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.     

Ongoing: On grief’s open-ended rehearsal

Peter Goldie’s account of grief as a narrative process that unfolds over time allow us to address the structure of self-understanding in the experience of loss. Taking up the Goldie’s idea that narrativity plays a crucial role in grief, I will argue that the experience of desynchronization and an altered relation to language disrupt even of our ability to compose narratives and to think narratively. Further, I will argue that Goldie’s account of grief as a narratively structured process focus on the process having come to an end. By contrast, I will propose the idea that grief can be understood as an open-ended rehearsal of our capacity to be alone in the company of an absent other. This makes grief a relational activity that differs from composing narratives about one’s past and about one’s process of grieving. Thus, grief is not primarily a process of recollecting our past narratively; rather, it can be seen as a dedicational activity which involves a future-oriented and open-ended rehearsal of relatedness despite irrevocable absence.     

The real of the rabble: Žižek and the historical truth of the Hegelo-Lacanian dialectic

In this essay I attempt to answer a fundamental question about ?i?ek’s heterodox reading of Hegel’s dialectic: What project sustains this reading in the first place? That is, what is at stake for ?i?ek himself? The purpose of this essay is to develop in this fashion a reading of ?i?ek (since he does not programmatically answer this question), although not one that is necessarily meant to compete against other alternatives. My argument, then, is that ?i?ek’s ontological and hermeneutical project is ultimately political, that when ?i?ek says we need Hegel “now more than ever,” he has a political situation in mind. By finding an element of Hegel’s thought, the political subjectivity of the “rabble,” that resists the traditional picture of dialectical system (especially the critical picture of the post-structuralists), ?i?ek can overturn the distinction between Hegelian method and system by suggesting that there’s no comprehensible distinction at all. And by politicizing Hegel and drawing out the seeds of Lacanian thought that were nonetheless incomplete until Lacan, ?i?ek’s historiographical project takes on the character of ideological critique. As such, Hegel and Lacan reach us anew, as theoretical players in an anti-postmodern political gambit.     

The last low whispers of our dead: when is it ethically justifiable to render a patient unconscious until death?

A number of practices at the end of life can causally contribute to diminished consciousness in dying patients. Despite overlapping meanings and a confusing plethora of names in the published literature, this article distinguishes three types of clinically and ethically distinct practices: (1) double-effect sedation, (2) parsimonious direct sedation, and (3) sedation to unconsciousness and death. After exploring the concept of suffering, the value of consciousness, the philosophy of therapy, the ethical importance of intention, and the rule of double effect, these three practices are defined clearly and evaluated ethically. It is concluded that, if one is opposed to euthanasia and assisted suicide, double-effect sedation can frequently be ethically justified, that parsimonious direct sedation can be ethically justified only in extremely rare circumstances in which symptoms have already completely consumed the patient’s consciousness, and that sedation to unconsciousness and death is never justifiable. The special case of sedation for existential suffering is also considered and rejected.