"Im Gesamtwerk des Pädagogen und Philosophen Theodor Litt (1880-1962) spielt das Verhältnis von Erkenntnis und Verantwortung eine zentrale Rolle.

We regularly wield powers that, upon close scrutiny, appear remarkably magical. By sheer exercise of will, we bring into existence things that have never existed before. With but a nod, we effect the disappearance of things that have long served as barriers to the actions of others. And, by mere resolve, we generate things that pose significant obstacles to others' exercise of liberty. What is the nature of these things that we create and destroy by our mere decision to do (...) so? The answer: the rights and obligations of others. And by what seemingly magical means do we alter these rights and obligations? By making promises and issuing or revoking consent When we make promises, we generate obligations for ourselves, and when we give consent, we create rights for others. Since the rights and obligations that are affected by means of promising and consenting largely define the boundaries of permissible action, our exercise of these seemingly magical powers can significantly affect the lives and liberties of others. (shrink)

Serious ethical violations in medicine, such as sexual abuse, criminal prescribing of opioids, and unnecessary surgeries, directly harm patients and undermine trust in the profession of medicine. We review the literature on violations in medicine and present an analysis of 280 cases. Nearly all cases involved repeated instances of intentional wrongdoing, by males in nonacademic medical settings, with oversight problems and a selfish motive such as financial gain or sex. More than half of cases involved a wrongdoer with a suspected (...) personality disorder or substance use disorder. Despite clear patterns, no factors provide readily observable red flags, making prevention difficult. Early identification and intervention in cases requires significant policy shifts that prioritize the safety of patients over physician interests in privacy, fair processes, and proportionate disciplinary actions. We explore a series of 10 questions regarding policy, oversight, discipline, and education options. Satisfactory answers to these questions will require input from diverse stakeholders to help society negotiate effective and ethically balanced solutions. (shrink)

It has been reported as an ethical problem within prehospital emergency care that ambulance professionals administer physiologically futile cardiopulmonary resuscitation (CPR) to patients having suffered cardiac arrest to benefit significant others. At the same time it is argued that, under certain circumstances, this is an acceptable moral practice by signalling that everything possible has been done, and enabling the grief of significant others to be properly addressed. Even more general moral reasons have been used to morally legitimize the use of (...) futile CPR: That significant others are a type of patient with medical or care needs that should be addressed, that the interest of significant others should be weighed into what to do and given an equal standing together with patient interests, and that significant others could be benefited by care professionals unless it goes against the explicit wants of the patient. In this article we explore these arguments and argue that the support for providing physiologically futile CPR in the prehospital context fails. Instead, the strategy of ambulance professionals in the case of a sudden death should be to focus on the relevant care needs of the significant others and provide support, arrange for a peaceful environment and administer acute grief counselling at the scene, which might call for a developed competency within this field. (shrink)

Fictional names present unique challenges for semantic theories of proper names, challenges strong enough to warrant an account of names different from the standard treatment. The theory developed in this paper is motivated by a puzzle that depends on four assumptions: our intuitive assessment of the truth values of certain sentences, the most straightforward treatment of their syntactic structure, semantic compositionality, and metaphysical scruples strong enough to rule out fictional entities, at least. It is shown that these four assumptions, taken (...) together, are inconsistent with referentialism, the common view that names are uniformly associated with ordinary individuals as their semantic value. Instead, the view presented here interprets names as context-sensitive expressions, associated in a context of utterance with a particular act of introduction, or dubbing, which is then used to determine their semantic value. Some dubbings are referential, which associate names with ordinary individuals as their semantic values; others are fictional, which associate names, instead, with sets of properties. Since the semantic values of names can be of different sorts, the semantic rule interpreting predication must be complex as well. In the body of the paper, I show how this new treatment of names allows us to solve our original puzzle. I defend the complexity of the semantic predication rule, and address additional worries about ontological commitment. (shrink)

