Recently there has been a somewhat surprising interest among Kantian theorists in the moral standing of animals, coupled with a no less surprising optimism among these theorists about the prospect of incorporating animal moral standing into Kantian theory without contorting its other attractive features. These theorists contend in particular that animal standing can be incorporated into Kantian moral theory without abandoning its logocentrism: the claim that everything that is valuable depends for its value on its relation to rationality. In this (...) essay I raise doubts about the prospects for accommodating animal moral standing within a logocentric Kantianism. I argue instead that the best way to incorporate animal moral standing into Kantian theory is to admit more radical departures from Kant’s position by maintaining that consciousness is a locus of moral standing independent from rationality. I propose that we should attribute moral standing to all conscious animals because the capacity of consciousness is the criterion distinguishing individuals whose well-being generates reasons from individuals whose well-being fails to do so. We need such a criterion because we speak of the well-being of things, such as artifacts and meteorological phenomena, which clearly lack moral standing. Having already argued against the Kantian view that the criterion of moral standing is rationality, I proceed to argue that consciousness is also superior to its other principal rival for the criterion of moral standing: life. On the view that emerges from this discussion, we have obligations to show concern for conscious individuals by treating their well-being as providing us with reasons for action; the view thus endorses the criterion of moral standing typically advanced by utilitarians. On this view we also have a distinct class of obligations to show respect for conscious rational individuals; the view thus endorses the Kantian claim that persons have a distinctive moral status in virtue of their possession of rational capacities. In this essay thus begin to show how a principal insight of each leading approach to modern moral theory may be captured in a unified theory. (shrink)

In recent defenses of moral responsibility skepticism, which is the view that no human agents are morally responsible for their actions or character, a number of theorists have argued against Peter Strawson’s (and others’) claim that “the sort of love which two adults can sometimes be said to feel reciprocally, for each other” would be undermined if we were not morally responsible agents. Among them, Derk Pereboom (2001, 2009) and Tamler Sommers (2007, 2012) most forcefully argue against this conception of (...) love. However, in this paper, I plan to defend the claim that there is an essential connection between love and moral responsibility, a thesis I will call love internalism. To begin, I will specify the content and scope of love internalism, and consider ways in which other theorists have attempted to motivate it. I will then consider the various arguments that Pereboom and Sommers advance against love internalism. These arguments, it seems to me, offer us powerful reasons to reject several of the ways in which philosophers have tried to connect moral responsibility to love. Consequently, in light of these criticisms, I will further precisify the content of love internalism. And as we will see, love internalism (as I argue for it) is immune to Pereboom’s and Sommers’ criticisms. Moreover, when its content is sufficiently clarified, love internalism can serve as a plausible premise in an anti-skeptical argument. I thus conclude by arguing that this suitably reformulated statement of love internalism offers a significant challenge to moral responsibility skepticism of the sort Pereboom and Sommers endorse. (shrink)

Political liberals, following Rawls, believe that justice should be ‘political’ rather than ‘metaphysical.’ In other words, a conception of justice ought to be freestanding from first-order moral and metaethical views. The reason for this is to ensure that the state’s coercion be justified to citizens in terms that meet political liberalism’s principle of legitimacy. I suggest that privileging a political conception of justice involves costs—such as forgoing the opportunity for political theory to learn from other areas of philosophy. I argue (...) that it is not clear that it provides any benefit in return. Whether a political conception of justice more adequately satisfies the liberal principle of legitimacy than a metaphysical conception of justice is an open question. To show this, I describe three ways in which political conceptions of justice have been developed within the literature. I then argue that while each might be helpful in finding reasons that reasonable citizens can accept, all face challenges in satisfying the liberal principle of legitimacy. Political conceptions of justice confront the same set of justificatory problems as ‘metaphysical’ conceptions. The question of whether a political conception is preferable should receive greater scrutiny. (shrink)

