Decisions about life and death: Assessing the Law Reform Commission and the Presidential Commission Reports

This paper compares and critically comments upon certain aspects of the Canadian Law Reform Commission Report,Euthanasia, Aiding Suicide and Cessation of Treatment, and the United States Presidential Commission Report,Deciding to Forego Life-Sustaining Treatment. It focuses on their positions on euthanasia and on the general principles, values, and procedures that ought to govern practices of foregoing life-sustaining treatment. The paper first comments on the recent debate over the moral relevance of the killing/letting die distinction, since this issue appears crucial in assessing the rationality of the current, absolute prohibitions of direct killing in medical contexts, embodied both in law and in codes of ethics. This issue bears upon a question in the closing section—whether the withdrawal of foods and fluids is ever morally permissible.     

Killing, letting die, and withdrawing aid

One of the aims of this article is to contribute to the identification of the empirical criteria governing the use of the concepts of killing and letting die. I will not attempt a comprehensive analysis of the concepts but will limit the inquiry to certain problematic cases -- namely, cases involving the removal or withdrawal of life-supporting aid or protection. The analysis of these cases will, however, shed light on the criteria for distinguishing killing and letting die in other cases as well. My overall aims in the article are partly constructive and partly skeptical. I hope to advance our understanding of the nature of the distinction between killing and letting die. This, I believe, will enable us to defend the moral relevance of the distinction against certain objections -- in particular, objections that claim that the distinction fails to coincide with commonsense moral intuitions. Yet I will suggest that, as we get clearer about the nature of the distinction and the sources of its intuitive appeal, it may seem that the intuitions it supports are not so well grounded as one could wish.     

Debating brain drain: Three objections that complicate the picture

In my contribution to this brain drain debate sparked by Brock and Blake’s book, Debating Brain Drain, I respond only to Brock’s position, and raise three objections which I suggest complicate the picture that she sketches. First, I take issue with the way in which she frames the moral question, namely by limiting her focus to what home countries may legitimately do to address the problems associated with the brain drain. I argue that the way in which she frames the question has important ideological consequences, because she does not adequately account for the larger context, in particular, by leaving out the moral obligations of the host countries who are the main beneficiaries of the brain drain. My second objection is rooted in the distinction between technical knowledge and practical knowledge found in the work of Habermas – an important distinction which gets obscured in Brock’s analysis in precisely the kind of ideological ways that Habermas was concerned about. She namely attempts to solve what are mainly practical (political) problems through purely instrumental, technical means. Several distortions accompany this fundamental confusion. My third point of critique has to do with the problem that an ethics of care (an ethics of responsibility and obligation) encounters within a liberal paradigm strongly shaped by an ethics of rights. Drawing on the work of Kroeger-Mappes, I argue that Brock arbitrarily singles out a group of people and holds them to an ethics of care which is strictly supererogatory within her own liberal paradigm.     

Ronald Dworkin on Abortion and Assisted Suicide

In the first part of this article, I raisequestions about Dworkin's theory of theintrinsic value of life and about the adequacyof his proposal to understand abortion in termsof different ways of valuing life. In thesecond part of the article, I consider hisargument in ``The Philosophers' Brief on AssistedSuicide', which claims that the distinctionbetween killing and letting die is morallyirrelevant, the distinction between intendingand foreseeing death can be morally relevantbut is not always so. I argue that thekilling/letting die distinction can be relevantin the context of assisted suicide, but alsoshow when it is not. Then I consider why theintention/foresight distinction can be morallyirrelevant and conclude by presenting analternative argument for physician-assistedsuicide.     

Puzzling cases about killing and letting die.

Discussions of euthanasia often appeal to the distinction between killing people and letting them die. Favor asks whether this distinction is morally important--in particular, whether killing is worse than merely letting someone die, even when the motivations and consequences are the same. She explores our moral intuitions via a discussion of various subtly different hypothetical examples.     