In Moral Case Deliberation, healthcare professionals discuss ethically difficult patient situations in their daily practice. There is a lack of knowledge regarding the content of MCD and there is a need to shed light on this ethical reflection in the midst of clinical practice. Thus, the aim of the study was to describe the content of healthcare professionals’ moral reasoning during MCD. The design was qualitative and descriptive, and data consisted of 22 audio-recorded inter-professional MCDs, analysed with content analysis. The (...) moral reasoning centred on how to strike the balance between personal convictions about what constitutes good care, and the perceived dissonant care preferences held by the patient. The healthcare professionals deliberated about good care in relation to demands considered to be unrealistic, justifications for influencing the patient, the incapacitated patient’s nebulous interests, and coping with the conflict between using coercion to achieve good while protecting human dignity. Furthermore, as a basis for the reasoning, the healthcare professionals reflected on how to establish a responsible relationship with the vulnerable person. This comprised acknowledging the patient as a susceptible human being, protecting dignity and integrity, defining their own moral responsibility, and having patience to give the patient and family time to come to terms with illness and declining health. The profound struggle to respect the patient’s autonomy in clinical practice can be understood through the concept of relational autonomy, to try to secure both patients’ influence and at the same time take responsibility for their needs as vulnerable humans. (shrink)

Abstract For centuries researchers have studied the universality of matters of ethics and morality. Now, the challenge is to make theoretical contributions which account not only for the universals, but also for the life conditions and cultural circumstances of various people in different societies. This paper attempts to capture the essence of morality and ethics in the African context and to elucidate forms of moral wisdom and behaviour grounded in the web of the African community.

This book is conceived as an introductory text into the theory of syntactic and semantic information, and information flow.

Launched by the United Nations in 2000, the Global Compact (GC) promotes private sector compliance with 10 basic principles covering human rights, labour standards, the environment, and anti-corruption. Its sponsors aim to establish a global corporate social responsibility (CSR) network based on a pledge to observe the 10 principles adopted by companies across the range of company size and regional origin, backed by a modest reporting system and collaborative programmes. The author analyzes the GC's progress toward building a global network (...) from its launch through 2006 and finds that, while the GC's nominal membership base of nearly 3000 companies makes it the largest system among collective action institutions (CAIs) for corporate responsibility, the GC has not reached 'critical mass'. Deficiencies in its nascent global network include limited market penetration among the largest corporations, a membership heavily weighted toward Western European companies, and major weaknesses in compliance with its reporting system. The author concludes that the GC must improve both penetration and compliance if it is to succeed in building a global standard for CSR. (shrink)

It is common for philosophers to argue that psychopaths are not morally responsible because they lack some of the essential capacities for morality. In legal terms, they are criminally insane. Typically, however, the insanity defense is not available to psychopaths. The primary reason is that they appear to have the knowledge and understanding required under the M’Naghten Rules. However, it has been argued that what is required for moral and legal responsibility is ‘deep’ moral understanding, something that psychopaths do not (...) have either due to their lacking empathy or practical reason. In the first part of the paper, I argue that psychopaths do not lack the abilities required for deep moral understanding, although they have deficits in those areas. According the M’Naghten Rules, therefore, psychopaths are not insane. Under a less strict formulation of the insanity plea, like the Model Penal Code, however, there is a good case to be made for their lacking substantial capacity. I argue that because psychopathy is an essentially moral disorder, and because of the nature of psychopathic violence, psychopaths should not be excused under the insanity plea. It would be tantamount to excusing someone for committing a crime because they are bad. Arguably, this contravenes the entire system of law. (shrink)

Numerous grounds have been offered for the view that healthcare workers have a duty to treat, including expressed consent, implied consent, special training, reciprocity (also called the social contract view), and professional oaths and codes. Quite often, however, these grounds are simply asserted without being adequately defended or without the defenses being critically evaluated. This essay aims to help remedy that problem by providing a critical examination of the strengths and weaknesses of each of these five grounds for asserting that (...) healthcare workers have a duty to treat, especially as that duty would arise in the context of an infectious disease pandemic. Ultimately, it argues that none of the defenses is currently sufficient to ground the kind of duty that would be needed in a pandemic. It concludes by sketching some practical recommendations in that regard. (shrink)

Many spectacular claims about psychopaths are circulated. This contribution aims at providing the reader with the more complex reality of the phenomenon (or phenomena), and to point to issues of particular interest to philosophers working in moral psychology and moral theory. I first discuss the current evidence regarding psychopaths’ deficient empathy and decision-making skills. I then explore what difference it makes to our thinking whether we regard their deficit dimensionally (as involving abilities that are on or off) and whether we (...) focus on primary or secondary psychopathy. My conclusion is that most grand claims about psychopathy settling long-standing debates in moral philosophy and psychology are overblown, but there is much to be learnt from this disorder when it comes to formulating modern theories of moral psychology. (shrink)

