Desire-based theories of well-being claim that a person's well-being consists of the satisfaction of her desires. Many of these theories say that well-being consists of the satisfaction of desires that she would have if her desires were "corrected" in various ways. Some versions of this theory claim that the corrections involve having "full information" or being an "ideal observer." I argue that well-being does not depend on what one would desire if she were an “ideal observer.” Rather, it depends on (...) what she would desire if she had as much information as she could have and still maintain her identity as the particular person she is. The paper attempts to spell out this suggestion by constructing a notion of integrity. Roughly, integrity is preserved if one’s most central projects, commitments, and character traits are left in tact. I argue that desire-based theories of well-being should define well-being in terms of the satisfaction of those desires that one would have if one’s epistemic situation were idealized as much as would be consistent with maintaining her integrity. (shrink)

Three pictures of integrity have gained philosophical currency. On the integrated self picture, integrity involves the integration of "parts" of oneself into a whole. On the identity picture, integrity means fidelity to projects and principles constitutive of one's core identity. On the clean hands picture, integrity means maintaining the purity of one's agency, especially in dirty hands situations. I sketch each picture and suggest two general criticisms. First, integrity is reduced to something else with which it is not equivalent--to the (...) conditions of unified agency, to the conditions for continuing as the same self, and to the conditions for having reason to refuse cooperating with evil. Second, integrity is understood as a personal, but not also a social virtue; this limits the analysis of what integrity is and why it is a virtue. In the last section, I suggest a way of understanding integrity as the social virtue of standing before others for what, in one's best judgment, is worth persons' doing. (shrink)

This paper argues that the medical conception of health as absence of disease is a value-free theoretical notion. Its main elements are biological function and statistical normality, in contrast to various other ideas prominent in the literature on health. Apart from universal environmental injuries, diseases are internal states that depress a functional ability below species-typical levels. Health as freedom from disease is then statistical normality of function, i.e., the ability to perform all typical physiological functions with at least typical efficiency. (...) This conception of health is as value-free as statements of biological function. The view that health is essentially value-laden, held by most writers on the topic, seems to have one of two sources: an assumption that health judgments must be practical judgments about the treatment of patients, or a commitment to "positive" health beyond the absence of disease. I suggest that the assumption is mistaken, the commitment possibly misdescribed. (shrink)

It is my view that one essential difference between persons and other creatures is to be found in the structure of a person's will. Besides wanting and choosing and being moved to do this or that, men may also want to have certain desires and motives. They are capable of wanting to be different, in their preferences and purposes, from what they are. Many animals appear to have the capacity for what I shall call "first-order desires" or "desires of the (...) first order," which are simply desires to do or not to do one thing or another. No animal other than man, however, appears to have the capacity for reflective self-evaluation that is manifested in the formation of second-order desires. (shrink)

This chapter contains sections titled: The Moral Foundation The Legal Requirement for Consent in Therapeutic Settings The Exceptions References.

Book reviewed in this article: Principles of Biomedical Ethics. By Tom L. Beauchamp and James F. Childress.

Book reviewed in this article: Bioethics and Secular Humanism: The Search for a Common Morality. By H. Tristram Engelhardt, Jr.

ABSTRACT It is accepted that treatment of previously competent, now incompetent patients can be limited if that is what the patient would desire, if she were now competent. Expressed past preferences or an advance directive are often taken to constitute sufficient evidence of what a patient would now desire. I distinguish between desires and rational desires. I argue that for a desire to be an expression of a person's autonomy, it must be or satisfy that person's rational desires. A person (...) rationally desires a course of action if that person desires it while being in possession of all available relevant facts, without committing relevant error of logic, and “vividly imagining” what its consequences would be like for her. I argue that some competent, expressed desires obstruct autonomy. I show that several psychological mechanisms operate to prevent a person rationally evaluating what future life in a disabled state would be like. Rational evaluation is difficult. However, treatment limitation, if it is to respect autonomy, must be in accord with a patient's rational desires, and not merely her expressed desires. I illustrate the implications of these arguments for the use of advance directives and for the treatment of competent patients. (shrink)

This important new book develops a new concept of autonomy. The notion of autonomy has emerged as central to contemporary moral and political philosophy, particularly in the area of applied ethics. professor Dworkin examines the nature and value of autonomy and uses the concept to analyse various practical moral issues such as proxy consent in the medical context, paternalism, and entrapment by law enforcement officials.

This is the earliest critical discussion in the context of modern/contemporary philosophy in the analytical tradition arguing that somebody with a reasonably stable character and the company of the right people would be able to enjoy eternity.

"A book from the Park Ridge Center for the Study of Health, Faith, and Ethics." Includes bibliographical references (p. [141]-195) and index.

This book examines the centrality of integrity in relation to a variety of philosophical and psychological concerns that impinge upon the ethical life.

In this marvellous book, Raimond Gaita discusses ideas about love and hatred, good and evil, guilt and forgiveness. Moving, wise and inspiring, A Common Humanity explores personal, political and philosophical ideas about the kind of society and the sort of public conversation we might have in the twenty-first century. 'Raimond Gaita's insights are original and his prose is as eloquent as it is affecting.' Economist, Books of the Year, 2000.

Despite the current popularity of what is commonly referred to as an `ethics of care', no one has yet undertaken a systematic philosophical study of `care' itself. In this book, Jeffrey Blustein presents the first such study, offering a detailed exploration of human `care' in its various guises: concern for and commitment to individuals, ideals, and causes. Blustein focuses on the nature and value of personal integrity and intimacy, and on the questions they raise for traditional moral theory.