Currently, value sensitive design (VSD) does not commit to a particular ethical theory. Critiques contend that without such an explicit commitment, VSD lacks a methodology for distinguishing genuine moral values from mere stakeholders-preferences and runs the risk of attending to a set of values that is unprincipled or unbounded. We argue that VSD practitioners need to complement it with an ethical theory. We argue in favour of a mid-level ethical theory to fulfil this role.

Students of the history of ethics sometimes find themselves tempted by moderate or extreme versions of an approach that might roughly be called ‘historicist’. This temptation may result from the difficulties of approaching historical texts from a ‘narrowly philosophical’ point of view. We may begin, for instance, by wanting to know what Aristotle has to say about ‘the problems of ethics’, so that we can compare his views with those of Aquinas, Hume, Kant, Sidgwick, and Rawls, and then decide what (...) is true or false in each theorist's position. But this narrowly philosophical attitude soon runs into difficulties, and writers on the history of ethics often warn us against it. (shrink)

According to pluralistic intuitionist theories, some of our moral beliefs are non-inferentially justified, and these beliefs come in both an a priori and an a posteriori variety. In this paper I present new support for this pluralistic form of intuitionism by examining the deeply social nature of moral inquiry. This is something that intuitionists have tended to neglect. It does play an important role in an intuitionist theory offered by Bengson, Cuneo, and Shafer-Landau (forth), but whilst they invoke the social (...) nature of moral inquiry in order to argue that ordinary moral intuitions are trustworthy, my argument focuses on what I will call the ‘frontiers’ of moral inquiry. I will show that inclusive and cooperative dialogue is necessary at moral inquiry’s frontiers, and that intuitionists can expect such dialogue to result in both a priori and a posteriori moral beliefs. (shrink)

This paper introduces and defends the paradigm response to external world skepticism. To understand it, consider an analogy. One of the hallmarks of being a bird is an ability to fly. A penguin lacks this hallmark and thus fails to be a paradigm bird. Likewise, there are various hallmarks of knowledge. Some of your external world beliefs lack some of these hallmarks, and thus fail to be paradigm cases of knowledge. Just as the inability of penguins to fly doesn’t prevent (...) them from being birds, likewise the lack of these hallmarks doesn’t prevent your beliefs from being knowledge. It just prevents them from being paradigm cases thereof. (shrink)

In recent discussions of the so-called “value of truth,” it is assumed that what is valuable in the relevant way is not the things that are true, but only various states and activities associated with those things: knowing them, investigating them, etc. I consider all the arguments I know of for this assumption, and argue that none provide good reason to accept it. By examining these arguments, we gain a better appreciation of what the value of the things that are (...) true would be, and why it would matter. We also encounter three indications that what is true really is valuable, each of which provides a promising starting point for a serious argument with that conclusion. (shrink)

Larry Alexander and Peter Westen each critically examine different topics from my recent collection of essays, The Philosophy of Criminal Law. Alexander focuses on my “Rapes Without Rapists,” “Mistake of Law and Culpability,” and “Already Punished Enough.” Westen offers a more extended commentary on my “Transferred Intent.” I briefly reply to each critic in turn and try to extend the debates in new directions.

To my knowledge, the term “flourishing” was introduced into contemporary philosophy in Elizabeth Anscombe's 1958 article “Modern Moral Philosophy.” In this article and in much of the writing subsequent to it, the concept of flourishing seems to have three principal facets, or to be associated with three philosophical views.