Empathy plays a central role in the history and contemporary study of ethics, interpersonal understanding, and the emotions, yet until now has been relatively underexplored. _The Routledge Handbook of Philosophy of Empathy_ is an outstanding reference source to the key topics, problems and debates in this exciting field and is the first collection of its kind. Comprising over thirty chapters by a team of international contributors, the _Handbook_ is divided into six parts: Core issues History of empathy Empathy and understanding (...) Empathy and morals Empathy in art and aesthetics Empathy and individual differences. Within these sections central topics and problems are examined, including: empathy and imagination; neuroscience; David Hume and Adam Smith; understanding; evolution; altruism; moral responsibility; art, aesthetics, and literature; gender; empathy and related disciplines such as anthropology. Essential reading for students and researchers in philosophy, particularly ethics and philosophy of mind and psychology, the _Handbook_ will also be of interest to those in related fields, such as anthropology and social psychology. (shrink)

Psychopaths are renowned for their immoral behavior. They are ideal candidates for testing the empirical plausibility of moral theories. Many think the source of their immorality is their emotional deficits. Psychopaths experience no guilt or remorse, feel no empathy, and appear to be perfectly rational. If this is true, sentimentalism is supported over rationalism. Here, I examine the nature of psychopathic practical reason and argue that it is impaired. The relevance to morality is discussed. I conclude that rationalists can explain (...) the moral deficits of psychopaths as well as sentimentalists. In the process, I identify psychological structures that underpin practical rationality. (shrink)

Feminist philosophers of science have been prominent amongst social epistemologists who draw attention to communal aspects of knowing. As part of this work, I focus on the need to examine the relations between scientific communities and lay communities, particularly marginalized communities, for understanding the epistemic merit of scientific practices. I draw on Naomi Scheman's argument (2001) that science earns epistemic merit by rationally grounding trust across social locations. Following this view, more turns out to be relevant to epistemic assessment than (...) simply following the standards of "normal science". On such an account, philosophers of science need to attend to the relations between scientific communities and various lay communities, especially marginalized communities, to understand how scientific practices can rationally ground trust and thus earn their status as "good ways of knowing". Trust turns out to involve a wide set of expectations on behalf of lay communities. In this paper I focus on expectations of knowledge sharing, using examples of "knowledge-sharing whistleblowers" to illustrate how failures in knowledge sharing with lay communities can erode epistemic trust in scientific communities, particularly in the case of marginalized communities. (shrink)

Some societies tolerate or encourage high levels of chickenpox infection among children to reduce rates of shingles among older adults. This tradeoff is unethical. The varicella zoster virus...

This volume contains twelve original papers about the importance of empathy and sympathy to morality, with perspectives from philosophy, psychology, psychiatry, anthropology, and neuroscience.

Background The ambulance service provides emergency care to meet the patient’s medical and nursing needs. Based on professional nursing values, this should be done within a caring relationship with a holistic approach as the opposite would risk suffering related to disengagement from the patient’s emotional and existential needs. However, knowledge is sparse on how ambulance personnel can meet caring needs and avoid suffering, particularly in conjunction with urgent and emergency situations. Aim The aim of the study was to explore ambulance (...) nurses’ experiences of relationships with patients in urgent and emergency situations. Methods Data collection was performed using individual open-ended interviews with six ambulance nurses. The data were analyzed using a thematic analysis. Results Relationships with patients during urgent and emergency assignments emerged as three themes: “ Ambiguous silence,” “ Professional competence” and “ Challenging inadequacy” comprising eight sub-themes in total. The result shows that the ambulance nurses found it difficult to prioritize between medical care and establishing a caring relationship with the patient. However, sometimes a wordless relationship was perceived sufficient and considered a first step towards a verbal relationship. Conclusions Ambulance nurses experience that a caring relationship cannot and does not need to be prioritized in the acute stage. This uncovers a dichotomy approach to medical care versus caring relationships that exclude a holistic approach. Thus, patients’ emotional, existential and physical needs are not considered as equally important. Clinical relevance: It is important to stimulate reflection on core ethical nursing values, in training and simulation exercises among clinically active ambulance nurses. (shrink)

: Feminist epistemologists have found the atomistic view of knowers provided by classical epistemology woefully inadequate. An obvious alternative for feminists is Lynn Hankinson Nelson's suggestion that it is communities that know. However, I argue that Nelson's view is problematic for feminists, and I offer instead a conception of knowers as "individuals-in-communities." This conception is preferable, given the premises and goals of feminist epistemologists, because it emphasizes the relations between knowers and their communities and the relevance of these relations for (...) epistemic assessments. Furthermore, it provides a sense of epistemic agents as active reflective inquirers, capable of transforming and improving knowledge-seeking practices. (shrink)

