we allow- involves a misleading theoretical inversion. I argue that the absolutist justification of non-intervention in acute cases must depend on a direct defence of the nature and the stringency of the moral norm with which the agent's non-intervention complies. The nature and stringency of this norm are basic to attribution of agent responsibility in acute cases, and not the other way around. (shrink)

This paper examines the doctrine of double effect as it is typically applied. The difficulty of distinguishing between what we intend and what we foresee is highlighted. In particular, Warren Quinn's articulation of that distinction is examined and criticised. It is then proposed that the only credible way that we can be said to foresee that a harm will result and mean something other than that we intend it to result, is if we are not certain that that harm will (...) result. The ramifications of this are explored. The paper concludes with a moral evaluation of a variety of cases that have harmful outcomes. It is recommended both that we abandon the doctrine of double effect and that we cease to describe cases with harmful outcomes in a dishonest way. (shrink)

When pregnant persons do not behave in the way deemed optimal for their fetus, they are often framed as doing harm. This framing acts as a justificatory bypass for defenses of widespread expectations of pregnant persons, allowing such defenses to avoid substantial questions about special obligations in pregnancy. Our main claim is that this justificatory bypass is unwarranted: in many cases either the pregnant person does not count as doing harm or substantive questions about special obligations cannot be avoided. Our (...) secondary claim is that direct engagement with these substantive questions is unlikely to justify widespread expectations on pregnant people. (shrink)

This issue of Christian Bioethics explores theological, metaphysical, and ethical questions surrounding emerging reproductive technologies. Narratives concerning such technologies are often manipulated via “language games.” Language games involve toying with language to ensure that one’s vision of the good gains or retains political prominence. Such games are common in academic discussions of “artificial womb” technologies. Abortion proponents, for example, are already using language to dehumanize subjects within “artificial wombs.” This is unsurprising. Were relevant subjects considered persons, then abortion access (and (...) other forms of “reproductive autonomy”) might be curtailed. Here, I show that abortion proponents’ language games often depend on dubious metaphysical claims. Second, I argue that Christians should oppose dehumanizing language games, since those games undermine “neighbor-love,” which Christians are commanded to show others. I also highlight how discussions of other technologies—such as medication abortion—are affected by confused (or manipulative) language. Ultimately, the language games I critique aim to preserve and expand the “rights” of the powerful to dehumanize, control, and kill vulnerable human beings. Since neighbor-love commands Christians to provide for “the least of these,” however, Christians must expose these manipulative language games, refute them, and resist the corrupt ideologies from which they flow. (shrink)

Christian pro-lifers often respond to Thomson’s defense of abortion that the violinist is allowed to die while the embryo is killed. Boonin and McMahan counter that this distinction does not provide an objection to extraction abortions that disconnect embryos and allow them to die. I disagree. I first argue that letting die and killing are not to be distinguished by differences between acts and omissions, moral and immoral motives, intentional or unintentional deaths, and causing or not causing a pathology. I (...) offer a taxonomy in which hysterotomies turn out to be killings. I then argue that if either the placenta is considered an organ of the embryo or the embryo is construed as a part of the pregnant woman, then abortion pills kill rather than allow death. So, assuming that killing people is morally worse than letting them die, extraction abortions can be condemned to the same degree as other abortions. (shrink)

The researcher believes that James Rachels’s defense of active euthanasia deserves a critical and normative analysis because of its dehumanizing consequences. The researcher demonstrates that Rachels’s position is conceptually, theoretically, practically, and normatively unjustifiable. The researcher supports his position by three steps.

Pacifism is the view that necessarily, the nonconsensual harming of pro tanto rights-bearers is all-things-considered morally impermissible. Critics of pacifism frequently point to common moral intuitions about self-defenders and other-defenders as evidence that pacifism is false and that self- and other-defense are often morally justified. I call this the Justification View and defend its rival, the Excuse View. According to the latter, a robust view of moral excuse adequately explains the common moral intuitions invoked against pacifism and is compatible with (...) pacifism. The paper proceeds in five steps. First, I identify ten intuitive data points that require explanation. Second, I introduce the justification/excuse distinction. Third, I demonstrate the Excuse View’s equal explanatory power with respect to the intuitive data. Fourth, I defend the Fair Use Principle: When evaluating the plausibility of rival theories J and E, the use of datum d’s full intuitive force against E and for J is epistemically permissible only if (i) d is better explained by J than E and (ii) no intuitive components of d are equally well-explained by E. Finally, I conclude that the conjunction of pacifism and the Excuse View renders the intuitive defense of the Justification View largely moot, and that this is a substantial victory for pacifism. (shrink)

