How do we judge whether an action is morally right or wrong? If an action is wrong, what reason does that give us not to do it? Why should we give such reasons priority over our other concerns and values? In this book, T. M. Scanlon offers new answers to these questions, as they apply to the central part of morality that concerns what we owe to each other. According to his contractualist view, thinking about right and wrong is thinking (...) about what we do in terms that could be justified to others and that they could not reasonably reject. He shows how the special authority of conclusions about right and wrong arises from the value of being related to others in this way, and he shows how familiar moral ideas such as fairness and responsibility can be understood through their role in this process of mutual justification and criticism. Scanlon bases his contractualism on a broader account of reasons, value, and individual well-being that challenges standard views about these crucial notions. He argues that desires do not provide us with reasons, that states of affairs are not the primary bearers of value, and that well-being is not as important for rational decision-making as it is commonly held to be. Scanlon is a pluralist about both moral and non-moral values. He argues that, taking this plurality of values into account, contractualism allows for most of the variability in moral requirements that relativists have claimed, while still accounting for the full force of our judgments of right and wrong. (shrink)

Bhattacharyya, K. The Advaita concept of subjectivity.--Deutsch, E. Reflections on some aspects of the theory of rasa.--Nakamura, H. The dawn of modern thought in the East.--Organ, T. Causality, Indian and Greek.--Chatterjee, M. On types of classification.--Lacombe, O. Transcendental imagination.--Bahm, A. J. Standards for comparative philosophy.--Herring, H. Appearance, its significance and meaning in the history of philosophy.--Chang Chung-yuan. Pre-rational harmony in Heidegger's essential thinking and Chʼan thought.--Staal, J. F. Making sense of the Buddhist tetralemma.--Enomiya-Lassalle, H. M. The mysticism of Carl Albrecht (...) and Zen.--Parrinder, G. The nature of mysticism.--Cairns, G. E. Axiological contributions of East and West to the spiritual development of mankind.--Mayeda, S. Śaṇkara's view of ethics.--Mercier, A. On peace.--Barlingay, S. S. A discussion of some aspects of Gaudapāda's philosophy. (shrink)

[T. M. Scanlon] It is clearly impermissible to kill one person because his organs can be used to save five others who are in need of transplants. It has seemed to many that the explanation for this lies in the fact that in such cases we would be intending the death of the person whom we killed, or failed to save. What makes these actions impermissible, however, is not the agent's intention but rather the fact that the benefit envisaged does (...) not justify an exception to the prohibition against killing or the requirement to give aid. The difference between this explanation and one appealing to intention is easily overlooked if one fails to distinguish between the prospective use of a moral principle to guide action and its retrospective use to appraise the way an agent governed him or herself. Even if this explanation is accepted, however, it remains an open question whether and how an agent's intention may be relevant to the permissibility of actions in other cases. \\\ [Jonathan Dancy] My first four sections concentrate on the second section of Professor Scanlon's contribution, where he lays out his conception of moral principles and of the role they play in theory and practice. I will raise questions on the following issues: 1. Scanlon's initial introduction of the notion of a principle. 2. His rejection of the standard view that principles are concerned with the forbidding, permitting and requiring of actions. 3. His rejection of pro tanto conceptions of principles in favour of a conception of them as conclusive. 4. The resulting account of what it is for a principle to face and survive exceptions. Scanlon's discussion of these matters here both appeals to and is in some respects more detailed than the relevant section of his recent What We Owe to Each Other. The topic is interesting both for the role played by principles in Scanlon's present discussion of intention and permissibility, and more generally because of his account of wrongness: an act is wrong iff it is ruled out by principles that nobody could reasonably reject. The remainder of my contribution is concerned with the ostensible focus of IP, namely the relevance of agent-intentions to the permissibility of what is done. (shrink)

