When and why is it right to kill? When and why is it wrong? Torbjörn Tännsjö examines three theories on the ethics of killing in this book: deontology, a libertarian moral rights theory, and utilitarianism. The implications of each theory are worked out for different kinds of killing: trolley-cases, murder, capital punishment, suicide, assisted death, abortion, killing in war, and the killing of animals. These implications are confronted with our intuitions in relation to them, and our moral intuitions are examined (...) in turn. Only those intuitions that survive an understanding of how we have come to hold them are seen as 'considered' intuitions. The idea is that the theory that can best explain the content of our considered intuitions gains inductive support from them. We must transcend our narrow cultural horizons and avoid certain cognitive mistakes in order to hold considered intuitions. In this volume, suitable for courses in ethics and applied ethics, Tännsjö argues that in the final analysis utilitarianism can best account for, and explain, our considered intuitions about all these kinds of killing. (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)

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.

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)

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)

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)

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)

Increasingly firm rejections of the distinction between positive and negative human rights as incoherent have created a gap between theory and practice, as well as tensions within legal doctrinal and philosophical literature. This article argues that the distinction can be preserved by means of a structural account of the interaction of duties within human rights, anchored in case law on the right to freedom of assembly in Article 11, the right to free elections in Article 3 of Protocol 1, and (...) the right to security as enshrined in Articles 2, 3, 5, and 8 of the European Convention on Human Rights. (shrink)

The article examines methods of distinguishing positive and negative duties within the provisions of the European Convention of Human Rights as applied by the European Court of Human Rights. It highlights problems with tying positive duties to acts and negative duties to omissions, and sets out a supplemental delineation method when those problems lead to systematic classification errors: duties sort as positive if they have the capacity for multiple fulfilment options and negative if they only allow one fulfilment option. These (...) delineation criteria allow for a more consistent reconstruction of case law and point to a causal mechanism for alleged asymmetries in proportionality review and margins of appreciation. Lastly, there are revisionary implications for human rights scholarship. Judgments have been sorted as positive rights cases because they feature a requirement that states commit to legislative amendment, yet performative acts of amendment may be continuous with underlying negative duties. (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)

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)

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 article analyses proportionality as a potential element of a theory of morally justified surveillance, and sets out a teleological account. It draws on conceptions in criminal justice ethics and just war theory, defines teleological proportionality in the context of surveillance, and sketches some of the central values likely to go into the consideration. It then explores some of the ways in which deontologists might want to modify the account and illustrates the difficulties of doing so. Having set out the (...) account, however, it considers whether the proportionality condition is necessary to a theory of morally justified surveillance. The article concludes that we need and should apply only a necessity condition, but notes that proportionality considerations may retain some use in in practice, as a form of coarse‐grained filter applied before assessing necessity when deliberating the permissibility of potential forms of surveillance. (shrink)

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)

Ramsey sees life as a gift and a trust given to people by God. This theological understanding of human life frames his judgment of the immorality of euthanasia in its many forms. Assuming Ramsey’s theological insights and framing of this issue, I highlight a particular way of thinking about euthanasia that both seems to capture the essence of the debate and does not necessarily build the moral evaluation into its description. I aim to identify and unpack the description most consistent (...) with the claims made by Ramsey of how other end-of-life (EOL) care options are seen as life choices in order to die well enough. If this project is right-headed, it can be used as a backdrop for assessing how many of the currently accepted and perhaps developing options in EOL and palliative care may or may not be morally distinct from euthanasia. Therefore, those who oppose euthanasia while wanting also to maintain the appropriateness of many of other EOL care options in certain situations are not acting inconsistently. This primarily conceptual work is done in service to those who take Ramsey’s theological framework seriously. (shrink)

Intentions have been a central subject of research since contemporary philosophy of action emerged in the middle of the twentieth century. For almost that entire period, the approach has been to treat the study of intentions as separate from the study of morality. This essay offers a brief overview of that history and then suggests some ways forward, as exemplified by the essays collected in this volume.

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)

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)

Justificatory defenses apply to actions that are generally wrong and illegal—mainly since they harm people—when they are justified—usually since they prevent harm to others. A strict conception of justification limits justificatory defenses to actions that reflect all pertinent principles in the optimal manner. A more relaxed conception of justification applies to actions that do not reflect all pertinent principles optimally due to mistake but are not too far from this optimum. In the paper, I consider whether justificatory defenses should reflect (...) the strict conception of justification or a more relaxed conception of justification. This question is important since often the relevant actions are not strictly justified, while the alternative of an excuse is frequently irrelevant or does not provide an appropriate solution. Reflection on this question raises the following dilemma: On the one hand, the strict interpretation seems too harsh, especially with regard to legal liability. On the other hand, it is difficult to explain the basis for a more relaxed conception of justification. I conclude, first, that justification—and accordingly wrongfulness—is a matter of degree and that the strictly justified action is merely the peak of a continuum, and, second, that a practical reaction is in place only with regard to actions whose wrongness is above a minimal threshold. (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)