Among theory theorists, it is commonly thought that folk psychological theory is tacitly known. However, folk psychological knowledge has none of the central features of tacit knowledge. But if it is ordinary knowledge, why is it that we have difficulties expressing anything but a handful of folk psychological generalisations? The reason is that our knowledge is of theoretical models and hypotheses, not of universal generalisations. Adopting this alternative view of (scientific) theories, we come to see that, given time and reflection, (...) we can say what we know. (shrink)

It used to be thought that folk psychology is the only game in town. Focusing merely on what people do will not allow you to predict what they are likely to do next. For that, you must consider their beliefs, desires, intentions, etc. Recent evidence from developmental psychology and fMRI studies indicates that this conclusion was premature. We parse motion in an environment as behavior of a particular type, and behavior thus construed can feature in systematizations that we know. Building (...) on the view that folk psychological knowledge is knowledge of theoretical models, I argue that social knowledge is best understood as lying on a continuum between behavioral and full-blown psychological models. Between the two extremes, we have what I call social models. Social models represent social structures in terms of their overall purpose and circumscribe individuals' roles within them. These models help us predict what others will do or plan what we should do without providing information about what agents think or want. Thinking about social knowledge this way gives us a more nuanced picture of what capacities are engaged in social planning and interaction, and gives us a better tool with which to think about the social knowledge of animals and young children. (shrink)

Shame is a painful emotion concerned with failure to live up to certain standards, norms, or ideals. The subject feels that she falls in the regard of others; she feels watched and exposed. As a result, she feels bad about the person that she is. The most popular view of shame is that someone only feels ashamed if she fails to live up to standards, norms, or ideals that she, herself, accepts. In this paper, I provide support for a different (...) view, according to which shame is about failure to live up to public expectations. Such a view of shame has difficulties explaining why an audience is central to shame, why shame concerns the self as a whole, and why the social rank of someone affects their ability to shame others. These features, I argue, are best explained by reference to the descent of shame in the emotion connected with submission in nonhuman animals. The function of submission-to appease relevant social others-also throws light on the sort of emotion that shame is. From the point of view of other people, a subject who experiences shame at her own failing is someone who is committed to living together with others in a socially sanctioned way. The argument is not that we must understand the nature of shame in terms of what it evolved for, but that its heritage is important to understanding the emotion that shame has become. (shrink)

Some people are now quite optimistic about the possibility of treating psychopathy with drugs that directly modulate brain function. I argue that this optimism is misplaced. Psychopathy is a global disorder in an individual’s worldview, including his social and moral outlook. Because of the unity of this Weltanschauung, it is unlikely to be treatable in a piecemeal fashion. Recent neuroscientific methods do not give us much hope that we can replace, in a wholesale manner, problematic views of the world with (...) more socially desirable ones. There are, therefore, principled reasons that psychopathy is so singularly treatment resistant. (shrink)

Global Corporate Citizenship (GCC) continues to become increasingly popular in large corporations. However, this concept has rarely been considered in small and medium size enterprises (SMEs). A case study of a Norwegian clothing company illustrates how GCC can be also applied to small companies. This case study also shows that SMEs can be very innovative in exercising corporate citizenship, without necessarily following the patterns of large multinational companies. The company studied engages as partner in some voluntary labor initiatives promoted by (...) the government, employs people in marginal situations, and exerts influence for the adoption of good working conditions in its supply chain. Environmental issues and actions of solidarity are also considered within a global scope. Ethics of care and concern for specific aspects of the common good seem crucial as GCC drivers in this company, as do personal values, character, and leadership of the owner-manager of the firm. (shrink)

Shame is a painful emotion concerned with failure to live up to certain standards, norms, or ideals. The subject feels that she falls in the regard of others; she feels watched and exposed. As a result, she feels bad about the person that she is. The most popular view of shame is that someone only feels ashamed if she fails to live up to standards, norms, or ideals that she, herself, accepts. In this paper, I provide support for a different (...) view, according to which shame is about failure to live up to public expectations. Such a view of shame has difficulties explaining why an audience is central to shame, why shame concerns the self as a whole, and why the social rank of someone affects their ability to shame others. These features, I argue, are best explained by reference to the descent of shame in the emotion connected with submission in nonhuman animals. The function of submission—to appease relevant social others—also throws light on the sort of emotion that shame is. From the point of view of other people, a subject who experiences shame at her own failing is someone who is committed to living together with others in a socially sanctioned way. The argument is not that we must understand the nature of shame in terms of what it evolved for, but that its heritage is important to understanding the emotion that shame has become. (shrink)