[T. M. Scanlon] It is clearly impermissible to kill one person because his organs can be used to save five others who are in need of transplants. It has seemed to many that the explanation for this lies in the fact that in such cases we would be intending the death of the person whom we killed, or failed to save. What makes these actions impermissible, however, is not the agent's intention but rather the fact that the benefit envisaged does (...) not justify an exception to the prohibition against killing or the requirement to give aid. The difference between this explanation and one appealing to intention is easily overlooked if one fails to distinguish between the prospective use of a moral principle to guide action and its retrospective use to appraise the way an agent governed him or herself. Even if this explanation is accepted, however, it remains an open question whether and how an agent's intention may be relevant to the permissibility of actions in other cases. \\\ [Jonathan Dancy] My first four sections concentrate on the second section of Professor Scanlon's contribution, where he lays out his conception of moral principles and of the role they play in theory and practice. I will raise questions on the following issues: 1. Scanlon's initial introduction of the notion of a principle. 2. His rejection of the standard view that principles are concerned with the forbidding, permitting and requiring of actions. 3. His rejection of pro tanto conceptions of principles in favour of a conception of them as conclusive. 4. The resulting account of what it is for a principle to face and survive exceptions. Scanlon's discussion of these matters here both appeals to and is in some respects more detailed than the relevant section of his recent What We Owe to Each Other. The topic is interesting both for the role played by principles in Scanlon's present discussion of intention and permissibility, and more generally because of his account of wrongness: an act is wrong iff it is ruled out by principles that nobody could reasonably reject. The remainder of my contribution is concerned with the ostensible focus of IP, namely the relevance of agent-intentions to the permissibility of what is done. (shrink)

Transplantation is a medically successful and cost-effective way to treat people whose organs have failed--but not enough organs are available to meet demand. T. M. Wilkinson explores the major ethical problems raised by policies for acquiring organs. Key topics include the rights of the dead, the role of the family, and the sale of organs.

This is the text of The Lindley Lecture for 1996, given by T.M. Scanlon, an American philosopher.

BackgroundSystems medicine is the name for an assemblage of scientific strategies and practices that include bioinformatics approaches to human biology ; “big data” statistical analysis; and medical informatics tools. Whereas personalized and precision medicine involve similar analytical methods applied to genomic and medical record data, systems medicine draws on these as well as other sources of data. Given this distinction, the clinical translation of systems medicine poses a number of important ethical and epistemological challenges for researchers working to generate systems (...) medicine knowledge and clinicians working to apply it.DiscussionThis article focuses on three key challenges: First, we will discuss the conflicts in decision-making that can arise when healthcare providers committed to principles of experimental medicine or evidence-based medicine encounter individualized recommendations derived from computer algorithms. We will explore in particular whether controlled experiments, such as comparative effectiveness trials, should mediate the translation of systems medicine, or if instead individualized findings generated through “big data” approaches can be applied directly in clinical decision-making. Second, we will examine the case of the Riyadh Intensive Care Program Mortality Prediction Algorithm, pejoratively referred to as the “death computer,” to demonstrate the ethical challenges that can arise when big-data-driven scoring systems are applied in clinical contexts. We argue that the uncritical use of predictive clinical algorithms, including those envisioned for systems medicine, challenge basic understandings of the doctor-patient relationship. Third, we will build on the recent discourse on secondary findings in genomics and imaging to draw attention to the important implications of secondary findings derived from the joint analysis of data from diverse sources, including data recorded by patients in an attempt to realize their “quantified self.”SummaryThis paper examines possible ethical challenges that are likely to be raised as systems medicine to be translated into clinical medicine. These include the epistemological challenges for clinical decision-making, the use of scoring systems optimized by big data techniques and the risk that incidental and secondary findings will significantly increase. While some ethical implications remain still hypothetical we should use the opportunity to prospectively identify challenges to avoid making foreseeable mistakes when systems medicine inevitably arrives in routine care. (shrink)

We introduce a simple model for so-called spin-echo experiments. We show that the model is a mincing system. On the basis of this model we study fine-grained entropy and coarse-grained entropy descriptions of these experiments. The coarse-grained description is shown to be unable to provide an explanation of the echo signals, as a result of the way in which it ignores dynamically generated correlations. This conclusion is extended to the general debate on the foundations of statistical mechanics. We emphasize the (...) need for an appropriate mechanism to explain the gradual suppression over time of the correlations in a thermodynamic system. We argue that such a mechanism can only be provided by the interventionist approach, in which the interaction of the system with its environment is taken into account. Irreversible behavior is then seen to arise not as a result of limited measurement accuracy , but as a result of the fact that thermodynamic systems are limited systems which interact with their environment. A detailed discussion is given of recent objections to the interventionist approach in the literature. (shrink)

