A number of health care professionals assert a right to be exempt from performing some actions currently designated as part of their standard professional responsibilities. Most advocates claim that they should be excused from these duties simply by averring that they are conscientiously opposed to performing them. They believe that they need not explain or justify their decisions to anyone; nor should they suffer any undesirable consequences of such refusal. Those who claim this right err by blurring or conflating three (...) issues about the nature and role of conscience, and its significance in determining what other people should permit them to do (or not do). Many who criticize those asserting an exemption conflate the same questions and blur the same distinctions, if not expressly, by failing to acknowledge that sometimes a morally serious agent should not do what she might otherwise be expected to do. Neither side seems to acknowledge that in some cases both claims are true: a conscientious professional should not do her professional duty AND others need not permit or excuse her refusal. I identify these conflations and specify conditions in which a professional might reasonably refuse to do what she is required to do. Then I identify conditions in which the public should exempt a professional from some of her responsibilities. I argue that professionals should refuse far less often than most advocates do . . . and that they should be even less frequently exempt for that failure. Finally, there are compelling reasons why we could not implement a consistent moral policy giving advocates what they want, likely not even in qualified form. (shrink)

History teems with instances of “man’s inhumanity to man.” Some wrongs are perpetrated by individuals; most ghastly evils were committed by groups or nations. Other horrific evils were established and sustained by legal systems and supported by cultural mores. This demands explanation. I describe and evaluate four common explanations of evil before discussing more mundane and psychologically informed explanations of wrong-doing. Examining these latter forms helps isolate an additional factor which, if acknowledged, empowers us to diagnose, cope with, and prevent (...) many ordinary and serious moral wrongs. In so doing, I do not assert that the explanations of first call are never appropriate. I claim only that their role is smaller than many of us reflexively suppose, and that the role of the later feature I identify is more significant, in part, because it supports and amplifies the more mundane and psychologically informed factors prompting wrong-doing. (shrink)

To varying degrees, many of us think we are “self-made.” Some explicitly state—while others imply—that our accomplishments resulted (almost) entirely from our intelligence, ingenuity, and hard work There is qualified truth in this supposition, even although it is commonly overstated. Others think they are pawns in the chess game of life. However, although some have less control than those more privileged, few are devoid of control. This tandem of judgments is akin to our propensity to make asymmetrical judgments about our (...) actions (and those we like) relative to judgments of those we dislike. We often blame our failures on something other than our ill-advised choices, limited abilities, or lack of persistence. If we receive a poor grade, do not land a desired job or coveted promotion, or are spurned by a potential lover, we often blame another, bad luck, or unfortunate circumstances. We scrounge for ways to excuse or mitigate our responsibility when things turn out badly, while taking credit when actions turn out well. We do not do same for negative traits or actions of those we dislike. The phenomenon I discuss in this paper, however, is more pervasive than blame-deflection or inappropriate pride. Even some who think the notion of the “self-made person” borders on a straw person, also think that we have considerable direct control of our lives. We do not. Although we are not leaves tossed by winds of circumstance, we are shaped by complex causal chains largely beyond our control. After seeing this broadly and in detail, we understand the limits on control and why it is not direct By understanding that and how we are shaped by cultures, governments, businesses, and others, we can isolate levers that help us maximize control we do have. (shrink)