Many investigations of moral decision-making employ hypothetical scenarios in which each participant has to choose between two options. One option is usually deemed “utilitarian” and the other either “non-utilitarian” or “deontological”. Very little has been done to establish the validity of such measures. It is unclear what they measure, let alone how well they do so. In this exploratory study, participants were asked about the reasons for their decisions in six hypothetical scenarios. Various concerns contributed to each decision. Action decisions (...) occurred when utilitarian concerns dominated. Bystanding decisions resulted from different concerns or combinations of concerns dominating in different situations, with utilitarianism usually among participants’ concerns. None of the labels usually used for either decision therefore seems entirely appropriate. Five concerns were identified as necessary and sufficient to predict over 85% of participants’ decisions. This suggests great promise for future research, particularly in investigation of real-world moral decisions. (shrink)

Six people were interviewed about the possibility of becoming posthumous body donors. Interview transcripts were analyzed using interpretative phenomenological analysis. Individual-level analysis suggested a common interest in Personhood Concerns and a common commitment to Enlightenment Values. Investigations of these possible themes across participants resulted in identification of two sample-level themes, each with two subthemes: Autonomy, with subthemes of agency and consent, and Rationality, with subthemes of knowledge/epistemology and materialism/ontology. This paper concentrates on the former. Consent for posthumous body donation was (...) felt to sometimes fall short of adequately identifying donors’ preferences about what happened after consent was given, even with respect to actions for which consent established permission. In turn, paucity of information about donors’ preferences limited others’ ability to act as proxy agents to facilitate donors’ posthumous autonomy. Thus, while consent may curtail violations of people’s autonomy by authorizing actions for which permission has been established, it may fall short of facilitating their autonomy in ways that might be possible with greater knowledge of those people’s desires. Alternative methods of establishing consent are explored that might better-determine people’s desires and thereby improve others’ ability to act as proxy agents for them to facilitate their subsequent (even posthumous) autonomy. (shrink)

Recent psychological research concerning determinantsof and barriers to organ donation is reviewed with theintention of ascertaining acceptable and potentiallyeffective ways of improving organ retrieval. On thebasis of this review, five recommendations are made.(1) Individuals' donation wishes, where explicit,should be decisive. (2) Next of kin should witnessdonor decisions. (3) Mandated choice should replacevoluntary `opting-in'. (4) Initial donation choicesshould be repeatedly re-evaluated. (5) Those involvedin organ procurement should distance themselves frommodel of bodies as machines or gardens and embracemodels where bodies are viewed (...) as sacred extensions ofself. In combination, these recommendations are arguedto be preferable in several ways to opt-out/presumedconsent procurement options. (shrink)

Objective: To explore the ways in which health care practitioners working within the morally contested area of prenatal screening balance their professional and private moral values.Design: Qualitative study incorporating semistructured interviews with health practitioners followed by multidisciplinary discussion groups led by a health care ethicist.Setting: Inner city teaching hospital and district general hospital situated in South East England.Participants: Seventy practitioners whose work relates directly or indirectly to perinatal care.Results: Practitioners managed the interface between their professional and private moral values in (...) a variety of ways. Two key categories emerged: “tolerators”, and “facilitators”. The majority of practitioners fell into the “facilitator” category. Many “facilitators” felt comfortable with the prevailing ethos within their unit, and appeared unlikely to feel challenged unless the ethos was radically challenged. For others, the separation of personal and professional moral values was a daily struggle. In the “tolerator” group, some practitioners sought to influence the service offered directly, whereas others placed limits on how they themselves would contribute to practices they considered immoral.Conclusions: The “official” commitment to non-directiveness does not encourage open debate between professionals working in morally contested fields. It is important that practical means can be found to support practitioners and encourage debate. Otherwise, it is argued, these fields may come to be staffed by people with homogeneous moral views. This lack of diversity could lead to a lack of critical analysis and debate among staff about the ethos and standards of care within their unit. (shrink)

