The trolley problem, first described by Foot (1967) and Thomson (The Monist, 59, 204–217, 1976), is one of the most famous and influential thought experiments in deontological ethics. The general story is that a runaway trolley is threatening the lives of five people. Doing nothing will result in the death of those persons, but acting in order to save those persons would unavoidably result in the death of another, sixth person. It appears that, depending on the situation, we have different (...) moral judgments about the permissibility of action. We will review and systematize all the proposals in the literature of the past 35 years that have attempted to grasp our moral intuitions in a simple deontological principle. In particular, seventeen proposals will be classified: six algorithmic, seven psychological, and four other invalid accounts. This review and classification sheds light on some subtle differences and clarify a few issues. (shrink)

When it comes to epistemic normativity, should we take the good to be prior to the right? That is, should we ground facts about what we ought and ought not believe on a given occasion in facts about the value of being in certain cognitive states (such as, for example, the value of having true beliefs)? The overwhelming answer among contemporary epistemologists is “Yes, we should.” This essay argues to the contrary. Just as taking the good to be prior to (...) the right in ethics often leads one to sanction implausible trade-offs when determining what an agent should do, so too, this essay argues, taking the good to be prior to the right in epistemology leads one to sanction implausible trade-offs when determining what a subject should believe. Epistemic value—and, by extension, epistemic goals—are not the explanatory foundation upon which all other normative notions in epistemology rest. (shrink)

In refutation of hedonism, Nozick offered a hypothetical thought experiment, known as the Experience Machine. This paper maintains that end-of-life-suffering of the kind that is resistant to state-of-the-art palliation provides a conceptually equal experiment which validates Nozick’s observations and conclusions. The observation that very many terminal patients who suffer terribly do no wish for euthanasia or terminal sedation is incompatible with motivational hedonism. Although irreversible vegetative state and death are equivalently pain-free, very many people loath the former even at the (...) price of the latter. This attitude cannot be accounted for by hedonism. Following these observations, the goals of palliative care are sketched along four circles. The first is mere removal or mitigation of noxious symptoms and suffering. The second targets sufferings that stymie patients’ life-plans and do not allow them to be happy, the third targets sufferings that interfere with their pursuance of other goods (palliation as a primary good). The fourth is the control of sufferings that do not allow the person to benefit from any human good whatsoever (“total pain” or critical suffering). Only in the fourth circle are people hedonists. (shrink)

Frances Kamm's characteristically subtle paper in response to Michael Sandel is an intriguing intervention in the long-standing and increasingly frustrating debate over the morality of enhancement...

The allocation of scarce health care resources such as flu treatment or organs for transplant presents stark problems of distributive justice. Persad, Wertheimer, and Emanuel have recently proposed a novel system for such allocation. Their “complete lives system” incorporates several principles, including ones that prescribe saving the most lives, preserving the most life-years, and giving priority to persons between 15 and 40 years old. This paper argues that the system lacks adequate moral foundations. Persad and colleagues' defense of giving priority (...) to those between 15 and 40 leaves them open to the charge that they discriminate unfairly against children. Second, the paper contends that the complete lives system fails to provide meaningful practical guidance in central cases, since it contains no method for balancing its principles when they conflict. Finally, the paper proposes a new method for balancing principles of saving the most lives and maximizing life-years. (shrink)

Kidneys for transplantation are scarce, and many countries give priority to children in allocating them. This paper explains and criticizes the paediatric priority. We set out the relevant ethical principles of allocation, such as utility and severity, and the relevant facts to do with such matters as sensitization and child development. We argue that the facts and principles do not support and sometimes conflict with the priority given to children. We next consider various views on how age or the status (...) of children should affect allocation. Again, these views do not support priority to children in its current form. Since distinctions based on age ought to be positively justified, the failure of all these attempts at justification implies that the priority to children is ethically mistaken. Finally, the paper points to evidence that the paediatric priority reduces the overall supply of kidneys, at least in the United States. Paediatric priority is a real-world policy that seems discriminatory, in some places probably reduces the supply of organs, has no robust official defence, and is unsupported by mainstream ethical principles. Consequently, it should be ended. (shrink)