This essay defends the asymmetry between the badness of spontaneous and induced abortions in order to explain why anti-abortionists prioritize stopping induced abortions over preventing spontaneous abortions. Specifically, it argues (1) the distinction between killing and letting-die is of more limited use in explaining the asymmetry than has sometimes been presumed, and (2) that accounting for intentions in moral agency does not render performances morally inert. Instead, anti-abortionists adopt a pluralist, nonreductive account of moral analysis which is situated against a (...) backdrop that sees the limits of our ability to control the process of fertility as themselves valuable. Although this view is complex, the paper concludes by arguing that it has the advantage of explaining features of the anti-abortion outlook that have sometimes been overlooked. First, it accounts for why the pre-Roe regime of abortion restrictions primarily imposed penalties on doctors who induced abortions rather than the women who seek them. Second, it explains why the advent of ectogestation will not prompt anti-abortionists to compromise on ‘disconnect abortions,’ which putatively let the embryo die by extracting it from the mother’s womb. (shrink)

The frequency of death from miscarriage is very high, greater than the number of deaths from induced abortion or major diseases.Berg (2017, Philosophical Studies 174:1217–26) argues that, given this, those who contend that personhood begins at conception (PAC) are obliged to reorient their resources accordingly—towards stopping miscarriage, in preference to stopping abortion or diseases. This argument depends on there being a basic moral similarity between these deaths. I argue that, for those that hold to PAC, there are good reasons to (...) think that there is no such similarity. There is a morally relevant difference between preventing killing and letting die, giving PAC supporters reasons to prioritize reducing abortion over reducing miscarriage. And the time-relative interest account provides a morally relevant difference in the badness of death of miscarriages and deaths of born adults, justifying attempts to combat major diseases over attempts to combat miscarriage. I consider recent developments in the literature and contend that these new arguments are unsuccessful in establishing moral similarities between deaths from miscarriage and abortion, and deaths from miscarriage and disease. (shrink)

Ex-ante deontology is an attempt to combine deontological constraints on doing or intending harm with the idea that one should act in everyone’s interest if possible. I argue that ex-ante deontology has serious problems in cases where multiple decisions are to be made over time. I then argue that these problems force us to choose between commonsense deontological morality and a more consequentialist morality. I suggest that we should choose the latter.

It is typically wrong to act in a way that foreseeably makes some impending harm worse. Sometimes it is permissible to do so, however, if one also offsets the harm increasing action by doing something that decreases the badness of the same harm by at least as much. This chapter argues that the standard deontological constraint against doing harm is not compatible with the permissibility of harm increases that have been offset. Offsetting neither prevents one's other actions from doing harm (...) nor ensures that the harm those actions do is made permissible by any of the constraint's familiar provisos. To make sense of offsetting, the old constraint against doing harm should be replaced with a new constraint against making unoffset harm increases. The chapter discusses how to formulate the new constraint so that it can handle both the offsetting cases that the old constraint gets wrong as as well as the non-offsetting cases that the old constraint gets right. Adopting this constraint against unoffset harm increases may have important implications both for theoretical questions about the sources of deontological constraints as well as for practical questions, such as whether buying carbon offsets can make emitting carbon dioxide permissible. (shrink)

In “Tragedy and Resentment” Ulrika Carlsson claims that there are cases when we are justified in feeling non-moral resentment against someone who harms us without wronging us, when the harm either consists in their attitude towards us or in the emotional suffering triggered by their attitudes. Since they had no duty to protect us from harm, the objectionable attitude is not disrespect but a failure to show love, admiration, or appreciation for us. I explain why unrequited love is the wrong (...) example to use when arguing for the possibility of justified non-moral resentment—and why, therefore, Carlsson’s claim remains unsubstantiated. Pace Carlsson, people who fail to return our love are not best described as harming us, but as merely failing to benefit us by saving us from harm. Moreover, their role in the causal chain that results in our coming to harm is insufficient to warrant our resentment; more plausibly, we ourselves play a greater and more direct causal role in this process. This is a welcome result: Responding with resentment to someone’s failure to return our love indicates that our love has not taken the form of a genuine gift. When we put conditions on successful gifting by allowing for justified resentment if the gift is not returned we are not in fact giving gifts but making a bid for an exchange: I love you so that you love me back. (shrink)

