Answers to the questions of what justifies conscientious objection in medicine in general and which specific objections should be respected have proven to be elusive. In this paper, I develop a new framework for conscientious objection in medicine that is based on the idea that conscience can express true moral claims. I draw on one of the historical roots, found in Adam Smith’s impartial spectator account, of the idea that an agent’s conscience can determine the correct moral norms, even if (...) the agent’s society has endorsed different norms. In particular, I argue that when a medical professional is reasoning from the standpoint of an impartial spectator, his or her claims of conscience are true, or at least approximate moral truth to the greatest degree possible for creatures like us, and should thus be respected. In addition to providing a justification for conscientious objection in medicine by appealing to the potential truth of the objection, the account advances the debate regarding the integrity and toleration justifications for conscientious objection, since the standard of the impartial spectator specifies the boundaries of legitimate appeals to moral integrity and toleration. The impartial spectator also provides a standpoint of shared deliberation and public reasons, from which a conscientious objector can make their case in terms that other people who adopt this standpoint can and should accept, thus offering a standard fitting to liberal democracies. (shrink)

One can feel guilty without thinking that one actually is guilty of moral wrongdoing. For example, one can feel guilty about eating an ice cream or skipping aerobics, even if one doesn't take a moralistic view of self-indulgence. And one can feel guilty about things that aren't one's doing at all, as in the case of survivor's guilt about being spared some catastrophe suffered by others. Guilt without perceived wrongdoing may of course be irrational, but I think it is sometimes (...) rational, and I want to explore how it can be. (shrink)

I offer an account of how ideals motivate us. My account suggests that although emulating an ideal is often rational, it can lead us to do irrational things. * This is the third in a series of four papers on narrative self-conceptions and their role in moral motivation. In the first paper, “The Self as Narrator” (to appear in Autonomy and the Challenges to Liberalism: New Essays, ed. Joel Anderson and John Christman), I explore the motivational role of narrative self-conceptions, (...) drawing on Daniel Dennett’s notion of the self as a “center of narrative gravity”. In the second paper, “Willing the Law” (in Practical Conflicts, ed. Monika Betzler and Peter Baumann [Cambridge: Cambridge University Press, forthcoming]), I explore the role of selfconceptions in Kantian “conflicts in the will”, drawing on Christine Korsgaard’s notion of “practical identities”. In a fourth paper, “A Sense of Self” (ms), I explore the role of narrative self-con-ceptions in Kantian “conflicts in conception”, drawing on the work of Thomas Nagel and John Perry on the self. (shrink)

How does shame differ from guilt? Empirical psychology has recently offered distinct and seemingly incompatible answers to this question. This article brings together four prominent answers into a cohesive whole. These are that shame differs from guilt in being a social emotion; shame, in contrast to guilt, affects the whole self; shame is linked with ideals, whereas guilt concerns prohibitions and shame is oriented towards the self, guilt towards others. After presenting the relevant empirical evidence, we defend specific interpretations of (...) each of these answers and argue that they are related to four different dimensions of the emotions. This not only allows us to overcome the conclusion that the above criteria are either unrelated or conflicting with one another, it also allows us to tell apart what is constitutive from what is typical of them. (shrink)

Do moral properties figure in the best explanatory account of the world? According to a popular realist argument, if they do, then they earn their ontological rights, for only properties that figure in the best explanation of experience are real properties. Although this realist strategy has been widely influential—not just in metaethics, but also in philosophy of mind and philosophy of science—no one has actually made the case that moral realism requires: namely, that moral facts really will figure in the (...) best explanatory picture of the world. This issue may have been neglected in part because the influential dialectic on moral explanations between philosophers Gilbert Harman and Nicholas Sturgeon has focused debate on whether moral facts figure in relevant explanations. Yet as others have noted, explanatory relevance is irrelevant when it comes to realism: after all, according to the popular realist argument, it is inference to the best explanation of experience that is supposed to confer ontological rights. I propose to ask, then, the relevant question about moral explanations: should we think that moral properties will figure in the best explanatory account of the world? (shrink)