This chapter contains sections titled: The Obligatory Ends Anti‐paternalism and the Duty of Beneficence Beneficence: The Finer Points The Question of Latitude Latitude and (Im)partiality Gratitude Sympathy Conclusion Bibliography.

This chapter asks what stance is morally appropriate as we consider when, whether, and how to assist persons experiencing physical, emotional, or intellectual disability. Appealing to a variety of intelligent and observant thinkers for inspiration (Ralph Barton Perry, Helen Keller, and Immanuel Kant), it argues that one important aspect of such a stance is an attitude of reciprocal beneficence. This has three central aspects: a perspective of fellowship acknowledging the disabled and the currently able as members of the community (...) of vulnerable human agents; a developed sympathy attuned to gaps in knowledge and failures of imagination and analogy; and a readiness to show gratitude or appreciation for what the currently disabled may teach about the vulnerable moral agency we share. The argument takes initial inspiration from Perry but owes most to its roots in Kantian moral and political theory. It also owes much to wise and insightful enrichments due to Keller. (shrink)

In the Doctrine of Virtue Kant divides duties of love into three categories: beneficent activity , gratitude and Teilnehmung – commonly referred to as the duty of sympathy . In this paper I will argue that the content and scope of the third duty of love has been underestimated by both critics and defenders of Kant's ethical theory. The account which pervades the secondary literature maintains that the third duty of love includes only two components: an obligation to make (...) use of our natural receptivity to sympathetic feelings as a means to fulfilling other duties of love, and an indirect duty to cultivate these feelings. As a result, Kant's duty of sympathy has been widely regarded as a duty whose value is derived from the way in which it serves other duties, in particular, the duty of beneficent activity, which obliges agents ‘to promote according to one's means the happiness of others in need’ . Teilnehmung has thus assumed something of a second-class status among the duties to others. My aim in this paper is to demonstrate that the prevailing account of Kant's third duty of love is incomplete. (shrink)

Do adult children have a particular duty, or set of duties, to their aging parents? What might the normative source and content of filial obligation be? This chapter examines Kant’s duty of beneficence in The Doctrine of Virtue and the Groundwork, suggesting that at its core, performance of filial duty occurs in response to the needs of aging parents. The duty of beneficence accounts for inevitable vulnerabilities that befall human rational beings and reveals moral agents as situated in (...) communities of dependence and mutual aid. Other accounts of filial obligation, such as those based on a notion of gratitude, virtue, or friendship, generate various difficulties and fail to adequately address and emphasize four morally significant features of the adult child/ aging parent relationship. First, the relationship between adult children and their aging parents is one of dependency created by the increasing frailty and need of those parents. Second, the obligations that adult children have to aging parents take place in the context of a relationship not voluntarily assumed, but not coerced. Third, given a cultural tendency toward paternalistic care of elderly individuals, the content of filial obligation should safeguard against such treatment. Fourth, because dependency relations between adult children and aging parents can involve an immense degree of sacrifice on the part of the caretaker, an acknowledgment of duties should be accompanied by a concurrent acknowledgment of the necessary limitation of duties. Addressing these four issues is essential in offering a coherent account of the normative source, content, nature, and scope of adult children’s duty to care for their aging parents. This essay demonstrates that the Kantian duty of beneficence, when functioning as the philosophical foundation of filial obligation, allows for ample light to be shed upon and for proper analysis to take place of these four issues. (shrink)

A collection of 17 essays on Kantian moral theory and practical ethics, including papers on autonomy, human dignity, utopian thinking, O'Neill and Rawls on constructivism, tragic choices, philanthropy, conscientious object, suicide, respect, self-respect, and an ideal attitude of appreciation beyond art, nature, and gratitude. TABLE OF CONTENTS Abbreviations for Kant’s Works INTRODUCTION PART II: KANT AND KANTIAN PERSPECTIVES (1) The Groundwork (2) Kant on Imperfect Duties to Oneself (3) Kantian Autonomy and Contemporary Ideas of Autonomy (4) Rüdiger Bittner on Autonomy (...) (5) Kantian Perspectives on the Rational Basis of Human Dignity (6) In Defense of Human Dignity (7) The Kingdom of Ends as an Ideal and Constraint on Legislation (8) Kantian Ethics and Utopian Thinking (9) Varieties of Constructivism PART II: PRACTICAL ETHICS (10) Human Dignity and Tragic Choices (11) Duties and Choices in Philanthropic Giving: A Kantian Perspective (12) Killing Ourselves (13) Conscientious Conviction and Conscience (14) Stability, A Sense of Justice, and Self-Respect (15) Two Conceptions of Virtue (16) Beyond Respect and Beneficence: An Ideal of Appreciation (17) Ideals of Appreciation and Expressions of Respect REFERENCES INDEX . (shrink)

I have shown here the different roles that sympathy plays in the accounts of justice in the Treatise and Enquiry. In the former work, a redirected sympathy naturally extends our concern, and subsequently our moral approval or blame, to all those included within the scope of the rules of justice. In the Enquiry, we find this same progress of sentiments, but Hume’s introduction of the sentiment of humanity allows him to make a stronger case for the importance of (...) those virtues that are useful, particularly the virtues of justice. The command of our esteem and our moral approval of justice secure a place for justice at the heart of Hume’s ethics. This does not entail, however, that other useful virtues are not also essential. Benevolence and the care of children, friendship, and gratitude not only help to sustain sociability, but they are essential for living a properly human life. (shrink)