Proponents of the legalization of assisted suicide often appeal to our supposed right to "die with dignity" to defend their case. I examine and assess different notions of "dignity" that are operating in many arguments for the legalization of assisted suicide, and I find them all to be deficient. I then consider an alternative conception of dignity that is based on Aristotle's conception of the conditions on the best life. I conclude that, while such a conception of dignity fits best (...) with our intuitions about the conditions under which a life has dignity, it supports the legalization of assisted suicide only under very limited circumstances. (shrink)

This book offers a solution to the ancient philosophical problem regarding the nature and the justification of morality. The importance of this subject matter is obvious, not merely as an abstract philosophical problem, but perhaps even more as a practical challenge, regarding the way we ought to live our lives: the values that ought to direct us, and the ends that we ought to pursue. -/- In the course of this inquiry, a wide array of philosophical topics is explored: the (...) nature of intentional action, and the role played by reason and desires in agency; the question of the final end of agency – better known in ancient terminology as the question of the purpose of life, and in modern terms as the question of the meaning of life; the nature of moral obligations and their rational justification; the challenge posed by determinism for the freedom of the will, with its implications on fatalism and moral responsibility; and normative questions regarding the value of life. (shrink)

The article examines the statements made by Immanuel Kant with reference to medicine as well as the impact of his philosophy on medicine. It describes the initial reaction of Kantian philosophy on medicine in the late 18th and early 19th century and its influence in the late 20th century.

In recent years, debates about euthanasia and assisted suicide have increased to the point that now, many people defend the recognition of the right to die, the right for people to decide upon the end of their life. Consistently, advocates fight to legalise practices such as euthanasia to guarantee patients’ possibility to die when they request it. In this paper, I review two of the strongest arguments invoked by proponents of physician-assisted suicide: the argument for compassion and the argument for (...) dignity. The focus of this paper is to propose a review of these arguments through the lens of virtue ethics to inform the debate on physician-assisted suicide and question the relevance of such arguments for the legalisation of that right that would greatly ease the possibilities to end the life of a patient asking for it. (shrink)

ABSTRACT Over the past few decades the concept of (human) dignity has deeply pervaded medical ethics. Appeals to dignity, however, are often unclear. As a result some prefer to eliminate the concept from medical ethics, whereas others try to render it useful in this context. We think that appeals to dignity in medical ethics can be clarified by considering the concept from an historical perspective. Firstly, on the basis of historical texts we propose a framework for defining the concept in (...) medical debates. The framework shows that dignity can occur in a relational, an unconditional, a subjective and a Kantian form. Interestingly, all forms relate to one concept since they have four features in common: dignity refers, in a restricted sense, to the ‘special status of human beings’; it is based on essential human characteristics; the subject of dignity should live up to it; and it is a vulnerable concept, it can be lost or violated. We argue that being explicit about the meaning of dignity will prevent dignity from becoming a conversation‐stopper in moral debate. Secondly, an historical perspective on dignity shows that it is not yet time to dispose of dignity in medical ethics. At least Kantian and relational dignity can be made useful in medical ethics. (shrink)

This article traces the history of the concept of dignity in Western thought, arguing that it became a formal Catholic theological concept only in the late nineteenth century. Three uses of the word are distinguished: intrinsic, attributed, and inflorescent dignity, of which, it is argued, the intrinsic conception is foundational. The moral norms associated with respect for intrinsic dignity are discussed briefly. The scriptural and theological bases for adopting the concept of dignity as a Christian idea are elucidated. The article (...) concludes by discussing the relevance of this concept of dignity to the spiritual and ethical care of the dying. (shrink)

