The relatively new practice of continuous sedation at the end of life (CS) is increasingly being debated in the clinical and ethical literature. This practice received much attention when a U.S. Supreme Court ruling noted that the availability of CS made legalization of physician-assisted suicide (PAS) unnecessary, as CS could alleviate even the most severe suffering. This view has been widely adopted. In this article, we perform an in-depth analysis of four versions of this ?argument of preferable alternative.? Our goal (...) is to determine the extent to which CS can be considered to be an alternative to PAS and to identify the grounds, if any, on which CS may be ethically preferable to PAS. (shrink)

In this book, T. M. Scanlon offers new answers to these questions, as they apply to the central part of morality that concerns what we owe to each other.

Is morality rational? In this book Gauthier argues that moral principles are principles of rational choice. He proposes a principle whereby choice is made on an agreed basis of cooperation, rather than according to what would give an individual the greatest expectation of value. He shows that such a principle not only ensures mutual benefit and fairness, thus satisfying the standards of morality, but also that each person may actually expect greater utility by adhering to morality, even though the choice (...) did not have that end primarily in view. In resolving what may appear to be a paradox, the author establishes morals on the firm foundation of reason. Gauthier's argument includes an account of value, linking it to preference and utility; a discussion of the curcumstances in which morality is unnecessary; and an application of morals by agreement to relations between peoples at different levels of development and different generations. Finally, he reflects on the assumptions about individuality and community made by his account of rationality and morality. (shrink)

Health and Social Justice (Ruger 2009a) developed the ?health capability paradigm,? a conception of justice and health in domestic societies. This idea undergirds an alternative framework of social cooperation called ?shared health governance? (SHG). SHG puts forth a set of moral responsibilities, motivational aspirations, and institutional arrangements, and apportions roles for implementation in striving for health justice. This article develops further the SHG framework and explains its importance and implications for governing health domestically.