This article will focus on the ethical issues of vaccine mandates and stake claim to the relatively extreme position that outright requirements for people to receive the vaccine are ethically correct at both the governmental and institutional levels. One novel strategy employed here will be to argue that deontological considerations pertaining to consent rights cut as much in favor of mandating vaccines as against them. The presumption seems to be that arguments from consent speak semi-definitively against forcing people to inject (...) something into their bodies, and so any argument in favor of mandates must produce different and overriding logical and ethical considerations. Our central claim will be that the same logic that might seem to prohibit vaccine mandates as violations of consent actually supports such mandates when viewed from the perspective of the potential bystander who might otherwise be exposed to COVID-19. (shrink)

One of the societal problems in a new influenza pandemic will be how to use the scarce medical resources that are available for prevention and treatment, and what medical, epidemiological and ethical justifications can be given for the choices that have to be made. Many things may become scarce: personal protective equipment, antiviral drugs, hospital beds, mechanical ventilation, vaccination, etc. In this paper I discuss two general ethical principles for priority setting (utility and equity) and explain how these principles will (...) often point in diverging directions. Moreover, each of these principles can be understood in different, again often competing, ways. Notwithstanding these controversies and conflicts, in the context of pandemic response there are at least some points of convergence: several policies can be justified by appeal to different ethical principles and theories. Convergence may be found with respect to a focus on saving the most lives (instead of other aggregative accounts); giving priority antiviral prophylaxis and therapy for life-saving pandemic responders; and, partly depending on epidemiology of the pandemic, to prioritise vaccination of children. Although decision-making about access to intensive care will involve choices with immediate tragic implications, the ethical complexity of these choices is relatively modest (although decisions will not be easy): there are persuasive moral reasons for giving priority to patients who are expected to benefit most within the shortest time. Finally, in the last section I tentatively argue that constraints on people’s freedom, as necessary for an effective public health approach, may support giving somewhat more weight to saving the most lives, than to concerns of equity. (shrink)

According to psychological research, people are more eager to help identified individuals than unidentified ones. This phenomenon significantly influences many important decisions, both individual and public, regarding, for example, vaccinations or the distribution of healthcare resources. This paper aims at presenting definitions of various levels of identifiability as well as a critical analysis of the main philosophical arguments regarding the normative significance of the identifiability effect, which refer to: (1) ex ante contractualism; (2) fair distribution of chances and risks; (3) (...) anti-aggregationist principles that recommend the distribution of bad effects and the concentration of good ones. I will show that these arguments, although connected with interesting philosophical problems regarding e.g. counterfactuals, aggregation, or probability, are unconvincing. (shrink)

Taurek cases focus a choice between two views of permissible action, Can Save One and Must Save Many . It is argued that Taurek cases do illustrate the rationale for Can Save One , but existing views do not highlight the fact that this is because they are examples of claims grounded on non-comparative justice. To act to save the many solely because they form a group is to discriminate against the one for an irrelevant reason. That is a canonical (...) form of non-comparative injustice. The error lies in taking a contingency of some presentations of some Taurek cases, namely, that they involve distribution, to introduce the claims of comparative as opposed to non-comparative justice. But cases of non-comparative justice can, contingently, also involve distribution. In order to settle which form of justice applies it is necessary to examine the nature of the distribution involved and the nature of “classes” to which individuals can be assigned. (shrink)