Respect for autonomy is typically considered a key reason for allowing physician assisted suicide and euthanasia. However, several recent papers have claimed this to be grounded in a misconception of the normative relevance of autonomy. It has been argued that autonomy is properly conceived of as a value, and that this makes assisted suicide as well as euthanasia wrong, since they destroy the autonomy of the patient. This paper evaluates this line of reasoning by investigating the conception of valuable autonomy. (...) Starting off from the current debate in end-of-life care, two different interpretations of how autonomy is valuable is discussed. According to one interpretation, autonomy is a personal prudential value, which may provide a reason why euthanasia and assisted suicide might be against a patient’s best interests. According to a second interpretation, inspired by Kantian ethics, being autonomous is unconditionally valuable, which may imply a duty to preserve autonomy. We argue that both lines of reasoning have limitations when it comes to situations relevant for end-of life care. It is concluded that neither way of reasoning can be used to show that assisted suicide or euthanasia always is impermissible. (shrink)

In a recent article, Albertsen both elaboratesthe best option argument for regulated marketsand levels a justice-based objection to kidney sales. In the present article, I show that Albertsen has crucially misunderstood the best option argument. It is not a defence of kidney sales, as Albertsen claims. It is a reply to an objection. The objection, perennial in the debate, opposes kidney sales on the grounds that sellers would be harmed. The best option argument—proving that prohibitions tend to set back the (...) interests of those denied their preferred option—shows this thinking to be confused. If sound, the best option argument dramatically undercuts any attempt to oppose a market citing would-be sellers’ interests. (shrink)

ZusammenfassungIm Blick auf ein Recht auf assistierten Suizid ist nicht nur umstritten, ob es ein solches Recht gibt, es ist auch umstritten, worauf ein solches Recht denn ein Recht wäre. Der vorliegende Artikel versucht deutlich zu machen, dass das, worum es in dieser Diskussion um den selbstbestimmten Suizid geht, die Frage ist, was Entscheidungen von Menschen achtungswürdig macht. Der Artikel plädiert für eine Idee von Achtungswürdigkeit, für welche die selbstbestimmte Ausübung von Rechten über sich selbst leitend ist, eine Idee, die (...) auch in unserer Rechtspraxis wirksam ist. Dabei legen achtungswürdige Entscheidungen fest, was getan werden darf, nicht aber was getan werden soll. (shrink)

Many theories of social justice maintain that concern for the social bases of self-respect grounds demanding requirements of political and economic equality, as self-respect is supposed to be dependent on continuous just recognition by others. This paper argues that such views miss an important feature of self-respect, which accounts for much of its value: self-respect is a capacity for self-orientation that is robust under adversity. This does not mean that there are no social bases of self-respect that such theories ought (...) to incorporate. It means that they are different: they consist of the motivational and epistemic resources needed to develop and maintain such robustness. (shrink)

ABSTRACTThis report on end‐of‐life decision‐making in Canada was produced by an international expert panel and commissioned by the Royal Society of Canada. It consists of five chapters.Chapter 1 reviews what is known about end‐of‐life care and opinions about assisted dying in Canada.Chapter 2 reviews the legal status quo in Canada with regard to various forms of assisted death.Chapter 3 reviews ethical issues pertaining to assisted death. The analysis is grounded in core values central to Canada's constitutional order.Chapter 4 reviews the (...) experiences had in a number of jurisdictions that have decriminalized or recently reviewed assisted dying in some shape or form.Chapter 5 provides recommendations with regard to the provision of palliative care in Canada, as well as recommendations for reform with respect to the various forms of assisted death covered in this document. (shrink)

Moral philosophy is often said to be about what we owe to each other. Do we owe anything to ourselves?

