In this paper, I argue that health plays a special role in the promotion of well-being within the capabilities approach framework. I do this by first presenting a scenario involving two individuals, both of whom lack access to only one capability. The first cannot secure the capability of bodily health due to an unhealthy lifestyle, whilst the second lacks access to bodily integrity due to a life of celibacy. Second, I explore these scenarios by assessing the nature of disadvantage suffered (...) in both instances. I suggest that corrosive disadvantage (or the type of disadvantage that adversely impacts one’s ability to secure other valuable things) is what leads us to conclude that health is of special moral importance in the promotion of justice and the endorsing of well-being. (shrink)

The debate between proponents and opponents of a role for empirical psychology in ethical theory seems to be deadlocked. This paper aims to clarify the terms of that debate, and to defend a principled middle position. I argue against extreme views, which see empirical psychology either as irrelevant to, or as wholly displacing, reflective moral inquiry. Instead, I argue that moral theorists of all stripes are committed to a certain conception of moral thought—as aimed at abstracting away from individual inclinations (...) and toward interpersonal norms—and that this conception tells against both extremes. Since we cannot always know introspectively whether our particular moral judgments achieve this interpersonal standard, we must seek the sort of self-knowledge offered by empirical psychology. Yet reflective assessment of this new information remains a matter of substantive normative theorizing, rather than an immediate consequence of empirical findings themselves. (shrink)

The nature of the relation between jurisprudential theories and first-order legal judgments is a strangely uncontroversial matter in contemporary legal philosophy. There is one dominant conception of the relation according to which jurisprudential theories are second-order or meta-legal theories that specify the ultimate grounds of first-order legal judgments. According to this conception, difficult first-order legal disputes are to be resolved by jurisprudential theorizing. According to an alternative conception that Ronald Dworkin has influentially advocated, jurisprudential theories are not second-order theories about (...) the nature of law, but instead covert first-order legal theories. These two conceptions of the relation between jurisprudential theories and first-order legal judgments dominate the contemporary legal philosophical scene and crowd out other possible conceptions. This article scrutinizes the two conceptions, and in the process raises the possibility of a different and arguably more credible conception. According to this new conception, our first-order legal views and a jurisprudential theory that we accept are supposed to form a mutually disciplining and supporting set of views that we accept in our pursuit of the epistemic ideal of wide reflective equilibrium. The two sets of views are supposed to constrain and discipline each other; but neither is meant to underwrite, certify, or ultimately determine the contents of the other. This new conception, which allows the relation between jurisprudential theories and first-order legal judgments to be much looser, untidier, and more complex than what the two dominant conceptions imply, should facilitate progress in legal philosophy and in first-order legal thinking. (shrink)

Recently, the idea that human beings may be totally egoistic has resurfaced in philosophical and psychological discussions. But many of the arguments for that conclusion are conceptually flawed. Psychologists are making a conceptual error when they think of the desire to avoid guilt as egoistic; and the same is true of the common view that the desire to avoid others’ disapproval is also egoistic. Sober and Wilson argue against this latter idea on the grounds that such a desire is relational, (...) but a deeper reason stems from the fact that it places such intrinsic importance on other human beings. And other basic human desires, like the desire for love, the desire for revenge, the impulse to imitate others, and the desire to belong, also treat others as important and on those grounds cannot count as egoistic. Another line of recent argument for egoism stems from the work of Robert Cialdini et al., and claims that the way we identify and feel one with those other people we empathize with and seek to help shows us to be thinking of those others as part of or identical with ourselves. This is supposed to show that our putative altruism is basically self-centered and egoistic, but Cialdini arguably misinterprets what we mean when we speak of feeling one with someone else, and the phenomena he mentions don’t therefore stand in favor of psychological egoism. More generally, many of the positive and negative emotions we feel toward others are best interpreted as non-egoistic, and there is no reason at this point to doubt that humans are capable of altruistic motivation. (shrink)

The current U.S. health care system, with both rising costs and demands, is unsustainable. The combination of a sense of individual entitlement to health care and limited acceptance of individual responsibility with respect to personal health has contributed to a system which overspends and underperforms. This sense of entitlement has its roots in a perceived right to health care. Beginning with the so-called moral right to health care, the issue of who provides health care has evolved as individual rights have (...) trumped societal rights. The concept of government providing some level of health care ranges from limited government intervention, a ‘negative right to health care’, to various forms of a ‘positive right to health care’. The latter ranges from a decent minimum level of care to the best possible health care with access for all. We clarify the concept of legal rights as an entitlement to health care and present distributive and social justice counter arguments to present health care as a privilege that can be provided/earned/altered/revoked by governments. We propose that unlike a ‘right’, which is unconditional, a ‘privilege’ has limitations. Going forward, expectations about what will be made available should be lowered while taking personal responsibility for one’s health must for elevated. To have access to health care in the future will mean some loss of personal rights and an increase in personal responsibility for gaining or maintaining one’s health. (shrink)

In this paper, I examine the terms on which John Simmons rejects all arguments for a moral obligation to obey the law and so defends “philosophical anarchism.” Although I accept his rejection of several criteria on which others might and often do insist, I criticize his reliance on the conditions of “generality” and “particularity.” In doing so, I propose an alternative to his influential conception of legitimacy.

