Bioethical Prescriptions collects F.M. Kamm's articles on bioethics -- revised for publication in book form -- which have appeared over the last 25 years and which have made her among the most widely-respected philosophers working in this field.

This book is a philosophical discussion of moral, legal, and medical issues related to aging, dying, and death. One of its aims is to decide whether and when it might make sense to not resist or bring about the end of one's life. To answer this question it considers views about meaning in life and what makes life worth living. It also evaluates recent attempts to help the general public plan in advance for the end of life. It also considers (...) whether or not physician-assisted suicide is morally permissible and if it should be legalized. (shrink)

I begin by reconsidering the arguments of John Taurek and Elizabeth Anscombe on whether the number of people we can help counts morally. I then consider arguments that numbers should count given by F. M. Kamm and Thomas Scanlon, and criticism of them by Michael Otsuka. I examine how different conceptions of the moral method known as pairwise comparison are at work in these different arguments and what the ideas of balancing and tie-breaking signify for decision-making in various types of (...) cases. I conclude by considering how another moral method that I call virtual divisibility functions and what it helps reveal about an argument by Otsuka against those who do not think numbers count. (shrink)

This article considers the possible relation between the idea of parity and some past work on the allocation of scarce resources. Parity of value is first connected with the idea of some goods being irrelevant in interpersonal comparisons. The notion of moral parity is introduced to describe the recognition that people who are moral equals (even when they are not on a par in terms of value) as not substitutable. The relation between a Separability Test and nonsubstitutability of persons is (...) considered. These ideas are then used to discuss various cases in which one must choose to whom to provide medical assistance, including whether and when to distinguish morally between a disabled and a nondisabled person. (shrink)

Ethics for Enemies comprises three original philosophical essays on torture, terrorism, and war. F. M. Kamm deploys ethical theory in her challenging new treatments of these most controversial practical issues. First she considers the nature of torture and the various occasions on which it could occur, in order to determine why it might be wrong to torture a wrongdoer held captive, even if this were necessary to save his victims. In the second essay she considers what makes terrorism wrong--whether it (...) is the intention to harm civilians, rather than harm to them being 'collateral damage,' or something else--and whether terrorism is always wrong. The third essay discusses whether having a right reason, in the sense of a right intention, is necessary in order for a war to be just. Kamm then examines ways in which the harms of war can be proportional to the achievement of the just cause and other goods that war can bring about, so as to make the declaration of war permissible. (shrink)

The Moral Target: Aiming at Right Conduct in War and Other Conflicts comprises essays that discuss aspects of war and other conflicts in the light of nonconsequentialist ethical theory. Topics include the relation between conditions that justify starting war and those that justify stopping it, the treatment of combatants and noncombatants in war, collaboration, justice after war and other conflicts, terrorism, resistance to communal injustice, and nuclear deterrence.

Abortion bans have been characterized as cruel especially in not allowing exceptions for rape or incest. The article first examines one approach to morally justifying bans based on the Doctrine of Double Effect (DDE) which distinguishes morally between killing or letting die intending death versus doing so only foreseeing death. It then presents some criticisms of the implications of the DDE but also argues that what the doctrine permits helps provide a ground for the permissibility of abortions even if the (...) fetus is a person. Whether there are limits on applying this argument is also considered. In conclusion, the article considers whether and why not permitting exceptions to bans for rape and incest is cruel and whether cruelty is a ground for opposition to bans. (shrink)

This article begins by comparing terror and death and then focuses on whether killing combatants and noncombatants as a mere means to create terror, that is in turn a means to winning a war, is ever permissible. The role of intentions and alternative acts one might have done is examined in this regard. The second part of the article begins by criticizing a standard justification for causing collateral (side effect) deaths in war and offers an alternative justification that makes use (...) of the idea of group liability. (shrink)

Peter Unger’s book has both substantive and methodological aims. Substantively, it aims to prove the following four claims in the following order: we must, in general, suffer great losses of property to prevent suffering and death; we may, in general, impose such losses on others for the same goals; we may, in general, kill others to prevent more deaths; and we must, in general, kill ourself to prevent more deaths. Methodologically, it aims to show that intuitive judgments about cases that (...) would be presented as evidence against the four substantive claims—the standard technique of nonconsequentialists arguing against consequentialists—are worthless because we can construct cases that generate the opposite intuitive judgment; further, we can show that the factors that distinguish the cases yielding such different intuitions are not morally significant; and hence, we must decide which judgments are correct by consulting such general moral values as the importance of reducing suffering and death. Thus, Unger offers an error theory of nonconsequentialist restrictions on harming others and prerogatives not to make large sacrifices to aid. This error theory is based on the psychological effects of morally insignificant factors. (shrink)

In this article, I first compare positions I have taken in the past and those taken by Peter Singer on how the allocation of life-saving resources should be affected by the aggregation of expected quality of life, quantity of life, and need, both within the life of a person and across persons . I then reexamine the specific issue of whether and why differences in expected years of life and quality of life that a scarce resource can provide a disabled (...) and a nondisabled person should affect our allocation decisions. I attend to how the use of the veil of ignorance bears on this issue and also how the conclusions I reach differ in certain ways from my past positions. (shrink)

In this essay, I shall discuss ethical issues that arise with our increasing ability to affect the genetic makeup of the human population. These effects can be produced directly by altering the genotype , or indirectly by aborting, not conceiving, or treating individuals because of their genetic makeup in ways made possible by genetic pharmacology. I shall refer to all of these sorts of procedures collectively as the Procedures. Some of the ethical issues the Procedures raise are old, arising quite (...) generally when we can affect the well-being of people, even in the absence of the ability to affect them in the ways just described. My examination of these issues is prompted by the recent at-length discussion of them, From Chance to Choice , by Allen Buchanan, Dan Brock, Norman Daniels, and Daniel Wikler. (shrink)