Autonomy and the Moral Symmetry Principle: Reply to Frowe and Tooley

Helen Frowe has recently objected to Michael Tooley’s famous Moral Symmetry Principle, which is meant to show that in themselves killing and letting die are morally equivalent. I argue that her objection is not compelling but a more compelling objection is available. Specifically, Tooley’s rebuttal of a proposed counter-example to his Moral Symmetry Principle has two problematic implications. First, it undercuts the very principle itself. If we reject the proposed counter-example, then any instance of the Moral Symmetry Principle will actually demonstrate the moral in-equivalence of killing and letting die. Second, it commits us to the view, which Tooley wishes to avoid, that we are just as obligated to refrain from doing wrong as we are to prevent others from doing the same. I conclude with a brief discussion of a more general concern regarding Tooley’s basic strategy. My focus here is quite narrow. My claims, if plausible, only show that the Moral Symmetry Principle is unsound and thus cannot serve as a basis for the view that killing and letting die are morally equivalent.     

Patterns of moral judgment derive from nonmoral psychological representations

Ordinary people often make moral judgments that are consistent with philosophical principles and legal distinctions. For example, they judge killing as worse than letting die, and harm caused as a necessary means to a greater good as worse than harm caused as a side‐effect ( Cushman, Young, & Hauser, 2006 ). Are these patterns of judgment produced by mechanisms specific to the moral domain, or do they derive from other psychological domains? We show that the action/omission and means/side‐effect distinctions affect nonmoral representations and provide evidence that their role in moral judgment is mediated by these nonmoral psychological representations. Specifically, the action/omission distinction affects moral judgment primarily via causal attribution, while the means/side‐effect distinction affects moral judgment via intentional attribution. We suggest that many of the specific patterns evident in our moral judgments in fact derive from nonmoral psychological mechanisms, and especially from the processes of causal and intentional attribution.     

Killing, letting die, and simple conflicts

Proponents of the moral equivalence of killing and letting die argue that in cases of simple conflict, where one agent must either perform a positive act and kill one person, or not perform that act and allow another person to die, the agent's alternatives are clearly morally equivalent. Malm rejects this view in a three part essay. He argues that in cases of simple conflict, the acts of killing and letting die are morally different, and that killing is not in itself worse than letting die. Malm considers and rejects the suggestion that the agent should decide randomly between the two alternatives. He concludes that while simple conflict cases require us to recognize a morally significant difference between killing and letting die, they do not require us to recognize a morally significant difference between acting and refraining.     

Moral inertia

I argue that, according to ordinary morality, there is moral inertia, that is, moral pressure to fail to intervene in certain circumstances. Moral inertia is manifested in scenarios with a particular causal structure: deflection scenarios, where a threatening or benefiting process is diverted from a group of people to another. I explain why the deflection structure is essential for moral inertia to be manifested. I argue that there are two different manifestations of moral inertia: strict prohibitions on interventions, and constraints on interventions. Finally, I discuss the connection between moral inertia and the distinction between killing and letting die (or doing and allowing harm).

Moral philosophy and moral psychology in Mencius

This paper defends both an interpretation of Mencius’ moral theory and that theory itself against alternative interpretive defences. I argue that the ‘virtue ethics’ reading of Mencius wrongly sees him as denying the distinction between moral philosophy and moral psychology. Virtue ethics is flawed, because it makes such a denial. But Mencius’ moral theory, in spite of Mencius’ obvious interest in moral psychology, does not have that flaw. However, I argue that Mencius is no rationalist. Instead, I show that he upholds a coherentist moral theory, in which reason and psychology both have a role. The final third of the paper compares my interpretation with the work of various important Mencius scholars. I point out that the issue of the difference between moral philosophy and moral psychology is quite important in contemporary Western moral theory.     

The Practicality of Ancient Virtue Ethics: Greece and China

Virtue ethics has been charged with being unable to provide solutions to practical moral issues. In response, the defenders of virtue ethics argue that normative virtue ethics exists. The debate is significant on its own, yet both sides of the controversy approach the issue from the assumption that moral philosophy has to tell us what we should do. In this essay, I would like to examine the question regarding the practicality of virtue ethics in a different way. Virtue ethics is an ancient approach shared by both ancient Greek philosophers and classic Chinese Confucians, and indeed, ancient Greeks call ethics “practical science.” How, then, do the ancients themselves view the issue of practicality? This essay shows that there is a notion of practicality which is prominent in both ancient Greek and ancient Chinese virtue ethics but is neglected in today’s ethics. According to this notion, ethics is to transform one’s life. The essay also raises a prospect of the revival of this notion.     

