Many ethicists maintain that medical research on human subjects that presents no prospect of direct medical benefit must have a prospect of social benefit to be ethical. Payment is not the sort of benefit that justifies exposing subjects to risk. Alan Wertheimer has raised a serious challenge to this view, pointing out that in industry, social value is not considered necessary to make dangerous jobs ethical. This article argues that Wertheimer was correct to think that the ethics of hazard pay (...) should be the same in medical research and in business. Nevertheless, a qualified social benefit requirement should apply in both fields. For a study or a job with significant net physical risk to be ethical, it must have social value beyond the satisfaction of ordinary preferences, including the preference for money. The requirement derives from a non-absolutist version of the doctrine of double effect. If a risky study or a dangerous job has no distinctive social value, and hazard pay is subjects' or workers’ only reason to undergo risks, the very fact that they undergo risk is intended as a means to a financial end. Inviting people to enrol in such a study or to take such a job wrongfully treats people as mere means. By contrast, if a study or a job has social value, people can participate with a primary end other than money, even if they accept compensation. Researchers or employers do not intend but merely foresee risks to subjects or workers. (shrink)

Does the content of a physically dangerous job affect the moral permissibility of hiring for that job? To what extent may employers consider costs in choosing workplace safety measures? Drawing on Kantian ethical theory, this article defends two strong ethical standards of workplace safety. First, the content of a hazardous job does indeed affect the moral permissibility of offering it. Unless employees need hazard pay to meet basic needs, it is permissible to offer a dangerous job only if prospective employees (...) have a reason other than hazard pay to choose this job instead of safer alternatives. Second, employers typically cannot justify omitting expensive safety measures by paying employees more, even if employees prefer higher pay to greater safety. Employers offering dangerous jobs must meet these two standards to avoid treating their employees merely as means. (shrink)

There is a puzzle about the very possibility of foreseen but unintended side effects, and solving this puzzle requires us to revise our basic picture of the structure of practical deliberation. The puzzle is that, while it seems that we can rationally foresee, but not intend, bringing about foreseen side effects, it also seems that we rationally must decide to bring about foreseen side effects and that we intend to do whatever we decide to do. I propose solving this puzzle (...) by rejecting the idea that we intend to do whatever we decide to do. My solution involves taking account of the underappreciated role that qualified intentions play in deliberation. I also argue that this solution fares better than those that instead reject the idea that we rationally must decide to bring about foreseen side effects, for these solutions are committed to rejecting the even more compelling idea that decisions rationally serve as the conclusions of practical deliberation. (shrink)

An influential objection to the view that intentions are non-derivatively relevant to the moral permissibility of actions states that if intentions were relevant to permissibility in such a way, one would have to take them into account in decision making, which would be odd (in some morally relevant sense of ‘oddness’). The paper outlines and assesses three candidates for the oddness: that considering intentions in decision making is an unordinary practice, that it is impossible or conceptually confused, and that it (...) assigns intentions the weight as moral considerations that they intuitively do not have. The paper rejects the first two and shows that the third is probably what motivates most critics of the relevance of intentions who raise this objection. If this is correct, the objection is a non-starter as it assumes what it has to prove. Towards the end, it is argued that the objection does not serve as a plausible error theory either. (shrink)

Does the moral status of an action provide in itself a non-instrumental, pro-tanto reason for a corresponding legal status – a reason that applies regardless of whether the law promotes a value that is independent of the law, such as preventing wrongdoing or promoting distributive or retributive justice? While the relation between morality and law is a familiar topic, this specific question is typically not considered explicitly. Yet it seems to be controversial and each of the contrasting answers to this (...) question has some appeal. The article highlights and considers this question. it concludes that the answer is negative: there is no necessary relation between morality and law in this respect. Rather, there is a reason in favor of incorporating morality into the law only when this incorporation promotes a moral value that is independent of the law. (shrink)