In this open access book, Timothy Aylsworth and Clinton Castro draw on the deep well of Kantian ethics to argue that we have moral duties, both to ourselves and to others, to protect our autonomy from the threat posed by the problematic use of technology. The problematic use of technologies like smartphones threatens our autonomy in a variety of ways, and critics have only begun to appreciate the vast scope of this problem. In the last decade, we have seen a (...) flurry of books making “self-help” arguments about how we could live happier, more fulfilling lives if we were less addicted to our phones. But none of these authors see this issue as one involving a moral duty to protect our autonomy. (shrink)

While suicide is typically associated with personal despair, people do sometimes kill themselves in the hope or expectation that their death will advance a political cause by way of its impact on the conscience of others, or in extreme cases simply as an expression of protest against a status quo felt to be unjust. Paradigm cases of such protest suicide may be public acts of self-immolation. This chapter distinguishes between instrumental and expressive protest suicide, examines the possible motivations behind them, (...) their possible moral justification, and their potential contribution to the meaning of the suicide’s life. It argues that when the value of the aim pursued by way of instrumental suicide is proportionate, killing oneself promotes it sufficiently, and other morally acceptable options are exhausted, instrumental protest suicide can be morally permissible and consistent with human dignity. It can even be an admirable act of self-sacrifice, provided that the agent’s motivations are suitable. Some of the standard moral objections to suicide don’t apply to such cases. But protest suicide remains morally risky, because one might be mistaken about the worth of one’s cause or the availability of alternatives, and because even these extreme acts typically have limited effect. (shrink)

As persons, beings with a capacity for autonomy, we face a certain practical task in living out our lives. At any given period we find ourselves with many desires or preferences, yet we have limited resources, and so we cannot satisfy them all. Our limited resources include insufficient economic means, of course; few of us have either the funds or the material provisions to obtain or pursue all that we might like. More significantly, though, we are limited to a single (...) life and one of finite duration. We also age, and pursuits that were possible at earlier points within a life may become impossible at later stages; we thus encounter not only an ultimate time limit but episodic limits as well. Because we must live our lives with limited resources—material and temporal—we are pressed to choose among and to order our preferences. Without some selection and ordering, few if any of them would be satisfied, and we would be unable to live lives that are recognizably good at all. Moreover, we would be unable to function well as the autonomous beings that we are. Our practical task then is to form a coherent, stable, and attractive ordering of aims—to develop a conception of our good. (shrink)

In his critique of egoism as a doctrine of ends, G. E. Moore famously challenges the idea that something can be someone. Donald Regan has recently revived and developed the Moorean challenge, making explicit its implications for the very idea of individual welfare. If the Moorean is right, there is no distinct, normative property good for, and so no plausible objectivism about ethics could be welfarist. In this essay, I undertake to address the Moorean challenge, clarifying our theoretical alternatives so (...) that we may better decide what to admit into our moral ontology and better assess what may be at stake in whether objectivists treat good or good for (or neither) as fundamental. I compare the Moorean and welfarist pictures of value, providing an account of the form and function of good for. According to this account expresses a distinct relational value that has its source in the value of persons. Good for value is thus a form of extrinsic value that provides agent-neutral reasons for action, and it plays a pervasive normative role in regulating child rearing, guiding individual life choices, and shaping social policy formation. (shrink)

Resumen Es muy conocida la opinión de Kant en relación con la inmoralidad del suicidio. De ahí que, muchos autores lo consideren como un prohibicionista absoluto. Sin embargo, no hay hasta el momento un análisis puntual sobre la definición metafísica-conceptual del suicidio en la teoría kantiana. En este artículo propongo entender el suicidio en Kant como una muerte física, total, autorreferencial, voluntaria e inmoral. Esta definición contrastará con la privación de la vida, la cual no implica inmoralidad. Al ser voluntarios, (...) tanto la privación de la vida, como el suicidio son actos racionales y entendibles a partir de las máximas de acción. La inmoralidad del suicidio sólo surgirá al considerar la primacía de las razones morales por encima de razones no morales.It is common knowledge theposition of Kant regarding the immorality of suicide. Several authors attribute him an absolutist-forbidden criterion. Nerveless, there is no extended analysis about the metaphysical-conceptual definition of suicide in Kantian theory. In this paper I hold that suicide in Kant can be defined asphysical death, full, self-referential, voluntary, and immoral. This definition conflicts with the definition of deprivation of life which is not immoral. As voluntarily acts, both suicide and deprivation of life are rational acts that can be understood as maxims of action. The immorality property of suicide is due to the primacy of moral over non-moral reasons. (shrink)