This paper examines H.A. Prichard's defense of the view that moral duty is underivative, as reflected in his argument that it is a mistake to ask “Why ought I to do what I morally ought?”, because the only possible answer is “Because you morally ought to.” This view was shared by other philosophers of Prichard's period, from Henry Sidgwick through A.C. Ewing, but Prichard stated it most forcefully and defended it best. The paper distinguishes three stages in Prichard's argument: one (...) appealing to his conceptual minimalism, one an epistemological argument that parallels Moore's response to skepticism about the external world, and one arguing that attempts to justify moral duties on non-moral grounds distort the phenomena by giving those duties the wrong explanation or ground. The paper concludes by considering Prichard's critique of ancient ethics and in particular the ethics of Aristotle. The paper is broadly sympathetic to Prichard's position and arguments; its aim is partly to make a case for him as a central figure in the history of ethics. (shrink)

In a chapter of The Methods of Ethics entitled “Ultimate Good”, Henry Sidgwick defends hedonism, the theory that pleasure and only pleasure is intrinsically good, that is, good in itself and apart from its consequences. First, however, he argues against the theory that virtue is intrinsically good. Sidgwick considers both a strong version of this theory — that virtue is the only intrinsic good — and a weaker version — that it is one intrinsic good among others. He tries to (...) show that neither version is or can be true. Against the strong version of the theory, Sidgwick argues as follows. Virtue is a disposition to act rightly, and right action is identified by the good it promotes. But this means that treating virtue as the only intrinsic good involves a “logical circle”: virtue is a disposition to promote what is good, where what is good is itself just a disposition to promote what is good. Virtue turns out to be a disposition to promote virtue. As Hastings Rashdall notes in a commentary on Sidgwick, one can accept many of this argument's premises yet reject its conclusion. One can agree that right action is identified by its consequences but still hold that virtue is the only intrinsic good. One can do this if one denies that the relevant consequences are good. This is the Stoic view: certain states are “preferred”, and thus supply the criterion of right action, but are not themselves intrinsically good. (shrink)

Abstract: The concepts of virtue and right action are closely connected, in that we expect people with virtuous motives to at least often act rightly. Two well-known views explain this connection by defining one of the concepts in terms of the other. Instrumentalists about virtue identify virtuous motives as those that lead to right acts; virtue-ethicists identify right acts as those that are or would be done from virtuous motives. This essay outlines a rival explanation, based on the "higher-level" account (...) of virtue defended in the author's Virtue, Vice, and Value . On this account rightness and virtue go together because each is defined by a (different) relation to some other, more basic moral concept. Their frequent coincidence is therefore like a correlation between A and B based not on either's causing the other but on their being joint effects of a single common cause. (shrink)

This article argues that there can be epistemic dilemmas: situations in which one faces conflicting epistemic requirements with the result that whatever one does, one is doomed to do wrong from the epistemic point of view. Accepting this view, I argue, may enable us to solve several epistemological puzzles.

In the practice of jury nullification, a jury votes to acquit a defendant in disregard of the factual evidence, on the grounds that a conviction would result in injustice, either because the law itself is unjust or because its application in the particular case would be unjust. Though the practice is widely condemned by courts, the arguments against jury nullification are surprisingly weak. I argue that, pursuant to the general ethical duty to avoid causing unjust harms to others, jurors are (...) often morally obligated to disregard the law. (shrink)

I argue that, given evidence of the factors that tend to distort our intuitions, ethical intuitionists should disown a wide range of common moral intuitions, and that they should typically give preference to abstract, formal intuitions over more substantive ethical intuitions. In place of the common sense morality with which intuitionism has traditionally allied, the suggested approach may lead to a highly revisionary normative ethics.

This paper is about how epistemic and practical reasons for belief can be compared against one another when they conflict. It provides a model for determining what one ought to believe, all-things-considered, when there are conflicting epistemic and practical reasons. The model is meant to supplement a form of pluralism about doxastic normativity that I call ‘Inclusivism’. According to Inclusivism, both epistemic and practical considerations can provide genuine normative reasons for belief, and both types of consideration can contribute to metaphysically (...) determining what beliefs one ought, all-things-considered, to have. (shrink)