Gratitude is the proper or called-for response in a beneficiary to benefits or beneficence from a benefactor. It is a topic of interest in normative ethics, moral psychology, and political philosophy, and may have implications for metaethics as well. Despite its commonness in everyday life, there is substantive disagreement among philosophers over the nature of gratitude and its connection to other philosophical concepts. The sections of this article address five areas of debate about what gratitude is, when it is (...) called for, and what implications it has for other debates in moral philosophy and philosophy generally. (shrink)

Psychologists and philosophers have written much about gratitude recently. Many of these contributions have endorsed expansionist views of gratitude, counseling agents to feel and express gratitude in many circumstances. I argue that the essential features of the moral norm of gratitude are that a beneficiary acknowledges and appreciates benefits provided by another who is acting from beneficence, and is disposed to provide a comparable benefit to the benefactor if a suitable occasion arises. The best-known philosophical version of expansionist views (...) claims that gratitude is apt even in cases where the “benefactor” not only did not intend to benefit the other, but intended to harm her. In the psychological literature, expansionists typically do distinguish between being grateful to and being grateful that. But they also write as if there is one general character trait of gratefulness. In this paper I argue that the philosophical position considered is mistaken on conceptual and moral grounds, and that the dominant view among psychologists fails to recognize the difference between two different traits of gratitude, one a moral virtue and the other a prudential virtue. (shrink)

Classically, gratitude is a tri-polar construal, logically ordering a benefactor, a benefice, and a beneficiary in a favour-giving-receiving situation. Grammatically, the poles are distinguished and bound together by the prepositions ”to’ and ”for’; so I call this classic concept ”to-for’ gratitude. Classic religious gratitude follows this schema, with God as the benefactor. Such gratitude, when felt, is a religious experience, and a reliable readiness or ”habit’ of such construal is a religious virtue. However, atheists have sometimes felt an urge or (...) need for an analogous experience and virtue of gratitude, and theists sometimes feel intellectual discomfort with classical theistic gratitude on consideration of the misfortunes that characterize our life along with its blessings. In response, another conception of religious gratitude has been attempted, a construal that lacks the to-for structure. This paper probes the significance of the benefactor for gratitude, both secular and religious, and, with Søren Kierkegaard’s help, some features of the theology of classical religious gratitude that dissolve the problem of misfortunes. (shrink)

In his published texts and lectures on moral philosophy, Kant repeatedly singles out gratitude for discussion. Nevertheless, puzzles about the derivation, content, and nature of this duty remain. This paper seeks to solve some of these puzzles. Centrally, I argue that it is essential to attend to a distinction that Kant makes between well-wishing benevolence (Wohlwollen) and active beneficence (Wohlthun) on the part of a benefactor. On the Kantian account, I argue, a different type of gratitude is owed in (...) response to each. With this distinction in place, I argue further that we can construct what many have thought to be missing from Kant’s discussion of gratitude – an argument explicating the precise contradiction generated by a maxim of ingratitude. (shrink)

It seems natural enough to suppose that there must be some very close connection between our feelings of sympathy and our moral principles. A large part, at any rate, of the badness of bad men seems to consist in their lack of real concern for other people, and a large part of the goodness of good men consists in the regard they have for their fellows. Could a man who never felt with of for another be regarded as good, (...) or even as a moral being at all ? We should be inclined to say that this was impossible were it not that some philosophers appear to maintain that reason is the fundamental moral requirement and that unsympathetic beings might act rightly from some purely rational principle. Kant, for example, in a well-known passage, contrasts the man who helps others because he is sympathetically inclined towards them with the man who is too unhappy to feel with them but nevertheless helps them because he thinks he ought to. It is the second of these men, in his view, whose action is most clearly moral. In reply to this we may say that although a man's personal griefs at a particular time may render him at that time unable to feel with others even though he helps them as he ought, nevertheless he could not have performed such an act of heroic beneficence if his heart had never warmed towards anybody. (shrink)