Given the wide the range of legally available options for end-of-life care in recent decades: from aggressive, even experimental, treatment to active euthanasia, our ethical analysis struggles to keep pace with technology and law. In this essay I show that the principle of double effect (PDE) remains, and will continue to be, a useful tool for ethical analysis of end-of-life care. According to PDE, an agent may ethically perform an act that s/he foresees will have a significant bad effect (e.g., (...) death) in addition to a good effect (e.g., pain relief) only if s/he does not intend the bad effect, the act is not bad for reasons other than its causing the bad effect, and there is a proportionately serious reason to act. Following a brief explanation of PDE and preliminary considerations in favor of counting death as a bad effect, I analyze several end-of-life options in terms of the principle. I begin with those that enjoy significant consensus among proponents of PDE: active euthanasia, “passive euthanasia,” and palliative care. Then I consider the less-straightforward cases of drug provision, refusing food and water, and terminal sedation, arguing that participation in such actions is justifiable via PDE only under very limited conditions. (shrink)

I argue that people are sometimes justified in participating in unjust wars. I consider a range of reasons why war might be unjust, including the cause which it is fought for, whether it is proportionate, and whether it wrongly uses resources that could help others in dire need. These considerations sometimes make fighting in the war unjust, but sometimes not. In developing these claims, I focus especially on the 2003 Iraq war.

The deeply entrenched, sometimes heated conflict between the disability movement and the profession of bioethics is well known and well documented. Critiques of prenatal diagnosis and selective abortion are probably the most salient and most sophisticated of disability studies scholars’ engagements with bioethics, but there are many other topics over which disability activists and scholars have encountered the field of bioethics in an adversarial way, including health care rationing, growth-attenuation interventions, assisted reproduction technology, and physician-assisted suicide. The tension between the (...) analyses of the disabilities studies scholars and mainstream bioethics is not merely a conflict between two insular political groups, however; it is, rather, also an encounter between those who have experienced disability and those who have not. This paper explores that idea. I maintain that it is a mistake to think of this conflict as arising just from a difference in ideology or political commitments because it represents a much deeper difference—one rooted in variations in how human beings perceive and reason about moral problems. These are what I will refer to as variations of moral psychology. The lived experiences of disability produce variations in moral psychology that are at the heart of the moral conflict between the disability movement and mainstream bioethics. I will illustrate this point by exploring how the disability movement and mainstream bioethics come into conflict when perceiving and analyzing the moral problem of physician-assisted suicide via the lens of the principle of respect for autonomy. To reconcile its contemporary and historical conflict with the disability movement, the field of bioethics must engage with and fully consider the two groups’ differences in moral perception and reasoning, not just the explicit moral and political arguments of the disability movement. (shrink)

The most blatant forms of discrimination are morally outrageous and very obviously so; but the nature and boundaries of discrimination are more controversial, and it is not clear whether all forms of discrimination are morally bad; nor is it clear why objectionable cases of discrimination are bad. In this paper I address these issues. First, I offer a taxonomy of discrimination. I then argue that discrimination is bad, when it is, because it harms people. Finally, I criticize a rival, disrespect-based (...) account according to which discrimination is bad regardless of whether it causes harm. (shrink)

Is there a reason to prevent deontological wrongdoing—an action that is wrong due to the violation of a decisive deontological constraint? This question is perplexing. On the one hand, the intuitive response seems to be positive, both when the question is considered in the abstract and when it is considered with regard to paradigmatic cases of deontological wrongdoing such as Bridge and Transplant. On the other hand, common theoretical accounts of deontological wrongdoing do not entail this answer, since not preventing (...) wrongdoing does not necessarily amount to doing harm or intending harm, for example. The puzzle is reinforced due to the fact that the intuitive response to other cases seems to be different, namely that there is no reason in favour of preventing deontological wrongdoing. This question is thus interesting in itself. It might also shed light on additional questions such as the “paradox of deontology” and the appropriate response to wrongful actions more generally. Yet, despite its importance, this question is typically overlooked. The paper explores this question. (shrink)

