As I write this, in November 1971, people are dying in East Bengal from lack of food, shelter, and medical caxc. The suffering and death that are occurring there now axe not inevitable, 1101; unavoidable in any fatalistic sense of the term. Constant poverty, a cyclone, and a civil war have turned at least nine million people into destitute refugees; nevertheless, it is not beyond Lhe capacity of the richer nations to give enough assistance to reduce any further suffering to (...) very small proportions. The decisions arid actions of human beings can prevent this kind of suffering. Unfortunately, human beings have not made the necessary decisions. At the individual level, people have, with very few exceptions, not responded to the situation in any signihczmt way. Generally speaking, people have not given large sums to relief funds; they have not written t0 their parliamentaxy representatives demanding increased government assistance; they have not demonstrated in the streets, held symbolic fasts, or done anything else directed toward providing thc refugees with the means to satisfy their essential needs. At thc government level, no govcrmmcnt has given the sort of massive aid that would enable the refugees to survive fm: more than a few days. Britain, for instance, has given rather more than most countries. It has, to date, given £14,750,000. For comparative purposes, B1~itain’s share of thc nonreccverabla development costs of the Anglo-French Concorde project is already in excess of £275,000,000, and on present estimates will reach £440,000,¤00. The implication is that the British government values a supersonic transport more than thirty times as.. (shrink)

Structural Injustice advances a theory of what structural injustice is and how it works. Powers and Faden present both a philosophically powerful, integrated theory about human rights violations and structural unfairness, alongside practical insights into how to improve them.

The philosopher Henry Richardson's short book is a defense of a position on a neglected topic in medical research ethics. Clinical research ethics has been a longstanding area of study, dating back to the aftermath of the Nazi death-camp doctors and the Tuskegee syphilis study. Most ethical regulations and institutions have developed in response to those past abuses, including the stress on obtaining informed consent from the subject. Richardson points out that that these ethical regulations do not address one of (...) the key dilemmas faced by medical researchers -- whether or not they have obligations towards subjects who need care not directly related to the purpose of the study, termed 'ancillary care obligation'. (shrink)

From the ethicist the_ New Yorker_ calls “the most influential living philosopher,” a new way of thinking about living ethically.

We do not live in a just world. This may be the least controversial claim one could make in political theory. But it is much less clear what, if anything, justice on a world scale might mean, or what the hope for justice should lead us to want in the domain of international or global institutions, and in the policies of states that are in a position to affect the world order. By comparison with the perplexing and undeveloped state of (...) this subject, domestic political theory is very well understood, with multiple highly developed theories offering alternative solutions to well-defined problems. By contrast, concepts and theories of global justice are in the early stages of formation, and it is not clear what the main questions are, let alone the main possible answers. I believe that the need for workable ideas about the global or international case presents political theory with its most important current task, and even perhaps with the opportunity to make a practical contribution in the long run, though perhaps only the very long run. (shrink)

According to Peter Singer, virtually all of us would be forced by adequate reflection on our own convictions to embrace a radical conclusion about giving. The following principle, he says, is “surely undeniable” -- at least once we reflect on secure convictions concerning rescue, as in his famous case of the drowning toddler.

Do differences in income or wealth matter, morally speaking? This essay addresses a broader issue than this question seems to pose. But this broader issue is, I believe, the salient philosophical issue which this question actually poses. Let me explain. Narrowly read, the question at hand is concerned only with inequality of income or wealth. It asks us to consider whether inequality of income or wealth as such is morally problematic. On this construal, the question invites us to consider whether (...) the bare fact that Joshua has a greater income or net worth than Rebekah is a morally defective social state of affairs. Is there at least a significant moral presumption on behalf of equality of income or wealth such that, if an inequality of income or wealth obtains vis-à-vis Joshua and Rebekah, that inequality ought to be nullified unless some impressive positive justification for the inequality can be provided? On this narrow reading, the salient issue is whether there exists in particular an egalitarian presumption with respect to income or wealth. But I believe that the genuinely salient issue here is whether there exists in general an egalitarian presumption with respect to whatever factual condition of individuals one is supposed to attend to when assessing social states of affairs. The crucial question is not whether income or wealth or utility or well-being is the condition the unequal distribution of which is as such morally problematic. (shrink)

Book reviewed in this article: Principles of Biomedical Ethics. By Tom L. Beauchamp and James F. Childress.

This book develops some of the most important themes of Sen's works over the last decade. He argues in a rich and subtle approach that we should be concerned with people's capabilities rather than their resources or welfare.