Around the world, the population is ageing in ways that pose new challenges for healthcare providers. To date these have mostly been formulated in terms of challenges created by increasing costs, and the focus has been squarely on life-prolonging treatments. However, this focus ignores the ways in which many older people require life-enhancing treatments to counteract the effects of physical and mental decline. This paper argues that in doing so it misses important aspects of what justice requires when it comes (...) to older people. (shrink)

Since 1989, widely circulating statistics on gay teen suicide in the United States have acted as catalysts for institutional reforms, scientific research, and the creation of an identity category “gay youth.” While one figure has been replicated scientifically, these numbers originated not from a scientific research study but as risk estimates developed by a social worker and published in a government document. Many people within the public took up these original numbers, attributing their author the status of scientific researcher. In (...) effect, the numbers became “black boxed,” often traveling without citation. Drawing on Ian Hacking’s “dynamic nominalist” perspective, this article utilizes interviews with the author of these statistics and other key claimants, along with textual analysis, to trace the origins, uptake, and effects of these figures. While making vital policy contributions, the numbers have led to some ironic consequences including the fostering of gay youth identification with suicide as a potential correlate of their identity and the potential antigay redeployment of decontextualized numbers. They have also led to a reaction in the form of “resilience” narratives. (shrink)

Considerations of the notion of preparedness have come to the fore in the recent pandemic, highlighting a need to be better prepared to deal with sudden, unexpected and unwanted events. However, the concept of preparedness is also important in relation to planned for and desired interventions resulting from healthcare innovations. We describe ethical preparedness as a necessary component for the successful delivery of novel healthcare innovations, and use recent advances in genomic healthcare as an example. We suggest that practitioners and (...) organisations charged with delivering innovative and ambitious healthcare programmes can only succeed if they are able to exhibit the attribute of ethical preparedness. (shrink)

This article reviews practitioners’ evaluations of in-hospital ethics seminars. A qualitative study included 11 innovative in-hospital ethics seminars, preceded and followed by interviews with most participants. The settings were obstetric, neonatal and haematology units in a teaching hospital and a district general hospital in England. Fifty-six health service staff in obstetric, neonatal, haematology, and related community and management services participated; 12 attended two seminars, giving a total of 68 attendances and 59 follow-up evaluation interviews. The 11 seminars facilitated by an (...) ethicist addressed the key local concerns of staff about the social and ethical consequences of advances in genetics and their impact on professional policies and practice. Seminar agendas were drawn from prior interviews with 70 staff members. During evaluation interviews, participants commented on general aspects that they had enjoyed, how the sessions could be improved, timing, the mix of participants, the quality of the facilitation, whether sessions should be more challenging, after-effects of sessions, and interest in attending seminars and contacting the ethicist in future. Participants valued the increased interprofessional understanding and coherent discussion of many pressing issues that addressed important though seldom discussed ethical questions. The seminars worked well in the different hospitals and specialties. (shrink)

How wrong is it to deceive someone into sex by lying, say, about one's profession? The answer is seriously wrong when the liar's actual profession would be a deal breaker for the victim of the deception: this deception vitiates the victim's sexual consent, and it is seriously wrong to have sex with someone while lacking his or her consent.

A personal reflection upon a career in medical ethics leads to four conclusions on what makes for 'good medical ethics'. Good medical ethics is practical in approach, philosophically well grounded, cross disciplinary, and while it might not be a necessary feature, the experience of the author suggests that it is the work of 'good people'.

Scientists are seekers of truth; but where science breaks into the everyday world should they be held accountable for the outcome of their actions? The contributors to this volume believe that scientists are more than mere cogs in a machine - science, technology and politics are inseparable. Part 1 describes current scientific practice from three personal perspectives; part 2 looks at the ways in which science, society and the environment could interact given the chance; and part 3 examines the more (...) general aspects of Western science and their relevance to our relationship with the environment, society and all global issues. (shrink)