Self-preservation: an argument for therapeutic cloning, and a strategy for fostering respect for moral integrity

The issues of human cloning and stem cell retrieval are inseparable in circumstances in which the rationale of self-preservation may be invoked as a negative right. I apply this rationale to a hypothetical case in which cloning is necessary to preserve the bodily integrity or life of an individual. Self-preservation as moral integrity is examined in a narrower context, i.e., as applicable to those for whom deliberate termination of embryonic life is morally-problematic. This issue is addressed through comparison with two paradigms commonly used in support of clinical practice: the distinction between letting die and killing, and the permissibility of vital organ retrieval after death. Although these paradigms are questionable in their own right, they offer a rationale by which scientists and clinicians may respect the negative right to moral integrity of those with whom they disagree.     

Killing and Relevantly Similarly Letting Die

Winston Nesbitt has argued that the usual examples appealed to as supporting the view that killing is no worse than letting die are misleading in that the comparison cases are not set up properly to tap our intuitions. Making various adjustments to the cases he judges killing to be intuitively worse than letting die and suggests that such a result is meta-ethically appropriate to one view of the point of ethics. I contest each of these claims.     

A Foreigner in My Own Country: Forgetting the Heterogeneity of Our National Community

The issues of human cloning and stem cell retrieval are inseparable in circumstances in which the rationale of self-preservation may be invoked as a negative right. I apply this rationale to a hypothetical case in which cloning is necessary to preserve the bodily integrity or life of an individual. Self-preservation as moral integrity is examined in a narrower context, i.e., as applicable to those for whom deliberate termination of embryonic life is morally-problematic. This issue is addressed through comparison with two paradigms commonly used in support of clinical practice: the distinction between letting die and killing, and the permissibility of vital organ retrieval after death. Although these paradigms are questionable in their own right, they offer a rationale by which scientists and clinicians may respect the negative right to moral integrity of those with whom they disagree.     

Sinnott–Armstrong's Moral Scepticism

Walter Sinnott–Armstrong's recent defence of moral scepticism raises the debate to a new level, but I argue that it is unsatisfactory because of problems with its assumption of global scepticism, with its use of the Sceptical Hypothesis Argument, and with its use of the idea of contrast classes and the correlative distinction between 'everyday' justification and 'philosophical' justification. I draw on Chisholm's treatment of the Problem of the Criterion to show that my claim that I know that, e.g., baby–torture is wrong, is no more question–begging than Sinnott–Armstrong's denial that I know this.     

The Balance Between Providing Support,Prolonging Suffering,and Promoting Death: Ethical Issues Surrounding Psychological Treatment of a Terminally Ill Client

The concept of moral identity based on virtue ethics has become an issue of considerable import in explaining moral behavior. This attempt to offer adequate explanations of the full range of morally relevant human behavior inevitably provokes boundary issues between ethics and moral psychology. In terms of the relationship between the two disciplines, some argue for “naturalized (or psychologized) morality,” whereas, on the other hand, others insist on “moralized psychology.” This article investigates the relationship between virtue ethics and moral identity based on previous research on the relationship between ethics and moral psychology. This article especially attempts to show that meaningful links between the two concepts possible by using theoretical frameworks constructed by the most influential philosophers of science such as Kuhn and Lakatos.     