In this article I am particularly interested in the question of solidarity within the boundaries of one's own country. I discuss a qualified beneficence requirement, which claims that we ought to prevent something very bad from happening if it is in our power and if we can do it without sacrificing anything morally significant. I also discuss a fair-share principle, according to which, in Liam B. Murphy's version, "the sacrifice each agent is required to make is limited to the level (...) of sacrifice that would be optimal if the situation were one of full compliance". I argue that the qualified beneficence requirement is reasonable only in the proximity of the one who needs help. When there is no proximity we ought to be guided by a fair-share principle. I also argue that there is an intimate relation between the fair-share principle and the welfare-state ideology. (shrink)

This chapter contains sections titled: Is There a Right to Health Care? What Does a Right to Health Care Include? Choice or Consent and the Exercise of our Right to Health Care References.

Bioethics' traditional focus on clinical relationships and exotic technologies has led the field away from population health, health disparities, and issues of justice. The result: a myopic view that misses the institutional context in which clinical relationships operate and can overlook factors that affect health more broadly than do exotic technologies. A broader bioethics agenda would take up unresolved questions about the distribution of health and the development of fair policies that affect health distribution.

Setting Up the Problem. What personal responsibilities do we, people living in rich countries, have for relieving miseries in the less fortunate countries? A great variety of prophets and philosophers urge us without qualification to do everything that we can. I mean, everything. Sartre holds that everybody “carries the weight of the whole world upon his shoulders; he is responsible for the world and for himself in whatever has to do with the character of their being.” Lévinas joins in: “I (...) am responsible for others without expecting any return, should it cost me my life. Any return is [the others’] business.” Peter Unger, following Peter Singer, asks us to do all that we can do to relieve suffering; and insists that the only limit, while the suffering continues, is our capacity to help. Jesus speaks most trenchantly of all: If you are to be saved, “Sell all you have and give it to the poor”, to which may be joined the injunction, powerfully worded in the Moffatt translation of the Bible, “You must be perfect as your heavenly Father is perfect”. (shrink)

Well-being occupies a central role in ethics and political philosophy, including in major theories such as utilitarianism. It also extends far beyond philosophy: recent studies into the science and psychology of well-being have propelled the topic to centre stage, and governments spend millions on promoting it. We are encouraged to adopt modes of thinking and behaviour that support individual well-being or 'wellness'. What is well-being? Which theories of well-being are most plausible? In this rigorous and comprehensive introduction to the topic, (...) Guy Fletcher unpacks and assesses these questions and many more, including: Are pleasure and pain the only things that affect well-being? Is desire-fulfilment the only thing that makes our lives go well? Can something be good for someone who does not desire it? Is well-being fundamentally connected to a distinctive human nature? Is happiness all that makes our lives go well? Is death necessarily bad for us? How is the well-being of a whole life related to well-being at particular times? Also included is a glossary of key terms, and annotated further reading and study and comprehension questions follow each chapter, making _The Philosophy of Well-Being_ essential reading for students in ethics and political philosophy, and also suitable for those in related disciplines such as psychology, politics and sociology. (shrink)

It used to be that everyone read the "notorious" Bernard Mandeville (1670-1733). He was a great satirist and come to have a profound impact on economics, ethics and social philosophy. "The Fable of the Bees" begins with a poem and continues with a number of essays and dialogues. It is all tied together by the startling and original idea that "private vices" (self-interest) lead to "publick benefits" (the development and operation of society).

In this volume, Feinberg focuses on the meanings of "interest," the relationship between interests and wants, and the distinction between want-regarding and ideal-regarding analyses on interest and hard cases for the applications of the concept of harm. Examples of the "hard cases" are harm to character, vicarious harm, and prenatal and posthumous harm. Feinberg also discusses the relationship between harm and rights, the concept of a victim, and the distinctions of various quantitative dimensions of harm, consent, and offense, including the (...) magnitude, probability, risk, and "importance" of harm. (shrink)

Is there a limit to the legitimate demands of morality? In particular, is there a limit to people's responsibility to promote the well-being of others, either directly or via social institutions? Utilitarianism admits no such limit, and is for that reason often said to be an unacceptably demanding moral and political view. In this original new study, Murphy argues that the charge of excessive demands amounts to little more than an affirmation of the status quo. The real problem with utilitarianism (...) is that it makes unfair demands on people who comply with it in our world of nonideal compliance. Murphy shows that this unfairness does not arise on a collective understanding of our responsibility for others' well being. Thus, according to Murphy, while there is no general problem to be raised about the extent of moral demands, there is a pressing need to acknowledge the collective nature of the demands of beneficence. (shrink)