PHOTO ID 121339257© Designer491| Dreamstime.com ABSTRACT When physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be apparent conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters future physicians’ commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. We use an ethical dilemma that was presented to a group of third-year medical students to examine how ethics education might (...) be causing them to give undue deference to autonomy, thereby undermining their commitment to beneficence. INTRODUCTION The right of patients to choose which treatments they prefer is rooted in today’s social mores and taught as a principle of medical ethics as respect for autonomy. Yet, when physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be a conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters a commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. I. An Ethical Dilemma The impetus for this paper arose when students who were completing their third clinical year discussed a real-life ethical dilemma. A middle-aged man developed a pulmonary hemorrhage while on blood thinners for a recently placed coronary stent. The bleeding was felt to be reversible, but the patient needed immediate intubation or he would die. The cardiologist was told that the patient previously expressed to other physicians that he never wanted to be intubated. However, the cardiologist made the decision to intubate the patient anyway, and the patient eventually recovered.[1] Students were asked if they believed that the cardiologist had acted ethically. Their overwhelming response was, “No, the patient should have been allowed to die.” We looked into how students applied ethical reasoning to conclude that this outcome was ethically preferred. To explore how the third-year clinical experience might have formed the students’ judgment, we presented the same case to students who were just beginning their third year. Their responses were essentially uniform in recommending intubation. While there is likely more than one reasonable view in this case, we agree with the physician and the younger medical students that intubation was the ethically appropriate decision and will present an argument for it. But first, we explain the reasoning behind the more advanced medical students’ decision to choose patient autonomy at the expense of beneficence. II. Medical Ethics Education and the Priority of Autonomy Beauchamp and Childress’s Principles of Biomedical Ethics, first published in 1979 and now in its 8th edition, is a significant part of the formal ethics education in medical school.[2] Students learn an ethical decision-making approach based on respect for four ethical principles: autonomy, beneficence, nonmaleficence, and justice. While Beauchamp and Childress officially afford no prima facie superiority to any principle, the importance of respect for patient autonomy has increased through the editions of their book. For example, early editions of their book opposed the legalization of physician-assisted death compared to recent editions that defended it.[3] As another example, Beauchamp and Childress make paternalism harder to justify by adding an autonomy-protecting condition to the list of conditions for acceptable paternalism.[4] Authority, they contend, need not conflict with autonomy—provided the authority is autonomously chosen.[5] “The main requirement,” they write, “is to respect a particular patient’s or subject’s autonomous choices, whatever they may be.[6] In the principlism of Beauchamp and Childress, autonomy now seems to have a kind of default priority.[7] However, the bioethics discourse has strong counternarratives, noting some movement to elevate the role of beneficence and to respect the input of stakeholders, including the family and the healthcare team. Ethics education achieves particular relevance in the third clinical year when students become embedded in the care of patients and learn from what has been called the informal curriculum. They observe how attending physicians approach day-to-day ethical problems at the patient’s bedside. In this context, students observe the importance of informed consent for serious treatments or invasive procedures, a practice that highlights the principle of patient autonomy. In both the formal and informal curriculum, medical students observe how, in the words of Paul Wolpe, “patient autonomy has become the central and most powerful principle in ethical decision-making in American medicine.”[8] In short, students appear to learn a deference for patient autonomy. This curricular shift in favor of autonomy coincides with legal developments that protect patients’ rights and decision-making with respect to their healthcare choices. The priority of autonomy in medicine benefits patients by reflecting their choices and, in some cases, their fundamental liberty. III. The Practice of Medicine and the Commitment to Beneficence There are many critiques of the dominant place that autonomy has in biomedical ethics,[9] especially considering that autonomy seems to be biased toward individualistic, Western, and somewhat American culture-driven values.[10] In addition, many bioethical dilemmas are cast as a conflict between autonomy and beneficence. Our point is that medical students bring to their study of medicine a commitment to beneficence that seems to be suppressed by practical ethics education. We think this commitment is rationally defensible and should be nurtured. It is striking that young medical students have a pre-reflective commitment to beneficence at all. For, as we mentioned, it is not just medicine but Western culture generally that prioritizes autonomy in settling ethical dilemmas. In wanting to act for the good of others (rather than simply agreeing to what others want), physicians are already swimming somewhat against the cultural tide.[11] However, doing so makes sense, given the nature of medicine and the profession of healing. When prospective medical students are asked why they wish to become physicians, the usual answer is some variation on caring for the sick and preventing disease. It is unlikely that a reason to become a physician is to respect a patient’s autonomy. It would be easy to dismiss medical students’ commitment to beneficence as a mere intuition and contrary to a more reasoned and deliberative approach. Beauchamp and Childress seem to minimize the value of physician intuition, stating that justifications for certain procedures are “…supported by good reasons. They need not rest merely in intuition or feeling.”[12] Henry Richardson writes that “situational or perceptive intuition…leaves the reasons for decision unarticulated.”[13] We think this is a crude and rather thin way of understanding intuition. Some bioethicists have defended intuition as essential to the practice of medicine and not something opposed to reason.[14] In the case we describe, we believe the ethical justifications s for the patient’s intubation are fundamentally sound: the patient did not have a “do not intubate” order written in the chart, the emergency intubation had not been foreseen, so the patient did not have the opportunity to consent to or reject intubation; the patient had consented to the treatment for his cardiac disease so his consent for intubation could have been assumed;[15] and the consequences of respecting his autonomy did not justify allowing him to die.