Martin Peterson argues for two interesting and appealing claims: multi-dimensionalism and degrees of rightness. Multi-dimensionalism is the view that more than one factor determines whether an act is right. According to Peterson’s multi-dimensionalism, these factors are not simply ways of achieving some greater aggregate good. Degrees of rightness is the view that some actions are more wrong or less right than others without being entirely wrong. It is of course, compatible with this, that some actions are right or wrong to (...) a maximal degree, or entirely right or wrong. Multi-dimensionalism and degrees are taken to be intertwined. On Peterson’s view, if there were only one dimension, we wouldn’t need degrees; where only one dimension applies, an act is entirely right or entirely wrong. Peterson claims that degrees of rightness or wrongness arise only because there are multi-dimensions, and that an act cannot be entirely right if it is wrong on some dimension. I shall argue against both of these claims. (shrink)

ABSTRACT Normativity seems characteristically, perhaps essentially, explained by claims about the competition between normative reasons. John Broome’s ‘quick objection’ aims to show that rationality cannot be explained by claims about normative reasons and, thus, that it is not normative. Broome’s objection turns on the idea that rationality is mind-dependent in a way that facts about reasons are not. However, this objection is shaped by a popular, powerful, and restrictive assumption about the substance of normative reasons called factualism, which holds that (...) the substances that are reasons are facts, either in the sense of true propositions or of the truth-makers of such propositions. I suggest that support for factualism is weaker than its popularity suggests. In particular, I suggest that arguments for factualism from (1) the nature of normative explanation, (2) expressions attributing reasons, (3) the relationship between normativity and actuality, and (4) common sense are weaker than they appear. Rejecting factualism allows us to tie some class of reasons—subjective reasons, we might call them—more closely to the mind and to thereby ground the normativity of rationality. Thus, Broome’s ‘quick objection’ is too quick for it must account for the possibility of non-factualist reasons. (shrink)

Let us say that a normative conflict is a situation in which an agent ought to perform an action A, and also ought to perform an action B, but in which it is impossible for the agent to perform both A and B. Not all normative conflicts are moral conflicts, of course. It may be that the agent ought to perform the action A for reasons of personal generosity, but ought to perform the action B for reasons of prudence: perhaps (...) A involves buying a lavish gift for a friend, while B involves depositing a certain amount of money in the bank. In general, our practical deliberation is shaped by a concern with a variety of morally neutral goods—not just generosity and prudence, but any number of others, such as etiquette, aesthetics, fun—many of which are capable of providing conflicting reasons for action. I mention these ancillary values in the present setting, however, only to put them aside. We will be concerned here, not with normative conflicts more generally, but precisely with moral conflicts—situations in which, even when our attention is restricted entirely to moral reasons for action, it is nevertheless true that an agent ought to do A and ought to do B, where it is impossible to do both. (shrink)

Moral phenomenology is (roughly) the study of those features of occurrent mental states with moral significance which are accessible through direct introspection, whether or not such states possess phenomenal character – a what-it-is-likeness. In this paper, as the title indicates, we introduce and make prefatory remarks about moral phenomenology and its significance for ethics. After providing a brief taxonomy of types of moral experience, we proceed to consider questions about the commonality within and distinctiveness of such experiences, with an eye (...) on some of the main philosophical issues in ethics and how moral phenomenology might be brought to bear on them. In discussing such matters, we consider some of the doubts about moral phenomenology and its value to ethics that are brought up by Walter Sinnott-Armstrong and Michael Gill in their contributions to this issue. (shrink)

Many morally significant outcomes can be brought about only if several individuals contribute to them. However, individual contributions to collective outcomes often fail to have morally significant effects on their own. Some have concluded from this that it is permissible to do nothing. What I call ‘the problem of insignificant hands’ is the challenge of determining whether and when people are obligated to contribute. For this to be the case, I argue, the prospect of helping to bring about the outcome (...) has to be good enough. Furthermore, the individual must be in a position to increase the probability of its being brought about to an appropriate extent. Finally, I argue that when too few are willing to contribute, people may have a duty to increase their number. Thus, someone can be obligated to contribute or to get others to contribute. This prospect account is consistent with Kantianism, contractualism and rule consequentialism but inconsistent with act consequentialism. (shrink)