The purpose of this paper is to identify a kind of discrimination that has hitherto gone unrecognised. ‘Terminalism’ is discrimination against the dying, or treating the terminally ill worse than they would expect to be treated if they were not dying. I provide four examples from healthcare settings of this kind of discrimination: hospice eligibility requirements, allocation protocols for scarce medical resources, right to try laws and right to die laws. I conclude by offering some reflections on why discrimination against (...) the dying has been hard to identify, how it differs from ageism and ableism, and its significance for end-of-life care. (shrink)

Personal autonomy is often lauded as a key value in contemporary Western bioethics. Though the claim that there is an important relationship between autonomy and rationality is often treated as uncontroversial in this sphere, there is also considerable disagreement about how we should cash out the relationship. In particular, it is unclear whether a rationalist view of autonomy can be compatible with legal judgments that enshrine a patient's right to refuse medical treatment, regardless of whether the reasons underpinning the choice (...) are known and rational, or indeed whether they even exist. Jonathan Pugh brings recent philosophical work on the nature of rationality to bear on the question of how we should understand personal autonomy in contemporary bioethics. In doing so, he develops a new framework for thinking about the concept of autonomy, one that is grounded in an understanding of the different roles that rational beliefs and rational desires have to play in it. Pugh's account allows for a deeper understanding of d the relationship between our freedom to act and our capacity to decide autonomously. His rationalist perspective is contrasted with other prominent accounts of autonomy in bioethics, and the revisionary implications it has for practical questions in biomedicine are also outlined. (shrink)

In this short paper I will discuss the ambiguous and, even, controversial term ‘right to die’ in the context of the euthanasia debate and, in particular, in the case of passive euthanasia. First I will present the major objections towards the moral legitimacy of a right to die, most of which I also endorse myself; then I will investigate whether the right to die could acquire adequate moral justification in the case of passive euthanasia. In the light of the Kantian (...) tradition I will argue that since rights are understood as based upon duties, the right to die should also presuppose a corresponding duty, which to me could be either an imperfect, solidarity-related duty, or an autonomy-related one, at least as far as the unwanted prolongation of life is concerned. I will conclude with the view that the right to die could actually be considered a legitimate one in the case of passive euthanasia, when the application of life-supporting techniques is against the wishes and the best interests of the patient. (shrink)

A wide body of psychological research corroborates the claim that whether one’s life is (or will be) meaningful appears relevant to whether it is rational to continue living. This article advances conceptions of life’s meaningfulness and of suicidal choice with an eye to ascertaining how the former might provide justificatory reasons relevant to the latter. Drawing upon the recent theory of meaningfulness defended by Cheshire Calhoun, the decision to engage in suicide can be understood as a choice related to life’s (...) meaningfulness insofar as an individual can see no point in investing her agency in her anticipated future. These meaning-based reasons relevant to suicidal choice either cannot be reduced to the reasons of well-being that philosophers have typically used to analyse suicide decisions or at least forms a distinct class of reasons within those that contribute to well-being. (shrink)