Philosophers from Hart to Lewis, Johnston and Bennett have expressed various degrees of reservation concerning the doctrine of double effect. A common concern is that, with regard to many activities that double effect is traditionally thought to prohibit, what might at first look to be a directly intended bad effect is really, on closer examination, a directly intended neutral effect that is closely connected to a foreseen bad effect. This essay examines the extent to which the commonsense concept of intention (...) supports a reasonably consistent and coherent application of double effect. Two important conclusions are these: (1) a number of traditionally proscribed activities involve a kind of “targeting” of innocents that can be taken to exhibit a direct intention to harm them; (2) a direct intention to harm need not involve a desire to harm in any ordinary sense of the latter expression. (shrink)

For ambitious metaphysical neo-sentimentalists, all normative facts are grounded in fitting attitudes, where fittingness is understood in naturalistic terms. In this paper, I offer a neo-sentimentalist account of blameworthiness in terms of the reactive attitudes of a morally authoritative subject I label a Nagelian Imp. I also argue that moral impermissibility is indirectly linked to blameworthiness: roughly, an act is morally impermissible if and only if and because it is not *possible* in the circumstances to adopt a plan of performing (...) it without meriting blame, assuming the agent is rational, informed, and meets the conditions of accountability. (shrink)

According to the Doctrine of Illicit Intentions, it is impermissible both to form and then to act on an illicit intention. An intention is illicit, roughly, if it causes the agent who has it to be, in a certain way, disposed to perform actions that are impermissible. If the range of actions an agent might be directed to perform by an intention includes impermissible actions, then it may be impermissible to form or act on that intention even if, in the (...) end, the agent performs no action that is impermissible (other than forming and acting on an illicit intention itself). (shrink)

Abstract: This essay consists of some clarifying remarks on the doctrine of double effect (DDE). After providing a contemporary formulation of the doctrine we put special emphasis on the distinction between those aspects of an action plan that are intended and those that are merely foreseen (the I/F distinction). Making use of this distinction is often made difficult in practice because salient aspects of the action plan exhibit a felt “closeness” to one another that is difficult if not impossible to (...) articulate with the precision we might like. The essay goes on to examine an especially adroit criticism of DDE best articulated by J.J. Thomson. We conclude with a brand new double effect case (new to the philosophical literature anyway) taken from medicine and Roman Catholic pastoral ministry. (shrink)

As an adherent to the U.N.’s Universal Declaration of Human Rights, the United States has made a commitment to social justice. As a part of this commitment, the U.S. maintains that the right to an education is both innate and compulsory. This paper addresses U.S. government’s failure to uphold its citizens’ educational rights, made clear by the inadequacy of the educational programs currently offered to juvenile offenders. Based on the findings of recent scholarly literature, this paper argues that both juvenile (...) and adult correctional institutions lack the resources necessary to provide proper educational instruction and adequately address the special educational needs of juvenile offenders. To help the U.S. maintain its commitment to social justice, alternatives to juvenile incarceration are proposed. (shrink)

Argues that there is no one it is irrational to love, that it is rational to act with partiality to those we love, and that the rationality of doing so is not conditional on love. It follows that Anscombe and Taurek are right: you are not required to save three instead of one, even when those you could save are perfect strangers.

Recent developments in biogerontology—the study of the biology of ageing—suggest that it may eventually be possible to intervene in the human ageing process. This, in turn, offers the prospect of significantly postponing the onset of age-related diseases. The biogerontological project, however, has met with strong resistance, especially by deontologists. They consider the act of intervening in the ageing process impermissible on the grounds that it would (most probably) bring about an extended maximum lifespan—a state of affairs that they deem intrinsically (...) bad. In a bid to convince their deontological opponents of the permissibility of this act, proponents of biogerontology invoke an argument which is grounded in the doctrine of double effect. Surprisingly, their argument, which we refer to as the ‘double effect argument’, has gone unnoticed. This article exposes and critically evaluates this ‘double effect argument’. To this end, we first review a series of excerpts from the ethical debate on biogerontology in order to substantiate the presence of double effect reasoning. Next, we attempt to determine the role that the ‘double effect argument’ is meant to fulfil within this debate. Finally, we assess whether the act of intervening in ageing actually can be justified using double effect reasoning. (shrink)