Many countries have adopted new triage recommendations for use in the event that intensive care beds become scarce during the COVID‐19 pandemic. In addition to establishing the exact criteria regarding whether treatment for a newly arriving patient shows a sufficient likelihood of success, it is also necessary to ask whether patients already undergoing treatment whose prospects are low should be moved into palliative care if new patients with better prospects arrive. This question has led to divergent ethical guidelines. This paper (...) explores the distinction between withholding and withdrawing medical treatment during times of scarcity. As a first central point, the paper argues that a revival of the ethical distinction between doing and allowing would have a revisionary impact on cases of voluntary treatment withdrawal. A second systematic focus lies in the concern that withdrawal due to scarcity might be considered a physical transgression and therefore more problematic than not treating someone in the first place. In light of the persistent disagreement, especially concerning the second issue, the paper concludes with two pragmatic proposals for how to handle the ethical uncertainty: (1) triage protocols should explicitly require that intensive care attempts are designed as time‐limited trials based on specified treatment goals, and this intent should be documented very clearly at the beginning of each treatment; and (2) lower survival prospects can be accepted for treatments that have already begun, compared with the respective triage rules for the initial access of patients to intensive care. (shrink)

Most theorists working on moral obligations to refugees conceive of western states as innocent bystanders with duties to aid refugees if they can do so at little cost to themselves. This paper challenges this dominant theoretical framing of global displacement by highlighting for the first time certain practices of western states in response to refugee flows such as border violence, detention, encampment and containment which may make us question whether states who engage in such practices are indeed innocent. This paper (...) provides the first normative analysis of these practices by seeking to classify them as either doing or allowing harm and invoking the fundamental moral imperative central to core common moral commitments - not to harm innocent people - to suggest that certain western states are not merely failing to aid refugees and allowing harm to come to them, but are instead responding to their calls for aid by harming them. (shrink)

This introduction aims to describe some fundamental problems of intergenerational justice and climate change. It also intends to provide comments on improved versions of some of the best papers presented in the International Meeting “Intergenerational Justice and Climate Change: juridical, moral and political issues” that took place at Cordoba National University (Argentina), in September 2017. In that meeting, the discussion focused on these topics by considering the ideas of the two keynote speakers invited to the event: Lukas H. Meyer and (...) Alessandro Pinzani. I devote the last part of this essay to discuss two pressing issues concerning climate change whose practical solutions challenge our standard understanding of the notion of harm. I discuss, on the one hand, certain issues related with the non-identity problem. On the other hand, I try to identify what kind of obligation do we have when we talk about minimizing the number of people who will suffer harm as a result of the adverse effects of climate change. (shrink)

Withholding and withdrawing treatment are widely regarded as ethically equivalent in medical guidelines and ethics literature. Health care personnel, however, widely perceive moral differences between withholding and withdrawing. The proponents of equivalence argue that any perceived difference can be explained in terms of cognitive biases and flawed reasoning. Thus, policymakers should clear away any resistance to accept the equivalence stance by moral education. To embark on such a campaign of changing attitudes, we need to be convinced that the ethical analysis (...) is correct. Is it? In this article, I take a closer look at the moral relation between withholding and withdrawing. My conclusion is that withholding and withdrawing are not in general ethically equivalent. Thus, medical guidelines should be rewritten, and rather than being “educated” away from their sound judgments, medical professionals and patients should have nuanced medico-ethical discussions regarding withholding and withdrawing treatment. (shrink)

Medicine has undergone substantial changes in the way medical dilemmas are being dealt with. Here we explore the attitude of Israeli physicians to two debatable dilemmas: disclosing the full truth to patients...

Many philosophers display relaxed scepticism about the Doctrine of Doing and Allowing and the Doctrine of Double Effect, suspecting, without great alarm, that one or both of these Doctrines is indefensible. This relaxed scepticism is misplaced. Anyone who aims to endorse a theory of right action with Nonconsequentialist implications should accept both the DDA and the DDE. First, even to state a Nonconsequentialist theory requires drawing a distinction between respecting and promoting values. This cannot be done without accepting some deontological (...) distinction. Second, if someone is going to accept any deontological distinction she should accept either the DDE or the DDA or some replacement. Finally, anyone who accepts either the DDE or the DDA should accept both doctrines or a replacement of each. Unless both Doctrines can be defended or given a defensible replacement, any Nonconsequentialist is in trouble. (shrink)

