Causal Responsibility and Rationing in Medicine

The article addresses the issue of rationing health care services, a topic currently being hotly debated in many countries. The author argues that the aspect of causal responsibility ought to play a decisive role in the allocation of limited medical resources. Starting out from Ronald Dworkin's distinction between option luck and brute luck, the appropriate and meaningful uses of the term causal responsibility are clarified first. A discussion of the conditions which might justify giving lower priority to patients whose illnesses are the result of unhealthy behavior, like e.g. alcohol abuse, follows. Causal responsibility is then viewed in the context of private health insurance and the club model of organ donation. It is argued that individuals themselves are basically responsible for their decisions regarding insurance coverage and membership in organ donors' clubs. Causal responsibility is shown to be a more suitable criterion for rationing scarce medical resources than other criteria which might alternatively be considered, such as patients' age.     

Responsible engineering: the importance of character and imagination

Engineering Ethics literature tends to emphasize wrongdoing, its avoidance, or its prevention. It also tends to focus on identifiable events, especially those that involve unfortunate, sometimes disastrous consequences. This paper shifts attention to the positive in engineering practice; and, as a result, the need for addressing questions of character and imagination becomes apparent.     

Knowledge-How and Epistemic Value

A conspicuous oversight in recent debates about the vexed problem of the value of knowledge has been the value of knowledge-how. This would not be surprising if knowledge-how were, as Gilbert Ryle [1945, 1949 Ryle, Gilbert 1949. The Concept of Mind, London: Hutchinson's University Library.[Crossref] , [Google Scholar]] famously thought, fundamentally different from knowledge-that. However, reductive intellectualists [e.g. Stanley and Williamson 2001 Ryle, Gilbert 1949. The Concept of Mind, London: Hutchinson's University Library.[Crossref] , [Google Scholar]; Brogaard 2008, 2009 Brogaard, Berit 2009. What Mary Did Yesterday: Reflections on Knowledge-Wh, Philosophy and Phenomenological Research 78/2: 439–67.[Crossref], [Web of Science ®] , [Google Scholar], 2011 Brogaard, Berit 2011. Knowledge-How: A Unified Account, in Knowing How: Essays on Knowledge, Mind, and Action, ed. John Bengson and Marc A. Moffett, New York: Oxford University Press: 136–60. [Google Scholar]; Stanley 2011a Stanley, Jason 2011a. Knowing (How), Noûs 45/2: 207–38.[Crossref], [Web of Science ®] , [Google Scholar], 2011b Stanley, Jason 2011b. Know How, Oxford: Oxford University Press.[Crossref] , [Google Scholar]] maintain that knowledge-how just is a kind of knowledge-that. Accordingly, reductive intellectualists must predict that the value problems facing propositional knowledge will equally apply to knowledge-how. We show, however, that this is not the case. Accordingly, we highlight a value-driven argument for thinking (contra reductive intellectualism) that knowledge-how and knowledge-that come apart.     

At one with our actions,but at two with our bodies

Jennifer Hornsby's account of human action frees us from the temptation to think of the person who acts as ‘doing’ the events that are her actions, and thereby removes much of the allure of ‘agent causation’. But her account is spoiled by the claim that physical actions are ‘tryings’ that cause bodily movements. It would be better to think of physical actions and bodily movements as identical; but Hornsby refuses to do this, seemingly because she thinks that to do so would be to endorse the so–called ‘standard causal story’. But Hornsby misses a possibility here, for we can insist on this identity claim without endorsing the standard story if we embrace an account which parallels the disjunctive account in the philosophy of perception. This will leave us with a picture of physical action that saves the insights of Hornsby's account without succumbing to its distortions.     

Virtue Epistemology and Epistemic Luck

The recent movement towards virtue–theoretic treatments of epistemological concepts can be understood in terms of the desire to eliminate epistemic luck. Significantly, however, it is argued that the two main varieties of virtue epistemology are responding to different types of epistemic luck. In particular, whilst proponents of reliabilism–based virtue theories have been focusing on the problem of what I call "veritic" epistemic luck, non–reliabilism–based virtue theories have instead been concerned with a very different type of epistemic luck, what I call "reflective" epistemic luck. It is argued that, prima facie at least, both forms of epistemic luck need to be responded to by any adequate epistemological theory. The problem, however, is that one can best eliminate veritic epistemic luck by adducing a so–called safety–based epistemological theory that need not be allied to a virtue–based account, and there is no fully adequate way of eliminating reflective epistemic luck. I thus conclude that this raises a fundamental difficulty for virtue–based epistemological theories, on either construal.     

Perpetrators and Social Death: A Cautionary Tale

Understanding evil requires both addressing the grave wrongs done to the victim and addressing the perpetrator who does these wrongs. Claudia Card's concept of social vitality was developed to explain what génocidaires destroy in their victims. This essay brings that concept into conversation with perpetrator testimony, arguing that the génocidaires’ desire for their own social vitality, achieved through their destruction of the social world of their targets, in fact boomerangs to corrode the vitality of their own lives. This is true whether they succeed or fail in their genocidal project. Card's recent analysis of “being a badass” is brought to bear on the cultivation of evil, and the essay suggests four strategies for meeting Card's “moral challenge of avoiding evil responses to evil.”     

Indeterminism, Explanation, and Luck

I first adumbrate pertinent aspectsof Robert Kane's libertarian theory of free choice oraction and an objection of luck that has been levelledagainst the theory. I then consider Kane's recentresponses to this objection. To meet these responses,I argue that the view that undetermined choices (ofthe sort implied by Kane's theory) are a matter ofluck is associated with a view about actionexplanation, to wit: when Jones does A and hisdoing of A is undetermined, and when hiscounterpart, Jones*, in the nearest possibleworld in which the past and the laws are held constantuntil the moment of choice does B instead, thereis no explanation (deterministic or indeterministic)of the difference in outcome – Jones's A-ing butJones*'s B-ing – in terms of prior reasonsor motives of either agent. Absence of such anexplanation is one crucial factor that underliesthe charge that Jones's A-ing and Jones*'sB-ing are matters of luck. I argue that thissort of luck is incompatible with responsibility.     

Beliefs around luck: Confirming the empirical conceptualization of beliefs around luck and the development of the Darke and Freedman beliefs around luck scale

The current study developed a multi-dimensional measure of beliefs around luck. Two studies introduced the Darke and Freedman beliefs around luck scale where the scale showed a consistent 4 component model (beliefs in luck, rejection of luck, being lucky, and being unlucky) across two samples (n = 250; n = 145). The scales also show adequate reliability statistics and validity by ways of comparison with other measures of beliefs around luck, peer and family ratings and expected associations with measures of personality, individual difference and well-being variables.     

RELIABILISM AND SAFETY

Abstract: Duncan Pritchard has recently highlighted the problem of veritic epistemic luck and claimed that a safety‐based account of knowledge succeeds in eliminating veritic luck where virtue‐based accounts and process reliabilism fail. He then claims that if one accepts a safety‐based account, there is no longer a motivation for retaining a commitment to reliabilism. In this article, I delineate several distinct safety principles, and I argue that those that eliminate veritic luck do so only if at least implicitly committed to reliabilism.