Integrating justice and care in animal ethics

In this paper I argue that the standoff between justice and care approaches to animal ethics presents us with a false dilemma. We should take justice's focus on reasoning from principles, and care's use of sympathetic awareness, as two integrated deliberative capacities necessary for the consideration of arguments for extending moral concern to animals. Such an integrated approach rests on a plausible account of the psychology of moral deliberation. I develop my argument as follows. Section I summarizes the nature of the debate between justice and care approaches to animal ethics, focusing on Brian Luke's arguments against justice approaches. Section II provides pro-justice rebuttals to Luke's objections. These rebuttals, while largely successful against Luke's objections, do not account for the intuition that sympathy does play a central epistemological role in animal ethics. Section III explains how sympathy cognitively simulates the perspective of the other, and thus can play an epistemological role in animal ethics. I argue that the abilities to simulate the perspective of the other and to reason from moral principles can complement each other. In section IV, I argue that though it may not be desirable to use both sympathy and reasoning from principles in all moral deliberation, it is a desirable aim when offering, and considering, moral arguments for what I will term the "extensionist project" of extending over moral concern to animals. I make this idea plausible by elucidating the claim that arguments for this project are best thought of as second-order deliberations about our first-order deliberative life.     

A Bad Disease, a Fatal Cure: Why Sterilization is Permissible and the Autonomy of Medicine is Not

The debate in this issue regarding the Roman Catholic condemnationof the morality of sterilization is puzzling for Protestants.As I will argue the puzzlement arises on two grounds. First,why would anyone object to direct sterilization for the cureor prevention of disease? Second, if one wanted to challengesuch an objection on moral grounds why would one turn to medicineto do so? For Christian ethics there is nothing wrong in principlewith direct sterilization when there are good reasons for precludingthe possibility of an additional pregnancy; and it is a serioustheological mistake to treat medicine as an independent moralauthority.     

The Relativistic Car: Applying Metaethics to the Debate about Self-Driving Vehicles

Almost all participants in the debate about the ethics of accidents with self-driving cars have so far assumed moral universalism. However, universalism may be philosophically more controversial than is commonly thought, and may lead to undesirable results in terms of non-moral consequences and feasibility. There thus seems to be a need to also start considering what I refer to as the “relativistic car” — a car that is programmed under the assumption that what is morally right, wrong, good, bad, etc. is determined by the moral beliefs of one’s society or culture. My investigation of this idea involves six steps. First, I explain why and how the moral universalism/relativism debate is relevant to the issue of self-driving cars. Second, I argue that there are good reasons to consider accident algorithms that assume relativism. Third, I outline how a relativistic car would be programmed to behave. Fourth, I address what advantages such a car would have, both in terms of its non-moral consequences and feasibility. Fifth, I address the relativistic car’s disadvantages. Finally, I qualify and conclude my considerations.

     

From Normative Spheres to Normative Practices: New Prospects for Normative Theory after Habermas

Abstract

In this paper I argue against Jürgen Habermas’s theoretical dualism between ethics and morality. I do this by showing how his account of normativity is vitiated by an unnecessary superposition of a social-evolutionary and a theoretical-linguistic account of normativity, and that this brings about theoretical problems that in the end cannot be overcome. I also show that Rainer Forst’s attempt at salvaging Habermas’s distinction is equally doomed to failure, but that his attempt nevertheless invites new and more fruitful avenues for normative theory that are worth exploring. The conclusion of this paper is that traditional notions of ethics and morality can be preserved provided we heavily redefine their meanings and release them from some of the theoretical work they have been expected to accomplish, but that to complete this transition we also need to supersede Forst’s pluralization of normative contexts toward a theory of normative practices that in the end makes the distinction between ethics and morality workable but useless. I begin by first locating the debate about ethics and morality within the context of recent normative theory (§1), and proceed to examine the two main strategies through which Habermas has elaborated his idea of a sharp dualism between ethics and morality (§2). I then introduce a theoretical distinction between what I call a horizontal and a vertical integration of ethics and morality (§3) and contend that whilst only the horizontal is viable, Habermas decidedly prefers the idea of a vertical integration (§4). With this work done, I proceed to complete my critique of Habermas’s argument and show how, by recovering the pragmatist roots of his thought, an alternative solution based on a functionalist understanding of morality could be envisaged (§5). I then conclude by examining Rainer Forst’s attempt at salvaging Habermas’s account, and show that the failure of Forst’s attempts opens the way for new and more fruitful approaches to normative theory which are more likely to recover the pragmatist roots of Habermas’s thought (§6).