Justice and care: The implications of the Kohlberg-Gilligan debate for medical ethics

Carol Gilligan has identified two orientations to moral understanding; the dominant ‘justice orientation’ and the under-valued ‘care orientation’. Based on her discernment of a ‘voice of care’, Gilligan challenges the adequacy of a deontological liberal framework for moral development and moral theory. This paper examines how the orientations of justice and care are played out in medical ethical theory. Specifically, I question whether the medical moral domain is adequately described by the norms of impartiality, universality, and equality that characterize the liberal ideal. My analysis of justice-oriented medical ethics, focuses on the libertarian theory of H.T. Engelhardt and the contractarian theory of R.M. Veatch. I suggest that in the work of E.D. Pellegrino and D.C. Thomasma we find not only a more authentic representation of medical morality but also a project that is compatible with the care orientation's emphasis on human need and responsiveness to particular others.     

Christianity in Singapore: The Voice of Moral Conscience to the State

Christianity has historically been influential in shaping morality, a project which still continues. While substantial literature has addressed the question how conservative Christians in America attempt to maintain moral control, there is little research on the way in which Christianity influences morality in other societies. This study examines the case of Singapore where conservative Christianity dominates the Christian landscape. The first part of this article discusses Christian groups which have become intricately involved in the production and policing of morality in Singapore and the state patronage which this attempt enjoys. This is based on evidence of state support for various Christian based initiatives which focus on the family and sexuality. Also, the recent sites of discord are considered which result from the state's increased tolerance of homosexuality and gambling. Interview data, public speeches, and writings of local church leaders are used to show that the Christian church wants to be the state's voice of conscience. However, while opposing moral degradation, the ‘well disciplined’ Singaporean Christian leaders have carefully negotiated their strategies and tried to avoid being labelled by the state as undesirable voices of conscience.     

THE ILLIBERALITY OF ‘LIBERAL EUGENICS’

This essay evaluates the moral logic of ‘liberal eugenics’: the ideal of genetic control which leaves decisions about what sort of people to produce in the hands of individual parents, absent government intervention. I argue that liberal eugenics cannot be justified on the basis of the underlying liberal theory which inspires it. I introduce an alternative to Rawls's social primary goods that might be called natural primary goods: hereditable mental and physical capacities and dispositions that are valued across a range of projects and pursuits. I suggest that reproductive genetic biotechnologies like embryo selection, cellular surgery, and genetic engineering, which aim to enhance ‘general purpose’ traits in offspring are less like childrearing practices a liberal government leaves to the discretion of parents than like practices the state makes compulsory. I argue that if the liberal commitment to autonomy is important enough for the state to mandate childrearing practices such as health care and basic education, that very same interest is important enough for the state to mandate safe, effective, and functionally integrated genetic practices that act on analogous all‐purpose traits such as resistance to disease and general cognitive functioning. I conclude that the liberal case for compulsory eugenics is a reductio against liberal theory.     

Liberal Naturalism: The Curious Case of Hegel

Abstract

My aim in this paper is to defend the claim that the absolute idealism of Hegel is a liberal naturalist position against Sebastian Gardner’s claim that it is not genuinely naturalistic, and also to defend the position of ‘liberal naturalism’ from Ram Neta’s charge that there is no logical space for it to occupy. By ‘liberal naturalism’, I mean a doctrine which is a non-reductive form of philosophical naturalism. Like Fred Beiser, I take the thesis of liberal naturalism to find support in the idealism of Hegel. I begin by first explaining what philosophical naturalism amounts to. I then move on to show, using Finn Spicer’s and Alison Stone’s understandings of philosophical naturalism, how there is a stronger form of philosophical naturalism but also how there is a weaker form as well. Having established the distinction between stronger and weaker variants of philosophical naturalism, I discuss Sebastian Gardner’s recent objections to treating absolute idealism as a genuinely naturalist position. I argue that Gardner is incorrect to claim that absolute idealism is not a genuinely naturalist position on both historical and interpretive grounds, where to do so I bring in features of Hegel’s idealism to show that Hegel was committed to liberal naturalism. In the next section of the paper, I address Ram Neta’s charge that there is no logical space for liberal naturalism. To counter this claim, I offer an Hegelian diagnosis of Neta’s charge and argue that Neta’s concern about the possibility of liberal naturalism is illegitimately motivated.     

