Is the relation ‘is a morally permissible alternative to’ transitive? The answer seems to be a straightforward yes. If Act B is a morally permissible alternative to Act A and Act C is a morally permissible alternative to B then how could C fail to be a morally permissible alternative to A? However, as both Dale Dorsey and Frances Kamm point out, there are cases where this transitivity appears problematic. My aim in this paper is to provide a solution to (...) this problem. I will then investigate Kamm’s justification for rejecting the transitivity of the ‘is a permissible alternative to’ relation. Next, I will look at Dorsey’s solution, which involves a reinterpretation of the intuitions used to generate the problem. I will argue that neither of these solutions are fully satisfying before going on to provide my own solution to the problem and arguing that it avoids these problems. (shrink)

Alternative allocations of a fixed bundle of healthcare resources often involve significantly different indirect, non-health effects. The question arises whether these effects must figure in accounts of the conditions under which a distribution of healthcare resources is morally justifiable. In this article we defend a Scanlonian, affirmative answer to this question: healthcare resource managers should sometimes select an allocation which has worse direct, health-related effects but better indirect, nonhealth effects; they should do this when the interests served by such a (...) policy are more urgent than the healthcare interests better served by an alternative allocation. We note that there is a prima facie case for the claim that such benefits (and costs) are relevant—i.e. they are real benefits, and in other contexts our decisions can permissibly be guided by them. We then proceed to rebut three lines of argument that might be thought to defeat this prima facie case: they appeal to fairness, the Kantian Formula of Humanity as an End in Itself, and the equal moral worth of persons, respectively. (shrink)

A venerable idea in the history of moral philosophy is that central among the normative notions is the notion of goodness or value. This idea, which can be found at least as early as 1903 in G.E. Moore’s Principia Ethica, claims that goodness is central in that all other normative notions can be explained in terms of it. Moore’s approach and the dominant approach to the project of explaining the normative notions of rightness and what we have reason to do (...) is the consequentialist program. While the most famous element of this program is the consequentialist moral theory that says an act is right just in case the outcome of that act is at least as good as the outcome of any alternative act, the consequentialist program in general hopes to similarly explain the notion of a reason in terms of goodness. So the consequentialist theory of practical reason says that an agent has more reason to do some act a than to do some act b just in case the outcome of doing a is better than the outcome of doing b. (shrink)