Discrimination might be considered unjust on account of the comparative disadvantage it imposes, the absolute disadvantage it imposes, the disrespect it shows, or the prejudice it shows. This article argues that each of these accounts overlooks some cases of unjust discrimination. In response to this state of affairs we might combine two or more of these accounts. A promising approach combines the comparative disadvantage and absolute disadvantage accounts.

The Doctrine of Double Effect (DDE) is an influential non-consequentialist principle positing a role for intention in affecting the moral permissibility of some actions. In particular, the DDE focuses on the intend/foresee distinction, the core claim being that it is sometimes permissible to bring about as a foreseen but unintended side-effect of one’s action some harm it would have been impermissible to aim at as a means or as an end, all else being equal. This article explores the meaning and (...) application of the DDE along with current debates over the nature of the intend/foresee distinction and its moral significance. How is the line between intended effects and merely foreseen but unintended side-effects to be drawn, and how are problem cases best handled? What is an appropriate methodology for debating the tenability of the DDE? How might the DDE interact with other non-consequentialist principles, and how might it be modified to capture other related factors (resulting perhaps in a Doctrine of Triple Effect) or to avoid certain problem cases? Does the DDE make permissibility turn on the actual intentions of particular agents, as critics such as Thomson and Scanlon assume, or is the role of intention more abstract? (shrink)

When does a defendant not deserve punishment because he is unaware that his conduct breaches a penal statute? Retributivists must radically rethink their answer to this question to do justice to our moral intuitions. I suggest that modest progress on this topic can be made by modeling our approach to ignorance of law on our familiar approach to ignorance of fact. We need to distinguish different levels of culpability in given mistakes and to differentiate what such mistakes may be about. (...) I discuss the advantages and disadvantages of this approach with special attention to how to contrast offenses from defenses. The alternative I tend to favor probably should not be implemented in existing penal codes. As a result, we are likely to remain dissatisfied with the decisions made by our criminal justice system about the exculpatory effect of ignorance of law. (shrink)

I attempt to describe the several costs that criminal theory would be forced to pay by adopting the view (currently fashionable among moral philosophers) that the intentions of the agent are irrelevant to determinations of whether his actions are permissible (or criminal).

Certain theorists argue that intention cannot be a wrong-making feature of actions because (a) it is morally impermissible to encourage morally impermissible actions; (b) there are certain putatively impermissible actions that seem to be impermissible because of the intention with which they are performed; and (c) at least some of these actions can permissibly be encouraged. If one accepts (a) and (c), then one should conclude that these actions cannot really be impermissible. This paper rejects the premise that it is (...) always impermissible to encourage impermissible acts. The argument explores three ways one could encourage an act that would be permissible but for its being performed with a wrong-making intention. It argues that there is at most a strong but defeasible presumption against encouraging the performance of impermissible actions. (shrink)

Throw: Harry throws a stone at Dick, hitting him. Intuitively, there is a moral difference between the first and the second case of each of these pairs.1 In the second case, the agent’s behavior is morally worse than his behavior in the first case. But in each pair, the agent’s behavior has the same outcome: in No Check and Shoot, the outcome is that a child dies, and Jim saves $40; in No Catch and Throw, the outcome is that Dick (...) is hit by a stone. Let us call these pairs of cases “the paradigm pairs.” The paradigm pairs, and others like them, provide evidence that common sense morality is not consequentialist: common sense morality does not judge the moral worth of actions just in terms of their consequences. But it has proved extremely difficult to provide an account of a morally relevant difference between the members of pairs like the ones above. One hypothesis about the difference that has received a lot of attention in the literature is that in the first kind of case the agent allows the outcome to occur, while in the second the agent makes the.. (shrink)