Many morally significant outcomes can be brought about only if several individuals contribute to them. However, individual contributions to collective outcomes often fail to have morally significant effects on their own. Some have concluded from this that it is permissible to do nothing. What I call ‘the problem of insignificant hands’ is the challenge of determining whether and when people are obligated to contribute. For this to be the case, I argue, the prospect of helping to bring about the outcome (...) has to be good enough. Furthermore, the individual must be in a position to increase the probability of its being brought about to an appropriate extent. Finally, I argue that when too few are willing to contribute, people may have a duty to increase their number. Thus, someone can be obligated to contribute or to get others to contribute. This prospect account is consistent with Kantianism, contractualism and rule consequentialism but inconsistent with act consequentialism. (shrink)

This case study applies ethics theories and codes to the mainstream news media's response to the CBS News-National Guard forged documents fiasco of 2004. It finds that 177 newspaper editorials applied truth telling, accountability, independence, and stewardship principles in their criticism of CBS, but only in a limited way. While the editorials dealt well with the specific issues of the case, they missed an opportunity to discuss the broader ethical principles involved.

The debate over the civilian use of nuclear power is highly polarised. We argue that a reasonable response to this deep disagreement is to maintain that advocates of both camps should modify their positions. According to the analysis we propose, nuclear power is neither entirely right nor entirely wrong, but rather right and wrong to some degree. We are aware that this non-binary analysis of nuclear power is controversial from a theoretical point of view. Utilitarians, Kantians, and other moral theorists (...) make sharp, binary distinctions between right and wrong acts. However, an important argument speaking in favour of our non-binary analysis is that it better reflects our considered intuitions about the ethical trade-offs we face in discussions of nuclear power. The aim of this article is to make this argument sharp by explaining how it can be rendered compatible with, and supported by, the Capability Approach, which is quickly becoming one of the most influential frameworks for thinking about human development. (shrink)

I defend a solution to the puzzle of petitionary prayer based on some ideas of Aquinas, Gregory the Great, and contemporary desert theorists. I then address a series of objections. Along the way broader issues about the nature of desert, what is required for an action to have a point, and what is required for a puzzle to have a solution are discussed.

Organ procurement presents several ethical concerns (from what constitutes acceptable criteria for death to issues involved in specifically designating to whom an organ can be given), but none is more central than the concern for what are appropriate means for acquiring organs. The following discussion attempts a different perspective on the issue of organ procurement by arguing that, rather than appealing to our charitable consciences or our pocketbooks, relinquishing our organs after death in this day and age is, in fact, (...) obligatory for most people. Each of us is pressed by the growing demand for our organs should we die ?rightly,? and that desperate need has risen to such a level that not to release our organs for transplantation would constitute a serious moral wrong. (shrink)

It is a common idea that morality, or moral truths, if there are any, must have some sort of source, or grounding. It has also been claimed that constructivist theories in metaethics have an advantage over realist theories in that the former but not the latter can provide such a grounding. This paper has two goals. First, it attempts to show that constructivism does not in fact provide a complete grounding for morality, and so is on a par with realism (...) in this respect. Second, it explains why it seems that morality in fact couldn't have a source. (shrink)

Many philosophers think that, when someone deserves something, it’s intrinsically good that she get it or there’s a non-instrumental reason to give it to her. Retributivists who try to justify punishment by appealing to claims about what people deserve typically assume this view or views that entail it. In this paper, I present evidence that many people have intuitions that are inconsistent with this view. And I argue that this poses a serious challenge to retributivist arguments that appeal to desert.