Following the revival of virtue theory, some moral theorists have argued that virtue ethics can provide the basis for a radical politics. Such a politics essentially departs from the liberal model of the moral agent as an autonomous reason-giver. It instead privileges an understanding of the agent as conditioned by her community, and in the case of social oppression and marginalization, communal virtues may become a vehicle for social change. This essay compares political appropriations of virtue theory by Christian theologian (...) Stanley Hauerwas and secular feminist thinkers Lisa Tessman and Margaret Urban Walker. Hauerwas and feminist theorists both embrace a kind of embodied vulnerability as a political virtue, arguing that it enables more genuine social recognition. The virtue feminist critique is more robust than Hauerwas's, however, insofar as it understands mutual recognition to involve acknowledgment of social difference and the concomitant pursuit of justice. (shrink)

Positional goods are goods whose relative amount determines their absolute value. Many goods appear to have positional aspects. For example, one’s relative standing in the distribution of education and wealth may determine one’s absolute condition with respect to goods like employment opportunities, self-respect, and social inclusion. Positional goods feature in recent arguments from T.M. Scanlon, Brian Barry, and Harry Brighouse and Adam Swift that assert that we should favor egalitarian distributions of positional goods even if we reject equality as a (...) fundamental principle of distributive justice. With respect to positional goods, worsening the better off is required to better the worse off. Thus, we have reason to “level down” goods such as education and wealth in order to benefit those worse off with respect to the value of those goods. I argue that the allegedly positional aspects of the goods in question are not actually positional. Moreover, leveling down these goods risks self-defeat: it may produce a net decrease in the value of the shares of individuals with less of such goods. If so, leveling down measures would fail on their own terms. (shrink)

In his classic text, A Theory of Justice, John Rawls argues that the structural principles of a society are just when they issue from a procedure that is fair. One crucial feature that makes the procedure fair is that the persons who will be subjected to these principles choose them after they have deliberated together in a condition marked by a certain balance of knowledge and ignorance. In particular, these people know enough to consider principles that are workable, yet converse (...) behind a “veil of ignorance,” unable to predict what their place in society will be and hence discouraged from slanting the principles toward any preferential interests. My paper questions whether this attempt to ensure the disinterestedness of the conversation of justice is feasible. I worry that when we approach this question practically, we discover that the education that furnishes us with the knowledge necessary to choose viable principles must at the same time preclude genuine ignorance about our social position and interests. As an alternative, I suggest that we convene the conversation of justice behind a “veil of existence.” In this condition, people possess knowledge about how their society works and even about their places in it; however, this knowledge does not foster preferential interests because all interests are subjected to the question of their existential meaning. As Jean-Paul Sartre explains in his essay, “Existentialism is a Humanism,” for our interests to be truly meaningful, they must be affirmed as free responses to our thrownness into existence. Yet how do we find the wherewithal to make such responsible choices rather than lapse into paralysis before their essentially arbitrary differences? My positive thesis is that we may do so by acknowledging how all of us in this existential predicament critically and mutually provoke each to commit oneself to depart from the others in specific ways. This process of provocation is thus educational. It broaches a conception of non-instrumental, non-mimetic, liberal study, one which I try to enact in a writing that employs direct address, regular returns to questions that put discourse at a loss, and expanding webs of association. In this manner, I hope to demonstrate that liberal study may deepen our appreciation of our communal nature, our camaraderie, and thus motivate us to participate unselfishly in the conversation of justice. (shrink)

Scholars have extensively debated the family’s place within liberalism, generally, and specific attention and critique has been given to the family in Rawls’ work. What has received less focus are the requirements of parents in a Rawlsian polity and, further, what those requirements might imply for the one case where states explicitly regulate the process of becoming parents: adoption. This paper seeks to discover what might be required of parents, adoptive or otherwise, in a Rawlsian social contract state. Second, it (...) considers adoptive parent selection in light of these requirements as well as Rawls’ arguments regarding merit and fair equality of opportunity. Finally, it considers what such a merit-based selection of adoptive parents implies for the disputed rights of same-sex couples to adopt children. Further, because the question of merit in this case will hinge upon what it means to be a “fit parent,” it also draws upon relevant empirical social science studies regarding gay and lesbian parents. The paper, then, evaluates both the theoretical and empirical validity of generalized claims that same-sex couples are less fit to be parents than are heterosexual couples. (shrink)