Sidgwick gives various tests for highest certainty. When he applies these tests to commonsense morality, he finds nothing of highest certainty. In contrast, when he applies these tests to his own axioms, he finds these axioms to have highest certainty. The axioms culminate in Benevolence: “Each one is morally bound to regard the good of any other individual as much as his own, except in so far as he judges it to be less, when impartially viewed, or less certainly knowable (...) or attainable by him.” The axioms face challenges from two sides.First, one test requires that a claim not be denied by someone of whom one has no more reason to suspect of error than oneself. For Sidgwick, then, the egoist must not deny the axioms. But it would seem that an egoist would reject benevolence. Second, Sidgwick thinks he must show that the commonsense moralist agrees to the axioms. Benevolence seems to say that the only reason for departing from being bound to treat others like oneself is that more good would be produced. But the commonsense moralist will not agree that this is the only reason. In reply to the threat of an egoist's disagreement, this essay argues that many of the axioms should be read as having as their antecedent “from the point of view of the universe.” The essay replies to the objection that this makes these axioms analytic. In reply to the threat of a commonsense moralist's disagreement, this essay argues that each axiom states, in effect, a prima facie duty. The argument against the commonsense moralist concerns not benevolence but whether there are further duties that pass the tests. The essay raises the worry that here Sidgwick is unfair since sometimes he criticizes all-things-considered versions of commonsense duties; such criticisms would count against benevolence as well. (shrink)

Many think that equality is an intrinsic value. However, this view, especially when based on a consequential foundation, faces familiar objections related to the claim that equality is sometimes good for none and bad for some: most notably the levelling down objection. This article explores a unique (consequential) conception of equality, as part of a more general conception of fairness concerning the resolution of interpersonal conflicts, which is not exposed to these objections.

Psychologists and philosophers often work hand in hand to investigate many aspects of moral cognition. In this paper, we want to highlight one aspect that to date has been relatively neglected: the stability of moral judgment over time. After explaining why philosophers and psychologists should consider stability and then surveying previous research, we will present the results of an original three-wave longitudinal study. We asked participants to make judgments about the same acts in a series of sacrificial dilemmas three times, (...) 6–8 days apart. In addition to investigating the stability of our participants’ ratings over time, we also explored some potential explanations for instability. To end, we will discuss these and other potential psychological sources of moral stability (or instability) and highlight possible philosophical implications of our findings. (shrink)

There is, on a given moral view, an agent-centered restriction against performing acts of a certain type if that view prohibits agents from performing an instance of that act-type even to prevent two or more others from each performing a morally comparable instance of that act-type. The fact that commonsense morality includes many such agent-centered restrictions has been seen by several philosophers as a decisive objection against consequentialism. Despite this, I argue that agent-centered restrictions are more plausibly accommodated within a (...) consequentialist framework than within the more standard side-constraint framework. For I argue that when we combine agent-relative consequentialism with a Kantian theory of value, we arrive at a version of consequentialism, which I call 'Kantsequentialism', that has several advantages over the standard side-constraint approach to accommodating constraints. What’s more, I argue that Kantsequentialism doesn’t have any of the disadvantages that critics of consequentializing have presumed that such a theory must have. (shrink)

Cost-effectiveness analysis suggests that a society should allocate its health care budget in order to achieve the greatest total health for its budget. However, in ‘rescue’ cases, where an individual’s life is in immediate peril, reasoning in terms of cost-effectiveness can appear inhumane. Hence considerations of cost-effectiveness and of rescue appear to be in tension. However, by attending to the division of labour in medical decision making it is possible to see how cost-effectiveness analysis and rescue-style reasoning are commonly combined (...) in an ethically acceptable fashion. (shrink)

Ethical theory often starts with our intuitions about particular cases and tries to uncover the principles that are implicit in them; work on the ‘trolley problem’ is a paradigmatic example of this approach. But ethicists are no longer the only ones chasing trolleys. In recent years, psychologists and neuroscientists have also turned to study our moral intuitions and what underlies them. The relation between these two inquiries, which investigate similar examples and intuitions, and sometimes produce parallel results, is puzzling. Does (...) it matter to ethics whether its armchair conclusions match the psychologists’ findings? I argue that reflection on this question exposes psychological presuppositions implicit in armchair ethical theorising. When these presuppositions are made explicit, it becomes clear that empirical evidence can (and should) play a positive role in ethical theorising. Unlike recent assaults on the armchair, the argument I develop is not driven by a naturalist agenda, or meant to cast doubt on the reliability of our moral intuitions; on the contrary, it is even compatible with non-naturalism, and takes the reliability of intuition as its premise. The argument is rather that if our moral intuitions are reliable, then psychological evidence should play a surprisingly significant role in the justification of moral principles. (shrink)

