One of the principal aims of Kant’s Metaphysics of Morals, especially of the Doctrine of Virtue, is to present a taxonomy of our duties as human beings. The basic division of duties is between juridical duties and ethical duties, which determines the division of the Metaphysics of Morals into the Doctrine of Right and the Doctrine of Virtue. Juridical duties are duties that may be coercively enforced from outside the agent, as by the civil or criminal laws, or other social (...) pressures. Ethical duties must not be externally enforced (to do so violates the right of the person coerced). Instead, the subject herself, through her own reason and the feelings and motives arising a priori from her rational capacities -- the feelings of respect, conscience, moral feeling and love of other human beings, must constrain herself to follow them (MS 6:399-404).1 Among ethical duties, the fundamental division is between duties to oneself and duties to others. Within each of these two main divisions of ethical duty, there is a further division between duties that are strictly owed, requiring specific actions or omissions, and whose violation incurs moral blame, and duties that are wide or meritorious, the specific actions not strictly owed, but deserving of moral credit or merit. Kant treats these latter as ‘duties’ (eschewing any category such as ‘supererogation’) because the actions in question are conceived as fit objects of self-constraint – things we can make ourselves do through the exercise of reason and the moral feelings arising from the application of practical reason to our faculty of desire. Regarding duties to oneself, this division is between ‘perfect’ and ‘imperfect’ duty; regarding duties to others, the strict or narrow... (shrink)

Questions about information inform many debates in bioethics. One of the reasons for this is that at least some level of information is taken by many to be a prerequisite of valid consent. For others, autonomy in the widest sense presupposes information, because one cannot be in control of one’s life without at least some insight into what it could turn out to contain. Yet not everyone shares this view, and there is a debate about whether or not there is (...) a right to remain in ignorance of one’s medical, and especially genetic, information. It is notable, though, that this debate leaves unexamined the assumption that, if a person wants information, he is entitled to it. This paper examines the assumption, specifically in relation to genetics, where learning facts about oneself may reveal facts about other people, particularly one’s close relatives. This may be taken as a violation of their privacy, and since privacy is something that we normally think should be respected, it is worth asking whether one ought to abjure the opportunity to obtain genetic information for the sake of privacy. In effect, there may be an argument to be made not just for a right to remain in ignorance, but for a duty to do so. (shrink)

Recently some bioethicists and neuroscientists have argued for an imperative of chemical cognitive enhancement. This imperative is usually based on consequentialist grounds. In this paper, the topic of cognitive self-enhancement is discussed from a Kantian point of view in order to shed new light on the controversial debate. With Kant, it is an imperfect duty to oneself to strive for perfecting one’s own natural and moral capacities beyond one’s natural condition, but there is no duty to enhance (...) others. A Kantian approach does not directly lead to a duty of chemical cognitive self-enhancement, but it also does not clearly rule out that this type of enhancement can be an appropriate means to the end of self-improvement. The paper shows the benefits of a Kantian view, which offers a consistent ideal of self-perfection and teaches us a lesson about the crucial relevance of the attitude that underlies one’s striving for cognitive self-improvement: the lesson of treating oneself as an end in itself and not as mere means to the end of better output. (shrink)

This paper analyses the thorny interpretative puzzle surrounding the connection between humanity and the good will. It discusses this puzzle: if the good will is the only good without qualification, why does Kant claim that humanity is something possessing an absolute value? It explores the answers to this question within Kantian scholarship; answers that emanate from a commitment to the human capacity for freedom and morality and to actual obedience to the moral law. In its final analysis, it endorses Richard (...) Dean’s good will reading as the most reflective of Kant’s ethics. It claims that in order for a person to reach the moral ideal of acting rightly and giving priority to moral law, he must always honour his duties to himself. Accordingly, it argues that before a person can be deemed as an object of respect, he must first respect the right of humanity in his own person. (shrink)

ABSTRACT There is a strong pragmatic argument that in our times, dominated as they are by continuous change, one's education needs to be a lifelong process. But can another, different, argument be made that lifelong education is a moral duty everyone owes to oneself irrespective of any other pragmatic justijication? The answer evidently depends largely on whether the notion of a moral duty owed to oneself is an intelligible one. In effect, it turns out, on examination, (...) to be very problematic. It is suggested rather that a moral duty to educate oneselffor life can be more coherently grounded in another different notion: one of membership in one's community regarded as a ‘learning society’. (shrink)