Business activity can be analyzed through a ‘risk awareness’ perspective and a ‘responsibility awareness’ perspective. However, risk and responsibility are actually interdependent. Risk-taking triggers responsibility issues and taking responsibility means risking being asked critical questions. This article suggests some first steps for combining these two perspectives conceptually. After several introductory illustrations showing how risk and responsibility issues are intertwined, the article looks separately each at risk and at responsibility. Then the argument that such perspectives could be usefully combined is elaborated (...) further from a theoretical angle and from a practical angle, by looking at various ethical issues and by presenting paradigmatic examples of balancing or sharing risk and responsibility related to leadership, to ERM and to insurance. (shrink)

Bioethics is not a spectator sport. Health is an applied field that requires that insight be connected to the real world. Few have done more thoughtful writing on the need to advance a moral basis...

The explanation of promising is fraught with problems. In particular the problem that promises can be valid even when nothing good comes of keeping the promise (the problem of ‘bare wrongings’), and the bootstrapping problem with explaining how the mere intention to put oneself under an obligation can create such an obligation have been recognized since Hume’s famous discussion of the topic. There are two influential accounts of promising, and promissory obligation, which attempt to solve the problems: The expectation account (...) and the practice account. While those accounts solve both the bootstrapping problem and the problem of bare wrongings, it turns out that they encounter numerous problems of their own. (shrink)

Many moral philosophers assume that a person is entitled to respect; this suggests that there is a right to respect. I argue, however, that there is no such right. There can be no right to respect because of what respect is, in conjunction with what a right demands and certain limitations of human agency. In this paper, I first examine the nature and ontological basis of rights. I next consider the notion of respect in general; I adduce several varieties of (...) respect, then present a primary distinction needed to discern the notion of respect relevant to the putative right. Then I propound the argument that there can be no right to respect and consider some means of challenging its conclusion. In closing, I trace some of the consequences of this argument and suggest how it might motivate a different approach to understanding our most basic obligations to one another. (shrink)

-/- I start from three premises, roughly as follows: (1) that if possible world x is better than world y for every individual who exists in either world, then x is better than y; (2) that if x has a higher average utility, a higher total utility, and no more inequality than y, then x is better than y; (3) that better than is transitive. From these premises, it follows that benefits given to the worse off contribute no more to (...) the world’s value than equal-sized benefits given to the better off. (shrink)

Organisational approaches to talent management are often concerned with the ways that a small proportion of relatively high-performing employees are identified and managed in relation to the majority. Despite a growing literature on talent management, no papers have provided any guidance on how to evaluate it from an ethical standpoint. After considering what is meant by talent, this paper considers the ethical issues that arise from the operation of talent management programmes. These considerations are then used to create a framework (...) that has the potential to influence the practical design of talent programmes and which may focus further debate into the ethics of talent management. (shrink)

This article examines the difficulties encountered in teaching professionalism to medical students in the current social and political climate where economic considerations take top priority in health care decision making. The conflict between the commitment to advocate at all times the interests of one’s patients over one’s own interests is discussed. With personal, institutional, tech industry, pharmaceutical industry, and third-party payer financial imperatives that stand between patients and the delivery of health care, this article investigates how medical ethics instructors are (...) to teach professionalism in a responsible way that does not avoid dealing with the principle of justice. (shrink)

The recent and dramatic emergence of digital and other electronic technology in social work?such as online counseling, video counseling, avatar therapy, and e-mail therapy?has tested and challenged the profession's longstanding and widely accepted perspectives on the nature of both clinical relationships and core ethics concepts. These developments have transformed key elements of social work practice and require critical examination of the meaning and application of relevant ethical concepts in diverse cultures. This article explores pertinent ethical implications related to social workers' (...) commitment to clients; privacy/confidentiality; client self-determination and professional paternalism; informed consent; and professional?client boundaries and dual relationships. The author discusses the need for social workers to re-examine time-honored ethics concepts and explore their implications for the profession's ethical standards pertaining to the practitioner?client relationship. (shrink)

Pratt, Zion, and Loff (2012) correctly point out that most international clinical research (ICR) is not intended to address the vast inequities in access to health care between developed and develo...