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)

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)

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)

It has recently been argued by Miller and Truog (2008) that, while procuring vital organs from transplant donors is typically the cause of their deaths, this violation of the requirement that donors be dead prior to the removal of their organs is not a cause for moral concern. In general terms, I endorse this heterodox conclusion, but for different and, as I think, more powerful reasons. I end by arguing that, even if it is agreed that retrieval of vital organs (...) causes the deaths of those who provide them, that does not pose any new substantive difficulties for efforts to justify “opt-out” organ procurement systems. (shrink)

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)

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)

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)

It is sometimes asserted that enabling harm is morally equivalent to allowing harm. In this article, I criticize this view. Positively, I show that cases involving self-defence and cases involving people acting on the basis of a reasonable belief to the effect that certain obstacles to harm will remain in place, or will be put in place, show that enabling harm is harder to justify than allowing it. Negatively, I argue that certain cases offered in defence of the moral equivalence (...) thesis fail, because either their similarity with the archetypal trolley case limits their relevance to an assessment of this thesis, or they are compromised by their reliance on the elusive notion of a situation being completely stable. (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.

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)

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)

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)

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 deontologists claim that it is more objectionable to do harm than it is to allow harm of comparable magnitude. I argue that this view faces a largely neglected puzzle regarding the moral relevance of an agent's past behavior. Consider an agent who chooses to save five people rather than one, where the one person's life is in jeopardy because of something the agent did earlier. How are the agent's obligations affected by the fact that his now letting the one (...) die would retroactively make it the case that he has killed? I argue that the most promising deontological responses to this question are difficult to defend. Further, it is unclear how the deontologist can resolve a further set of cases, in which commonsense intuition indicates that an agent is required to terminate a threat she initiated more recently in preference to a threat she initiated less recently. (shrink)

Most deontologists claim that it is more objectionable to do harm than it is to allow harm of comparable magnitude. I argue that this view faces a largely neglected puzzle regarding the moral relevance of an agent's past behavior. Consider an agent who chooses to save five people rather than one, where the one person's life is in jeopardy because of something the agent did earlier. How are the agent's obligations affected by the fact that his now letting the one (...) die would retroactively make it the case that he has killed? I argue that the most promising deontological responses to this question are difficult to defend. Further, it is unclear how the deontologist can resolve a further set of cases, in which commonsense intuition indicates that an agent is required to terminate a threat she initiated more recently in preference to a threat she initiated less recently. (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)

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)

In contemplating any life and death moral dilemma, one is often struck by the possible importance of two distinctions; the distinction between killing and “letting die”, and the distinction between an intentional killing and an action aimed at some other outcome that causes death as a foreseen but unintended “side-effect”. Many feel intuitively that these distinctions are morally significant, but attempts to explain why this might be so have been unconvincing. In this paper, I explore the problem from an explicitly (...) consequentialist point of view. I first review and endorse the arguments that the distinctions cannot be drawn with perfect clarity, and that they do not have the kind of fundamental significance required to defend an absolute prohibition on killing. I go on to argue that the distinctions are nonetheless important. A complete consequentialist account of morality must include a consideration of our need and ability to construct and follow rules; our instincts about these rules; and the consequences that might follow if the agent breaks a good general rule, particularly if this involves acting contrary to moral instinct. With this perspective, I suggest that the distinctions between killing and letting die and between intending and foreseeing do have moral relevance, especially for those involved in the care of the sick and dying. (shrink)

Negative duties are duties not to perform an action, while positive duties are duties to perform an action. This article focuses on the question of who holds the positive duties correlative to human rights. I start by outlining the Universal Scope Thesis, which holds that these duties fall on everyone. In its support, I present an argument by analogy: positive and negative duties correlative to human rights perform the same function; correlative negative duties are generally thought to be universal; by (...) analogy, we have reason to think that positive duties are held by everyone. I then consider three disanalogies that challenge the above argument. To address these worries, I introduce the notion of ‘aggregative duties’ – duties that can only be adequately grasped when we focus on the aggregate effect of the actions and omissions of different agents. This framework allows me to refine the initial thesis and address the objections. (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.

There are many conflicting attitudes to technological progress: some people are fearful that robots will soon take over, even perhaps making ethical decisions for us, whilst others enthusiastically embrace a future largely run for us by them. Still others insist that we cannot predict the long term outcome of present technological developments. In this paper I shall be concerned with the impact of the new technology on medicine, and with one particularly agonizing ethical dilemma to which it has already given (...) rise. (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.