The problem of necessary evil is a sub-class of the problem of moral dilemmas. In cases of genuine moral dilemmas the agent cannot avoid doing evil whatever he does. In some cases of genuine moral dilemmas, the options facing the agent are incommensurable. But in some other cases of genuine moral dilemmas, though wrong doing is inescapable, there is a rationally best course of action. These are cases of necessary evil. There are several views regarding the doing of necessary evil. (...) On the closure view it is never necessary to do what is evil. This is the view of some utilitarians and of Kant. Then there are people who believe that it is sometimes necessary to do evil. Of these some (like John Gardner) believe that evil in such cases is justified even though it remains an evil; while there are others (like Gandhi) who believe that evil in such cases can never be justified but it can at best be excused or pardoned. Some even think that in some extreme cases the individual who does evil (even if it is the lesser evil) should be punished even though the individual could not avoid doing evil whatever he chose. The paper stresses the significance of the distinction between justified wrong doing, pardonable wrong doing, and excusable wrong doing. (shrink)

What is the connection between action that is caused by inauthentic antecedent springs of action, such as surreptitiously engineered-in desires and beliefs, and moral obligation? If, for example, an agent performs an action that derives from such antecedent springs can it be that the agent is not obligated to perform this action owing to the inauthenticity of its causal antecedents? I defend an affirmative response, assuming that we morally ought to bring about the states of affairs that occur in the (...) intrinsically best worlds accessible to us and that a version of attitudinal hedonism is the axiology for ranking worlds. (shrink)

There are two fundamental classes of terms traditionally distinguished within moral vocabulary: the deontic and the aretaic. The terms from the first set serve in the prescriptive function of a moral code. The second class contains terms used for a moral evaluation of an action. The problem of the relationship between the aretaic and the deontic has not been discussed often by philosophers. It is, however, a very important and interesting issue: any normative ethical theory which takes as basic one (...) set of these concepts should justify such choice and establish, at least implicitly, the logical relation with the other set. This paper is organized around the criticism of Stocker’s ‘sameness thesis’ (Stocker 1973 ): the claim that ‘good’ or ‘right’ mean the same thing. It is first presented in Stocker’s own formulation and criticized as implausible in that form. Some friendly modifications to his idea are suggested and then further discussed with the skeptical conclusion: no matter how close we bring deontic and aretaic notions, the gap between them will remain and any attempt to define or even explain one set of terms in another will leave something behind. (shrink)

My aim is to map some ethical ground. Many people who reject consequentialism and deontology adopt virtue ethics. Contemporary forms of virtue ethics occupy quite a variety of positions, and we do not yet have any satisfactory view of the whole territory that we call “virtue ethics.” Also, I think that there is a lot of logical space outside consequentialism and deontology not occupied by virtue ethics. In fact, I am myself rather more attracted to the environs of virtue ethics (...) than to virtue ethics itself, which particular environs I shall come to later. But, first, we have roughly to locate virtue ethics. (shrink)

This paper aims to critique the phenomenon of advanced patient autonomy and choice in healthcare within the specific context of self-testing devices. A growing number of self-testing medical devices are currently available for home use. The premise underpinning many of these devices is that they assist individuals to be more autonomous in the assessment and management of their health. Increased patient autonomy is assumed to be a good thing. We take issue with this assumption and argue that self-testing provides a (...) specific example how increased patient autonomy and choice within healthcare might not best serve the patient population. We propose that current interpretations of autonomy in healthcare are based on negative accounts of liberty to the detriment of a more relational understanding. We also propose that Kantian philosophy is often applied to the healthcare arena in an inappropriate manner. We draw on the philosophical literature and examples from the self-testing process to support these claims. We conclude by offering an alternative account of autonomy based on the interrelated concepts of relationality, care and responsibility. (shrink)

A principle that many have found attractive is one that goes by the name “'Ought' Implies 'Can'.” According to this principle, one morally ought to do something only if one can do it. This essay has two goals: to show that the principle is false and to undermine the motivations that have been offered for it. Toward the end, a proposal about moral obligation according to which something like a restricted version of 'Ought' Implies 'Can' is true is floated. Though (...) no full-fledged argument for this proposal is offered, that it fits with a rather natural and intuitive picture of the structure of morality and seems to explain certain salient features of the debate over whether the principle is true, goes some way toward recommending it. (shrink)