The aim of this paper is to clarify what kind of normativity characterizes a convention. First, we argue that conventions have normative consequences because they always involve a form of trust and reliance. We contend that it is by reference to a moral principle impinging on these aspects (i.e. the principle of Reliability) that interpersonal obligations and rights originate from conventional regularities. Second, we argue that the system of mutual expectations presupposed by conventions is a source of agreements. Agreements stemming (...) from conventions are “tacit” in the sense that they are implicated by what agents do (or forbear from doing) and without that any communication between them is necessary. To justify this conclusion, we assume that: (1) there is a salient interpretation, in some contexts, of everyone’s silence as confirmatory of the others’ expectations (an epistemic assumption), and (2) the participating agents share a value of not being motivated by hostile attitudes (a motivational assumption). By clarifying the relation between conventions and agreements, the peculiar normativity of conventions is analyzed. (shrink)

There are several strategies to promote health in individuals and populations. Two general approaches to health promotion are behavior change and empowerment. The aim of this article is to present those two kinds of strategies, and show that the behavior-change approach has some moral problems, problems that the empowerment approach (on the whole) is better at handling. Two distinct ‘ideal types’ of these practices are presented and scrutinized. Behavior change interventions use various kinds of theories to target people’s behavior, which (...) they do through information, persuasion, coercion and manipulation. Empowerment is a collaborative method where those ‘facilitated’ participate in the change process. Some ethical problems with the behavior-change model are that it does not sufficiently respect the right to autonomy of the individuals involved and risks reducing their ability for autonomy, and that it risks increasing health inequalities. Empowerment, on the other hand, respects the participant’s right to autonomy, tends to increase the ability for autonomy, as well as increasing other coping skills, and is likely to reduce inequalities. A drawback with this approach is that it often takes longer to realize. (shrink)

The possibility of genetic enhancement to increase the likelihood of success in sport and life’s prospects raises questions for accounts of sport and theories of justice. These questions obviously include the fairness of such enhancement and its relationship to the goals of sport and demands of justice. Of equal interest, however, is the effect on our understanding of individual effort, merit, and desert of either discovering genetic contributions to components of such effort or recognizing the influence of social factors on (...) the development and exercise of individual effort. This paper analyzes arguments about genetic enhancement with the goal of raising questions about how sport and justice regard unchosen, undeserved inequalities and what is assumed to be their opposite—namely, the exercise and results of individual effort. It is suggested that contemplating enhancement of natural assets previously outside human control may reinforce recognition of responsibility to intervene with regard to social advantages so as to support individual effort and improve individuals’ life prospects. (shrink)

In my reply to Pogge's critique of Rawls's international relations theory, I will try to show two things: (1) that Pogge's account of the public criterion of domestic social justice endorsed by Rawls is a partial one and (2) that this leads him to wrongly postulate a significant asymmetry between Rawls's domestic and international theories of justice. In the end, I hope to show that the domestic and international accounts are characterized by a significant degree of symmetry ? that both (...) accounts are motivated by Rawls's fundamental concern with self-respect. In other words, a more expansive, complete account of the domestic public criterion of social justice necessarily leads us (contra Pogge) to affirm a significant degree of continuity between the domestic and international accounts. (shrink)

The ethics of corruption cannot be analysed without simultaneously addressing the legitimacy of public office or entrusted power. This paper introduces a concept of core unethical corruption, defined as violations of distributed ethical obligations for private gain. In other words, it is suggested that what is ethically wrong with corruption is that it entails the violation of certain obligations attributed to agents. By explicitly relating corruption to obligations, this approach helps make ethical sense of the concepts of public office or (...) entrusted power, attending to the question of their legitimacy. Since distributed obligations are implied by a wide range of ethical theories, the concept of core unethical corruption also reflects a (partial) overlapping consensus on the ethics of corruption. (shrink)

In this article, I develop and defend a prioritarian principle of justice for the distribution of educational resources. I argue that this principle should be conceptualized as directing educators to confer a general benefit, where that benefit need not be mediated by improved academic outcomes. I go on to argue that it should employ a metric of all-things-considered flourishing over the course of the student's lifetime. Finally, I discuss the relationship between my proposed prioritarian principle and the meritocratic principle that (...) it is presumed to supplement. (shrink)

For a prioritarian by contrast to a utilitarian, whether a certain quantity of utility falls within the boundary of one person's life or another's makes the following moral difference: the worse the life of a person who could receive a given benefit, the stronger moral reason we have to confer this benefit on this person. It would seem, therefore, that prioritarianism succeeds, where utilitarianism fails, to ‘take seriously the distinction between persons’. Yet I show that, contrary to these appearances, prioritarianism (...) fails, in ways strikingly parallel to those in which utilitarianism fails, to take this distinction seriously. In so doing, I draw on and develop an earlier critique of prioritarianism by disentangling and pressing two distinct separateness-of-persons objections offered there. One objection is that prioritarianism is insensitive to ‘prudential justifications’. The other is that it is insensitive to the competing claims of different individuals. (shrink)

This article distinguishes between a telic and a deontic version of Derek Parfit's influential Priority View. Employing the distinction, it shows that the existence of variations in how intrapersonal and interpersonal conflicts should be resolved fails to provide a compelling case in favour of relational egalitarianism and against all pure versions of the Priority View. In addition, the article argues that those variations are better understood as providing counterevidence to certain distribution-sensitive versions of consequentialism.