This book offers the fullest and most sophisticated account of Gert's influential moral theory, a model first articulated in the classic work The Moral Rules: A New Rational Foundation for Morality, published in 1970. In this final revision, Gert makes clear that the moral rules are only one part of an informal system that does not provide unique answers to every moral question but does always provide a range of morally acceptable options. A new chapter on reasons includes an account (...) of what makes one reason better than another and a second new chapter is devoted to the question of justifying violations of the rules. Moral impartiality, the moral ideals, and virtue and vice, are all treated in greater detail. Throughout, Gert attempts to answer all of the challenges that his work has provoked. (shrink)

Moral problems do not always come in the form of great social controversies. More often, the moral decisions we make are made quietly, constantly, and within the context of everyday activities and quotidian dilemmas. Indeed, these smaller decisions are based on a moral foundation that few of us ever stop to think about but which guides our every action. Here distinguished philosopher Bernard Gert presents a clear and concise introduction to what he calls "common morality" -- the moral system that (...) most thoughtful people implicitly use when making everyday, common sense moral decisions and judgments. Common Morality is useful in that -- while not resolving every disagreement on controversial issues -- it is able to distinguish between acceptable and unacceptable answers to moral problems. In the first part of the book Gert lays out the fundamental features of common morality: moral rules, moral ideals, and a two-step procedure for determining when a violation of a moral rule is justified. Written in a non-technical style, the ten general moral rules include rules on which everyone can agree, such as "do not kill," "do not deceive," and "keep your promises." The moral ideals include similarly uncontroversial precepts such as "Relieve pain" and "Aid the needy." In the second part of the book Gert examines the underlying concepts that justify common morality, such as the notions of rationality and impartiality. The distillation of over 40 years of scholarship, this book is the most accessible version of Gert's influential theory of morality as well as an eye-opening look at the moral foundations of our everyday actions. Throughout the discussion is clear enough for a reader with little or no philosophy background. (shrink)

This book addresses a range of relevant theoretical issues, including the possibility of an interpersonally comparable measure of well-being, or “utility” metric; the moral value of equality, and how that bears on the form of the social welfare function; social choice under uncertainty; and the possibility of integrating considerations of individual choice and responsibility into the social-welfare-function framework. This book also deals with issues of implementation, and explores how survey data and other sources of evidence might be used to calibrate (...) both a utility metric and a social welfare function, and whether distributive goals are ever best pursued through regulation rather than the tax system. In working through this range of theoretical and practical issues, the book draws from a wide variety of literatures, including philosophical scholarship on equality, responsibility, the nature of well-being, and personal identity over time; the social choice literature within economics; applied economic literatures concerning the measurement of inequality and poverty; legal and policy-analysis scholarship on cost-benefit analysis, environmental justice, and the choice between regulation and taxation; and the burgeoning field of “happiness studies”. (shrink)

Acting Now to End World Poverty Peter Singer. were our own, and we cannot deny that the suffering and death are bad. The second premise is also very difficult to reject, because it leaves us some wiggle room when it comes to situations in.

In bioethics, discussions of justice have tended to focus on questions of fairness in access to health care: is there a right to medical treatment, and how should priorities be set when medical resources are scarce. But health care is only one of many factors that determine the extent to which people live healthy lives, and fairness is not the only consideration in determining whether a health policy is just. In this pathbreaking book, senior bioethicists Powers and Faden confront foundational (...) issues about health and justice. How much inequality in health can a just society tolerate. The audience for the book is scholars and students of bioethics and moral and political philosophy, as well as anyone interested in public health and health policy. (shrink)

The face of the world is changing. The past century has seen the incredible growth of international institutions. How does the fact that the world is becoming more interconnected change institutions' duties to people beyond borders? Does globalization alone engender any ethical obligations? In Globalization and Global Justice, Nicole Hassoun addresses these questions and advances a new argument for the conclusion that there are significant obligations to the global poor. First, she argues that there are many coercive international institutions and (...) that these institutions must provide the means for their subjects to avoid severe poverty. Hassoun then considers the case for aid and trade, and concludes with a new proposal for fair trade in pharmaceuticals and biotechnology. Globalization and Global Justice will appeal to readers in philosophy, politics, economics and public policy. (shrink)

In a new preface, Peter Singer discusses the prospects for the ethical approach he advocates."--BOOK JACKET.

