Suppose you can save only one of two groups of people from harm, with one person in one group, and five persons in the other group. Are you obligated to save the greater number? While common sense seems to say ‘yes’, the numbers skeptic says ‘no’. Numbers Skepticism has been partly motivated by the anti-consequentialist thought that the goods, harms and well-being of individual people do not aggregate in any morally significant way. However, even many non-consequentialists think that Numbers Skepticism (...) goes too far in rejecting the claim that you ought to save the greater number. Besides the prima facie implausibility of Numbers Skepticism, Michael Otsuka has developed an intriguing argument against this position. Otsuka argues that Numbers Skepticism, in conjunction with an independently plausible moral principle, leads to inconsistent choices regarding what ought to be done in certain circumstances. This inconsistency in turn provides us with a good reason to reject Numbers Skepticism. Kirsten Meyer offers a notable challenge to Otsuka’s argument. I argue that Meyer’s challenge can be met, and then offer my own reasons for rejecting Otsuka’s argument. In light of these criticisms, I then develop an improved, yet structurally similar argument to Otsuka’s argument. I argue for the slightly different conclusion that the view proposed by John Taurek that ‘the numbers don’t count’ leads to inconsistent choices, which in turn provides us with a good reason to reject Taurek’s position. (shrink)

In this article, I critique a moral argument developed in Frances Kamm’s Intricate Ethics: Rights, Responsibilities, and Permissible Harm. The argument, which I label the Best Outcome Argument, aims to criticize the Taurekian idea that it is not worse if more people die than if fewer do in conflict situations, where it is hard to distinguish individuals from one another solely by reference to the relative strength of their claims. I argue that the Best Outcome Argument is flawed for three (...) reasons: the symmetry feature defined by the impartiality principle holds only in a limited class of conflict situations; individuals should be treated in a consistent way throughout the whole process of reasoning; comparative evaluations gained in different contexts, at least in some cases, cannot be used in one and the same argument. (shrink)

One of the societal problems in a new influenza pandemic will be how to use the scarce medical resources that are available for prevention and treatment, and what medical, epidemiological and ethical justifications can be given for the choices that have to be made. Many things may become scarce: personal protective equipment, antiviral drugs, hospital beds, mechanical ventilation, vaccination, etc. In this paper I discuss two general ethical principles for priority setting (utility and equity) and explain how these principles will (...) often point in diverging directions. Moreover, each of these principles can be understood in different, again often competing, ways. Notwithstanding these controversies and conflicts, in the context of pandemic response there are at least some points of convergence: several policies can be justified by appeal to different ethical principles and theories. Convergence may be found with respect to a focus on saving the most lives (instead of other aggregative accounts); giving priority antiviral prophylaxis and therapy for life-saving pandemic responders; and, partly depending on epidemiology of the pandemic, to prioritise vaccination of children. Although decision-making about access to intensive care will involve choices with immediate tragic implications, the ethical complexity of these choices is relatively modest (although decisions will not be easy): there are persuasive moral reasons for giving priority to patients who are expected to benefit most within the shortest time. Finally, in the last section I tentatively argue that constraints on people’s freedom, as necessary for an effective public health approach, may support giving somewhat more weight to saving the most lives, than to concerns of equity. (shrink)

According to contractualist theories in ethics, whether an action is wrong is determined by whether it could be justified to others on grounds no one could reasonably reject. Contractualists then think that reasonable rejectability of principles depends on the strength of the personal objections individuals can make to them. There is, however, a deep disagreement between contractualists concerning from which temporal perspective the relevant objections to different principles are to be made. Are they to be made on the basis of (...) the prospects the principles give to different individuals ex ante or on the basis of the outcomes of the principles ex post? Both answers have been found to be problematic. The ex ante views make irrelevant information about personal identity morally significant and lead to objectionable ex ante rules, whereas ex post views lead to counterintuitive results in the so-called different harm and social risk imposition cases. The aim of this article is to provide a new synthesis of these views that can avoid the problems of the previous alternatives. I call the proposal ‘risk-acknowledging’ ex post contractualism. The crux of the view is to take into account in the comparisons of different objections both the realized harms and the risks under which individuals have to live. (shrink)