In this article, I shall present three arguments for thc pcrmissibility 0f physician-assisted suicide (PAS), and then examine several objections 0f 21 "K21nti2m" and non-Kantian nature against them. These are really 0bjcctions against certain types of suicide. I shall focus 0n active PAS (eg., when 21 patient takes 21 lethal drug given by E1 physician, in which case both thc physician and patient are active). I shall assume the patient is 21 competent, responsible, rational agent, who gives his being in (...) physical discomfort (pain, nausea, ctc.) as thc reason for intending his death. I am assuming, therefore, thc pain while 21 sourcc of suffering docs not undermine his rational agency in 21 way that threatens responsibility for choice.] Current legal proposals for permitting PAS focus 0n procedures.. (shrink)

In the first part of this article, I argue that even those entities that in their own right and for their own sake give us reason not to destroy them and to help them are sometimes substitutable for the good of other entities. In so arguing, I consider the idea of being valuable as an end in virtue of intrinsic and extrinsic properties. I also conclude that entities that have claims to things and against others are especially nonsubstitutable. In the (...) second part, I argue that cloning poses no threat to the nonsubstitutability of these entities (and in this sense, to the dignity of persons). I also consider the relation between cloning and (what I called) holistic identity, and between the latter and genetic identity. In the concluding part of the article, I try to distinguish cases where identity over time and so-called person-affecting acts have and do not have greater moral significance than nonidentity over time and nonperson-affecting acts. I try to apply my results to cases involving embryos, future generations, and to the so-called Non-Identity Problem. (shrink)

[Considers Bernard Williams on negative responsibility as exemplified by his well-known case of Jim and the Indians].

This chapter first presents two arguments for the permissibility of physician-assisted suicide (PAS) and euthanasia (E) to eliminate physical suffering. I then present a third argument for PAS and E on grounds other than eliminating suffering. The chapter next considers several objections to these arguments that might be raised by Neil Gorsuch, now a US Supreme Court Justice. In the course of this I present a fourth argument for PAS and E. (I assume throughout that a patient’s free and informed (...) consent is required and present.). (shrink)

Some of the commentators on Intricate Ethics complain of my method. One finds the main ideas ‘Kammouflaged’ because the relevant causal distinctions are so fine-grained and the cases that illustrate them so numerous . Some say that they do not have the intuitions about many cases that I have, that I concoct dubious and ad hoc distinctions and invest them with moral significance; I am Ptolemaic in that new crystalline spheres and epicycles are constantly being added in an attempt to (...) fix the appearances. (shrink)

Kamm’s response to Tse’s comments deals with the following issues (among others): (1)the relevance of empirical facts to moral arguments about physician assisted suicide (PAS); (2) the moral relevance of the difference between foreseen risk and certainty of death as well as the difference between certain death and immediate death; (3) whether intention matters to the permissibility of giving morphine for pain relief (MPR) and whether objective factors can be the same whether one intends MPR or death in giving morphine; (...) (4) the relevance of the permissibility of MPR or terminating life-saving treatment for the permissibility of PAS. (shrink)

This chapter considers the relation between supererogation and duties (also here referred to as obligations) from a nonconsequentialist point of view. It first considers whether supererogation may sometimes take precedence over positive and negative duties and how this relates to personal costs (including efforts) required to perform one’s duty. It then considers how acquiescence to having large costs imposed on one (even permissibly) can be supererogatory. Finally, it considers how what are usually duties can become supererogatory and how what is (...) usually supererogatory can become a duty. The relation between these topics and the trolley problem, the so-called ‘all or nothing problem,’ and the issue of abortion are examined. (shrink)

Some of the commentators on Intricate Ethics complain of my method. One finds the main ideas ‘Kammouflaged’ because the relevant causal distinctions are so fine-grained and the cases that illustrate them so numerous. Some say that they do not have the intuitions about many cases that I have, that I concoct dubious and ad hoc distinctions and invest them with moral significance; I am Ptolemaic in that new crystalline spheres and epicycles are constantly being added in an attempt to fix (...) the appearances. (shrink)

This article considers some different views of fairness and whether they conflict with the use of a version of Cost Effectiveness Analysis (CEA) that calls for maximizing health benefits per dollar spent. Among the concerns addressed are whether this version of CEA ignores the concerns of the worst off and inappropriately aggregates small benefits to many people. I critically examine the views of Daniel Hausman and Peter Singer who defend this version of CEA and Eric Nord among others who criticize (...) it. I come to focus in particular on the use of CEA in allocating scarce resources to the disabled. (shrink)

This response to a commentary on “Allocation of scarce resources, disability, and parity” considers whether a difference that would be morally relevant when choosing which of two people to save retains its relevance if this would affect other people’s chances of being saved.

In the first part of this article, I raisequestions about Dworkin''s theory of theintrinsic value of life and about the adequacyof his proposal to understand abortion in termsof different ways of valuing life. In thesecond part of the article, I consider hisargument in ``The Philosophers'' Brief on AssistedSuicide'''', which claims that the distinctionbetween killing and letting die is morallyirrelevant, the distinction between intendingand foreseeing death can be morally relevantbut is not always so. I argue that thekilling/letting die distinction can be (...) relevantin the context of assisted suicide, but alsoshow when it is not. Then I consider why theintention/foresight distinction can be morallyirrelevant and conclude by presenting analternative argument for physician-assistedsuicide. (shrink)