[16] While it is possible to have more than one reasonable view on this case, we think the case for beneficence is strong and certainly should not be dismissed out of hand. We do not deny that if a patient makes a clearly documented, well-informed decision to forgo intubation that this decision ought to be respected by the physician (even if the physician disagrees with the patient’s decision). But, in this situation, as in many others in the practice of medicine, the patient’s real wishes and preferences are not well-articulated in advance. There are many cases where a physician acts based on what she believes the patient, or the surrogate, would want, sometimes in situations that do not allow much time for reflection. An example might be resuscitation of a newborn at the borderline of viability. In their ethics education, beneficence would mean acting first to save a life. If the patient or surrogate makes an informed decision to the contrary, a beneficent physician respects that autonomous decision. In the case presented, the patient expressed gratitude to the cardiologist when extubated. But what if he had expressed anger at the physician for violating his autonomy? There are those who could argue that not only was intubation ethically wrong but that the cardiologist put himself in legal jeopardy by his actions (especially if there had been a written refusal applicable to the specific situation). In the example we use, we point out that the cardiologist may not have escaped a lawsuit if the patient had died without intubation. His family, when hearing the circumstances, may have sued for failure to act and dereliction of the cardiologist’s duty to save him. Beyond a potential legal challenge for either action or inaction, there is an overriding ethical question the cardiologist had to address: what course would be most satisfying to his conscience? Would he rather allow a patient to die for fear of recrimination, or act to save his life, regardless of the personal consequences? In the absence of real knowledge about the patient’s considered wishes, it is most reasonable to err on the side of promoting patient well-being. A physician’s commitment to beneficence is not necessarily a way of undermining a patient’s autonomy. In acting for the patient's good, physicians are also acting on what it is reasonable to believe a patient (or most patients, perhaps) would want, which is obviously connected to what a patient does want. Pellegrino and Thomasma argue that beneficence includes respect for a patient’s autonomy since “the best interests of the patient are intimately linked with their preferences.”[17] Instead of conceptualizing ethical dilemmas in medicine as conflicts between autonomy and beneficence, it is possible that medical schools could teach students that truly practicing beneficence is a way of valuing patient autonomy, especially when the patient’s wishes are not specific to the situation and are not clearly expressed. CONCLUSION It is important for students and practicing physicians to understand the principle of respect for patient autonomy in a pluralistic society that demands personal self-determination. However, the role of the physician as a beneficent healer should not be diminished by this respect for autonomy. Respecting a patient’s autonomy is grounded in and manifested by physician beneficence.[18] That is, seeking what is good for the patient can only be good if it respects their personhood and dignity. We propose that a commitment to beneficence, incipient in young medical students, should be developed over time with their other clinical reasoning skills. Such a commitment need not be sacrificed on the altar of patient autonomy. Beneficence needs greater relative moral weight with students as they proceed in their ethics education. - [1] S. Jauhar, “When Doctors Need to Lie,” New York Times, February 22, 2014, https://www.nytimes.com/2014/02/23/opinion/sunday/when-doctors-need-to-lie.html. [2] T. L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019). [3] Louise A. Mitchell, “Major Changes in Principles of Biomedical Ethics,” The National Catholic Bioethics Quarterly 14, no. 3 (2014): 459–75, https://doi.org/10.5840/ncbq20141438. [4] Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019), 238. [5] Beauchamp and Childress, 103. [6] Beauchamp and Childress, p. 108. [7] For other accounts that prioritize autonomy, see e.g. Allen E. Buchanan and Dan W. Brock, Deciding for Others: The Ethics of Surrogate Decision Making (Cambridge University Press, 1989), 38–39; R Gillon, “Ethics Needs Principles—Four Can Encompass the Rest—and Respect for Autonomy Should Be ‘First among Equals,’” Journal of Medical Ethics 29, no. 5 (October 2003): 307–12, https://doi.org/10.1136/jme.29.5.307. For examples of critiques of these accounts, see footnote 9. [8] P. R. Wolpe, “The Triumph of Autonomy in American Bioethics: A Sociological View,” in Bioethics and Society: Constructing the Ethical Enterprise, p. 43. [9] V. A. Entwistle et al., “Supporting Patient Autonomy: The Importance of Clinician-Patient Relationships,” Journal of General Internal Medicine 25, no. 7 (July 2010): 741–45; C. Foster, Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law, 1st ed. (Oxford ; Hart Publishing, 2009); O. O’Neill, Autonomy and Trust in Bioethics, The Gifford Lectures, University of Edinburgh 2001 (Cambridge, UK: Cambridge University Press, 2002). [10] P. Marshall and B. Koenig, “Accounting for Culture in a Globalized Bioethics,” The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics 32, no. 2 (2004): 252–66; R. Fan, “Self-Determination vs. Family-Determination: Two Incommensurable Principles of Autonomy,” Bioethics 11, no. 3–4 (1997): 309–22. [11] Arguments stressing the importance of beneficence, as ours does here, certainly approach paternalistic arguments. We set aside the complex issue of paternalism for purposes of this paper and simply note that the principle of beneficence as such does not say anything specifically about acting against the patient’s will. In the case study that focuses this paper, we do not believe the patient’s will or wishes were clearly indicated. [12] Beauchamp and Childress, Principles of Biomedical Ethics, p. 20, see note 2 above. [13] H. S. Richardson, “Specifying, Balancing, and Interpreting Bioethical Principles,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 25, no. 3 (January 1, 2000): 285–307, p. 287. [14] H. D. Braude, Intuition in Medicine a Philosophical Defense of Clinical Reasoning (Chicago ; University of Chicago Press, 2012). [15] R. Kukla, “Conscientious Autonomy: Displacing Decisions in Health Care,” The Hastings Center Report 35, no. 2 (2005): 34–44. [16] M. Schermer, The Different Faces of Autonomy: Patient Autonomy in Ethical Theory and Hospital Practice, vol. 13, Library of Ethics and Applied Philosophy (Dordrecht: Springer Netherlands, 2002). [17] E. D. Pellegrino and D. C. Thomasma, For the Patient’s Good - the Restoration of Beneficence in Health Care (New York, NY: Oxford University Press, 1988), p. 29. [18] Pellegrino and Thomasma, For the Patient’s Good. 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THE CENTRALITY OF "SYMPATHY" to Adam Smith's Theory of Moral Sentiments points to the centrality of love in the book. While Smith delineates a somewhat unusual, technical sense of "sympathy", his actual use of the term frequently slips into its more ordinary sense of "compassion" or affectionate fellow feeling. This no doubt intentional equivocation on Smith's part helps suffuse the book with these themes, to the point that, without much exaggeration, one could say that the Theory of Moral (...) Sentiments is generally about love: our need for love and sympathy, love as friendship, self-love, the love of praise and praiseworthiness, the love of beauty. Even in the Wealth of Nations, our loves are thought to be very important in explaining our behavior. Smith is unusual among modern moral philosophers in according so central a place to love in this broad sense, although of course Christianity made love a central theme in reflection on ethical life, and philosophers such as Hutcheson made benevolence a key virtue in their ethical systems. However, it is not our purpose to examine Smith's critique of Hutcheson or indeed of any of his predecessors. Rather we aim in this paper to reflect on his treatment of this topic. We shall do so in part by means of comparisons with Aristotle and Plato, first with respect to friendship and then with respect to love generally. Smith's writing is replete with classical references, raising the issue of the degree to which his thought is "ancient" or "modern." Friendship is arguably the pinnacle of social relations for the ancients, and thus it provides us with a useful device for determining the degree to which Smith's thought embodies classical moral and philosophical principles. The subtlety of Smith's interweaving of traditions will become visible as we reflect not just on the ways Smith's thought exhibits classical conceptions of friendship and love, but also on the ways he departs from them. For in at least one important respect, love is a closed book from Smith's standpoint, and thus, as it turns out, also at odds with classical friendship. (shrink)