Most non-consequentialists “let the numbers count” when one can save either a lesser or greater number from equal or similar harm. But they are wary of doing so when one can save either a small number from grave harm or instead a very large number from minor harm. Limited aggregation is an approach that reconciles these two commitments. It is motivated by a powerful idea: our decision whom to save should respect each person who has a claim to our help, (...) including those whom we fail to save. However, it has recently been argued that it is open to decisive objections. I develop a new limitedly aggregative view:Hybrid Balance Relevant Claims. This view is well grounded in the reasons we have to be skeptical of aggregation and resolves all recent challenges by paying careful attention to the rationale for limited aggregation. (shrink)

In this article I explore a kind of tragic choice that has not received due attention, one in which you have to save only one of two persons but the probability of saving is not equal (and all other things are equal). Different proposals are assessed, taking as models proposals for a much more discussed tragic choice situation: saving different numbers of persons. I hold that cases in which (only) numbers are different are structurally similar to cases in which (only) (...) probabilities are different. After a brief defense of this claim, I conclude that some version of consequentialism seems more promising for offering a plausible solution to the probability case. (shrink)

When facing a choice between saving one person and saving many, some people have argued that fairness requires us to decide without aggregating numbers; rather we should decide by coin toss or some form of lottery, or alternatively we should straightforwardly save the greater number but justify this in a non-aggregating contractualist way. This paper expands the debate beyond well-known number cases to previously under-considered probability cases, in which not (only) the numbers of people, but (also) the probabilities of success (...) for saving people vary. It is shown that, in these latter cases, both the coin toss and the lottery lead to what is called an awkward conclusion, which makes probabilities count in a problematic way. Attempts to avoid this conclusion are shown to lead into difficulties as well. Finally, it is shown that while the greater number method cannot be justified on contractualist grounds for probability cases, it may be replaced by another decision method which is so justified. This decision method is extensionally equivalent to maximising expected value and seems to be the least problematic way of dealing with probability cases in a non-aggregating manner. (shrink)

It is widely believed that consequentialists are committed to the claim that persons are mere containers for well-being. In this article I challenge this view by proposing a new version of consequentialism, according to which the identities of persons matter. The new theory, two-dimensional prioritarianism, is a natural extension of traditional prioritarianism. Two-dimensional prioritarianism holds that wellbeing matters more for persons who are at a low absolute level than for persons who are at a higher level and that it is (...) worse to be deprived of a given number of units than it is good to gain the same number of units, even if the new distribution is a permutation of the original one. If a fixed amount of well-being is transferred from one person to another and then transferred back again, two-dimensional prioritarianism implies that it would have been better to preserve the status quo. (shrink)

John Taurek argues that, in a choice between saving the many or the few, the numbers should not count. Some object that this view clashes with the transitivity of ‘better than’; others insist the clash can be avoided. I defend a middle ground: Taurek cannot have transitivity, but that doesn’t doom his view, given a suitable conception of value. I then formalize and explore two conceptions: one context-sensitive, one multidimensional.

In recent years, many non-consequentialists such as Frances Kamm and Thomas Scanlon have been puzzling over what has come to be known as the Number Problem, which is how to show that the greater number in a rescue situation should be saved without aggregating the claims of the many, a typical kind of consequentialist move that seems to violate the separateness of persons. In this article, I argue that these non-consequentialists may be making the task more difficult than necessary, because (...) allowing aggregation does not prevent one from being a non-consequentialist. I shall explain how a non-consequentialist can still respect the separateness of persons while allowing for aggregation. (shrink)

John Taurek famously argued that, in ‘conflict cases’, where we are confronted with a smaller and a larger group of individuals, and can choose which group to save from harm, we should toss a coin, rather than saving the larger group. This is primarily because coin-tossing is fairer: it ensures that each individual, regardless of the group to which he or she belongs, has an equal chance of being saved. This article provides a new response to Taurek’s argument. It proposes (...) that there are two possible types of unfairness that have to be avoided in conflict cases, as far as possible: ‘selection unfairness’, which is the unfairness of not giving individuals an equal chance of being saved; and ‘outcome unfairness’, which is the unfairness of not actually saving them, when others are saved. Since saving the greater number generates less outcome unfa-irness than coin-tossing, it is argued that, in many conflict cases, fairness demands that we save the greater number. (shrink)