That Kant’s moral thought is invoked by both advocates and opponents of a right to assisted dying attests to both the allure and and the elusiveness of Kant’s moral thought. In particular, the theses that individuals have a right to a ‘death with dignity’ and that assisting someone to die contravenes her dignity appear to gesture at one of Kant’s signature moral notions, dignity. The purposes of this article are to outline Kant’s understanding of dignity and its implications for the (...) ethics of assisted dying. According to Kant, that which has dignity must be treated as an end in itself and may not permissibly be exchanged for that which merely has price. Kant’s reasoning thus seems to preclude acts of self-killing, including voluntary assisted dying, that rest on individual self-interest, since a person’s interests merely have price. However, a recognizably Kantian view of dignity can permit assisted dying under two sets of circumstances: First, it can be permissible for agents who anticipate a degradation of their rational agency due to conditions such as dementia to direct others to end their lives once sufficiently demented. In so doing, such agents in effect exercise a right to impose obligations on others regarding how their bodies, which will at some future point no longer be the vessels of their rational agency, are to be disposed of. Second, Kant errs in supposing that our dignity can stem solely from our moral personality, i.e., from our capacity to abide by universalizable moral principles. Rather, complete dignity also requires the capacity for setting discretionary ends and the means to those ends, i.e., the dignity of humanity. Individuals with prolonged and intense depression, in severe pain, or with serious disability may lack humanity while retaining their moral personality. In such cases, I propose that their opting to end their lives, with or without the assistance of others, does not amount to exchanging their dignified selves for something which merely has price and is therefore not objectionable on Kantian grounds. (shrink)

Some sacrifices—like giving a kidney or heroically dashing into a burning building—are supererogatory: they are good deeds beyond the call of duty. But if such deeds are really so good, philosophers ask, why shouldn’t morality just require them? The standard answer is that morality recognizes a special role for the pursuit of self-interest, so that everyone may treat themselves as if they were uniquely important. This idea, however, cannot be reconciled with the compelling picture of morality as impartial—the view that (...) we are each anyone’s equal. I propose an alternative Self-Other Symmetric account of our moral freedom: the limits on what morality may demand of us are set by the duties we owe to ourselves. I begin with a defense of the Self-Other Symmetry: the idea that we owe the same duties to ourselves—and have the same rights against ourselves—as any relevantly similar other. Because we are consenting parties to our own actions, I argue, our rights against ourselves do not function like the rights of unwilling others. Instead, they play a permissive function, allowing us to block the demand to give up what is ours. I conclude by uniting, aggravating, and trying to solve some paradoxes of supererogatory permissions, guided by the idea that morality cannot be reduced to a ranking of options from best-to-worst. Rights against oneself are an irreducible second dimension, one that we need if we are to unify rights and supererogation into an impartial moral vision. (shrink)

In The Sources of Normativity and elsewhere, Korsgaard defends a Kantian ethical theory by arguing that valuing anything commits one to valuing humanity as the source of all value. I reconstruct Korsgaard’s influential argument to show how she can resist many of the objections that critics have raised. I also show how the argument fails because, at a crucial point, it begs the question in favor of the value of humanity. It thus fails for internal reasons that do not depend (...) on rejecting Korsgaard’s metaethical constructivism or her conception of rational agency. (shrink)

_ Source: _Page Count 24 Seat belt mandates seem like a paradigmatic case of justified paternalism. Even those who generally object to paternalism often concede that seat belt laws are justified. Against this near-consensus in favor of mandates, I argue that seat belt laws are unjust and public officials should not enforce them. The most plausible exceptions to a principle of anti-paternalism do not justify seat belt mandates. Some argue that seat belt mandates are not paternalistic because unbelted riders are (...) not fully autonomous. Others claim that the decision to ride unbelted harms other people. Yet these attempts to defend seat belt mandates on non-paternalistic grounds cannot overcome the case against seat belt mandates. I therefore conclude that _even_ seat belt mandates are unjust. With this comprehensive case against seat belt mandates, I demonstrate the more general difficulties in justifying any form of coercive paternalism. (shrink)

The current debate on recreational drug policy is roughly a contest between prohibition advocates and legalization advocates. This paper offers a third alternative that is a compromise between those two. The centralized-use compromise can secure the autonomy interests that are important to defenders of legalization, and it can prevent harms to others that are the focus of prohibition arguments. The centralized-use compromise also offers a possible way to reduce the black market while also reducing the rate of addiction and the (...) associated debasing harms to self. (shrink)