An increasingly popular suggestion is that empathy and/or sympathy plays a foundational role in understanding harm norms and being motivated by them. In this paper, I argue these emotions play a rather more moderate role in harms norms than we are often led to believe. Evidence from people with frontal lobe damage suggests that neither empathy, nor sympathy is necessary for the understanding of such norms. Furthermore, people's understanding of why it is wrong to harm varies and is by no (...) means limited to considerations of welfare arising from the abilities to sympathize and/or empathize. And the sorts of considerations of welfare that are central to sympathy and, to some extent empathy, are often already moralized. As such, these considerations cannot form the non-moral foundation of harm norms. Finally, empathy and sympathy are not the only emotions that motivate harm norms. Indeed, much of the evidence that has been adduced in favor of the motivational force of empathy and sympathy are studies on helping, which is quite a different behavior than aggression inhibition. Understanding and being motivated by harm norms are complex abilities. To understand them better, we need to move beyond the current fixation on empathy and sympathy. (shrink)

The paper deals with the question whether logical truth carry information. On the one hand it seems that we gain new information by drawing inferences or arriving at some theorems. On the other hand the formal accounts of information and information content which are most widely known today say that logical truth carry no information at all. The latter is shown by considering these accounts. Then several ways to deal with the dilemma are distinguished, especially syntactic and ontological solutions. A (...) version of a syntactical solution is favoured. (shrink)

In this paper, I present a version of theory theory, so-called model theory, according to which theories are families of models, which represent real-world phenomena when combined with relevant hypotheses, best interpreted in terms of know-how. This form of theory theory has a number of advantages over traditional forms, and is not subject to some recent charges coming from narrativity theory. Most importantly, practice is central to model theory. Practice matters because folk psychological knowledge is knowledge of the world only (...) if it is combined with knowledge of how to apply it. By combining the general and the particular in this way, model theory gives a deep and explanatorily satisfactory account of the centrality of practice. Model theory accounts not just as well as, but better than, narrativity theory for the fact that our folk psychological explanations appear to contain, or form part of, narratives. (shrink)

Much of the literature concerning epistemic injustice has focused on the variety of harms done to socially marginalized persons in their capacities as potentialcontributorsto knowledge projects. However, in order to understand the full implications of the social nature of knowing, we must confront the circulation of knowledge and the capacity of epistemic agents to take up knowledge produced by others and make use of it. I argue that members of socially marginalized lay communities can sufferepistemic trust injusticeswhen potentially powerful forms (...) of knowing such as scientific understandings are generated in isolation from them, and when the social conditions required for aresponsibly-placed trustto be formed relative to the relevant epistemic institutions fail to transpire. (shrink)

: Psychopaths are renowned for their immoral behavior. They are ideal candidates for testing the empirical plausibility of moral theories. Many think the source of their immorality is their emotional deficits. Psychopaths experience no guilt or remorse, feel no empathy, and appear to be perfectly rational. If this is true, sentimentalism is supported over rationalism. Here, I examine the nature of psychopathic practical reason and argue that it is impaired. The relevance to morality is discussed. I conclude that rationalists can (...) explain the moral deficits of psychopaths as well as sentimentalists. In the process, I identify psychological structures that underpin practical rationality. (shrink)

“The discipline of theological bioethics is in trouble.” So wrote Charles Camosy in November 2014, claiming that “Today’s centers of power in academic and clinical bioethics (at least in the develo...

I consider here several versions of finitism or conceptions that try to work around postulating sets of infinite size. Restricting oneself to the so-called potential infinite seems to rest either on temporal readings of infinity (or infinite series) or on anti-realistic background assumptions. Both these motivations may be considered problematic. Quine’s virtual set theory points out where strong assumptions of infinity enter into number theory, but is implicitly committed to infinity anyway. The approaches centring on the indefinitely large and the (...) use of schemata would provide a work-around to circumvent usage of actual infinities if we had a clear understanding of how schemata work and where to draw the conceptual line between the indefinitely large and the infinite. Neither of this seems to be clear enough. Versions of strict finitism in contrast provide a clear picture of a (realistic) finite number theory. One can recapture standard arithmetic without being committed to actual infinities. The major problem of them is their usage of a paraconsistent logic with an accompanying theory of inconsistent objects. If we are, however, already using a paraconsistent approach for other reasons (in semantics, epistemology or set theory), we get finitism for free. This strengthens the case for paraconsistency. (shrink)