As an adherent to the U.N.’s Universal Declaration of Human Rights, the United States has made a commitment to social justice. As a part of this commitment, the U.S. maintains that the right to an education is both innate and compulsory. This paper addresses U.S. government’s failure to uphold its citizens’ educational rights, made clear by the inadequacy of the educational programs currently offered to juvenile offenders. Based on the findings of recent scholarly literature, this paper argues that both juvenile (...) and adult correctional institutions lack the resources necessary to provide proper educational instruction and adequately address the special educational needs of juvenile offenders. To help the U.S. maintain its commitment to social justice, alternatives to juvenile incarceration are proposed. (shrink)

In order to discuss the normative aspects of euthanasia one has to clarify what is meant by active and passive euthanasia. Many philosophers deny the possibility of distinguishing the two by purely descriptive means, e.g. on the basis of theories of action or the differences between acting and omitting to act. Against this, such a purely descriptive distinction will be defended in this paper by discussing and refining the theory developed by Dieter Birnbacher in his “Tun und Unterlassen”. On this (...) basis I will suggest a new definition of active and passive euthanasia. (shrink)

Zusammenfassung. Der Beitrag diskutiert die ethischen Grundlagen der sogenannten Triage (der Sortierung von Behandlungsbedürftigen in Dringlichkeitskategorien beim Massenanfall Verwundeter) und prüft, inwieweit eine Übertragung dieser Praxis auf eine unter Rationierungsdruck geratende Alltagsmedizin begründbar bzw. zu erwarten ist. Insbesondere wird der ethische Status der sog. Maximierungsregel („rette so viele Menschenleben wie möglich”) erläutert, und es werden die bereits in der katastrophenmedizinischen Praxis nicht ganz unwirksamen Grenzen der Orientierung an dieser Regel deutlich gemacht.

In “Moral Luck” Bernard Williams describes a lorry driver who, through no fault of his own, runs over a child, and feels “agent-regret.” I believe that the driver’s feeling is moral since the thought associated with this feeling is a negative moral evaluation of his action. I demonstrate that his action is not morally inadequate with respect his moral obligations. However, I show that his negative evaluation is nevertheless justified since he acted in way that does not live up to (...) his moral values. I then use this distinctive negative moral evaluation to distinguish agent-regret from guilt and mere regret. (shrink)

If a doctor is trying to decide whether or not to provide a medical treatment, does it matter ethically whether that treatment has already been started? Health professionals sometimes find it harder to stop a treatment (withdraw) than to refrain from starting the treatment (withhold). But does that feeling correspond to an ethical difference? In this article, we defend equivalence—the view that withholding and withdrawal of treatment are ethically equivalent when all other factors are equal. We argue that preference for (...) withholding over withdrawal could represent a form of cognitive bias—withdrawal aversion. Nevertheless, we consider whether there could be circumstances in which there is a moral difference. We identify four examples of conditional nonequivalence. Finally, we reflect on the moral significance of diverging intuitions and the implications for policy. We propose a set of practical strategies for helping to reduce bias in end-of-life decision making, including the equivalence test. (shrink)

It is sometimes proposed that killing or harming abortion providers is the only logically consistent position available to opponents of abortion. Since lethal violence against morally responsible attackers is normally viewed as justified in order to defend innocent parties, pro-lifers should also think so in the case of the abortion doctor and so they should act to defend the unborn. In our paper, we defend the mainstream pro-life view against killing abortion doctors. We argue that the pro-life view can, in (...) various ways, reject the assumption that defensive violence to save innocent individuals is always permissible. Now even if that assumption is accepted, we contend that defensive violence against abortion doctors still is not justified. Drawing on Frances Kamm’s work, we contend that there are structural similarities between abortion and letting someone die who needs your help to stay alive; and we argue that it is impermissible to kill those who kill in order to avoid giving life-saving aid. (shrink)

Most people believe that the rights of others sometimes require us to act in ways that have even substantially sub-optimal outcomes, as viewed from an axiological perspective that ranks outcomes objectively. Bringing about the optimal outcome, contrary to such a requirement, is an ‘optimific wronging’. It is less clear, however, that we are required to prevent optimific wrongings. Perhaps the value of the outcome, combined with the relative weakness of prohibitions on allowing harm as compared to those against doing harm, (...) justifies non-intervention. In this article, I consider arguments to that effect, focusing on a recent paper in this journal by Andreas Mogensen. I argue that while we do not, in general, do wrong by failing to prevent optimific wrongings, we are nevertheless not permitted, in key cases, to refrain from intervening on the grounds that not intervening will secure the optimal outcome. (shrink)