Consequentialism and the Standard Story of Action

I challenge the common picture of the “Standard Story” of Action as a neutral account of action within which debates in normative ethics can take place. I unpack three commitments that are implicit in the Standard Story, and demonstrate that these commitments together entail a teleological conception of reasons, upon which all reasons to act are reasons to bring about states of affairs. Such a conception of reasons, in turn, supports a consequentialist framework for the evaluation of action, upon which the normative status of actions is properly determined through appeal to rankings of states of affairs as better and worse. This covert support for consequentialism from the theory of action, I argue, has had a distorting effect on debates in normative ethics. I then present challenges to each of these three commitments, a challenge to the first commitment by T.M. Scanlon, a challenge to the second by recent interpreters of Anscombe, and a new challenge to the third commitment that requires only minimal and prima facie plausible modifications to the Standard Story. The success of any one of the challenges, I demonstrate, is sufficient to block support from the theory of action for the teleological conception of reasons and the consequentialist evaluative framework. I close by demonstrating the pivotal role that such arguments grounded in the theory of action play in the current debate between evaluator-relative consequentialists and their critics.     

Keith Lehrer on Compatibilism

Keith Lehrer has been publishing on free will and compatiblism since 1960. Our concern here is to present an account of the development on his work on the subject.     

Korsgaard’s Constitutivism and the Possibility of Bad Action

Neo-Kantian accounts which try to ground morality in the necessary requirements of agency face the problem of “bad action”. The most prominent example is Christine Korsgaard’s version of constitutivism that considers the categorical imperative to be indispensable for an agent’s self-constitution. In my paper I will argue that a constitutive account can solve the problem of bad action by applying the distinction between constitutive and regulative rules to the categorical imperative. The result is that an autonomous agent can violate the categorical imperative in so far as it amounts to a regulative rule of morality; however, an agent cannot call into question the categorical imperative as a constitutive rule of the practice of morality without losing her or his identity as a moral agent. The paper then compares this approach to bad action with the one Korsgaard provides and outlines also a new way of grounding the categorical imperative.     

A new path for humanistic medicine

According to recent approaches in the philosophy of medicine, biomedicine should be replaced or complemented by a humanistic medical model. Two humanistic approaches, narrative medicine and the phenomenology of medicine, have grown particularly popular in recent decades. This paper first suggests that these humanistic criticisms of biomedicine are insufficient. A central problem is that both approaches seem to offer a straw man definition of biomedicine. It then argues that the subsequent definition of humanism found in these approaches is problematically reduced to a compassionate or psychological understanding. My main claims are that humanism cannot be sought in the patient–physician relationship alone and that a broad definition of medicine should help to revisit humanism. With this end in view, I defend what I call an outcomes-oriented approach to humanistic medicine, where humanism is set upon the capacity for a health system to produce good health outcomes.     

How (not) to think of the ‘dead-donor’ rule

Although much has been written on the dead-donor rule (DDR) in the last twenty-five years, scant attention has been paid to how it should be formulated, what its rationale is, and why it was accepted. The DDR can be formulated in terms of either a Don’t Kill rule or a Death Requirement, the former being historically rooted in absolutist ethics and the latter in a prudential policy aimed at securing trust in the transplant enterprise. I contend that the moral core of the rule is the Don’t Kill rule, not the Death Requirement. This, I show, is how the DDR was understood by the transplanters of the 1960s, who sought to conform their practices to their ethics—unlike today’s critics of the DDR, who rethink their ethics in a question-begging fashion to accommodate their practices. A better discussion of the ethics of killing is needed to move the debate forward.     

The ethics of separating conjoined twins: two arguments against

I argue that the separation of conjoined twins in infancy or early childhood is unethical (rare exceptions aside). Cases may be divided into three types: both twins suffer from lethal abnormalities, only one twin has a lethal abnormality, or neither twin does. In the first kind of case, there is no reason to separate, since both twins will die regardless of treatment. In the third kind of case, I argue that separation at an early age is unethical because the twins are likely to achieve an irreplaceably good quality of life—the goods of conjoinment—that separation takes away. Evaluation of this possibility requires maturation past early childhood. Regarding the second type, I point out that with conceivable but unrecorded exceptions, these cases will consistently involve sacrifice separation. I present an argument that sacrifice separation is unethical, but in some cases a moral dilemma may exist in which separation and refraining from separation are both unethical. Perhaps in such cases a decision can be made on non-moral grounds; however, the possibility of such a decision serves not to mitigate but to underscore the fact that the separation is unethical. My conclusion, which applies to all three types of cases, is that it is unethical to separate conjoined twins before their developing personalities give some reliable indication as to whether they desire separation and whether they will achieve those goods of conjoinment.     

Contractualism,Person-Affecting Wrongness and the Non-identity Problem

A number of theorists have argued that Scanlon's contractualist theory both "gets around" and "solves" the non-identity problem. They argue that it gets around the problem because hypothetical deliberation on general moral principles excludes the considerations that lead to the problem. They argue that it solves the problem because violating a contractualist moral principle in one's treatment of another wrongs that particular other, grounding a person-affecting moral claim. In this paper, I agree with the first claim but note that all it shows is that the act is impersonally wrong. I then dispute the second claim. On Scanlon's contractualist view, one wrongs a particular other if one treats the other in a way that is unjustifiable to that other on reasons she could not reasonably reject. We should think of person-affecting wronging in terms of the reasons had by the actual agent and the actual person affected by the agent's action. In non-identity cases, interpersonal justifiability is therefore shaped both by the reason to reject the treatment provided by the bad suffered and the reason to affirm the treatment provided by the goods had as a result of existing. I argue it would be reasonable for the actual person to find the treatment justifiable, and so I conclude that Scanlon's contractualist metaethics does not provide a narrow person-affecting solution to the non-identity problem on its own terms. I conclude that the two claims represent a tension within Scanlon's contractualist theory itself.