La relación entre el problema de la temporalidad del valor y el de nuestra persistencia diacrónica prácticamente no ha sido explorada hasta ahora. Sin embargo, el análisis de cada una de estas cuestiones puede arrojar luz sobre la otra de manera interesante. Este artículo argumentará que las conexiones entre la asimetría de nuestras actitudes hacia el futuro y el pasado, y la cuestión de nuestra persistencia diacrónica pueden defenderse sin incurrir en modo alguno a una petición de principio. The relation (...) between the problem of the temporality of value and the problem of our diachronic persistence has virtually not been explored so far. However, the analysis of these questions can shed light on each other in an interesting way. This paper argues that an explanation of the connections between the asymmetry of our attitudes towards the future and the past and the question of our diachronic persistence is possible without begging the question in any way. (shrink)

Suppose we can save either a larger group of persons or a distinct, smaller group from some harm. Many people think that, all else equal, we ought to save the greater number. This article defends this view (with qualifications). But unlike earlier theories, it does not rely on the idea that several people's interests or claims receive greater aggregate weight. The argument starts from the idea that due to their stakes, the affected people have claims to have a say in (...) the rescue decision. As rescuers, our primary duty is to respect these procedural claims, which we must do by doing what these people would decide, in a process where each is given an equal vote on the matter. So in cases where each votes in their own self-interest, respect for their equal right to decide, or their autonomy, will lead us to save the greater number. The argument is explained in detail, with special attention to the questions of how, exactly, it avoids aggregation, and of why majority rule is superior to lottery procedures. The view has further advantages. Especially, it explains the “partial” relevance of numbers in cases involving unequal harms, and it does so in a way that dissolves the appearance of paradox that besets theories of “partial aggregation.”. (shrink)

Consider the Strong Beneficence Principle (SBP): Persons of affluent means ought to give to those who might fail basic human subsistence until the point at which they must give up something of comparable moral importance. This principle has been the subject of much recent discussion. In this paper, I argue that no coherent interpretation of SBP can be found. SBP faces an interpretive trilemma, each horn of which should be unacceptable to fans of SBP; SBP is either (a) so strong (...) as to be patently absurd; (b) implausible given its acceptance of a form of numbers skepticism; (c) drained of all its demanding force. In the conclusion, I show how the problems with SBP generalize to all similarly demanding principles of beneficence. (shrink)

this paper advances a novel account of part of what justifies killing in war, grounded in the duties we owe to our loved ones to protect them from the severe harms with which war threatens them. It discusses the foundations of associative duties, then identifies the sorts of relationships, and the specific duties that they ground, which can be relevant to the ethics of war. It explains how those associa- tive duties can justify killing in theory—in particular how they can (...) justify overrid- ing the rights to life of some of those who must be killed to win a war. It then shows how these duties can be operationalised in practice: first, showing how soldiers who fight on behalf of their community can act on reasons that apply to the members of that community; second, showing that the argument from associative duties does not prove too much—in particular, that it does not license the intentional killing of noncombatants in war. (shrink)