There is a strong pragmatic argument that in our times, dominated as they are by continuous change, one's education needs to be a lifelong process. But can another, different, argument be made that lifelong education is a moral duty everyone owes to oneself irrespective of any other pragmatic justijication? The answer evidently depends largely on whether the notion of a moral duty owed to oneself is an intelligible one. In effect, it turns out, on examination, to (...) be very problematic. It is suggested rather that a moral duty to educate oneselffor life can be more coherently grounded in another different notion: one of membership in one's community regarded as a ‘learning society’. (shrink)

Duties to oneself are allegedly incoherent: if we had duties to ourselves, we would be able to opt out of them. I argue that there is a constraint on one’s ability to release oneself from duties to oneself. The release must be autonomous in order to be normatively transformative. First, I show that the view that combines the division of the self with the second-personal characterization of morality is problematic. Second, I advance a fundamental solution to the (...) problem of the incoherence of duties to oneself, one that does not rely on any division of the self, temporal or otherwise. I build upon the prevalent idea that, in releasing others from duties, we exercise the power of consent. The transformative force of consent partly derives from our autonomy. Invoking a plausible characterization of autonomy, I argue that release from duties requires the right kind of mental state. (shrink)

Philosophers have long argued that duties to oneself are paradoxical, as they seem to entail an incoherent power to release oneself from obligations. I argue that self-release is possible, both as a matter of deontic logic and of metaethics.

Ethical issues related to comparative effectiveness research, or research that compares existing standards of care, have recently received considerable attention. In this paper we focus on how Ethics Review Committees should evaluate the risks of comparative effectiveness research. We discuss what has been a prominent focus in the debate about comparative effectiveness research, namely that it is justified when “nothing is known” about the comparative effectiveness of the available alternatives. We argue that this focus may be misleading. Rather, we should (...) focus on the fact that some experts believe that the evidence points in favor of one intervention, whereas other experts believe that the evidence favors the alternative. We will then introduce a case that illustrates this point, and based on that, discuss how ERCs should deal with such cases of expert disagreement. We argue that ERCs have a duty to assess the range of expert opinions and based on that assessment arrive at a risk judgment about the study under consideration. We also argue that assessment of expert disagreement is important for the assignment of risk level to a clinical trial: what is the basis for expert opinions, how strong is the evidence appealed to by various experts, and how can clinical trial monitoring affect the possible increased risk of clinical trial participation. (shrink)

Why is it that most among the relatively few moral philosophers since Kant who, like J. S. Mill, have discussed the question whether there can be moral duties to oneself, have answered it negatively? One reason is that those philosophers have supposed that all moral action must be, inter alia, social; and they may have thought so because of their commitment to what is here called a 'corporationist' moral view. But such a conception of morality as social is objectionable (...) because it does not square with ordinary opinion and because it introduces an artificial division between types of action which go together in real life. (shrink)

Background: Ethical issues related to comparative effectiveness research, or research that compares existing standards of care, have recently received considerable attention. In this paper we focus on how Ethics Review Committees should evaluate the risks of comparative effectiveness research. Main text: We discuss what has been a prominent focus in the debate about comparative effectiveness research, namely that it is justified when “nothing is known” about the comparative effectiveness of the available alternatives. We argue that this focus may be misleading. (...) Rather, we should focus on the fact that some experts believe that the evidence points in favor of one intervention, whereas other experts believe that the evidence favors the alternative. We will then introduce a case that illustrates this point, and based on that, discuss how ERCs should deal with such cases of expert disagreement. Conclusion: We argue that ERCs have a duty to assess the range of expert opinions and based on that assessment arrive at a risk judgment about the study under consideration. We also argue that assessment of expert disagreement is important for the assignment of risk level to a clinical trial: what is the basis for expert opinions, how strong is the evidence appealed to by various experts, and how can clinical trial monitoring affect the possible increased risk of clinical trial participation. (shrink)

KANT is the foremost philosopher to have argued at length for there being moral duties to oneself, and he puts forward the most extensive list of such duties to be found in philosophical writings. Kant's most detailed statement of his views concerning duties to oneself is to be found in his late work, the Tugendlehre or Doctrine of Virtue, which forms the second part of his Metaphysic of Morals, that work for which the much more famous Grundlegung was (...) the foundational study. I shall confine my consideration of Kant entirely to the Tugendlehre, for his views there, at least concerning duties to oneself, represent only an amplification of ideas that he had expressed in earlier writings. (shrink)