After describing the disorder of psychopathy, I examine the theories and the evidence concerning the psychopaths’ deficient moral capacities. I first examine whether or not psychopaths can pass tests of moral knowledge. Most of the evidence suggests that they can. If there is a lack of moral understanding, then it has to be due to an incapacity that affects not their declarative knowledge of moral norms, but their deeper understanding of them. I then examine two suggestions: it is their deficient (...) practical reason or their stunted emotions that are at fault. The evidence supports both explanations. I conclude with an overview of the debate concerning whether they are morally or legally responsible for their actions. (shrink)

It is widely assumed that Christianity enjoins its followers to practice universal, unconditional forgiveness. But universal, unconditional forgiveness is regarded by many as morally problematic. Some Christian scholars have denied that Christianity in fact requires universal, unconditional forgiveness, but I believe they are mistaken. In this essay, I show two things: that Christianity does enjoin universal, unconditional forgiveness of a certain sort, and that Christians, and perhaps other theists, are always justified in exercising unconditional forgiveness. Though most philosophers treat forgiveness (...) as grounded in our beliefs about the offender's current state, I argue that we might more fruitfully ground forgiveness in hope for the wrongdoer. Christianity's commitment to the existence of an omnipotent God who is concerned about the moral status of His creatures always justifies such hope and thus always justifies forgiveness. (shrink)

With their book Logical Pluralism, Jc Beall and Greg Restall have elaborated on their previous statements on logical pluralism. Their view of logical pluralism is centred on ways of understanding logical consequence. The essay tries to come to grips with their doctrine of logical pluralism by highlighting some points that might be made clearer, and questioning the force of some of Beall’s and Restall’s central arguments. In that connection seven problems for their approach are put forth: (1) The Informal Common (...) Core Problem, (2) The Formal Common Core Problem, (3) The Superior Judge Problem, (4) The Problem of the Conditional, (6) The Problem of an Unsettled Concept of Consequence, (7) The Methodological Problem, (8) The General Logical Form Problem. It seems that the case for logical pluralism is far from clear. It is even unclear what exactly logical pluralism is and where is stops. It is also unclear if logical pluralism could be stated as it is, if it were true. So far universalism seems to be the better position to take. (shrink)

In the first part the paper rehearses the main arguments why to be a dialetheist (i.e. why to assume that some contradictions are true). Dialetheism, however, has been criticised as irrational or self-refutating. Therefore the second part of the paper outlines one way to make dialetheism rational assertable. True contradictions turn out to be both believable and assertable. The argument proceeds by setting out basic principles of assertion and denial, and employing bivalent truth value operators.

Hybrid accounts of folk psychology maintain that we sometimes theorize and sometimes simulate in order to understand others. An important question is why this is the case. In this paper, I present a view according to which simulation, but not theory, plays a central role in empathy. In contrast to others taking a similar approach to simulation, I do not focus on empathy’s cognitive aspect, but stress its affective-motivational one. Simulating others’ emotions usually engages our motivations altruistically. By vicariously feeling (...) what others are feeling, we directly come to be motivated by their projects and concerns. Simulation contrasts with more theoretical approaches to psychological attribution that help us understand and explan others, but that do not move us altruistically. This helps us see why we would posit two different folk psychological approaches instead of merely one. (shrink)

In a recent article, 1 Riisfeldt attempts to show that the principle of double effect is unsound as an ethical principle and problematic in its application to palliative opioid and sedative use in end-of-life care. Specifically, he claims that routine, non-lethal opioid and sedative administration may be “intrinsically bad” by PDE’s standards, continuous deep palliative sedation should be treated as a bad effect akin to death for purposes of PDE, PDE cannot coherently be applied in cases where death “indirectly” furthers (...) an agent’s intended end of pain relief via medically appropriate palliative care, and application of PDE requires sacrificing common beliefs about the sanctity of human life. I respond by showing that Riisfeldt’s understanding of PDE is seriously mistaken: he misattributes Kantian and Millian reasoning to the principle and conflates acts’ intrinsic properties with their effects. Further, a corrected understanding of PDE can address Riisfeldt’s case-specific objections. (shrink)