The concepts of 'ethical' and 'socially responsible' investment (SRI) have become increasingly popular in recent years and funds which offer this kind of investment have attracted many individual inve... merstors. The present book addresses the issue of 'How ought one to invest?' by critically engaging with the ideas of the proponents of this movement about what makes 'ethical' investing ethical. The standard suggestion that ethical investing simply consists in refraining from investing in certain 'morally unacceptable companies' is criticised for being (...) both too rigid (often resting on absolute moral rules which lead to an austere conclusion) and too ineffective for individual investors (investors who after all control only a small part of the investment universe). Furthermore, the idea that ethical investing could consist in engaging more actively with the companies one invests in, in order to make them change their ways and become more socially responsible, is criticised for being just as ineffective for individual investors. Some more radical alternatives are elaborated on and defended - for instance, the suggestion that investors should make as much money from their investments as possible and then donate the proceeds to socially worthwhile charities. From similar suggestions, the common idea that there is no conflict between morality and profitability, or that genuinely ethical investing can be just as profitable as mainstream investing, is criticised for being too naïve. Making a difference may indeed require personal sacrifice of investors, but it is argued that the needs of the possible recipients of philanthropy are morally more important than the luxury of investment returns. (shrink)

Contemporary just war theory is divided into two broad camps: revisionists and traditionalists. Traditionalists seek to provide moral foundations for something close to current international law, and in particular the laws of armed conflict. Although they propose improvements, they do so cautiously. Revisionists argue that international law is at best a pragmatic fiction—it lacks deeper moral foundations. In this article, I present the contemporary history of analytical just war theory, from the origins of contemporary traditionalist just war theory in Michael (...) Walzer's work to the revisionist critique of Walzer and the subsequent revival of traditionalism. I discuss central questions of methodology, as well as consider the morality of resorting to war and the morality of conduct in war. I show that although the revisionists exposed philosophical shortcomings in Walzer's arguments, their radical conclusions should prompt us not to reject the broad contemporary consensus, but instead to seek better arguments to underpin it. (shrink)

New biotechnologies have the potential to both dramatically improve human well-being and dramatically widen inequalities in well-being. This paper addresses a question that lies squarely on the fault line of these two claims: When as a matter of justice are societies obligated to include a new biotechnology in a national healthcare system? This question is approached from the standpoint of a twin aim theory of justice, in which social structures, including nation-states, have double-barreled theoretical objectives with regard to human well-being. (...) The first aim is to achieve a sufficient level of well-being in each of six core dimensions. In the special case of healthcare systems, this aim is focally but not exclusively attentive to achieving health sufficiency as one of the core dimensions. The second aim is to combat the emergence and persistence of densely woven patterns of systematic disadvantage that tend to undermine the achievement of a sufficient level of health and the other core elements of well-being of some persons and groups. Judgments about entitlements to health related resources, including new biotechnologies, are made in light of a threshold notion of health sufficiency. What is enough or sufficient health? The answer that is defended here is that sufficient health is enough health for a decent human life, understood as enough health to live a full life course without preventable, significant functional disability or decrement in health, or treatable pain or suffering. When a state must include a new biotechnology in its national healthcare system is also influenced by ancillary concerns about the connection between health and other core dimensions of well-being. What counts as a significant functional impairment or health decrement is thus explicated, in part, in relation to the theory’s sufficiency aim for the other essential dimensions of well-being, and thus for a decent life, overall. Those elements of health that play a critical role in the experience of sufficient reasoning, affiliation, security, respect and self determination are especially important; any loss of health function or capacity that threatens the individual’s prospects for sufficiency in these other dimensions, including the relational egalitiarian concerns they entail, constitutes a significant functional impairment. Within national borders, individuals are thus entitled to those health-related goods and services that are essential for a sufficiency of each of the dimensions of well-being; with regard to self determination and respect, what is sufficient by way of guaranteed access to specific goods and services is going to depend on the implications of such access for where an individual stands in relation to her co-nationals. The content of any entitlement to health-related goods and services is also necessarily dynamic. What can be done for health and the other core dimensions of well-being as a function of technological innovation and diffusion is in constant flux. The paper concludes by considering the implications of this analysis for the conditions under which states are obligated to include access in their healthcare systems to one biotechnology, deep brain stimulation. (shrink)