Faced with a choice between saving one stranger and saving a group of strangers, some people endorse weighted lotteries, which give a strictly greater chance of being saved to the group of strangers than the single stranger. In this paper I attempt to criticize this view. I first consider a particular version of the weighted lotteries, Frances Kamm's procedure of proportional chances, and point out two implausible implications of her proposal. Then, I consider weighted lotteries in general, and claim (1) (...) that the correct thing to distribute is not the chance of being saved but the good of being saved, (2) that assigning some chance to the single stranger is not the only way to give a positive (and equal) respect to the people concerned, and (3) that the weighted lottery appears to be deceptive since it would show the respect to the single stranger in a negligible way. (shrink)

Many critics of utilitarianism claim that we should reject interpersonal aggregation because aggregative principles do not take the separateness of persons seriously. In this article, I will reject this claim. I will first elucidate the theoretical structure of aggregation. I will then consider various interpretations of the notion of the separateness of persons and clarify what exactly those critics are trying to reject by appealing to the notion of the separateness of persons. I will argue that none of these interpretations (...) can serve as the ground for rejecting aggregation. (shrink)

Many authors in ethics, economics, and political science endorse the Lottery Requirement, that is, the following thesis: where different parties have equal moral claims to one indivisible good, it is morally obligatory to let a fair lottery decide which party is to receive the good. This article defends skepticism about the Lottery Requirement. It distinguishes three broad strategies of defending such a requirement: the surrogate satisfaction account, the procedural account, and the ideal consent account, and argues that none of these (...) strategies succeed. The article then discusses and discharges some remaining grounds for resistance to these skeptical conclusions, as well as the possibility of defending a weaker version of a normative lottery principle. The conclusion is that we have no reason to believe that where equal claims conflict, we are morally required to hold a lottery, as opposed to simply picking one of the parties on more subjective grounds or out of pure whim. In addition to the practical consequences of this skeptical view, the article sketches some theoretical implications for debates about saving the greater number and about axiomatic utilitarianism. (shrink)

Deontic constraints prohibit an agent performing acts of a certain type even when doing so will prevent more instances of that act being performed by others. In this article I show how deontic constraints can be interpreted as either maximizing or non-maximizing rules. I then argue that they should be interpreted as maximizing rules because interpreting them as non-maximizing rules results in a problem with moral advice. Given this conclusion, a strong case can be made that consequentialism provides the best (...) account of deontic constraints. (shrink)

Is an outcome where many people are saved and one person dies better than an outcome where the one is saved and the many die? According to the standard utilitarian justification, the former is better because it has a greater sum total of well-being. This justification involves a controversial form of moral aggregation, because it is based on a comparison between aggregates of different people's well-being. Still, an alternative justification—the Argument for Best Outcomes—does not involve moral aggregation. I extend the (...) Argument for Best Outcomes to show that any utilitarian evaluation can be justified without moral aggregation. (shrink)

Suppose you find yourself in a situation in which you can either save both A and B or save only C. A, B and C are relevantly similar – all are strangers to you, none is more deserving of life than any other, none is responsible for being in a life-threatening situation, and so on. John Taurek argued that when deciding what to do in such a situation, you should flip a coin, thereby giving each of A, B and C (...) a 50% chance of survival . Only by doing this can we treat each person with the appropriate degree of respect. Taurek seemed to be employing the “Equal Greatest Chance” principle , according to which, when deciding whom to save, one must give each person the greatest possible chance of survival consistent with everyone else having the same chance. An obvious alternative is the “Save the Greater Number” principle . I describe an example that shows that EGC is false. I show that the example also demonstrates the falsity of other related views, including Jens Timmermann’s “Individualist Lottery Principle.” I conclude that SGN is true. And I extend the argument to other kinds of cases, showing that which person should be saved may depend on whether some additional well-being may be gained for someone in the process. (shrink)

In response to the charge that deontic ("argent-centered") restrictions are paradoxical, several recent writers suggest that such restrictions find support within T.M. Scanlon's contractualism. I suggest that this claim is only interesting if these restrictions are stronger than those supported by indirect consequentialism. I argue that contractualism cannot support restrictions any stronger than those supported by indirect consequentialism. The contractualists have mislocated the source of the paradox, which arises under any theory that defines right action in patient-focused terms. Consequentialism and (...) contractualism share this feature, so contractualism cannot support stronger deontic restrictions than consequentialism supports. (shrink)

