Patient and citizen participation is now regarded as central to the promotion of sustainable health and health care. Involvement efforts create and encounter many diverse ethical challenges that have the potential to enhance or undermine their success. This article examines different expressions of patient and citizen participation and the support health ethics offers. It is contended that despite its prominence and the link between patient empowerment and autonomy, traditional bioethics is insufficient to guide participation efforts. In addition, the turn to (...) a “social paradigm” of ethics in examinations of biotechnologies and public health does not provide an account of values that is commensurable with the pervasive autonomy paradigm. This exacerbates rather than eases tensions for patients and citizens endeavoring to engage with health. Citizen and patient participation must have a significant influence on the way we do health ethics if its potential is to be fulfilled. (shrink)

This article is about the implications of a conciliatory view about the epistemology of peer disagreement for our moral beliefs. Many have endorsed a conciliatory view about the epistemology of peer disagreement according to which if we find ourselves in a disagreement about some matter with another whom we should judge to be our epistemic peer on that matter, we must revise our judgment about that matter. This article focuses on three issues about the implications of conciliationism for our moral (...) beliefs. The first is whether there is an asymmetry between the implications of conciliationism for the epistemic status of our moral beliefs and the implications of conciliationism for the epistemic status of our non-moral beliefs; for instance, some have argued that conciliationism leads to epistemological moral skepticism but not to epistemological nonmoral skepticism. The second is what the implications of conciliationism are for the epistemic status of particular moral beliefs. The third is whether conciliationism's impact on the epistemic status of our moral beliefs has practical implications. (shrink)

Should the existence of moral disagreement reduce one’s confidence in one’s moral judgments? Many have claimed that it should not. They claim that we should be morally self-sufficient: that one’s moral judgment and moral confidence ought to be determined entirely one’s own reasoning. Others’ moral beliefs ought not impact one’s own in any way. I claim that moral self-sufficiency is wrong. Moral self-sufficiency ignores the degree to which moral judgment is a fallible cognitive process like all the rest. In this (...) paper, I take up two possible routes to moral self-sufficiency.First, I consider Robert Paul Wolff’s argument that an autonomous being is required to act from his own reasoning. Does Wolff’s argument yield moral self-sufficiency? Wolff’s argument does forbid unthinking obedience. But it does not forbid guidance: the use of moral testimony to glean evidence about nonmoral states of affairs. An agent can use the existence of agreement or disagreement as evidence concerning the reliability of their own cognitive abilities, which is entirely nonmoral information. Corroboration and discorroboration yields nonmoral evidence, and no reasonable theory of autonomy can forbid the use of nonmoral evidence. In fact, by using others to check on my own cognitive functionality, an agent is reasoning better and is thereby more autonomous.Second, I consider Philip Nickel’s requirement that moral judgment proceed from personal understanding. I argue that the requirement of understanding does forbid unthinking obedience, but not discorroboration. When an agent reasons morally, and then reduces confidence in their judgments through discorroboration, they are in full contact with the moral reasons, and with the epistemic reasons. Discorroboration yields more understanding, not less. (shrink)

Striving to boldly redirect the philosophy of science, this book by renowned philosopher Philip Kitcher examines the heated debate surrounding the role of science in shaping our lives. Kitcher explores the sharp divide between those who believe that the pursuit of scientific knowledge is always valuable and necessary--the purists--and those who believe that it invariably serves the interests of people in positions of power. In a daring turn, he rejects both perspectives, working out a more realistic image of the sciences--one (...) that allows for the possibility of scientific truth, but nonetheless permits social consensus to determine which avenues to investigate. He then proposes a democratic and deliberative framework for responsible scientists to follow. Controversial, powerful, yet engaging, this volume will appeal to a wide range of readers. Kitcher's nuanced analysis and authorititative conclusion will interest countless scientists as well as all readers of science--scholars and laypersons alike. (shrink)

Recent research has relied on trolley-type sacrificial moral dilemmas to study utilitarian versus nonutili- tarian modes of moral decision-making. This research has generated important insights into people’s attitudes toward instrumental harm—that is, the sacrifice of an individual to save a greater number. But this approach also has serious limitations. Most notably, it ignores the positive, altruistic core of utilitarianism, which is characterized by impartial concern for the well-being of everyone, whether near or far. Here, we develop, refine, and validate a (...) new scale—the Oxford Utilitarianism Scale—to dissociate individual differences in the ‘negative’ (permissive attitude toward instrumental harm) and ‘positive’ (impartial concern for the greater good) dimensions of utilitarian thinking as manifested in the general population. We show that these are two independent dimensions of proto-utilitarian tendencies in the lay population, each exhibiting a distinct psychological profile. Empathic concern, identification with the whole of humanity, and concern for future generations were positively associated with impartial beneficence but negatively associated with instrumental harm; and although instrumental harm was associated with subclinical psychopathy, impartial beneficence was associated with higher religiosity. Importantly, although these two dimensions were independent in the lay population, they were closely associated in a sample of moral philosophers. Acknowledging this dissociation between the instrumental harm and impartial beneficence components of utilitarian thinking in ordinary people can clarify existing debates about the nature of moral psychology and its relation to moral philosophy as well as generate fruitful avenues for further research. (shrink)

The moral philosophy of the first half of the twentieth century, at least in the English-speaking part of the world, has been largely devoted to problems of an ontological or epistemological nature. This concentration of effort by many acute analytical minds has not produced any general agreement with respect to the solution of these problems; it seems likely, on the contrary, that the wealth of proposed solutions, each making some claim to plausibility, has resulted in greater disagreement than ever before, (...) and in some cases disagreement about issues so fundamental that certain schools of thought now find it unrewarding, if not impossible, to communicate with one another. Moral philosophers of almost all schools seem to agree, however, that no major possibility has been neglected during this period, and that every proposed solution which can be adjudged at all plausible has been examined with considerable thoroughness. It is now common practice, for example, for the authors of books on moral philosophy to introduce their own theories by what purports to be a classification and review of all \emph{possible} solutions to the basic problems of analysis; and in many cases, indeed, the primary defense of the author's own position seems to consist in the negative argument that his own position cannot fail to be correct because none of the others which he has mentioned is satisfactory. (shrink)