Theorising 'Talk' about 'Religious Pluralism' and 'Religious Harmony' in Singapore

This article aims to make sense of the discourse on 'religious pluralism' and 'religious harmony' in Singapore. My choice of the 'Maintenance of Religious Harmony Act' , passed in 1990, to launch this inquiry is by no means accidental or random. I argue that in addition to an empirical domain, it is a central analytical tool that has provided an occasion for the articulation of a range of taken-for-granted statements about 'religion', 'religious pluralism', and 'religious harmony' in Singapore. I map out how the religious scene is discussed by various parties. The inevitability of Singapore's multi-religiosity, the fragility of religious harmony, and the need for constant vigilance are dominant strands. The article addresses these related areas: a brief historical contextualisation of religion in secular Singapore is followed by a condensed narrative of the conditions and deliberations leading to the Act. Further, the discourse on religious harmony from the early 1990s is juxtaposed to present concerns about religion and religious encounters in Singapore. The intention for this is two-fold: to see if there have been any major shifts in such 'talk, and to use the empirical material to call for the re-conceptualisation of categories/notions, such as 'religious pluralism' and 'religious harmony'.     

Alasdair MacIntyre's Analysis of Tradition

I argue that, in analysing the structure and development of moral traditions, MacIntyre relies primarily on Kuhn's model of scientific tradition, rather than (as is held by at least two influential commentators) on Lakatos' model. I unpack three foci of Kuhn's conception of the sciences, namely: the ‘crisis’ conception of scientific development, what I call the ‘systematic conception’ of scientific paradigms, and the view that successive paradigms are incommensurable. I then show that these three foci are integrated into MacIntyre's account of the development of moral traditions with a surprising degree of faithfulness to Kuhn. And crucially, I argue against the overall cogency of his account, given the disparities I pinpoint between scientific and moral traditions. My overall critique is, however, fundamentally friendly, since nothing I have to say invalidates the very notion of a moral tradition, and all I am calling for are less problematic construals of that notion.     

CHARACTER,PSYCHOANALYTIC IDENTIFICATION,AND NUMERICAL IDENTITY

Identification figures prominently in moral psychological explanations. I argue that in identification the subject has an ‘identity‐thought’, which is a thought about her numerical identity with the figure she identifies with. In Freud's psychoanalytic psychology character is founded on unconscious identification with parental figures. Moral philosophers have drawn on psychoanalysis to explain how undesirable or disadvantageous character dispositions are resistant to insight through being unconscious. According to Richard Wollheim's analysis of Freud's theory, identification is the subject's disposition to imagine, unconsciously, her bodily merging with the figure she identifies with. I argue that this explanation of identification is not adequate. Human character is held to be capable of change when self‐reflection brings unconscious identifications to conscious self‐knowledge. I argue that for self‐knowledge these identifications must be an intelligible part of the subject's self‐conception, and that Wollheim's ‘merging phantasy’ is not intelligible to the subject in this way. By contrast, the subject's thought that she is numerically identical to the figure she identifies with does provide an intelligible starting‐point for reflecting on this identification. This psychoanalytic account provides a clear conception of identification with which to investigate puzzle cases in the moral psychology of character.     