According to rationalism regarding the psychology of moral judgment, people’s moral judgments are generally the result of a process of reasoning that relies on moral principles or rules. By contrast, intuitionist models of moral judgment hold that people generally come to have moral judgments about particular cases on the basis of gut-level, emotion-driven intuition, and do so without reliance on reasoning and hence without reliance on moral principles. In recent years the intuitionist model has been forcefully defended by Jonathan Haidt. (...) One important implication of Haidt’s model is that in giving reasons for their moral judgments people tend to confabulate – the reasons they give in attempting to explain their moral judgments are not really operative in producing those judgments. Moral reason-giving on Haidt’s view is generally a matter of post hoc confabulation. Against Haidt, we argue for a version of rationalism that we call ‘morphological rationalism.’ We label our version ‘morphological’ because according to it, the information contained in moral principles is embodied in the standing structure of a typical individual’s cognitive system, and this morphologically embodied information plays a causal role in the generation of particular moral judgments. The manner in which the principles play this role is via ‘proceduralization’ – such principles operate automatically. In contrast to Haidt’s intuitionism, then, our view does not imply that people’s moral reason-giving practices are matters of confabulation. In defense of our view, we appeal to what we call the ‘nonjarring’ character of the phenomenology of making moral judgments and of giving reasons for those judgments. (shrink)

Paternalist policies in public health often aim to improve people’s well-being by reducing their options, regulating smoking offering a prime example. The well-being challenge is to show that people really are better off for having their options reduced. The distribution challenge is to show how the policies are justified since they produce losers as well as winners. If we start from these challenges, we can understand the importance of the empirical evidence that a very high proportion of smokers regret smoking. (...) In short, it is important that they regret it and important that the proportion is so high. This paper explains how, philosophically, regret can relate to well-being and it considers some of the strengths and weakness in the empirical research that the explanation brings out. The regret case for regulating smoking is indeed strong, although not as strong as the empirical researchers think. It is much weaker for paternalistic intervention in other public health problems, such as obesity and binge drinking. (shrink)

Awareness is a personal experience, which is only accessible to the rest of world through interpretation. We set out to identify a neural correlate of visual awareness, using brief subliminal and supraliminal verbal stimuli while measuring cerebral blood flow distribution with H215O PET. Awareness of visual verbal stimuli differentially activated medial parietal association cortex (precuneus), which is a polymodal sensory cortex, and dorsolateral prefrontal cortex, which is thought to be primarily executive. Our results suggest participation of these higher order perceptual (...) and executive cortical structures in visual verbal awareness. (shrink)

It is generally wrong to manipulate. One leading reason is because manipulation interferes with autonomy, in particular the component of autonomy called ‘independence’, that is, freedom from intentional control by others. Manipulative health promotion would therefore seem wrong. However, manipulative techniques could be used to counter-manipulation, for example, playing on male fears of impotence to counter ‘smoking is sexy’ advertisements. What difference does it make to the ethics of manipulation when it is counter-manipulation? This article distinguishes two powerful defences of (...) counter-manipulative health promotion: that the counter-manipulation would prevent manipulation occurring, leaving people unmanipulated; and that the counter-manipulation would make people healthier without being any more manipulated than they would otherwise be. The article explains how counter-manipulation might work and the limits to its scope. The upshot is that counter-manipulative health promotion could respect the independence people are owed in virtue of their autonomy. However, autonomy is not the only consideration, and the article discusses further potential problems. Counter-manipulative health promotion might be misapplied, it might undermine trust, it might infringe on some norms for role behaviour and it might encourage a regrettable social practice. These objections are likely to be decisive against the counter-manipulation in some but not all cases. (shrink)

The current position on the deceased’s consent and the family’s consent to organ and tissue donation from the dead is a double veto—each has the power to withhold and override the other’s desire to donate. This paper raises, and to some extent answers, questions about the coherence of the double veto. It can be coherently defended in two ways: if it has the best effects and if the deceased has only negative rights of veto. Whether the double veto has better (...) effects than other policies requires empirical investigation, which is not undertaken here. As for rights, the paper shows that it is entirely possible that individuals have a negative right of veto but no positive right to compel acceptance of their offers. Thus if intensivists and transplant teams turn down the deceased’s offer, they do not thereby violate the deceased’s right. This leaves it open whether non-rights based reasons—such as avoiding bad publicity or distress —require intensivists and transplant teams to turn down or accept the deceased’s offer. This, however, is beyond the scope of this paper. The current position may or may not be wrong, but it is at least coherent. (shrink)