In order to operate effectively, modern capitalism depends on agents who evince a rather morally undemanding type of moral character; one that is acquisitive, pecuniary, recognition-seeking and merely prudent. Adam Smith is considered to have been the key legitimiser of this archetype. In this paper I respond to the view that Smith is actually sceptical about the value of material acquisition and explore whether he really believed that the pursuit of tranquillity and virtue—especially beneficence—offers a superior route to happiness (...) than the commercial world of materialist acquisition. I approach these issues partly by considering the roles of beneficence and sympathy in Smith's system and partly by analysing the story of ‘The Poor Man's Son’ related in Book IV of The Theory of Moral Sentiments. As he narrates this story, Smith seems highly critical of the unrelenting drive for worldly success. But what is the real moral of the story? Should people contain their ambition for recognition and material succe... (shrink)

In recent years there has been renewed interest in the +Doctrine of Virtue½ or +Tugendlehre½, the ethical part of Kant's late systematic treatise on moral philosophy, the Metaphysics of Morals. The present volume responds to these demands. Following a series of research workshops, 18 scholars from Germany, Italy, Britain and the United States provide a seamless commentary on the +Doctrine of Virtue½, discussing topics such as suicide, truthfulness, moral perfection, beneficence, gratitude, sympathy, respect and friendship as well as (...) Kant's moral psychology, philosophy of action and theory of moral education. This book will be an invaluable resource for moral philosophers and Kant scholars alike. (shrink)

In the aftermath of Peter Singer’s ‘Famine, Affluence and Morality’, the argument he put forward received significant criticism, largely on the grounds that it demanded too much of moral agents. Several attempts have been made since to formulate moral principles that adequately express the stringency of our duties of beneficence. Richard Miller proposed one such option, which has several advantages over Singer’s principle. In particular, because it concerns our dispositions rather than operating over every possible occasion for beneficence, (...) it avoids problems of iterative demands. However, I argue that Miller’s principle is inadequate, because 1) it seems too weak, 2) it appears to be ambiguous and 3) it can give unduly harsh verdicts on unlucky moral agents. (shrink)

Imagine a world where everyone is healthy, intelligent, long living and happy. Intuitively this seems wonderful albeit unrealistic. However, recent scienti c breakthroughs in genetic engineering, namely CRISPR/Cas bring the question into public discourse, how the genetic enhancement of humans should be evaluated morally. In 2001, when preimplantation genetic diagnosis (PGD) and in vitro fertilisation (IVF), enabled parents to select between multiple embryos, Julian Savulescu introduced the principle of procreative bene cence (PPB), stating that parents have the obligations to choose (...) the child that is expected to have the best life. In this paper I argue that accepting the PPB and the consequentialist principle (CP) that two acts with the same consequences are morally on par, commits one to accepting the parental obligation of genetically enhancing one's children. (shrink)

The distinction between “empathy” and “sympathy” in the context of ethics is a dynamic and challenging one. The eighteenth century texts of David Hume and Adam Smith used the word "sympathy," but not "empathy," although the conceptual distinction marked by empathy was doing essential work in their writings. After discussing the early uses of these terms, this article is organized historically. Two traditions are distinguished. The first is the Anglo-American tradition, and it extends from Hume and Smith to (...) the twenty-first century work of Michael Slote. Stephen Darwall’s contribution is applied in engaging Hume and Smith. Finally, the interrelation of empathy, sympathy and altruism is explored in the work of John Rawls and Thomas Nagel. The second tradition is the Continental one. It extends from the spirituality of Johann Herder to the phenomenological movement of Edmund Husserl, Martin Heidegger, Max Scheler, and Edith Stein. The intentional analysis of empathy is directly relevant to the constitution of the social community in a broad, normative relationship with the "Other.". (shrink)

Organizational members are likely to harbor different allegiances, values, and identifications that can affect how they respond to their organization’s stigmatization. Drawing on the empirical case of a public broadcaster in South Korea initially stigmatized for its association with an authoritarian government, we focus on the responses of different intra-organizational groups to stigma and their interactions with each other and with external audiences. We find that faced with stigma, groups in the organization were divided about how to respond, with those (...) defying the stigma and advocating a close relationship with the government competing with those who shared the values of stigmatizing audiences. Both groups sought control over journalism work, the organizational attribute for which the broadcaster was stigmatized, allying with external audiences that shared their respective visions. The dominance of the group that defied the stigma led to increased stigmatization of the organization by existing audiences and additionally prompted the participation of initially passive audiences in its denigration, eventually leading to organizational decline. We contribute to the literature on stigma by promoting an understanding of heterogeneity among members in stigmatized organizations and its implications for the consequences of stigma. We also contribute to theorizing stigmatization as a relational process by demonstrating how the heterogeneity of organizational members’ experience of stigma interacted with audience heterogeneity and highlighting the relative roles played by active and passive audiences in bringing about the decline of a stigmatized organization. (shrink)