In the first part of this article, I raisequestions about Dworkin''s theory of theintrinsic value of life and about the adequacyof his proposal to understand abortion in termsof different ways of valuing life. In thesecond part of the article, I consider hisargument in ``The Philosophers'' Brief on AssistedSuicide'''', which claims that the distinctionbetween killing and letting die is morallyirrelevant, the distinction between intendingand foreseeing death can be morally relevantbut is not always so. I argue that thekilling/letting die distinction can be (...) relevantin the context of assisted suicide, but alsoshow when it is not. Then I consider why theintention/foresight distinction can be morallyirrelevant and conclude by presenting analternative argument for physician-assistedsuicide. (shrink)

Person-affecting views in population ethics state that (in cases where all else is equal) we’re permitted but not required to create people who would enjoy good lives. In this paper, I present an argument against every possible variety of person-affecting view. The argument takes the form of a dilemma. Narrow person-affecting views must embrace at least one of three implausible verdicts in a case that I call ‘Expanded Non-Identity.’ Wide person-affecting views run into trouble in a case that I call (...) ‘Two-Shot Non-Identity.’ One plausible practical upshot of my argument is as follows: we individuals and our governments should be doing more to reduce the risk of human extinction this century. (shrink)

Many philosophers accept that, as well as having a right that others not harm us, we also have a right that others not subject us to a risk of harm. And yet, when we attempt to spell out precisely what this ‘right against risk imposition’ involves, we encounter a series of notorious puzzles. Existing attempts to deal with these puzzles have tended to focus on the nature of rights – but I propose an approach that focusses instead on the nature (...) of risk. The key move is to distinguish two different ways in which to conceptualise the risk that a given action presents – one of which is linked to the notion of probability and the other to the notion of normalcy. (shrink)

According to an appealing and common view, the moral status of an action – whether it is wrong, for example – is sometimes important in itself in terms of the moral status of other actions – especially those that respond to the original action. This view is especially influential with respect to the criminal law. It is accepted not only by legal moralists but also by adherents of the harm principle, for example. In this paper, I argue against this view. (...) The main arguments emphasize the distinctions between the moral status of actions, consequences, and agents. I argue that what matters, in terms of other actions, is not the moral status of the original action but rather other factors that may be confused with it, such as the moral status of its consequences – whether they are good or bad – and the moral status of the agent – whether she is praiseworthy or blameworthy. The intuitive appeal of the common view is, I argue, at least partly due to a conflation of these factors. Most importantly, once we recall the distinctions between these factors, we can see more clearly that this view lacks a compelling rationale. Or, at least, that it is based on assumptions that, first, are much more controversial than their conclusion, and, second, do not support every aspect of this view – and thus do not offer a unified foundation for this view. (shrink)

This thesis consists of a series of papers in population ethics: a subfield of normative ethics concerned with the distinctive issues that arise in cases where our actions can affect the identities or number of people of who ever exist. Each paper can be read independently of the others. In Chapter 1, I present a dilemma for Archimedean views in population axiology: roughly, those views on which adding enough good lives to a population can make that population better than any (...) other. In Chapter 2, I extend Gustaf Arrhenius’s famous impossibility theorems in population axiology into the domain of choices under risk. My risky impossibility theorems dispense with the assumption that welfare levels are finitely fine-grained, and so tell against lexical views in population axiology. In Chapter 3, I present objections to critical-level and critical-range views in population axiology. I then sketch out what I call the ‘Imprecise Exchange Rates View’ and argue that it is an attractive alternative. In Chapter 4, I address critical-level and critical-range views again. This time, I note that they are vulnerable to objections from biographical identity: identity between lives. I suggest that these objections give us reason to reject critical-level and critical-range views and embrace the Total View. In Chapter 5, I argue that objections of the same form – objections from personal identity – tell against person-affecting views in population ethics. In Chapter 6, I draw out some counterintuitive implications of two recent complaints-based theories of the procreation asymmetry. (shrink)

