Bioethics has increasingly become a standard part of medical school education and the training of healthcare professionals more generally. This is a promising development, as it has the potential to help future practitioners become more attentive to moral concerns and, perhaps, better moral reasoners. At the same time, there is growing recognition within bioethics that nonideal theory can play an important role in formulating normative recommendations. In this chapter we discuss what this shift toward nonideal theory means for ethical curricula (...) within healthcare education. In particular, we contend that more attention to the particularities of historical and social context needs to be incorporated into bioethics training. To make this argument, we focus on two examples: teaching units on race and medicine and those that focus on stigma and coercion in mental health. For both, we show how a pedagogical approach in which educators focus on social injustice could influence how practitioners engage in ethics in the clinic. This chapter, then, demonstrates what a commitment to nonideal theory can mean practically when it comes to bioethics education. (shrink)

In her seminal attack on modern moral philosophy, G. E. M. Anscombe claims that Kant's ‘rule about universalizable maxims is useless without stipulations as to what shall count as a relevant description of an action with a view to constructing a maxim about it’. Although this so-called problem of relevant descriptions has received considerable attention in the literature, there is little agreement on how it should be understood or solved. My aim in this paper is, first, to clarify the problem (...) by clearing up several misunderstandings, and, second, to show that the problem is rooted in a standard assumption about Kant's stance on the scope of moral principles—an assumption that precludes its solution. I argue that the problem consists in the fact that Kant's formula of universal law seems to stand in need of an account of moral sensibility that does not render the formula superfluous. But, as my discussion of existing solutions reveals, there can be no such account. Instead, I propose a dissolution: we should think of the formula of universal law itself as Kant's account of moral sensibility. In order to do so, we must reject the standard assumption that a principle is universal if and only if it holds for all instances of the action type that it specifies. (shrink)

In this paper I argue that there would be no obligatory maxims if the only standards for assessing maxims were Kant’s universalizability tests. The paper is divided into five sections. In the first, I clarify my thesis: I define my terms and disambiguate my thesis from other related theses for which one might argue. In the second, I confront the view that says that if a maxim passes the universalizability tests, then there is a positive duty to adopt that maxim; (...) I also confront a close relative of this view. In the third, I confront the view that says that if a maxim does not pass the universalizability tests, then there is a positive duty to adopt the contradictory of that maxim. In the fourth, I confront two variations of the view that says that if a maxim does not pass the universalizability tests and an agent is deliberating about the action in the maxim, then the agent has a positive duty to adopt the contrary of that maxim. In the fifth, I confront the view that says that if an agent has adopted a maxim of ends, then the agent has a positive duty to universalize that end. I then wrap up the paper with some concluding remarks. (shrink)

Despite all the attention given to Kant’s universalizability tests, one crucial aspect of Kant’s thought is often overlooked. Attention to this issue, I will argue, helps us resolve two serious problems for Kant’s ethics. Put briefly, the first problem is this: Kant, despite his stated intent to the contrary, doesn’t seem to use universalization in arguing for duties to oneself, and, anyway, it is not at all clear why duties to oneself should be grounded on a procedure that envisions a (...) world in which everyone wills the contrary of those duties. The second, more global problem is that if we follow Barbara Herman in holding that Kantian ethics can provide a structure for moral deliberation, we need an interpretation of the universalization procedure that unproblematically allows it to generate something like prima facie duties to guide that deliberation; but it is not at all clear that we have such an interpretation. I argue here that if we expand our limited way of thinking about universalization, we can solve the first problem and work towards a solution to the second. We can begin by recalling that Kant’s ‘Law of Nature’ formulation (FLN) of the Categorical Imperative obligates us to ‘act as if the maxim of your action were to become by your will a universal law of nature’ (G, 421). (shrink)

Given Kant's exceptionless moral prohibition on lying, one might suspect that he is committed to a similar prohibition on withholding diagnostic and prognostic information from patients. I confirm this suspicion by adapting arguments against therapeutic privilege from his arguments against lying. However, I show that all these arguments are importantly flawed and submit that they should be rejected. A more compelling Kantian take on informed consent and therapeutic privilege is achievable, I argue, by focusing on Kant's duty of beneficence, which (...) requires us to aim at furthering others’ ends. But I show that there are some cases in which furthering a patient's ends requires withholding material medical information from her. Although I concede that these cases are probably quite rare, I conclude that the best Kantian thinking agrees with that of therapeutic privilege's advocates. (shrink)

Are our actions morally good because we approve of them or are they good independently of our approval? Are we projecting moral values onto the world or do we detect values that are already there? For many these questions don’t state a real alternative but a secular variant of the Euthyphro dilemma: If our actions are good because we approve of them moral goodness appears to be arbitrary. If they are good independently of our approval, it is unclear how we (...) come to know their moral quality and how moral knowledge can be motivating. None of these options seems attractive; the source of moral goodness unclear. Despite the growing literature on Kant’s moral epistemology and moral epistemology the question remains open what Kant’s answer to this apparent dilemma is. The Kantian view I attempt to lay out in this paper is supposed to dissolve the secular version of the Euthyphro dilemma. In responding to this dilemma we need to get clear about the source or the origin of our moral knowledge: Voluntary approval or mind-independent moral facts? Projectivism or detectivism? Construction or given? I believe that all these ways of articulating the problem turn out, on closer inspection, to be false alternatives. (shrink)