Healthcare priority-setting institutions have good reason to want to demonstrate that their decisions are morally justified—and those who contribute to and use the health service have good reason to hope for the same. However, finding a moral basis on which to evaluate healthcare priority-setting is difficult. Substantive approaches are vulnerable to reasonable disagreement about the appropriate grounds for allocating resources, while procedural approaches may be indeterminate and insufficient to ensure a just distribution. In this paper, we set out a complementary, (...) coherence-based approach to the evaluation of healthcare priority-setting. Drawing on Rawls, we argue that an institutional priority-setter’s claim to moral justification can be assessed, in part, based on the extent to which its many normative commitments are mutually supportive and free from dissonance; that is, on the ability to establish narrow reflective equilibrium across the normative content of a priority-setter’s policy and practice. While we do not suggest that the establishment of such equilibrium is sufficient for moral justification, we argue that failure to do so might—like the proverbial canary in the coalmine—act as a generalised warning that something is awry. We offer a theoretical argument in support of this view and briefly outline a practical method for systematically examining coherence across priority-setting policy and practice. (shrink)

The World Health Assembly has encouraged WHO member-states to establish capacity in health technology assessment (HTA) as a support for achieving universal health coverage (UHC). Simultaneously, the WHO has stated that UHC is “a practical expression of the concern for health equity and the right to health.” This has prompted questions about potential tensions between priority-setting efforts and the right to health on the road to UHC. South Africa (SA) is an ideal setting in which to explore how the priority-setting (...) work of an HTA body may be integrated with an existing rights framework. (shrink)

Following the death on April 19, 2015 of Freddie Gray from injuries sustained while unarmed and in police custody, many citizens of Baltimore took to the streets and the National Guard was called into the city. A 2017 article published in the American Journal of Public Health measured the effect of this civil unrest on maternal and child health. I argue that this research does not acknowledge the full range of motivations, behaviors, aims and values that may have been inherent (...) in this unrest. I first describe the article’s characterization of Baltimore’s unrest as community violence. I then provide a negative argument against employing this characterization alone, before providing positive arguments for two alternative characterizations—as protest and apt anger. Finally, I discuss upshots of considering these alternatives. Broadly, while viewing civil unrest as community violence focuses exclusive attention on victims of unrest, these alternatives direct attention to unrest participants, with implications for public health research and practice. While I focus on Baltimore’s 2015 unrest, the proposals raised here apply wherever civil unrest occurs. (shrink)

Volume 19, Issue 6, June 2019, Page 71-73.

There is a special need for solidarity at the global level to address global health disparities. Ter Meulen argues that solidarity must complement justice, and is, in fact, more fundamental than justice to the arrangement of health care practices. We argue that PG/SHG, though a theory of justice, is fundamentally synergistic with solidarity. We relate PG/SHG to Jodi Dean’s conceptual work on reflective solidarity, contrasted with conventional solidarity, as an approach to transnational solidarity that dovetails with PG/SHG. We argue that (...) PG/SHG meets both the need for solidarity at the global level and the need for solidarity within theories of the arrangement of health care practices. (shrink)

An Essay on Human Action seeks to provide a comprehensive, detailed, enlightening, and (in its detail) original account of human action. This account presupposes a theory of events as abstract, proposition-like entities, a theory which is given in the first chapter of the book. The core-issues of action-theory are then treated: what acting in general is (a version of the traditional volitional theory is proposed and defended); how actions are to be individuated; how long actions last; what acting intentionally is; (...) what doing one thing by doing another is; what basic action is; and what omitting to do something is. Attention is also given to the concepts of causation, intention, volition, deciding, choosing, and trying. Finally, a libertarian account of free action is tentatively proposed and defended. (shrink)