In her influential book, The Practice of Moral Judgment, Barbara Herman argues that Kantian ethics requires a “middle theory” applying formal rational constraints on willing to the particular circumstances and nature of human existence. I claim that a promising beginning to such a theory can be found in Kant’s discussion of duties of virtue in The Metaphysics of Morals. I argue that Kant’s distinction between perfect and imperfect duties of virtue should be understood as a distinction between duties concerned with (...) respect for necessary conditions of moral health and moral prosperity in sensibly affected human agents who realize their moral nature only through the development and continuing exercise of inner freedom. Thus understood, perfect duties prohibiting self-deception, miserly avarice, and humility are oriented around concerns with the conditions of rational self-constraint in human agents and are contrasted with imperfect duties requiring the development of our talents and the perfection of our moral disposition concerned with the effective exercise of this kind of inner freedom in choice and action. Generalizing this account, I claim that it allows us to accommodate the range of duties that Kant discusses here including perfect duties owed to others prohibiting arrogance, defamation, and ridicule and imperfect duties enjoining gratitude and beneficence and suggests a much more subtle and promising account of moral duty than those typically associated with Kant’s view. (shrink)

In his recent and suitably provocative book on The Object of Morality G. J. Warnock argues that the fundamental moral concern is with what he sums up as the ‘amelioration of the human predicament’, a predicament which is made even more pressing by the natural limitations of our human sympathies. The distinctively moral virtues, Warnock concludes, will be those dispositions which tend to countervail these natural limitations, especially non-maleficence, fairness, beneficence, and non-deception; and from these fundamental moral virtues we (...) can derive, in turn, four fundamental moral standards or principles. The theory of morality—and it is thank heaven a theory of morality, not of moral language—which I have crudely summarised here seems to me correct as far as it goes, but it also seems to me that Warnock’s concentration on the predicament of the individual human being leads him to ignore what is at least as fundamental, the essentially social and interpersonal aspect of much morality. (shrink)

This article provides an analysis of moral emotions from an attributional point of view, guided by the metaphors of man as a naïve scientist (Heider, 1958) and as a moral judge (Weiner, 2006). The theoretical analysis focuses on three concepts: (a) The distinction between the actor and the observer, (b) the functional quality of moral emotions, and (c) the perceived controllability of the causes of events. Moral emotions are identified (admiration, anger, awe, contempt, disgust, elevation, embarrassment, envy, gratitude, guilt, indignation, (...) jealousy, pity, pride, rage, regret, remorse, resentment, respect, schadenfreude, scorn, shame, and sympathy). A classification of these moral emotions is suggested and the empirical evidence briefly summarized. In discussing our results, we identify unresolved issues awaiting further analyses and research. (shrink)

In this comment on Thomas Nisters’ “Gratitude, Anger and the Horror of Asymmetry” I propose a different reading of Schnitzler’s short story that serves as a basis for Nisters’ reflections. On my interpretation, the behaviour of Franz is best understood on the background of a traditional understanding of gratitude, one that we can find, for instance, in Thomas Aquinas.

Many maintain that if a beneficiary has a right to a benefit provided by his benefactor, then the former cannot owe the latter gratitude for that benefit. In this paper I argue against that view. I provide examples in which benefactors provide others with benefits to which they have a right even though most others are denying them that right. These benefactors are moral standouts; they do what is right when most similarly situated agents fail to do so. I then (...) spell out some of the features of these benefactors’ actions that make them worthy of gratitude. (shrink)

It is plausible to think that it is wrong to cure many people’s headaches rather than save someone else’s life. On the other hand, it is plausible to think that it is not wrong to expose someone to a tiny risk of death when curing this person’s headache. I will argue that these claims are inconsistent. For if we keep taking this tiny risk then it is likely that one person dies, while many others’ headaches are cured. In light of (...) this inconsistency, there is a conflict in our intuitions about beneficence and chance. This conflict is perplexing. And I have not been able to find a satisfactory way of resolving it. Perhaps you can do better? (shrink)

Kantian responses to three related questions are considered: Given the limits of our altruistic sentiments, is it possible for us to act beneficently as duty seems to require? What are we morally required to do for others besides respecting their rights? Why is this a reasonable requirement? Although the importance of empirical facts in deliberation is undeniable, the distinction between a practical deliberative point of view and the perspective of empirical inquiry proves to be crucial. Kant's grounds for an imperfect (...) duty of beneficence are examined. From a deliberative perspective, we must assume that we can act beneficently, even when lacking altruistic sentiments, provided we understand the good reasons for doing so. (shrink)

Citizenship education is a complex matter, and not least the place of civic virtues in it. This is illustrated by a consideration of the civic virtue of gratitude. Two conceptions of gratitude are explored. Gratitude seen as a debt is examined and Kant’s exposition of it, including his objections to a person’s getting himself into the position where he has to show gratitude as a beneficiary, is explored. An alternative conception of gratitude as recognition is developed. This, it is claimed, (...) has more relevance to the kind of gratitude it would be appropriate for citizens of a democratic state to feel. The educational implications of these views are indicated. (shrink)

Common sense tells us that in certain circumstances, helping someone is morally obligatory. That intuition appears incompatible with Kant's account of beneficence as a wide imperfect duty, and its implication that agents may exercise latitude over which beneficent actions to perform. In this paper, I offer a resolution to the problem from which it follows that some opportunities to help admit latitude and others do not. I argue that beneficence has two components: the familiar wide duty to help (...) others achieve their ends and a narrow duty to avoid indifference to others as end-setters. Although we are not always required to help, we are always required not to be indifferent. When helping someone is the only way not to be indifferent to a person, helping him/her is obligatory. My account avoids certain difficulties with other proposed solutions and can also address an important concern about proximity. (shrink)