The Moralism of Multiculturalism

abstract Moralism is a frequent charge in politics, and especially in relation to the ‘politics of recognition’. In this essay, I identify three types of moralism — undue abstraction, unjustified moralism and impotent moralism — and then discuss each in relation to recent debates over multiculturalism in liberal political theory. Each of these forms of moralism has featured in interesting ways in recent criticisms of the political theory and public policy of multiculturalism. By ‘multiculturalism’ I mean, broadly speaking, the pursuit of group‐differentiated public policies that move beyond the protection of basic individual civil and political rights. Here the charge is not so much that moral judgments have no application in relation to the treatment of cultural and associational minorities, but that the moral claims of defenders of multiculturalism are: (a) appealed to without any sense of the practical realities on the ground (the undue abstraction charge); (b) asserted as if they were self‐evidently true (the unjustified moralism charge); which often results in (c) a stifling of reasoned criticism of the orthodoxy surrounding multiculturalism (thus engendering impotent moralism). I assess these charges in the course of defending the democratic character of the most plausible forms of multicultural accommodation in liberal democratic societies.     

The Origins of Social Citizenship in Pre-Apartheid South Africa

Abstract

South Africa's 1996 Constitution promises a measure of ‘social citizenship’ alongside formal political and legal equality. South Africa's public welfare and social policies may be less effective in ensuring social citizenship, through reducing insecurity and inequality, than those of the more established democracies, but they are far more effective than those of other ‘developing’ countries. The origins of social citizenship in South Africa lie in the early and mid-1940s, when the state first assumed responsibility for the welfare, broadly understood, of all South Africans. The most significant achievement was the introduction of a universal old-age pension system. The importance of these initiatives has been largely overlooked. This has been in part because later scholars largely ignored the heterogeneity of liberal thought in South Africa in the mid-twentieth century, as followers of the ‘New Liberalism’ broke with the classical liberalism of John Stuart Mill and argued for a range of state interventions in social and economic life. In South Africa, as elsewhere, the Second World War provided a context in which revised liberal thought gave rise to major policy reforms, some of which were to survive even the election of a National Party government in 1948.     

Fiction,Pleasurable Tragedy,and the HOT Theory of Consciousness

Abstract

The ‘feeling fiction problem’ asks: is it rational to be moved by what happens to fictional characters? The so-called ‘paradox of tragedy’ is embodied in the question: Why or how is it that we take pleasure in artworks which are clearly designed to cause in us such feelings as sadness and fear? My focus in this paper is to examine these problems from the point of view of the so-called ‘higher-order thought theory of consciousness’ (HOT theory) which says that the best explanation for what makes a mental state conscious is that it is accompanied by a thought that one is in that state. I examine the feeling fiction problem in light of the HOT theory and through a critique of Colin Radford's view. For example, I argue that Radford equivocates in his use of the term ‘aware’ in his response to some of the proposed solutions to the feeling fiction problem. Finally, I show how Susan Feagin's approach to the paradox of tragedy can be analysed and supported by the HOT theory.     

God,Mixed Modes,and Natural Law: An Intellectualist Interpretation of Locke's Moral Philosophy

The goal of this paper is to explicate the theological and epistemological elements of John Locke's moral philosophy as presented in the ‘Essay Concerning Human Understanding’ and ‘The Reasonableness of Christianity’. Many detractors hold that Locke's moral philosophy is internally inconsistent due to his seeming commitment to both the intellectualist position that divinely instituted morality admits of pure rational demonstration and the competing voluntarist claim that we must rely for our moral knowledge upon divine revelation. In this paper I argue that Locke is guilty of no such contradiction. In doing so, I attempt to accommodate Locke's position in the ‘Essay’ that moral principles are demonstrable a priori with his views on the sanctity of Christian revelation. I then consider Locke's conception of moral ideas as a species of mixed modes, or arbitrarily constructed complex ideas, and attempt to navigate the mechanism whereby human understanding can recognize these ideas as conforming to, or straying from, divinely appointed natural law. I conclude that despite Locke's failure to actually provide a full-fledged moral theory, he lays a rationally coherent groundwork for the fulfilment of such a project that accommodates a-priori rational reflection and divine revelation as complementary paths to moral understanding.     