This book is the result of over 30 years of collaboration among its authors. It uses the systematic account of our common morality developed by one of its authors to provide a useful foundation for dealing with the moral problems and disputes that occur in the practice of medicine. The analyses of impartiality, rationality, and of morality as a public system not only explain why some bioethical questions, such as the moral acceptability of abortion, cannot be resolved, but also provide (...) a method for determining the correct answer for those occasions when a bioethical question has a unique correct answer. This new edition includes an entire chapter that has been added to address the controversial issue of abortion within the authors' distinct framework. This book presents the latest revisions of the authors' orignial analyses of the concepts of death and disease, analyses that have had a significant impact on the field of bioethics. It also includes an added chapter on mental disorders, where the authors' definition influenced what psychiatry classifies as a mental disorder, and so has had an impact that reveals beyond the field of bioethics. In this edition, the authors also offer a new, more developed perspective on the concept of valid or informed consent by considering what information physicians should be required to know before proposing screening, diagnostic testing, prescribing medications, or performing surgery. The book also integrates some of the important insights of the field of clinical epidemiology into its discussion of valid consent. Its account of paternalism and its justification, perhaps the most ubiquitous moral problem in medical ethics, has had considerable influence. Its discussion of euthanasia and physician assisted suicide challenges the standard views that have been put forward by both proponents and opponents of physician assisted suicide and voluntary active euthanasia. (shrink)

Richard Miller presents a bold new program for international justice. He argues for new standards of responsible conduct by governments, firms, and individuals in developed countries, to govern trade, investment, environmental policy, and the use of force. He offers an urgently needed strategy for moving humanity toward genuine global co-operation.

Principles of bcnciiccnce require us to promote the good. If we believe that a plausible mom] conception will contain some such principle, we must address the issue of the demands it imposes on agents. Some writers have defended extremely demanding principles, while others have argued that only principles with limited demands are acceptable. In this paper I su ggest that we 100k at the demands 0f beneficencc in a different way; 0ur concern should not just be with the extent of (...) the demands faced by individual agents. Instead, we should consider how the demands imposed Ol'] an agent by a principle of beneiiccncc are affected by the level of compliance with the principle by others. Act—[email protected], for example, in effect requires each complying agent to shoulder her share of the demands of bcncficcnce plus as many of the shares of noncomplying agents as would be optimal. I suggest that we focus OH this feature ofconsequentialism, and not just on the very high demands it can impose Ol'] individual agents. Thus I defend the View that principles of beneiicence should not demand more of agents as expected compliance by othcr agents decreases, and formulate a principle of bencficcnce that meets this condition. This View about beneiicence and compliance is supported by a particular conception 0f beneiiccnce. Rather than as an aim we each have as individuals, benciicence could be understood as a cooperative project, where each of us aims to promote the good together with others. If s0, it would be natural t.. (shrink)

This paper’s first section invokes a relevant meta-ethical principle about what a moral theory needs in order to be plausible and superior to its rivals. In subsequent sections, I try to pinpoint exactly what the demandingness objection has been taken to be. I try to explain how the demandingness objection developed in reaction to impartial act-consequentialism’s requirement of beneficence toward strangers. In zeroing in on the demandingness objection, I distinguish it from other, more or less closely related, objections. In particular, (...) I discuss arguments put forward by Bernard Williams concerning integrity, Samuel Scheffler on prerogatives, and Liam Murphy on fairness. The final part of the paper acknowledges some ways in which vagueness bedevils my own rule-consequentialism’s rules about doing good and preventing disasters. (shrink)

If you came upon a small child drowning in a pond, you ought to save the child even at considerable cost and risk to yourself. In 1972 Peter Singer observed that inhabitants of affluent industrialized societies stand in exactly the same relationship to the millions of poor inhabitants of poor undeveloped societies that you would stand to the small child drowning in the example just given. Given that you ought to help the drowning child, by parity of reasoning we ought (...) to help the impoverished needy persons around the globe. To capture this intuition Singer proposed this principle of benevolence: If one can prevent some significant bad from occurring, without sacrificing anything of comparable moral importance, one ought morally to do so.1 Premature death caused by preventable disease, injury, and poverty is uncontroversially a significant bad. Donations to charitable organizations such as Oxfam can prevent many of these deaths around the world, so Singer’s principle holds that we ought to donate (or take some action that is comparably efficient at saving lives). (shrink)