This articles assesses the arguments that bioethicists have presented for the view that patient’ autonomy has value over and beyond its instrumental value in promoting the patients’ wellbeing. It argues that this view should be rejected and concludes that patients’ autonomy should be taken to have only instrumental value in medicine.

Evolutionary debunking arguments are arguments that appeal to the evolutionary origins of evaluative beliefs to undermine their justification. This paper aims to clarify the premises and presuppositions of EDAs—a form of argument that is increasingly put to use in normative ethics. I argue that such arguments face serious obstacles. It is often overlooked, for example, that they presuppose the truth of metaethical objectivism. More importantly, even if objectivism is assumed, the use of EDAs in normative ethics is incompatible with a (...) parallel and more sweeping global evolutionary debunking argument that has been discussed in recent metaethics. After examining several ways of responding to this global debunking argument, I end by arguing that even if we could resist it, this would still not rehabilitate the current targeted use of EDAs in normative ethics given that, if EDAs work at all, they will in any case lead to a truly radical revision of our evaluative outlook. (shrink)

Do I have a special reason to care about my future, as opposed to yours? We reject the common belief that I do. Putting our thesis paradoxically, we say that nothing matters in survival: nothing in our continued existence justifies any special self-concern. Such an "extreme" view is standardly tied to ideas about the metaphysics of persons, but not by us. After rejecting various arguments against our thesis, we conclude that simplicity decides in its favor. Throughout the essay we honor (...) Jim Rachels, whose final days exemplified his own unselfish morality as well as the “neutralist” ideal we espouse. As an appendix, we include the last original work to be published by James Rachels, in which he criticizes Sidgwick’s most famous defense of egoism. (shrink)

Intrinsic value has traditionally been thought to lie at the heart of ethics. Philosophers use a number of terms to refer to such value. The intrinsic value of something is said to be the value that that thing has “in itself,” or “for its own sake,” or “as such,” or “in its own right.” Extrinsic value is value that is not intrinsic.