The physicalist credo is that the world is physical. But some phenomena, such as minds, morals, and mathematics, appear to be nonphysical. While an uncompromising physicalism would reject these, a conciliatory physicalism needn’t if it can account for them in terms of an underlying physical basis. Any such account must refer to the nonphysical. But won’t this unavoidable reference to the nonphysical conflict with the physicalist credo? This essay aims to clarify this problem and introduce a novel solution that relies (...) on a distinction between “circumstantial” facts that are based in the circumstances and “acircumstantial” facts that are not. This is used in two ways. First, physicalism is restricted to circumstantial facts: only they must have a physical basis that does not refer to the nonphysical. Second, facts accounting for the nonphysical are not restricted to the circumstantial: they may refer to the nonphysical if they are acircumstantial. Facts about how the physical accounts for the nonphysical therefore do not conflict with the physicalist’s credo. This provides a credible answer to what physicalism could be. (shrink)

Every choice we make is set against a background of massive ignorance about our past, our future, our circumstances, and ourselves. Philosophers are divided on the moral significance of such ignorance. Some say that it has a direct impact on how we ought to behave - the question of what our moral obligations are; others deny this, claiming that it only affects how we ought to be judged in light of the behaviour in which we choose to engage - the (...) question of what responsibility we bear for our choices. Michael Zimmerman claims that our ignorance has an important bearing on both questions, and offers an account of moral obligation and moral responsibility that is sharply at odds with the prevailing wisdom. His book will be of interest to a wide range of readers in ethics. (shrink)

The principal aim of this book is to develop and defend an analysis of the concept of moral obligation. The analysis is neutral regarding competing substantive theories of obligation, whether consequentialist or deontological in character. What it seeks to do is generate solutions to a range of philosophical problems concerning obligation and its application. Amongst these problems are deontic paradoxes, the supersession of obligation, conditional obligation, prima facie obligation, actualism and possibilism, dilemmas, supererogation, and cooperation. By virtue of its normative (...) neutrality, the analysis provides a theoretical framework within which competing theories of obligation can be developed and assessed. This study is a major contribution to metaethics that will be of particular interest to all philosophers concerned with normative ethical theory. (shrink)

This superbly crafted account of the notion of moral responsibility and of its relations to freedom, control, ignorance, negligence, attempts, omissions, compulsion, mental disorders, virtues and vices, desert, and punishment fills that gap. The treatment of character and luck is particularly sophisticated and well-argued.

At the heart of ethics reside the concepts of good and bad; they are at work when we assess whether a person is virtuous or vicious, an act right or wrong, a decision defensible or indefensible, a goal desirable or undesirable. But there are many varieties of goodness and badness. At their core lie intrinsic goodness and badness, the sort of value that something has for its own sake. It is in virtue of intrinsic value that other types of value (...) may be understood, and hence that we can begin to come to terms with questions of virtue and vice, right and wrong, and so on. This book investigates the nature of intrinsic value: just what it is for something to be valuable for its own sake, just what sort of thing can have such value, just how such a value is to be computed. In the final chapter, the fruits of this investigation are applied to a discussion of pleasure, pain, and displeasure and also of moral virtue and vice, in order to determine just what value lies within these phenomena. (shrink)

Michael J. Zimmerman explores whether and how our ignorance about ourselves and our circumstances affects what our moral obligations and moral rights are. He rejects objective and subjective views of the nature of moral obligation, and presents a new case for a 'prospective' view.

Intrinsic value has traditionally been thought to lie at the heart of ethics. Philosophers use a number of terms to refer to such value. The intrinsic value of something is said to be the value that that thing has “in itself,” or “for its own sake,” or “as such,” or “in its own right.” Extrinsic value is value that is not intrinsic.

What's wrong with designer children, bionic athletes, and genetic engineering.

Introduction: Doing the right thing -- Utilitarianism : Bentham and J.S. Mill -- Libertarianism -- John Locke -- Markets and morals -- Immanuel Kant -- John Rawls -- Affirmative action -- Aristotle -- Liberals and communitarians -- Conclusion: Reconnecting politics and morals.