If we can save the lives of only one of multiple groups of people, we might be inclined simply to save whichever group is largest. We may worry, though, that automatically saving the largest group fails to take each saveable individual sufficiently into account, offering some of these individuals no chance at all of being rescued. Still wanting to give larger groups higher chances of survival, we may then say that we ought to employ a proportionally weighted lottery to determine (...) which group to save. In this paper, I argue that this would be a mistake. Given the most plausible way of specifying it, the weighted-lottery view itself fails to treat each saveable individual with equal moral respect. (shrink)

The rule of rescue holds that special weight should be given to protecting the lives of assignable individuals in need, implying that less weight is given to considerations of cost-effectiveness. This is sometimes invoked as an argument for funding or reimbursing life-saving treatment in public healthcare even if the costs of such treatment are extreme. At first sight one might assume that an individualist approach to ethics—such as Scanlon’s contractualism—would offer a promising route to justification of the rule of rescue. (...) In this chapter I argue that contractualism cannot endorse the rule of rescue, whereas a collectivist approach that appeals to group solidarity would offer support for rescue cases. The argument, however, has its limitations, and though solidarity is of central concern in shaping public healthcare, there are good reasons for not endorsing the rule of rescue as a moral basis for allocating scarce resources in clinical care. (shrink)

In this thesis, I discuss the aggregation problem for T. M. Scanlon’s “contractualism”. I argue that Scanlonian contractualists have the following two options when it comes to the aggregation problem. First, they can choose to limit aggregation directly via a specific version of the Relevance View, “Sequential Claims-Matching”. Second, Scanlonian contractualists can adopt a so-called “mixed solution” of which I propose a specific version. My mixed solution does not limit aggregation. Rather, it either avoids some of the counterintuitive results in (...) certain cases, or at least makes these same results look a lot less counterintuitive by putting them into perspective thanks to a plausible plurality of precisely specified values. The stakes between these two options are as follows. The first option justifies Scanlon’s intuition in one vs. many cases of which his “World Cup Case” is one example, but it comes at the cost of a seemingly quite limited range of application: any version of the Relevance View only works in cases in which we have no more than two groups of competing claimants. The second option has the exact opposite implications: my mixed solution cannot justify Scanlon’s intuition in one vs. many cases, but it could be applied to any case with any number of groups of competing claimants. In this choice between pre-theoretical intuition and feasibility, I would urge Scanlonian contractualists to choose feasibility. (shrink)

This thesis discusses the possibility of limited moral trade-offs between different people’s welfare. In chapter 2, I introduce the two central limited trade-off conditions. First, according to minimal infinite superiority, significantly benefiting one person matters more than slightly benefiting each of any number of better-off people. Second, according to minimal finite superiority, significantly benefiting many people matters more than slightly benefiting one person. I consider both axiological and deontic interpretations of these conditions. However, I explain why none of the simple (...) classic moral principles—the simple total and the maximin principles—satisfy both conditions. Furthermore, in chapter 3, I strengthen several proved impossibility results according to which no moral theory satisfies weak interpretations of these central trade-off conditions and several other seemingly plausible minimal conditions. I show that giving up structural axiological and deontic conditions is not a satisfactory solution to these paradoxes. In chapter 4, I discuss the modification of a background assumption of these impossibility results on the measurement of welfare. I show that, given a modification that allows for lexicographically ordered welfare components, a total principle can satisfy all the conditions of the impossibility results. However, I argue that such a modification is not entirely satisfactory because it does not apply in certain instances of the paradoxes. In chapter 5, I discuss a further weakening of minimal infinite superiority. However, I show that a suggested possibility result based on this modification is not valid and that further moral conditions, such as minimal finite superiority, need to be modified. Moreover, I argue that these modified conditions and the principle suggested in the possibility proof—a minimax complaint principle—do not capture the basic idea of the two central limited trade-off conditions sufficiently well. In chapter 6, I argue that other principles suggested for the task—the total claim principles—share the same fate as the simple total principles or the minimax complaint principle. In chapter 7, I propose new principles that take their structural roots from voting theory. I show that, in contrast to the other principles discussed, these principles give plausible verdicts where the other principles failed. Finally, in chapter 8, I consider possible objections levelled against this proposal, and I suggest solutions and avenues for future research. (shrink)