Healthcare ethics has to date had very little to say about the treatment of chronic illness. That is problematic. Chronic illness differs from other illnesses in that: 1. in most cases it cannot be cured; 2. patients can live with it for many years; and 3. its day to day management is typically carried out, not by healthcare professionals, but by the patient and/or members of their family. These features problematise key distinctions that underlie much existing work in healthcare ethics (...) — including those between beneficence and autonomy, between treatment and prevention, and between the recipient and provider of treatment. They also raise ethical questions that have not to date been addressed in any detail — including what healthcare professionals should do when patients are managing their illness poorly, or when changes occur that affect their patients. For these reasons chronic illness provides a lens through which to challenge the adequacy of existing approaches to healthcare ethics, exposing the gaps and false assumptions built into them. In doing so it also provides the materials to build a more philosophically adequate account of healthcare professionals’ moral obligations than exists to date. Providing such an account is the aim of this monograph. (shrink)

Nearly everyone prefers pain to be in the past rather than the future. This seems like a rationally permissible preference. But I argue that appearances are misleading, and that future-biased preferences are in fact irrational. My argument appeals to trade-offs between hedonic experiences and other goods. I argue that we are rationally required to adopt an exchange rate between a hedonic experience and another type of good that stays fixed, regardless of whether the hedonic experience is in the past or (...) future. (shrink)

Our successful engagement with the world is plausibly underwritten by our sensitivity to affordances in our immediate environment. The considerable literature on affordances focuses almost exclusively on affordances for bodily actions such as gripping, walking or eating. I propose that we are also sensitive to affordances for mental actions such as attending, imagining and counting. My case for this ‘Mental Affordance Hypothesis’ is motivated by a series of examples in which our sensitivity to mental affordances mirrors our sensitivity to bodily (...) affordances. Specifically, subjects perceive opportunities to perform a mental action and their doing so leads, under the right conditions, to the automatic preparation of that action. I conclude by sketching a mental affordance research program that would reinforce my case for the Mental Affordance Hypothesis and establish its ramifications for a number of debates across philosophy and psychology. (shrink)

This paper stems from an ethnographic, multidisciplinary study that explored the views and experiences of practitioners and scientists on social, ethical and clinical dilemmas encountered when working in the area of pre-implantation genetic diagnosis for serious genetic disorders. We focus here on staff perceptions and experiences of working with embryos and helping women/couples to make choices that will result in selecting embryos for transfer and disposal of 'affected' embryos, compared to the termination of affected pregnancies following prenatal diagnosis. Analysis and (...) discussion of our data led us to consider the possible advantages of pre-implantation genetic diagnosis and whether a gradualist account of the embryo's and fetus's moral status can account for all of these, particularly since a gradualist account concentrates on the significance of time (developmental stage) and makes no comment as to the significance of place (in vitro, in utero). (shrink)

The scope of someone's consent is the range of actions that they permit by giving consent. The Scope of Consent investigates the under-explored question of which normative principle governs the scope of consent. To answer this question, the book's investigation involves taking a stance on what constitutes consent. By appealing to the idea that someone can justify their behaviour by appealing to another person's consent, Dougherty defends the view that consent consists in behaviour that expresses a consent-giver's will for how (...) a consent-receiver behaves. The ultimate conclusion of the book is that the scope of consent is determined by certain evidence that bears on the appropriate interpretation of the consent. (shrink)

You are morally permitted to save your friend at the expense of a few strangers, but not at the expense of very many. However, there seems no number of strangers that marks a precise upper bound here. Consequently, there are borderline cases of groups at the expense of which you are permitted to save your friend. This essay discusses the question of what explains ethical vagueness like this, arguing that there are interesting metaethical consequences of various explanations.

First Published in 2004. Routledge is an imprint of Taylor & Francis, an informa company.

