ABSTRACT Should surgeons be permitted to amputate healthy limbs if patients request such operations? We argue that if such patients are experiencing significant distress as a consequence of the rare psychological disorder named Body Integrity Identity Disorder (BIID), such operations might be permissible. We examine rival accounts of the origins of the desire for healthy limb amputations and argue that none are as plausible as the BIID hypothesis. We then turn to the moral arguments against such operations, and argue that (...) on the evidence available, none is compelling. BIID sufferers meet reasonable standards for rationality and autonomy: so as long as no other effective treatment for their disorder is available, surgeons ought to be allowed to accede to their requests. (shrink)

Ordinarily, we take moral responsibility to come in degrees. Despite this commonplace, theories of moral responsibility have focused on the minimum threshold conditions under which agents are morally responsible. But this cannot account for our practices of holding agents to be more or less responsible. In this paper we remedy this omission. More specifically, we extend an account of reasons-responsiveness due to John Martin Fischer and Mark Ravizza according to which an agent is morally responsible only if she is appropriately (...) receptive to and reactive to reasons for action. Building on this, we claim that the degree to which an agent is responsible will depend on the degree to which she is able to recognize and react to reasons. To analyze this, we appeal to relations of comparative similarity between possible worlds, arguing that the degree to which an agent is reasons-reactive depends on the nearest possible world in which given sufficient reason to do otherwise, she does so. Similarly, we argue that the degree to which an agent is reasons-receptive will depend on the intelligibility of her patterned recognition of reasons. By extending an account of reasons-responsiveness in these ways, we are able to rationalize our practice of judging people to be more or less responsible. (shrink)

In 1997, a Scottish surgeon by the name of Robert Smith was approached by a man with an unusual request: he wanted his apparently healthy lower left leg amputated. Although details about the case are sketchy, the would-be amputee appears to have desired the amputation on the grounds that his left foot wasn’t part of him – it felt alien. After consultation with psychiatrists, Smith performed the amputation. Two and a half years later, the patient reported that his life had (...) been transformed for the better by the operation [1]. A second patient was also reported as having been satisfied with his amputation [2]. (shrink)

Do fetuses have a right to life in virtue of the fact that they are potential adult human beings? I take the claim that the fetus is a potential adult human being to come to this: if the fetus grows normally there will be an adult human animal that was once the fetus. Does this fact ground a claim to our care and protection? A great deal hangs on the answer to this question. The actual mental and physical capacities of (...) a human fetus are inferior to those of adult creatures generally thought to lack a serious right to life, and the mere fact that a fetus belongs to our species in particular seems morally irrelevant. Consequently, a strong fetal claim to protection rises or falls with the appeal to the fetus's potentiality, for nothing else can justify it. (shrink)

John Fischer and Mark Ravizza defend in this book a painstakingly constructed analysis of what they take to be a core condition of moral responsibility: the notion of guidance control. The volume usefully collects in one place ideas and arguments the authors have previously published in singly or jointly authored works on this and related topics, as well as various refinements to those views and some suggestive discussions that aim to show how their account of guidance control might fit into (...) a more comprehensive account of moral responsibility. (shrink)