According to this paper, respect for informed consent implies that subjects should often be told a good deal more than ethical guidelines explicitly or implicitly require. Unless subjects are informed of the researchers’ personal characteristics, views, and sponsors whenever they would be likely to consider them significant, their autonomy is being overridden. However, overriding subjects’ autonomy is sometimes required by the interests of researchers in not being discriminated against or suffering intrusions into their privacy. This paper resolves the conflict between (...) informed consent and the interests of researchers by recommending that (i) subjects generally should be told of the personal characteristics of researchers when relevant as part of the researchers’ job and (ii) that subjects should be told of researchers’ views when conceptually connected to the research and (iii) that subjects should almost always be told about sponsorship. While the paper explicitly limits the role of informed consent, these recommendations go significantly beyond most guidelines in their requirements about what information should be disclosed. (shrink)

It is clearly impermissible to kill one person because his organs can be used to save five others who are in need of transplants. It has seemed to many that the explanation for this lies in the fact that in such cases we would be intending the death of the person whom we killed, or failed to save. What makes these actions impermissible, however, is not the agent's intention but rather the fact that the benefit envisaged does not justify an (...) exception to the prohibition against killing or the requirement to give aid. The difference between this explanation and one appealing to intention is easily overlooked if one fails to distinguish between the prospective use of a moral principle to guide action and its retrospective use to appraise the way an agent governed him or herself. Even if this explanation is accepted, however, it remains an open question whether and how an agent's intention may be relevant to the permissibility of actions in other cases. \\\ [Jonathan Dancy] My first four sections concentrate on the second section of Professor Scanlon's contribution, where he lays out his conception of moral principles and of the role they play in theory and practice. I will raise questions on the following issues: 1. Scanlon's initial introduction of the notion of a principle. 2. His rejection of the standard view that principles are concerned with the forbidding, permitting and requiring of actions. 3. His rejection of pro tanto conceptions of principles in favour of a conception of them as conclusive. 4. The resulting account of what it is for a principle to face and survive exceptions. Scanlon's discussion of these matters here both appeals to and is in some respects more detailed than the relevant section of his recent What We Owe to Each Other. The topic is interesting both for the role played by principles in Scanlon's present discussion of intention and permissibility, and more generally because of his account of wrongness: an act is wrong iff it is ruled out by principles that nobody could reasonably reject. The remainder of my contribution is concerned with the ostensible focus of IP, namely the relevance of agent-intentions to the permissibility of what is done. (shrink)

In response to comments on my book, Being Realistic about Reasons, by Justin Clarke-Doane, David Enoch and Tristram McPherson, and Gideon Rosen, I try to clarify my domain-based view of ontology, my understanding of the epistemology of normative judgments, and my interpretation of the phenomenon of supervenience.

Within the moral/social order maintained and reproduced by biomedical ethics (i.e., the “peaceable community”), suffering is a senseless accident with no value. Insofar as suffering compromises the fundamental pillar of this order, namely, autonomy, it threatens the existence of the “peaceable community”. Consequently, biomedical ethics is only able to offer those who suffer one moral or practical response: that of elimination, embodied most vividly in the increasingly approved practice of assisted-suicide. Another moral/ social order, however, the “peaceable Kingdom” or the (...) “Body of Christ”, provides an alternative understanding of the meaning, purpose, and significance of suffering, through the Roman Catholic sacrament of anointing of the sick. Recognizing the power of sickness and suffering to “dis-inscribe” bodies of their normative self-understandings, the Church responds with a set of liturgical practices which intend to respond to the dynamics of suffering, re-inscribe these bodies, and assist persons in fulfilling the vocation of “participating in Christ's suffering for the salvation of the world”. (shrink)

T. M. Rudavsky tells the story of the development of Jewish philosophy from the 10th century to Spinoza in the 17th, as part of a dialogue with medieval Christian and Islamic thought. She gives a broad historical survey of major figures and schools within the medieval Jewish tradition, focusing on the tensions between Judaism and rational thought.

This essay argues that normative judgments, in general, and moral judgments, in particular, are "truth apt" and can be objects of belief. Other main claims are: judgments about reasons, if interpreted as true, do not have metaphysical implications that are incompatible with a scientific view of the world. Two kinds of normative claims should be distinguished: substantive claims about what reasons people have and structural claims about what attitudes people must have insofar as they are rational. Employing this distinction, the (...) practical significance of substantive normative judgments is explained, and critical analysis of expressivist and Kantian views on this question is offered. (shrink)