This paper focuses on a hypothetical case that represents an intervention request familiar to those who work with individuals with intellectual disability. Stacy has autism and moderate intellectual disability. Her parents have requested treatment for her hand flapping. Stacy is not competent to make her own treatment decisions; proxy consent is required. There are three primary justifications for proxy consent: the right to an open future, substituted judgment, and the best interest standard. The right to an open future justifies proxy (...) consent on the assumption of future autonomy whereas substituted judgment justifies proxy consent via reference to past autonomy. Neither applies. Stacy has not been, nor will she be, competent to make her own treatment decisions. The best interest standard justifies proxy consent on the grounds of beneficence. It is unlikely that hand flapping harms Stacy. None of the three primary means of justifying proxy consent apply to Stacy’s case. (shrink)

This paper examines the ethical pitfalls and challenges that non-ethicists, such as researchers and programmers in the fields of computer science, artificial intelligence and robotics, face when building moral machines. Whether ethics is “computable” depends on how programmers understand ethics in the first place and on the adequacy of their understanding of the ethical problems and methodological challenges in these fields. Researchers and programmers face at least two types of problems due to their general lack of ethical knowledge or expertise. (...) The first type is so-called rookie mistakes, which could be addressed by providing these people with the necessary ethical knowledge. The second, more difficult methodological issue concerns areas of peer disagreement in ethics, where no easy solutions are currently available. This paper examines several existing approaches to highlight the ethical pitfalls and challenges involved. Familiarity with these and similar problems can help programmers to avoid pitfalls and build better moral machines. The paper concludes that ethical decisions regarding moral robots should be based on avoiding what is immoral in combination with a pluralistic ethical method of solving moral problems, rather than relying on a particular ethical approach, so as to avoid a normative bias. (shrink)

Business ethics as an applied inquiry requires an expanded normative method which allows both philosophical and religious ethical considerations to be employed in resolving complex issues or cases. The proposed foundational normative method provides a comprehensive framework composed of major philosophical and religious ethical theories. An extensive rationale from the current trends in business ethics and metaethical considerations supports the development of this method which is illustrated in several case studies. By using this method, scholars and business persons gain greater (...) certitude about the ethical quality of their deliberations and decision making than what may be achieved with current nonsystematic or nascent normative methods. (shrink)

Software systems play an ever more important role in our lives and software engineers and their companies find themselves in a position where they are held responsible for ethical issues that may arise. In this paper, we try to disentangle ethical considerations that can be performed at the level of the software engineer from those that belong in the wider domain of business ethics. The handling of ethical problems that fall into the responsibility of the engineer has traditionally been addressed (...) by the publication of Codes of Ethics and Conduct. We argue that these Codes are barely able to provide normative orientation in software development. The main contribution of this paper is, thus, to analyze the normative features of Codes of Ethics in software engineering and to explicate how their value-based approach might prevent their usefulness from a normative perspective. Codes of Conduct cannot replace ethical deliberation because they do not and cannot offer guidance because of their underdetermined nature. This lack of orientation, we argue, triggers reactive behavior such as “cherry-picking,” “risk of indifference,” “ex-post orientation,” and the “desire to rely on gut feeling.” In the light of this, we propose to implement ethical deliberation within software development teams as a way out. (shrink)

Clinicians have good moral and professional reasons to contribute to pragmatic clinical trials (PCTs). We argue that clinicians have a defeasible duty to participate in this research that takes place in usual care settings and does not involve substantive deviation from their ordinary care practices. However, a variety of countervailing reasons may excuse clinicians from this duty in particular cases. Yet because there is a moral default in favor of participating, clinicians who wish to opt out of this research must (...) justify their refusal. Reasons to refuse include that the trial is badly designed in some way, that the trial activities will violate the clinician’s conscience, or that the trial will impose excessive burdens on the clinician. (shrink)