Recent work in the psychology of happiness has led some to conclude that we are unreliable assessors of our lives and that skepticism about whether we are happy is a genuine possibility worth taking very seriously. I argue that such claims, if true, have worrisome implications for procreation. In particular, they show that skepticism about whether many if not most people are well positioned to create persons is a genuine possibility worth taking very seriously. This skeptical worry should not be (...) confused with a related but much stronger version of the argument, which says that all human lives are very bad and not worth starting. I criticize the latter stance, but take seriously the former stance and hope it can be answered in future work. (shrink)

Kant has famously argued that human beings or persons, in virtue of their capacity for rational and autonomous choice and agency, possess dignity, which is an intrinsic, final, unconditional, inviolable, incomparable and irreplaceable value. This value, wherever found, commands respect and imposes rather strict moral constraints on our deliberations, intentions and actions. This paper deals with the question of whether, as some Kantians have recently argued, certain types of (physician-assisted) suicide and active euthanasia, most notably the intentional destruction of the (...) life of a terminally-ill, but rational and autonomous patient in order to prevent certain serious harms, such as enduring or recurring pain or the loss of the meaning in life, from befalling him really are inconsistent with respect for the patient’s human dignity. I focus on two independent, though interrelated explications of the rather vague initial idea that the patient (as well as the doctor), in intending and bringing about his death, treats his person or rational nature merely as a means and so denigrates his dignity: (i) that in doing what he is doing, he does not act for the sake of his person, but for the sake of something else; (ii) that, by trading his person for pain relief, he engages himself in an irrational and hence immoral exchange. After critically discussing some suggestions about how to understand this charge, I eventually find Kantian objections to suicide and (active) euthanasia, based on the idea of human dignity, less than compelling. For all the paper proves, suicide and (active) euthanasia may still be morally impermissible, but then this must be so for some other reason than the one given above. (shrink)

One often hears Catholic and non-Catholic politicians and private citizens claim “I am personally opposed to abortion . . . ” but add that it is morally permissible for others to accept abortion. We consider a Rawlsian defense of this position based on the recognition that one’s opposition to abortion stems from acomprehensive doctrine which is incompatible with Public Reason. We examine a second defense of this position based upon respecting the autonomy of others and a third grounded in the (...) harm to the unwilling mother overriding that to the aborted fetus. We look at a fourth and fifth defense based upon our epistemic ignorance regarding the burdens on others of unwanted pregnancies and the ontological and moral status of embryo. We find most versions of these defenses to be wanting and conclude that only if the proponents of the position are subjectivist about morals, which few are, can they offer a coherent defense. (shrink)

I shall draw on my experience of being an ICU patient to make some practical, ethical, and philosophical points about the care of the critically ill. The recurring theme in this paper is ICU psychosis. I suggest that discharged patients ought to be educated about it; I discuss the obstacles in the way of accurately measuring it; I argue that we must rethink autonomy in light of it; and I suggest that the self disintegrates in the face of it.

The notion of a non-renounceable right is an integral part of recent liberal reconciliatory attempts to justify apparently paternalistic policies, such as compulsory insurance or providing people with certain goods irrespective of their subjective preferences, non-paternalistically. However, non-renounceable rights cannot be justified non-paternalistically. A critical scrutiny of the liberal reconciliatory arguments in question reveals this and points towards a plausible paternalist justification of the policies in question.

Here I pursue two main aims: (1) to articulate and defend a Kantian conception of duties to self, and (2) to explore the ramifications of such duties for the moral justification of paternalism. I conclude that there is a distinctive reason to resent paternalistic intercessions aimed at assisting others in fulfilling their duties to self (or the self-regarding virtues necessary thereunto), based on the fact that the goods realized via their fulfillment are historical, i.e., their value depends on an individual's (...) casual contribution to their fulfillment. (shrink)