The following argument is addressed: (1) a person is morally responsible for an event's occurring only if that event's occurring was not a matter of luck; (2) no event is such that its occurring is not a matter of luck; therefore, (3) no event is such that someone is morally responsible for its occurring. Two notions of control are distinguished: restricted and complete. (2) is shown false on the first interpretation, (1) on the second. The discussion involves a distinction between (...) resultant and situational luck, And it is argued that, Even when luck's role in life, And the unfairness that stems from it, Is acknowledged, Moral responsibility remains possible. (shrink)

In _The Immorality of Punishment_ Michael Zimmerman argues forcefully that not only our current practice but indeed any practice of legal punishment is deeply morally repugnant, no matter how vile the behaviour that is its target. Despite the fact that it may be difficult to imagine a state functioning at all, let alone well, without having recourse to punishing those who break its laws, Zimmerman makes a timely and compelling case for the view that we must seek and put (...) into practice alternative means of preventing crime and promoting social stability. (shrink)

Preface In these days, an anthology on the topic of possible worlds hardly needs justification. No issue has given rise to as much literature in the past ...

Many philosophers hold that whether an act is overall morally obligatory is an ‘objective’ matter, many that it is a ‘subjective’ matter, and some that it is both. The idea that it is or can be both may seem to promise a helpful answer to the question ‘What ought I to do when I do not know what I ought to do?’ In this article, three broad views are distinguished regarding what it is that obligation essentially concerns: the maximization of (...) actual value, the maximization of expected value, and the perceived maximization of actual value. The first and third views are rejected; the second view is then refined and defended. The unfortunate upshot is that there may be no very helpful answer to the question just mentioned. As to the question posed in the title of the article, the answer unsurprisingly depends on what ‘objective’ and ‘subjective’ are taken to mean. (Published Online November 24 2006). (shrink)

In this book, Michael Sandel takes up some of the hotly contested moral and political issues of our time, including affirmative action, assisted suicide, ...

We develop a framework for assessing security market quality, relating five elements of market design to three metrics of market integrity and two metrics of market efficiency. We empirically implement this integrity–efficiency MQ framework by testing a hypothesis that trade-based ramping manipulation at the close raises execution costs on 24 security markets worldwide. Estimating a simultaneous equations model of ramping incidence, spreads, and the probability of deploying real-time surveillance, we show that quoted bid-ask spreads are positively related to the incidence (...) of MTC across seven liquidity deciles. The magnitude is economically significant; improving market integrity by cutting MTC in half reduces spreads 6–11 %. Allowing direct market access in conjunction with RTS, conducting auctions at the close, and developing regulations that require surveillance, all reduce MTC and thereby lower spreads, assuring better market integrity and enhancing market efficiency. Introducing circuit breakers or prohibiting shorts poses integrity–efficiency tradeoffs. (shrink)

Many philosophers endorse the idea that there can be no moral responsibility without a moral community and thus hold that such responsibility is essentially interpersonal. In this paper, various interpretations of this idea are distinguished, and it is argued that no interpretation of it captures a significant truth. The popular view that moral responsibility consists in answerability is discussed and dismissed. The even more popular view that such responsibility consists in susceptibility to the reactive attitudes is also discussed, and it (...) is argued that this view at best supports only an etiolated interpretation of the idea that moral responsibility is essentially interpersonal. (shrink)

University of North Carolina at Greensboro Greensboro, NC 27402-6170, USA.

University of North Carolina at Greensboro Greensboro, NC 27402-6170, USA.

_Metaphysics: A Contemporary Introduction_ is for students who have already completed an introductory philosophy course and need a fresh look at the central topics in the core subject of metaphysics. It is essential reading for any student of the subject. This Fourth Edition is revised and updated and includes two new chapters on Parts and Wholes, and Metaphysical Indeterminacy or vagueness. This new edition also keeps the user-friendly format, the chapter overviews summarizing the main topics, concrete examples to clarify difficult (...) concepts, annotated further reading at the end of each chapter, endnotes, and a full bibliography. Topics addressed include: the problem of universals the nature of abstract entities the problem of individuation the nature of modality identity through time the nature of time the nature of parts and wholes the problem of metaphysical indeterminacy the Realism/anti-Realism debate. Wherever possible, Michael J. Loux and Thomas M. Crisp relate contemporary views to their classical sources in the history of philosophy. As experienced teachers of philosophy and important contributors to recent debates, Loux and Crisp are uniquely qualified to write this book. (shrink)