Empathy and sympathy are feeling-acts which bring the self into direct encounter with other persons. In empathy a self grasps the affective act of another self; in sympathy x n persons apprehend a common object while immersed in similar feeling acts. Since touch is the paradigmatic sense for bringing what is felt into proximity with feeling, structural affinities between touch and these feeling acts can be shown. This relationship has been obscured by classical theories of touch in which (...) it is interpreted on analogy with the other senses. When the subject of touch is seen as the living body as a whole, the full range of its possible relationships to affective states can be explored. In this connection the theories of touch of Aristotle, Berkeley and Condillac are critically evaluated. While none recognizes the uniqueness of touch, each sees difficulties in incorporating touch in a general theory of sense. In the course of the exposition pity is distinguished from empathy and sympathy and a criticism of Nietzsche's ressentiment theory offered. CiteULike Connotea Del.icio.us What's this? (shrink)

Consider a duty of beneficence towards a particular individual, S, and call a reason that is grounded in that duty a “beneficence reason towards S.” Call a person who will be brought into existence by an act of procreation the “resultant person.” Is there ever a beneficence reason towards the resultant person for an agent to procreate? In this paper, I argue for such a reason by appealing to two main premises. First, we owe a pro tanto (...) duty of beneficence to future persons; and second, some of us can benefit some of those persons by procreating. In support of the first premise I reject the presentist account of time in favor of the view that future persons are just as real as presently existing persons. I then argue that future persons are like us in all the morally relevant ways, and since we owe duties of beneficence to each other, we also owe duties of beneficence to future persons. In support of the second premise I offer an account of benefiting according to which an individual can be benefited by an action even if it makes her no better off than she would have been, had the action not been performed. This account of benefiting solves what I call the “non-identity benefit problem.” Finally, I argue that having a life worth living is a benefit, and some of us can cause some persons that benefit by causing them to exist. (shrink)

Volume 20, Issue 3, March 2020, Page 65-68.

This article explores the motives underlying corporate responses to the COVID-19 pandemic. The analysis begins with Thomas Dunfee’s Statement of Minimum Moral Obligation, which specifies, more precisely than any other contribution to the business ethics canon, the level of corporate beneficence required during a pandemic. The analysis then turns to Milton Friedman’s neoliberal understanding of human nature, critically contrasting it with the notion of stoic virtue that informs the works of Adam Smith. Friedman contends that beneficence should play (...) no role in corporate settings. Smith, by contrast, emphasizes the need for prudence, beneficence and self-command in all human endeavours. The article then uses these competing frameworks to reflect on a published survey of 145 corporate responses to COVID-19. In many of these responses, the benefit to a non-financial stakeholder is clear, while the financial consequence to the firm remains nebulous. This supports the contention that during a pandemic, beneficence provides a more complete explanation of many corporate actions than the profit motive alone. The article contests Friedman’s Chicago School profit imperative and goes beyond Dunfee’s SMMO by endorsing the more full-throated embrace of beneficence and stoic virtue found in the works of Smith. (shrink)

The paper presents a perspective on our relation to our environment that is inspired by Confucian thought and that stands in contrast to certain common strands in contemporary philosophical discussions. It conceptualizes our relation to what we encounter on a day-to-day basis primarily in terms of the way we experience and respond to situations, rather than to the objects affected in the situations. From this perspective, the contemporary philosophical distinction between a first- and a third-person point of view is often (...) not suited for describing our responses to situations. Instead, our responses to situations can vary along different dimensions, including the way we direct our attention, our thoughts and sentiments, our motivations, etc., and these variations admit of degrees. Such variations depend on various factors, such as the different ways in which one relates to the object affected in a situation and the kind of person one is. and cannot be adequately described in terms of a shift from one point of view to another. The paper discusses two examples, anger and compassion, to illustrate this alternative perspective, but the discussion can be extended to other areas such as gratitude. (shrink)

In this paper, I present briefly a view about intrinsic value, one connected to the concepts of ethically required attitudes of favor, disfavor, and preference. If lives can have both welfare value and intrinsic value, how are these values related? I defend the view that the welfare value of a life does not track the intrinsic value of that life. Some philosophers, however, deny that anything can have intrinsic value or absolute value. Some argue that to hold that something is (...) both bad for a person and bad simpliciter leads to an objectionable double counting. Others hold views that would, if true, diminish the practical importance of intrinsic value. Some hold that our relations with others should not be guided by what is intrinsically good or bad, but only by what is good or bad for someone. Others hold that the concepts of love, benefit, and harm are tied exclusively to welfare value or well-being. Still others suggest that the moral principles of beneficence and non-maleficence are tied exclusively to welfare and well-being. I argue that these views are mistaken. In this regard, I attempt to defend the practical importance of intrinsic value. (shrink)

I attempt to sketch in general terms an alternative moral perspective that goes beyond the traditional normative theories, a moral perspective called ?contributivism?. This focuses on contribution: caring about one's contribution, I claim, lies at the centre of moral cncern. First I illustrate the need for a contribution-focussed moral theory, primarily by considering gratitude, the typical required response to altruism. Second, I point out some of the motivational resources of such a contribution-based view. I conclude by showing how focusing on (...) contributions can uncover neglected areas of moral significance, which both broaden our recognition of altruistic behavious, and raise questions concerning the moral centrality of altruism. (shrink)

In this presidential address, the author argues that being disabled is being a “misfit,” and that being a philosopher is often considered to be something like a disability, rendering philosophy, and philosophers, misfits as well. But not all disabilities are negative, and there are even cases in which disability can be something for which the disabled person and others can be grateful. Comparing her own physical disability that renders her a “misfit” to philosophy as a misfit discipline, the author argues (...) that there is a connection between gratitude as a virtue, disability, and philosophy as an academic discipline and as a way of life. (shrink)