Considerations of autonomy and independence, properly understood, support strictly egalitarian provision of necessary medical treatment. If the financially better-off can purchase access to necessary medical treatments that the financially less well-off cannot purchase without help, then their discretionary power to give or to withhold monetary gifts indirectly gives them the power to make life-and-death or sickness-and-health decisions for others. To prevent private citizens from having this objectionable form of power, government must ensure that citizens’ finances do not affect their access (...) to medical treatments that significantly prolong life, relieve suffering, or cure or mitigate disabilities. Government should ensure this even if doing so involves leveling down and even if it is unclear whether egalitarian provision of necessary treatment would provide better care to the poor than a less egalitarian health care system would. (shrink)

In this article I articulate two pairs of theses about the relationship between the right and the good and I sketch an account of morality that systematically vindicates all four theses, despite a nearly universal consensus that they are not all true. In the first half I elucidate and motivate the theses and explain why leading ethical theorists maintain that at least one of them is false; in the second half I present the outlines of an account of the relationship (...) between the right and the good satisfying all four theses. (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)

Hazing is a widespread moral phenomenon that has attracted little theoretical discussion. Here are my purposes are two fold: First, I provide a characterization of hazing that captures the features relevant to analyzing and evaluating hazing from a moral point of view. Hazing is harmful or humiliating transaction between members of a coveted group and an individual seeking membership in said group where the transaction bears no intrinsic relationship to the group’s mission. Second, I provide an analysis of the moral (...) wrongs of hazing that is broadly Kantian in spirit. The wrongfulness of hazing cannot be captured in terms of familiar categories of wrongdoing wherein individuals are treated as mere means (e.g., deception or coercion). However, hazing has no place in Kant’s Kingdom of Ends, for as a form of social interaction, it exploits and endorses an inequality between the hazer and the hazed that is antithetical to the equality of rational worth characteristic of social interaction in the Kingdom of Ends. In addition, hazing amounts to an invitation for a person to trade their humanity or self-respect in exchange for full inclusion in a group or organization. Issuing such an invitation, I claim, violates a Kantian duty to treat others’ humanity as an end in itself, violating a duty not to “give scandal” by tempting others to act in ways they will later have grounds to rationally regret. -/- . (shrink)

McCarthy, Homan, and Rozier (2020) state that the Christian bioethical categories, namely sin, human dignity, and the common good, can shed light on bioethical issues, whereas secular bioethics may...

This is a review essay of Jeff McMahan's recent book The Ethics of Killing : Problems at the Margins of Life. In the first part, I lay out the central features of McMahan's account of the wrongness of killing and its implications for when it is permissible to kill. In the second part of the essay, I argue that we ought not to accept McMahan's rejection of species membership as having any bearing on whether it is permissible to kill a (...) particular individual, as there are ways of understanding its relevance that are more plausible than McMahan allows. (shrink)

There is currently much concern over the use of pharmaceuticals and other biomedical techniques to enhance athletic performance—a practice we might refer to as doping. Many justifications of anti-doping efforts claim that doping involves a serious moral transgression. In this article, I review a number of arguments in support of that claim, but show that they are not conclusive, suggesting that we do not have good reasons for thinking that doping is wrong.

Our ambivalent attitudes toward the notion of ‘a life worth living’ present a philosophical puzzle: Why are we of two minds about the birth of a severely disabled child? Is the child’s life worth living or not worth living? Between these two apparently incompatible evaluative judgments, which is true? If one judgment is true and the other false, what makes us continue to find both evaluations appealing? Indeed, how can we manage to hold these inconsistent judgments simultaneously at all? I (...) critically examine two solutions to this puzzle: the hidden-indexical account and Velleman’s anti-realist account. I propose an alternative explanation which appeals to (a) state-given, as opposed to object-given, reasons for belief and (b) the distinction between belief and acceptance. I argue that (1) the fact that a severely disabled life is not worth living provides object-given reason to believe that that life is not worth living, but (2) after the birth of a severely disabled child, the psychological utility of positive evaluation gives us a state-given reason to believe that that child’s life is worth living, and a reason to accept that, in our relation with the child, her life is worth living. I conclude by drawing a practical lesson about wrongful life suits. (shrink)