Environmental pollution and greenhouse gas emissions that contribute to climate change have adverse impacts on global health. Somewhat paradoxically, health care systems that aim to prevent and cure disease are themselves major emitters and polluters. In this paper we develop a justification for the claim that solidaristic health care systems should include sustainability as one of the criteria for determining which health interventions are made available or reimbursed – and which not. There is however a complication: most adverse health effects (...) due to climate change do occur elsewhere in the world. If solidarity would commit us to take care of everyone’s health, worldwide, it might imply that solidaristic health system cannot justifiably restrict universal access to their own national populations. In response we explain health solidarity is to be considered as a moral ideal. Such an ideal does not specify what societies owe to whom, but it does have moral implications. We argue that ignoring sustainability in political decision making about what health care is to be offered, would amount to betrayal of the ideal of solidarity. (shrink)

Moral ideals should not be seen as simple and purely personal, but as complex values with a social dimension that transcend attempts to formulate or realize them. Orientation towards ideals needs a realistic component: people should identify with the quest for an ideal, not with the ideal itself, and consider the possibility of negative consequences of their pursuit. Such realism about ideals includes acknowledging that ideals are not the only, nor the most important, motivating force of morality.

A recurrent issue in the vast amount of literature on reasoning models in ethics is the role and nature of moral intuitions. In this paper, we start from the view that people who work and live in a certain moral practice usually possess specific moral wisdom. If we manage to incorporate their moral intuitions in ethical reasoning, we can arrive at judgements and (modest) theories that grasp a moral experience that generally cannot be found outside the practice. Reflective equilibrium (RE) (...) provides a framework for balancing moral intuitions, ethical principles and general theories. Nevertheless, persisting problems associated with the use of intuitions need to be addressed. One is the objection that moral intuitions lack the credibility necessary to guide moral reasoning. Ethicists have tried to solve this problem by formulating criteria to separate the “bad” intuitions from the “good” ones at the beginning of the reasoning process. We call this the credible input-justified outcome strategy. An example is the appeal to the common morality by Beauchamp and Childress. We think this approach is unsuccessful. As an alternative, we outline the good reasoning-justified outcome strategy. It connects to a variant of RE in which intuitions from different sources are incorporated. We argue that the elements of RE have different levels of justificatory power at the start of reasoning. In our strategy, each element can gain or lose justificatory power when it is tested in a reasoning process that meets several criteria. (shrink)

Part of being a good professional is, so we contend, to have ideals. Ideals essentially complement the deontic considerations that are usually taken as the main components of professional moral deliberation. Yet the notion of professional ideals is problematic. As professional ideals they refer to a profession collectively, while as professional ideals they are first of all strong personal commitments of individual professionals. As collective aspirations, professional ideals have a kind of external normative thrust on individual professionals, but people cannot (...) be forced to identify with ideals on demand. Endorsing ideals can only come from within. On the basis of an analysis of ?professional ideals? and ?professional identity?, we conclude that professional ideals are necessary constituents of the personal identity of professionals. This explains the dual character of professional ideals: they are pursued by a collective and constitute the group professional identity but they also need to be endorsed by individual professionals in order to be able to say that the ideals are their own. We end with a short and tentative description of some practical implications for the fostering and education of professional ideals. (shrink)

Ethics and Sustainability: Guest or Guide? On Sustainability as a Moral Ideal Content Type Journal Article Pages 1-5 DOI 10.1007/s10806-011-9322-6 Authors Franck L. B. Meijboom, Ethics Institute, Utrecht University, Janskerkhof 13a, 3512 BL Utrecht, The Netherlands Frans W. A. Brom, Ethics Institute, Utrecht University, Janskerkhof 13a, 3512 BL Utrecht, The Netherlands Journal Journal of Agricultural and Environmental Ethics Online ISSN 1573-322X Print ISSN 1187-7863.