The Principle of Procreative Beneficence (PB) holds that when a couple plans to have a child, they have significant moral reason to select, of the possible children they could have, the child who is most likely to experience the greatest wellbeing – that is, the most advantaged child, the child with the best chance at the best life.1 PB captures the common sense intuitions of many about reproductive decisions. PB does not posit an absolute moral obligation – it does (...) not dictate what people must do. Instead it holds that there is a significant moral reason to select the best child, but one that must be weighed against other reasons.Recent research suggests that it may become possible to derive gametes (eggs and sperm) from human stem cells in vitro, a process which we will term in vitro gametogenesis (IVG). The ability to create large numbers of eggs or sperm through IVG greatly increases our capacity to select the best child possible. (shrink)

I argue that ignorance of who will die makes a difference to the ethics of killing. It follows that reasons are subject to ‘specificity’: it can be rational to respond more strongly to facts that provide us with reasons than to the fact that such reasons exist. In the case of killing and letting die, these reasons are distinctively particular: they turn on personal acquaintance. The theory of rights must be, in part, a theory of this relation.

This paper puts two propositions to the test: First, gratitude and active ingratitude are in one sense opposed, yet in another sense they bear a striking resemblance. Second, mature morality sometimes expects us to transcend the quid pro quo structure implied by common gratitude.

Love and Sympathy in Theravada Buddhism. Harvey B. Aronson. Motilal Banarsidass, Delhi 1980. 127 pp. Rs 45.

Patricia White (Stud Philos Educ 18:43–52, 1999) argues that the virtue gratitude is essential to a flourishing democracy because it helps foster universal and reciprocal amity between citizens. Citizens who participate in this reciprocal relationship ought to be encouraged to recognize that “much that people do does in fact help to make communal civic life less brutish, pleasanter and more flourishing.” This is the case even when the majority of citizens do not intentionally seek to make civic life better for (...) others. Were citizens to recognize the appropriateness of gratitude in these situations, the bonds of our democratic communities would be strengthened. In this paper, I examine White’s argument more carefully, arguing that it fails to address adequately the difficulties that arise when we attempt to encourage the virtue of gratitude in our students. To address these difficulties, I turn to an unlikely source for democratic inspiration: Friedrich Nietzsche. In spite of his well-known anti-democratic sentiments, Nietzsche offers democratic citizens insights into the social value of gratitude. I argue that Nietzsche’s ideas resolve the educational difficulties in White’s argument and viably establish gratitude as an important democratic virtue that ought to be cultivated. (shrink)

_GPs serve in a double role of treatment provider and expert in certain social insurance systems, such as the Norwegian one. Some physicians assert that the ethical obligations of the two roles conflict with each other. The objective of this article is to show that social insurance medical ethics, which are based on recognised principles of medical ethics, unite the physicians’ obligations associated with these roles. The method applied is a medical ethics conceptual analysis. The material consists of literature on (...) normative SIME. The study shows that SIME expands the role of the treatment provider to a wider societal context. Here, physicians should attempt to balance the perspectives of sympathy with empathy, as treatment providers, with the impartiality in their role as experts. Five principles of medical ethics are fundamental. Respect for human dignity is the overarching principle of medical ethics. The four others are nonmaleficence, beneficence, autonomy, and social justice. The article discusses two areas where it is asserted that the roles of treatment provider and expert conflict with each other: the application of beneficence and justice, and the duty of confidentiality versus the duty to provide information to the National Insurance service. The study concludes that there are no basic ethical conflicts between the two roles. The ethical problems that may arise when exercising this duality should be viewed in the same way as other ethical problems in medicine. Actual application and balancing of the principles may necessitate negotiations between patients and physicians. _ _Keywords_: dual roles, professionalism, deliberation, impartiality, medical principle ethics, values of welfare state. (shrink)

We define and examine a notion of logical friendliness, which is a broadening of the familiar notion of classical consequence. The concept is tudied first in its simplest form, and then in a syntax-independent version, which we call sympathy. We also draw attention to the surprising number of familiar notions and operations with which it makes contact, providing a new light in which they may be seen.

In an era of rapidly rising health care costs, physicians and policymakers are searching for new and effective ways to contain health care spending without sacrificing the quality of services provided. These proposals are increasingly articulated in terms of an ethical duty of stewardship. The duty of stewardship in medicine, however, is not at present well understood, and it is frequently conflated with other duties. This article presents a critical analysis of the notion of stewardship, which shows that it has (...) an important and distinctive place in medical ethics. It claims that stewardship in medicine concerns the responsible use of a society’s medical resources and it discusses the extent to which medical professionals are the proper stewards of these resources. The article argues that the duty of stewardship is best understood as a duty that applies in a space between the obligations of health care providers to provide beneficent care to their patients on the one hand and the obligations of citizens to bring about and support a just health care system on the other. Seen with clear eyes, stewardship in medicine is neither a consequence of beneficent medical care nor a substitute for justice. (shrink)

Julian Savulescu has given clear expression to a principle—that of “procreative beneficence”—which underlies the thought of many contemporary writers on bioethics. The principle of procreative beneficence holds that parents or single reproducers are at least prima facie obliged to select the child, out of a range of possible children they might have, who will be likely to lead the best life. My aim in this paper is to argue that prospective parents, just by dint of their being prospective (...) parents, are in fact not obliged to act on PPB. That is, there is something about their filling the role of prospective parents that exempts them from selecting the child with the best life. I urge that it is more realistic to view prospective parents as bound by a principle of acceptable outlook, which holds that they ought not to select children whose lives will contain an unacceptable amount of suffering. (shrink)