The indeterminacy failures of moral cosmopolitanism and liberal nationalism

Much of the discussion on cosmopolitanism and nationalism has focused on their different normative views. The purpose of this article is to shift the attention away from the normative debate to the metatheoretical argument about how we determine moral and political principles independently of each other. I argue that the discussion among proponents of cosmopolitanism and contextualist models boils down to latent methodological and metatheoretical assumptions about what selection of facts are considered politically relevant. In the article, I explore what I call ‘the indeterminacy failure’ of moral cosmopolitanism, that is, the view according to which moral principles fail to determine what political-institutional level might be preferable; and the ‘indeterminacy failure’ of liberal nationalism, that is, the view according to which national identity fails to determine moral principles. In opposition to dichotomist cosmopolitan models (including various nonideal types of moral cosmopolitanism) and alternative contextualist approaches (including the practice-dependence thesis and liberal nationalism), I promote a ‘split-level’ model that is set to avoid the difficulties in the other approaches. The split-level corrects the indeterminacy failures of cosmopolitanism and contextualism by distinguishing clearly between the level of moral theorising and the level of political theorising.     

Kant's Conception of Inner Value

Abstract: This article addresses a foundational issue in Kant's moral philosophy, the question of the relation of the Categorical Imperative to value. There is an important movement in current Kant scholarship that argues that there is a value underlying the Categorical Imperative. However, some scholars have raised doubts as to whether Kant has a conception of value that could ground the Categorical Imperative. In this paper I seek to add to these doubts by arguing, first, that value would have to be of a particular kind in order to be the foundation of Kant's moral philosophy. Second, I argue that Kant does not have such a conception of value, and that his arguments rule out that value could ground his moral philosophy. I then outline an alternative reading of how Kant uses ‘inner value’. My conclusion will be that Kant does not derive the Categorical Imperative from an underlying value. While some of his passages could also be read as if value were foundational for Kant, a close look at these passages and his arguments point away from this conclusion.     

Do I need ethnic culture to be free? A critique of Will Kymlicka’s liberal nationalism

Abstract

As part of a vigorous debate about the politics of multiculturalism, Will Kymlicka has sought to find grounds within liberal political theory to defend rights for cultural groups. Kymlicka argues that the individual’s ability to choose the good life necessarily takes place in a cultural context such that access to one’s ethnic or national culture constitutes a condition of autonomy. Thus, in liberal societies where the culture of minority ethnic groups or nations is under threat, these groups should enjoy certain special rights so as to uphold the autonomy of their individual members. However, Kymlicka’s ‘liberal nationalist’ argument relies on a problematic isomorphism between culture and identity. Very simply, I shall argue that an individual’s culture is not necessarily given by their membership of an ethnic group or nation, thus breaking the link between individual autonomy and rights for ethnic groups or nations.     

On being and holding responsible

In his Responsibility and the moral sentiments, Wallace develops the idea that we should think of what it is to be morally responsible for an act in terms of norms for holding someone responsible for that act. Smith has recently claimed that Wallace's approach and those like it are ‘fundamentally misguided’. She says that such approaches make the mistake of incorporating conditions for ‘actively blaming’ others into the basic conditions for being responsible, when in fact the conditions for active blame ‘go beyond’ the basic conditions. In this essay, I argue that Smith's otherwise illuminating discussion of these ‘Normativist’ approaches does not undermine them. Specifically, I maintain that being actively blamable by certain persons with the relevant standing is actually constitutive of being responsible for at least some acts. By distinguishing between persons with different sorts of standing, a Normativist approach can avoid Smith's challenge. My larger aim is thus to clarify and defend the Normativist approach.     