Since the middle of the 20th century, philosophers and legal scholars have debated the precise definition of punishment. This chapter surveys the debate, identifies six potential conditions of punishment, and critically reviews each of them: 1) the response condition, which holds that punishment must be in response to wrongdoing, 2) the culpability condition, which holds that punishment must be of a person morally responsible for wrongdoing, 3) the authority condition, which holds that punishment must be imposed by a relevant authority, (...) 4) the hard treatment condition, which holds that punishment must impose hard consequences on the punishee, 5) the intentionality condition, which holds that punishment must be intentional, and 6) the censure condition, which holds that punishment must communicate disapproval. The article argues that it is often unclear that there is a version of the condition that provides optimal lexical fit. It discusses the implications of this analysis, and concludes that there may be less reason to worry about the lack of an authoritative definition than has sometimes been assumed, but that definitional clarity remains an objective worth pursuing. (shrink)

The article explores one prominent account of what makes discrimination morally bad (when it is) – the disrespect-based account. The article first reviews and clarifies the account, arguing that it is most charitably understood as the claim that discrimination is morally bad when the discriminator gives lower weight to reasons grounded in the moral status of the discriminatee(s) in her decision-making. It then presents three challenges to the account, and reviews a recent argument in defense of it. The first challenge (...) is the fact that intuitions that might support the disrespect-based account can also be explained by reference to the fact that disrespect reflects poorly on the moral character of the discriminator. The second challenge is that there are cases where disrespectful discrimination is not intuitively worse than non-disrespectful discrimination. The third challenge is that the disrespect-based account has difficulties explaining our intuitions about cases of “doing right for the wrong reasons”. Finally, pace a recent argument in its defense, cases of harmless and apparently morally bad discrimination are plausibly best explained by other factors than disrespect. In the light of this analysis, the article concludes that the disrespect-based account should be abandoned. (shrink)

In this article, we critically scrutinize the principle of proportionality when used in the context of security and government surveillance. We argue that McMahan’s distinction from just warfare between narrow proportionality and wide proportionality can generally apply to the context of surveillance. We argue that narrow proportionality applies more or less directly to cases in which the surveilled is liable and that the wide proportionality principle applies to cases characterized by ‘collateral intrusion’. We argue, however, that a more demanding criterion (...) than the lesser-evil justification that wide proportionality frequently entails is necessary in cases characterized by intentional intrusion upon non-liable individuals. The distinction between foreseeing and intending intrusion into the lives of individuals who are not liable has not previously been specifically addressed in discussions concerning surveillance ethics. This specification is thus increasingly important due to the general growing tendency for adherence to the precautionary principle and policies aimed at anticipating criminal acts before they are committed. Preventive surveillance of non-liable actors is considered an important instrument for obtaining this aim and thus calls for moral scrutiny in terms of permissibility and proportionality. We suggest the concept ‘wide proportionality +’ which applies to cases of intentional intrusion of non-liable individuals. (shrink)

It has long been thought that by using morphine to alleviate the pain of a dying patient, a doctor runs the risk of causing his death. In all countries this kind of killing is explicitly or silently permitted by the law. That permission is usually explained by appealing to the doctrine of double effect: If the use of morphine shortens life, that is only an unintended side effect. The paper evaluates this view, finding it flawed beyond repair and proposing an (...) alternative explanation. It is not the intention of the doctor that counts, but the availability of an “objective” palliative justification. (shrink)

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

Without taking a position on the overall justification of anti-doping regulations, I analyse the possible justification of Therapeutic Use Exemptions from such rules. TUEs are a creative way to prevent the unfair exclusion of athletes with a chronic condition, and they have the potential to be the least bad option. But they cannot be competitively neutral. Their justification must rest, instead, on the relevance of intentions to permissibility. I illustrate this by means of a set of thought experiments in which (...) only an athlete’s intentions vary. I argue that the Doctrine of Double Effect sheds some light on TUEs and illustrate this by applying different readings of the DDE to the thought experiment. This underpins a justification of anti-doping exemptions very different from the approach adopted by the World Anti-Doping Agency. I argue for three changes to bring TUEs in line with this understanding: rewriting of the regulations, transparency, and a greater role for athletes in determining what exemptions are allowed, and when. (shrink)

