In slogan form, the thesis of this dissertation is that shaping the far future is overwhelmingly important. More precisely, I argue that: Main Thesis: From a global perspective, what matters most is that we do what is best for the general trajectory along which our descendants develop over the coming millions, billions, and trillions of years. The first chapter introduces some key concepts, clarifies the main thesis, and outlines what follows in later chapters. Some of the key concepts include: existential (...) risk, the world's development trajectory, proximate benefits and ripple effects, speeding up development, trajectory changes, and the distinction between broad and targeted attempts to shape the far future. The second chapter is a defense of some methodological assumptions for developing normative theories which makes my thesis more plausible. In the third chapter, I introduce and begin to defend some key empirical and normative assumptions which, if true, strongly support my main thesis. In the fourth and fifth chapters, I argue against two of the strongest objections to my arguments. These objections come from population ethics, and are based on Person-Affecting Views and views according to which additional lives have diminishing marginal value. I argue that these views face extreme difficulties and cannot plausibly be used to rebut my arguments. In the sixth and seventh chapters, I discuss a decision-theoretic paradox which is relevant to my arguments. The simplest plausible theoretical assumptions which support my main thesis imply a view I call fanaticism, according to which any non-zero probability of an infinitely good outcome, no matter how small, is better than any probability of a finitely good outcome. I argue that denying fanaticism is inconsistent with other normative principles that seem very obvious, so that we are faced with a paradox. I have no solution to the paradox; I instead argue that we should continue to use our inconsistent principles, but we should use them tastefully. We should do this because, currently, we know of no consistent set of principles which does better. (shrink)

One mainstream approach to philosophy involves trying to learn about philosophically interesting, non-mental phenomena—ethical properties, for example, or causation—by gathering data from human beings. I call this approach “wide tent traditionalism.” It is associated with the use of philosophers’ intuitions as data, the making of deductive arguments from this data, and the gathering of intuitions by eliciting reactions to often quite bizarre thought experiments. These methods have been criticized—I consider experimental philosophy’s call for a move away from the use of (...) philosophers’ intuitions as evidence, and recent suggestions about the use of inductive arguments in philosophy—and these criticisms point out important areas for improvement. However, embracing these reforms in turn gives wide-tent traditionalists strong reasons to maintain other traditional approaches to philosophy. Specifically, traditionalists’ commitment to using intuitions and to gathering them with bizarre thought experiments is well founded, both philosophically and empirically. I end by considering some problems with gathering trustworthy intuitions, and give suggestions about how best to solve them. (shrink)

Proposed solutions to the problems of this country's health care system range along a spectrum from central planning to free market. Central planners and free market advocates provide various ethical justifications for the policies they propose. The crucial flaw in the philosophical rationale of central planning is failure to distinguish between normative and metanormative principles, which leads to mistaken understanding of the nature of rights. Natural rights, based on the principle of noninterference, provide the link between individual morality and social (...) order. Free markets, the practical expression of natural rights, are uniquely capable of achieving the goals that central planners seek but find beyond their grasp. The history of this country's health care system and the experiences of other nations provide evidence of the superiority of free markets in reaching for the goals of universal access, control of costs, and sustaining the quality of health care. (shrink)

This article sets out the moral failure of single-tier basic healthcare. Single-tier basic healthcare has been advocated on the grounds that the provision of healthcare should be divorced from ability to pay and unequal access to basic healthcare is morally intolerable. However, single-tier basic healthcare encounters a host of catastrophic moral failings. Given the fact of human pluralism it is impossible to objectively define “basic” healthcare. Attempts to provide single-tier healthcare therefore become political processes in which interest groups compete for (...) control of scarce resources with the most privileged possessing an inherent advantage. The focus on outputs in arguments for single-tier provision neglects the question of justice between individuals when some people provide resources for others without reciprocal benefits. The principle that only healthcare that can be provided to everyone should be provided at all leads to a leveling-down problem in which advocates of single-tier provision must prefer a situation where some individuals are made worse-off without any individual being made better-off compared to plausible multi-tier alternatives. Contemporary single-tier systems require the exclusion of noncitizens, meaning that their universalism is a myth. In the light of these pathologies, it is judged that multi-tier healthcare is morally required. (shrink)

Humans clearly have trouble thinking about death. This trouble is often used to explain behavior like delay in writing wills or buying life insurance, or interest in odd medical and religious beliefs. But the problem is far worse than most people imagine. Fear of death makes us spend fifteen percent of our income on medicine, from which we get little or no health benefit, while we neglect things like exercise, which offer large health benefits.