Truthfulness,risk, and trust in the late lectures of Michel Foucault

This paper argues that Foucault's late, unpublished lectures present a model for evaluating those ethical authorities who claim to speak truthfully. In response to those who argue that claims to truth are but claims to power, I argue that Foucault finds in ancient practices of parrhesia (fearless speech) a resource by which to assess modern authorities' claims in the absence of certain truth. My preliminary analytic framework for this model draws exclusively on my research of his unpublished lectures given at the Collège de France between 1982–84. I argue that this model proceeds in three stages: the truth‐teller is first established as independently authoritative, he is subsequently tested under conditions of risk, and the encounter concludes by generating trust and a relation of ‘care’ with the audience. Foucault's model results in an ‘aesthetics of existence’ organized around a set of ethical practices, and thus offers an alternative to other forms of ethical subjectivity. In so doing, this model also critiques the place for risk in liberal political institutions.     

Heidegger,Art, and the Overcoming of Metaphysics

In this paper, I advance a new interpretation of Heidegger's reflections on art as we find them in his essay, ‘The Origin of the Work of Art’. I begin, in Section 1, by uncovering the fundamental concern that motivates Heidegger's essay. I show that Heidegger's reflections on art are part of his attempt to uncover a path beyond the history of metaphysics. I then suggest, in Section 2, that while Heidegger does think that art may allow for the overcoming of metaphysics, recent interpreters [Dreyfus ( 2005 ), Thomson ( 2011 ), and Young ( 2001 )] have mistook the kind of art that Heidegger has in mind here. The kind of art that can allow for the overcoming of metaphysics, I argue, is not art that simply thematizes and/or reconfigures cultural worlds (as these interpreters have argued). It is instead what Heidegger calls ‘primal poesy’. After discussing the nature of primal poesy, I show in more detail how this kind of art may be capable of getting us beyond the history of metaphysics in Section 3. Finally, in Section 4, I reconsider the more common reading of ‘The Origin of the Work of Art’ in light of the interpretation I've offered in Sections 2 and 3.     

Nonsense on Stilts? Wittgenstein,Ethics, and the Lives of Animals

Wittgenstein is often invoked in philosophical disputes over the ethical justifiability of our treatment of animals. Many protagonists believe that Wittgenstein's philosophy points to a quantum difference between human and animal nature that arises out of humans' linguistic capacity. For this reason – its alleged anthropocentrism – animal liberationists tend to dismiss Wittgenstein's philosophy, whereas, for the same reason, anti‐liberationists tend to embrace it. I endorse liberationist moral claims, but think that many on both sides of the dispute fail to grasp the import of Wittgenstein's philosophy. My argument proceeds through close engagement with Michael Leahy's Against Liberation, which makes extensive use of Wittgenstein's ‘notion of language‐games’ as an ‘essential methodological aid’ in its defence and justification of the moral status quo. Leahy's understanding and application of that method exemplifies an entrenched interpretative stance in the wider Wittgensteinian scholarship which I seek to counter. This enables me to show that far from entailing conservatism, as some of his critics and followers contend, Wittgenstein's philosophical method is just as conducive to radical moral and political critique as it is to any other normative position.     

Towards a new epistemology of moral progress

Abstract: Awareness that moral beliefs and practices have changed across time threatens our confidence in our current moral beliefs: if past moral beliefs turned out to be wrong, how can we be sure ours aren't likewise mistaken? In this paper, I set up four desiderata for a successful theory of moral progress: it must allow us to judge that progress has occurred, avoid the image of increasing correspondence towards ahistorical truthmakers, allow for revision in belief, and yet not be disobligating. Rorty's pragmatist account of moral progress delivers on the first three, but at the cost of failing to meet the fourth: it drains moral beliefs of their categorical force. I then outline K.E. Løgstrup's understanding of the relation between the ‘ethical demand’ and changing, socially mediated norms. While Løgstrup does posit an unchanging ground of normativity ‐ the “ethical demand” to act for the sake of the other whose welfare is in our hands – he also thinks that changing social norms are an indispensable part of ethical life. I argue that Løgstrup's discussion of the ‘refraction‘ of the ethical demand through changing social norms provides resources for an account of moral progress that fulfils these four desiderata.