The anglophone philosophy profession has a well-known problem with gender equity. A sig-nificant aspect of the problem is the fact that there are simply so many more male philoso-phers than female philosophers among students and faculty alike. The problem is at its stark-est at the faculty level, where only 22% - 24% of philosophers are female in the United States (Van Camp 2014), the United Kingdom (Beebee & Saul 2011) and Australia (Goddard 2008).<1> While this is a result of the (...) percentage of women declining at each point through-out the standard career trajectory, recent large-scale studies in the United States (Paxton et al. 2012) and Australia (Goddard et al. 2008) have identified a key drop-off point as the transi-tion between taking introductory classes and majoring in philosophy. So why do dispropor-tionately few female students choose to major in philosophy? (shrink)

To develop a theoretical framework for drawing moral distinctions between instances of sexual misconduct, I defend the “Ameliorative View” of consent, according to which there are three possibilities for what effect, if any, consent has: “fully valid consent” eliminates a wronging, “fully invalid consent” has no normative effect, and “partially valid consent” has an ameliorative effect on a wronging in the respect that it makes the wronging less grave. I motivate the view by proposing a solution to the problem of (...) characterizing the moral effect of consent that is given in response to minor coercion. (shrink)

In this essay, I discuss why consent is invalidated by duress that involves attaching penalties to someone's refusal to give consent. At the heart of my explanation is the Complaint Principle. This principle specifies that consent is defeasibly invalid when the consent results from someone conditionally imposing a penalty on the consent‐giver's refusal to give the consent, such that the consent‐giver has a legitimate complaint against this imposition focused on how it is affects their incentives for consenting. The Complaint Principle (...) says that this consent is defeasibly invalid to make room for the Authorization Principle, which allows sincere authorizations to constitute valid consent, even when these are issued by an agent acting under duress. The Authorization Principle has application only in cases of third‐party duress because when the consent‐receiver is the source of the duress, the consent‐giver is not sincerely authorizing the action. (shrink)

In the middle of the last century, it was common to explain the notion of necessity in linguistic terms. A necessary truth, it was said, is a sentence whose truth is guaranteed by linguistic rules. Quine famously argued that, on this view, de re modal claims do not make sense. “Porcupettes are porcupines” is necessarily true, but it would be a mistake to say of a particular porcupette that it is necessarily a porcupine, or that it is possibly purple. Linguistic (...) theories of necessity fell out of favour with the publication of Kripke’s Naming and Necessity, and Quine’s arguments were put aside. In her recent book, Norms and Necessity, Amie Thomasson presents her modal normativism, which is an updated version of the mid-century theories just described. Quine’s arguments are thus relevant once again. We recapitulate Quine’s central argument, in the context of modal normativism. We then criticise Amie Thomasson’s discussion of de re modality. We finish by briefly presenting an alternative account of de re modal statements, which is compatible with modal normativism. (shrink)

This book explores and explains how deep semantics works, how new deep semantics research can be conducted, and how the new scientific method of deep semantics can be used to create new scientific theories and discoveries.

'By identifying the extent to which Aristotle's thinking about ethics was shaped by notions drawn from the crafts Angier has thrown new light on a surprising number of topics and has deepened our understanding of tensions within Aristotle's thought. It is by now a rare achievement to have said something new, true and important about Aristotle.' -- Alasdair MacIntyre, Emeritus Professor of Philosophy, University of Notre Dame, USA.

In this paper we focus on a kind of perceptual states that we call perceptual motivations, that is, perceptual experiences that plausibly motivate us to act, such as itching, perceptual salience and pain. Itching seems to motivate you to scratch, perceiving a stimulus as salient seems to motivate you to attend to it and feeling a pain in your hand seems to motivate actions such as withdrawing from the painful stimulus. Five main accounts of perceptual motivation are available: Descriptive, Conative, (...) Imperativist, Reflexive and Dual Content views. Some of these have been developed in detail and others are natural extensions of existing views. However, we argue that none provides a satisfactory account of the target perceptual states. Driven by the failings of each account, we identify three conditions that any satisfactory theory of perceptual motivation must meet: Direct Motivational Force, Non-Obligatory Force and Intention-Independent Influence. Then we offer an account that attempts to fulfil these conditions: the Affordance Model. This model of perceptual motivation is premised on the claim that each of the target states involves the perception of a specific affordance for action and the triggering of Automatic Motor Initiations. We suggest that AMIs can explain the motivational force of these perceptual states. (shrink)