The fitting-attitudes analysis of value, which states that something's being good consists in its being the fitting object of some pro-attitude, has recently been the focus of intense debate. Many objections have been levelled against this analysis. One objection to it concerns the ‘challenge from partiality’, according to which it can be fitting to display partiality toward objects of equal value. Several responses to the challenge have been proposed. This paper criticizes these and other responses and then offers a response (...) that, it is claimed, solves the challenge. (shrink)

T. M. Scanlon has revived a venerable tradition according to which something's being good consists in its being such that there is a reason to respond positively towards it. He has presented novel arguments for this thesis. In this article, I first develop some refinements of the thesis with a view to focusing on intrinsic value in particular, then discuss the relation between the thesis and consequentialism, then critically examine Scanlon's arguments for the thesis, and finally turn to the question (...) whether we should reject the thesis on the grounds that, when there is a reason to respond positively towards something, this is so because the thing in question is good. Two appendices follow. In the first, I discuss whether it is good to do right. In the second, I discuss whether an act's being wrong provides a reason not to do it. (shrink)

The idea that immoral behaviour can sometimes be admirable, and that moral behaviour can sometimes be less than admirable, has led several of its supporters to infer that moral considerations are not always overriding, contrary to what has been traditionally maintained. In this paper I shall challenge this inference. My purpose in doing so is to expose and acknowledge something that has been inadequately appreciated, namely, the moral aspect of nonmoral goods and evils. I hope thereby to show that, even (...) if immorality can be admirable, this poses no threat to morality. (shrink)

Researchers misunderstand their role in creating ethical problems when they allow dogmas to purportedly divorce scientists and scientific practices from the values that they embody. Cortina, Edwards, and Powell help us clarify and further develop our position by responding to our critique of, and alternatives to, this misleading separation. In this rebuttal, we explore how the desire to achieve the separation of facts and values is unscientific on the very terms endorsed by its advocates—this separation is refuted by empirical observation. (...) We show that positivists like Cortina and Edwards offer no rigorous theoretical or empirical justifications to substantiate their claims, let alone critique ours. Following Powell, we point to how classical pragmatism understands ‘purpose’ in scientific pursuits while also providing an alternative to the dogmas of positivism and related philosophical positions. In place of dogmatic, unscientific cries about an abstract and therefore always-unobservable ‘reality,’ we invite all organizational scholars to join us in shifting the discussion about quantitative research towards empirically grounded scientific inquiry. This makes the ethics of actual people and their practices central to quantitative research, including the thoughts, discourses, and behaviors of researchers who are always in particular places doing particular things. We propose that quantitative researchers can thus start to think about their research practices as a kind of work, rather than having the status of a kind of dogma. We conclude with some implications that this has for future research and education, including the relevance of research and research methods. (shrink)

There is currently an explosion of interest in grounding. In this article we provide an overview of the debate so far. We begin by introducing the concept of grounding, before discussing several kinds of scepticism about the topic. We then identify a range of central questions in the theory of grounding and discuss competing answers to them that have emerged in the debate. We close by raising some questions that have been relatively neglected but which warrant further attention.

There has been considerable debate regarding the relative merits of two theses about moral obligation known as actualism and possibilism. Both theses seek to give expression to the general idea that one ought to do the best one can. According to actualism, one’s obligations turn on what would happen if one chose some course of action, whereas, according to possibilism, they turn on what could happen if one chose some course of action. There are two strands to the debate: the (...) substantive verdicts that the two theses render in particular cases, and the accounts that they yield of the conceptual structure of moral obligation. Possibilism is conceptually appealing, whereas actualism is not, but the latter may seem to render superior substantive verdicts. In this paper, it is argued that, by turning from the objectivist’s emphasis on what is actually best to the prospectivist’s emphasis on what one’s evidence indicates is best, possibilists can provide an account of moral obligation that is both conceptually and substantively attractive. (shrink)

Problems of and explanations for evil -- Neo-cartesianism -- Animal suffering and the fall -- Nobility, flourishing, and immortality : animal pain and animal well-being -- Natural evil, nomic regularity, and animal suffering -- Chaos, order, and evolution -- Combining CDs.