Primeiramente, oferecemos uma apresentação teórica da representação do pensamento prático, começando pela distinção entre silogismo dialético e silogismo demonstrativo. Fazemos referência à crítica de Toulmin contra o dedutivismo dominante de seu tempo. Em seguida, fornecemos argumentos para apoiar a relevância heurística do modelo de Toulmin para entender a discussão sobre a inclusão da lógica padrão na representação do pensamento comum. Afirmamos que o projeto analítico toulmaniano permite entender, com clareza metódica, a derrotabilidade dos argumentos do senso comum por meio da (...) investigação da noção modal de probabilidade na linguagem comum. First, we offer theoretical resemblance of the representation of practical reasoning, beginning with the distinction between demonstrative and dialectical syllogism. We make reference to the Toulmin’s critique against to the dominant deductivism in his time. Then we give arguments to sustain the heuristic relevance of Toulmin’s model to understand the discussion about the inclusion of default logics in the representation of ordinary reasoning. We assert that the Toulminian analytic design allows to understand, with methodical clarity, the defeasibility of common sense arguments by means of the investigation of the modal notion of probability in ordinary language. (shrink)

Entscheidungen am Lebensende rechtzeitig zu thematisieren und eine Vorausverfügung festzulegen, beispielsweise im Rahmen von Advance Care Planning, kann Patientenautonomie bei medizinischen Entscheidungen ermöglichen, wenn Patient*innen nicht mehr einwilligungsfähig sind. Davon profitieren nicht nur Patient*innen, sondern auch ihre Angehörigen und die behandelnden Ärzt*innen. In der klinischen Realität finden entsprechende Gespräche dennoch häufig nicht statt.In dieser Arbeit wird anhand einer prinzipienethisch geleiteten Analyse unter Einbezug eines Konzepts von personaler Autonomie nach Quante untersucht, ob die Initiierung bzw. das Führen eines Gespräches über Entscheidungen (...) am Lebensende eine verbindliche Aufgabe von Ärzt*innen ist.Im Ergebnis besteht eine prima facie Pflicht für Ärzt*innen, ihren Patient*innen mit einer eingeschränkten Lebenserwartung Gespräche über Entscheidungen am Lebensende anzubieten. Eine Verpflichtung zur tatsächlichen Durchführung dieser Gespräche wird durch die Patientenselbstbestimmung begrenzt. Mit Patient*innen, die angeben, über Entscheidungen am Lebensende nicht sprechen zu wollen, sollten die Verzichtsentscheidung gemeinsam kritisch reflektiert werden, Vertrauensangebote aufgegriffen und das Angebot zum Gespräch regelmäßig wiederholt werden. (shrink)

Ethical intuitionists regard moral knowledge as deriving from moral intuition, moral observation, moral emotion and inference. However, moral intuitions, observations and emotions are cultural artefacts which often differ starkly between cultures. Intuitionists attribute uncongenial moral intuitions, observations or emotions to bias or to intellectual or moral failings; but that leads to sectarian ad hominen attacks. Intuitionists try to avoid that by restricting epistemically genuine intuitions, observations or emotions to those which are widely agreed. That does not avoid the problem. It (...) also limits epistemically genuine intuitions, observations or emotions to those with meagre content, and the intuitionists offer no plausible explanation for how inference from such insubstantial propositions can engender substantial moral knowledge. Instead of moral knowledge, intuitionism offers the prospect of mutual name-calling between intellectually stagnant groups. I criticise and reject the principle of phenomenal conservatism, to which intuitionists sometimes appeal. (shrink)

I begin with a note about moral goodness as a quality, disposition, or trait of a person or human being. This has at least two different senses, one wider and one narrower. Aristotle remarked that the Greek term we translate as justice sometimes meant simply virtue or goodness as applied to a person and sometimes meant only a certain virtue or kind of goodness. The same thing is true of our word “goodness.” Sometimes being a good person means having all (...) the virtues, or at least all the moral ones; then goodness equals the whole of virtue. But sometimes, being a good person has a narrower meaning, namely, being kind, generous, and so forth. Thus, my OED sometimes equates goodness with moral excellence as a whole and sometimes with a particular moral excellence, viz., kindness, beneficence, or benevolence; and the Bible, when it speaks of God as being good sometimes means that God has all the virtues and sometimes only that he is kind, mereiful, or benevolent. When Jesus says, “Why callest thou me good: None is good, save one, that is God,” he seems to be speaking of goodness in the inclusive sense, but when the writer of Exodus has God himself say that he is “merciful and gracious, long-suffering, and abundant in goodness and truth,” God is using “goodness” in the narrower sense in which it means benevolence, for he goes on to make it clear that he is also just and severe. Similarly, “good will” may mean either “morally good will” in general, as it does in Kant, or it may mean only “benevolent will,” as it usually does; in “men of good will” it is perhaps ambiguous. (shrink)