T. M. Scanlon has argued that the intentions with which one acts, or more specifically, one’s reasons for acting, are non-derivatively irrelevant to the moral permissibility of one’s actions. According to one of his arguments in favor of that thesis, it can be permissible to act for one reason rather than another only if one can choose to act for a reason but, since that choice is impossible since believing as will is impossible, one can be permitted to act but (...) one cannot be permitted to act for a reason. This paper aims to show that that argument is unsound. It first argues that the assumption that choosing an action is necessary for it being an object of a moral duty or permission cannot be made consistent with Scanlon’s idea that the same does not hold for an action being an object of blame. It then argues that even if direct control over forming beliefs is impossible, it is not impossible to choose one’s reason for action and, therefore, to be permitted or forbidden to act for it. (shrink)

The doctrine of double effect, together with other moral principles that appeal to the intentions of moral agents, has come under attack from many directions in recent years, as have a variety of rationales that have been given in favor of it. In this paper, our aim is to develop, defend, and provide a new theoretical rationale for a secular version of the doctrine. Following Quinn (1989), we distinguish between Harmful Direct Agency and Harmful Indirect Agency. We propose the following (...) version of the doctrine: that in cases in which harm must come to some in order to achieve a good (and is the least costly of possible harms necessary), the agent foresees the harm, and all other things are equal, a stronger case is needed to justify Harmful Direct Agency than to justify Harmful Indirect Agency. We distinguish between two Kantian rationales that might be given for the doctrine, a “dependent right” rationale, defended by Quinn, and an “independent right” rationale, which we defend. We argue that the doctrine and the “independent right” rationale for it are not vulnerable to counterexamples or counterproposals, and conclude by drawing implications for the larger debate over whether agents' intentions are in any way relevant to permissibility and obligation. (shrink)

Many medical interventions have both negative and positive effects. When health care professionals cannot achieve a particular desired good result without bringing about some bad effects also they often rely on double-effect reasoning to justify their decisions. The principle of double effect is therefore an important guide for ethical decision-making in medicine. At the same time, however, it is a very controversial tool for resolving complex ethical problems that has been criticized by many authors. For these reasons, I examine in (...) this paper whether the principle of double effect can serve as a basis for ethical decisions in medicine. The conclusion reached in this article is that even though this principle has desirable effects on clinical conduct, it is only an unreliable guide and physicians and nurses cannot feel secure in continuing to use this principle for ethical guidance. (shrink)

The doctrine of double effect, together with other moral principles that appeal to the intentions of moral agents, has come under attack from many directions in recent years, as have a variety of rationales that have been given in favor of it. In this paper, our aim is to develop, defend, and provide a new theoretical rationale for a secular version of the doctrine. Following Quinn (1989), we distinguish between Harmful Direct Agency and Harmful Indirect Agency. We propose the following (...) version of the doctrine: that in cases in which harm must come to some in order to achieve a good (and is the least costly of possible harms necessary), the agent foresees the harm, and all other things are equal, a stronger case is needed to justify Harmful Direct Agency than to justify Harmful Indirect Agency. We distinguish between two Kantian rationales that might be given for the doctrine, a “dependent right” rationale, defended by Quinn, and an “independent right” rationale, which we defend. We argue that the doctrine and the “independent right” rationale for it are not vulnerable to counterexamples or counterproposals, and conclude by drawing implications for the larger debate over whether agents' intentions are in any way relevant to permissibility and obligation. (shrink)