Malpractice insurance rates have created a crisis in American medicine. Rates are rising and reimbursements are not keeping pace. In response, physicians in the states hardest hit by this crisis are feeling compelled to take political action, and the current action of choice seems to be physician strikes. While the malpractice insurance crisis is acknowledged to be severe, does it justify the extreme action of a physician walkout? Should physicians engage in this type of collective action, and what are the (...) costs to patients and the profession when such action is taken? I will offer three related arguments against physician strikes that constitute a prima facie prohibition against such action: first, strikes are intended to cause harm to patients; second, strikes are an affront to the physician-patient relationship; and, third, strikes risk decreasing the public's respect for the medical profession. As with any prima facie obligation, there are justifying conditions that may override the moral prohibition, but I will argue that the current malpractice crisis does not rise to the level of such a justifying condition. While the malpractice crisis demands and justifies a political response on the part of the nation's physicians, strikes and slow-downs are not an ethically justified means to the legitimate end of controlling insurance costs. (shrink)

Martha Nussbaum grounds her version of the capabilities approach in political liberalism. In this paper, we argue that the capabilities approach, insofar as it genuinely values the things that persons can actually do and be, must be grounded in a hybrid account of liberalism: in order to show respect for adults, its justification must be political; in order to show respect for children, however, its implementation must include a commitment to comprehensive autonomy, one that ensures that children develop the skills (...) necessary to make meaningful choices about whether or not to exercise their basic capabilities. Importantly, in order to show respect for parents who do not necessarily recognize autonomy as a value, we argue that the liberal state, via its system of public education, should take on the role of ensuring that all children within the state develop a sufficient degree of comprehensive autonomy. (shrink)

Act-utilitarianism and other theories in normative ethics confront the implementability problem: normal human agents, with normal human epistemic abilities, lack the information needed to use those theories directly for the selection of actions. Two Level Theories have been offered in reply. The theoretical level component states alleged necessary and sufficient conditions for moral rightness. That component is supposed to be true, but is not intended for practical use. It gives an account of objective obligation. The practical level component is offered (...) as an implementable system for the choice of actions by agents lacking some relevant information. It gives an account of subjective obligation. Several different ways of developing Two Levelism are explained and criticized. Five conditions that must be satisfied if the practical level principle is to be a good match for a given theoretical level principle are stated. A better form of Two Levelism is presented. (shrink)

Advances at the interface between the biological sciences and engineering are giving rise to emerging research fields such as synthetic biology. Harnessing the potential of synthetic biology requires timely and adequate translation into clinical practice. However, the translational research enterprise is currently facing fundamental obstacles that slow down the transition of scientific discoveries from the laboratory to the patient bedside. These obstacles including scarce financial resources and deficiency of organizational and logistic settings are widely discussed as primary impediments to translational (...) research. In addition, a number of socio-ethical considerations inherent in translational research need to be addressed. As the translational capacity of synthetic biology is tightly linked to its social acceptance and ethical approval, ethical limitations may—together with financial and organizational problems—be co-determinants of suboptimal translation. Therefore, an early assessment of such limitations will contribute to proactively favor successful translation and prevent the promising potential of synthetic biology from remaining under-expressed. Through the discussion of two case-specific inventions in synthetic biology and their associated ethical implications, we illustrate the socio-ethical challenges ahead in the process of implementing synthetic biology into clinical practice. Since reducing the translational lag is essential for delivering the benefits of basic biomedical research to society at large and promoting global health, we advocate a moral obligation to accelerating translational research: the “translational imperative.”. (shrink)