This article treats recent bioethical discussions of double effect reasoning (DER), offering a summary account of DER and construing it as rooted in a sensible view of what is central to someone's identity as a moral agent. It then treats objections raised in recent years by Judith Thomson, Alison McIntyre, and Frances Kamm against familiar ways of applying DER to certain controversies within medical ethics, especially, that over physician-assisted suicide. After detailing, interpreting, and attempting to rebut the challenges from these (...) philosophers, who are especially interesting because their criticisms of DER come from allies in DER's struggle against consequentialist reasoning, the essay engages DER's contribution to a recent dispute over treatment of patients in what is called ‘persistent vegetative state.' Near its end, the paper sketches several possible points of entry to DER and sources of justification for it. The essay concludes by indicating a connection between these paths and its opening idea of moral identity. (shrink)

This essay defends a version of the Doctrine of Double Effect (DDE) – the doctrine that there is normally a stronger reason against an act that has a bad state of affairs as one of its intended effects than against an otherwise similar act that has that bad state of affairs as an unintended effect. First, a precise account of this version of the DDE is given. Secondly, some suggestions are made about why we should believe the DDE, and about (...) why it is true. Finally, a solution is developed to the so-called ‘closeness problem’ that any version of the DDE must face. (shrink)

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

This article examines arguments concerning enhancement of human persons recently presented by Michael Sandel (2004). In the first section, I briefly describe some of his arguments. In section two, I consider whether, as Sandel claims, the desire for mastery motivates enhancement and whether such a desire could be grounds for its impermissibility. Section three considers how Sandel draws the distinction between treatment and enhancement, and the relation to nature that he thinks each expresses. The fourth section examines Sandel's views about (...) parent/child relations and also how enhancement would affect distributive justice and the duty to aid. In conclusion, I briefly offer an alternative suggestion as to why enhancement may be troubling and consider what we could safely enhance. (shrink)

By the time this essay is published, it will be a matter of weeks before doctors and nurse practitioners in Canada can legally end the lives (by medical assistance in dying, or MAID) of non-dying p...

In the third volume of On What Matters, Derek Parfit argued that the distinction between imposing a newly created threat on someone and making what threatens some people instead threaten someone else has no genuine moral significance. This article's central thesis is that although there is much to learn from Parfit's arguments, they are ultimately unsuccessful at establishing that the redirected versus newly created threats distinction is morally irrelevant. In particular, I show that my Causal Sequences Principle specifies this distinction (...) in such a way that it is immune to Parfit's objections against the Redirection Principle. It follows that any moral theory that can provide a sound rationale for the Causal Sequences Principle can solve the trolley problem. (shrink)

The simple knowledge norm of assertion holds that one may assert that p only if one knows that p. Turri :37–45, 2011) and Williamson both argue that more is required for epistemically permissible assertion. In particular, they both think that the asserter must assert on the basis of her knowledge. Turri calls this the express knowledge norm of assertion. I defend SKNA and argue against EKNA. First, I argue that EKNA faces counterexamples. Second, I argue that EKNA assumes an implausible (...) view of permissibility on which an assertion is epistemically permissible only if it is made for a right reason, i.e., a reason that contributes to making it the case that it is epistemically permissible to make that assertion. However, the analogous view in other normative domains is both controversial and implausible. This is because it doesn’t make it possible for one to act or react rightly for the wrong reason. I suggest that proponents of EKNA have conflated requirements for φ-ing rightly with requirements for φ-ing well. Finally, I argue that proponents of SKNA can explain the intuitive defectiveness of asserting on the basis of an epistemically bad reason, even when the asserters know the content of their assertion, by arguing that the asserters are epistemically blameworthy. (shrink)

How, if at all, does one's intention to realize an end bear on the justification for taking the means to that end? Theories that allow that intending an end directly provides a reason to take the means are subject to a well-known "bootstrapping" objection. On the other hand, "anti-psychologistic" accounts—which seek to derive instrumental reasons directly from the reasons that support adopting the end itself—have unacceptable implications where an agent faces multiple rationally permissible options. An alternative, predictive, role for intention (...) in means-end reasoning is considered and rejected. A new proposal is then developed, according to which instrumental reasons are not merely reasons to perform an act necessary for a given end, but to perform the act for the sake of that end. (shrink)