I draw on ideas salient in contemporary literate African philosophy to construct two new theoretical ways of capturing the essence of duties to oneself. According to one theory, a person has a foundational duty to “relate” to herself in ways similar to how the African field has often thought that a person should relate with others, viz., harmoniously. According to the second, one has a foundational duty to produce liveliness in oneself. In addition to articulating these (...) novel attempts to capture what all duties to oneself might have in common and showing that each one captures several intuitions about them, I offer some reasons to think that the harmony theory is more attractive than the vitality one. I conclude that there are values prominent in the African tradition that, upon some reformulation, ground comprehensive accounts of what one owes oneself that merit consideration by a global audience as rivals to, say, Kantian-rationalist approaches common in the West. (shrink)

According to indirect duty views, human beings lack direct moral duties to non-human organisms, but our direct duties to ourselves and other humans give rise to indirect duties regarding non-humans. On the orthodox interpretation of Kant’s account of indirect duties, one should abstain from treating organisms in ways that render one more likely to violate direct duties to humans. This indirect duty view is subject to several damaging objections, such as that it misidentifies the moral reasons we have (...) to treat non-humans in certain ways and that it sanctions only weak obligations vis-à-vis organisms. I develop an alternative indirect duty view: given a direct duty to oneself to cultivate virtuous dispositions, one has an indirect duty to abstain from treating organisms in ways that erode one’s virtues or develop vices. I argue that this indirect duty view strictly proscribes knowingly causing unnecessary harm to organisms, and I show that it is not subject to the damaging objections directed against the indirect duty view attributed to Kant by the orthodox interpretation. This suggests that indirect duty views are more worthy of consideration than is often supposed. (shrink)

Sensen analyzes Kant’s justification of duties to oneself. Why does Kant say that duties to oneself have priority over other duties? Sensen concludes that there is a common idea behind the different formulas of the categorical imperative: the idea that our human capacities have a high importance. Kant’s ethics needs anthropology to derive concrete duties from this general idea.

A number of viable ethical theories allow for the possibility of duties to oneself. If such duties exist, then, at least sometimes, by treating ourselves badly, we wrong ourselves and could rightly be held responsible, by ourselves and by non-affected third parties, for doing so. Yet, while we blame those who wrong others, we do not tend to, nor do we think ourselves entitled to blame people who treat themselves badly. If we try, they might justifiably respond that it (...) is none of our business. This disanalogy might be thought of as a reason for skepticism about duties to oneself. It allegedly indicates that self-inflicted harm, while irrational, is not immoral. In this paper, I argue that this disanalogy is deceptive. First, it relies on the unjustified assumption that our response to someone treating herself badly consists solely in a judgment that she is being irrational or foolish, which is incompatible with leading views about what constitutes blame. Second, the objection fails to recognize that third-party blame is positional: in some contexts, it is inappropriate for a third party to express blame just because of her position as a third party. (shrink)

Kant on Duty to Oneself and Resistance to Political Authority SVEN ARNTZEN in ms DOCTRI~tE OF Law and related writings? Kant denies the subject's right to resist political authority in the strongest terms. His argumentation to sup- port this denial is conceptual in character. The denial of a right of resistance follows from the relevant legal concepts of civil society, of the people as sub- ject, of the head of state as the supreme power in civil society, as (...) having only rights but no duties that he may be coerced to fulfill, and of a right as an authorization to use coercion. Civil society is the coexistence of persons as subject to a central authority, a supreme power, which is not itself subject to some other coercive authority. For the people as subject to have a right to resist the supreme power in civil society would be for it to have an authorization to use coercion to restrain that power, which would not, then, be the supreme power. In other words, a people's right to resist the supreme power would imply that the power is both supreme and not ' By Kant's Doctrine of Law I mean his Die metaphysische Anfangsgriinde der Rechtslehre, the first part ofD/e Metaphysik der Sitten, hereafter MdS . The other available translation of the Doctrine of Law is by John Ladd, and is rendered as The Metaphysical Elements of Justice (Indianapolis: The.. (shrink)

I argue that Kant's ethical framework cannot countenance a certain kind of failure to respect oneself that can occur within oppressive social contexts. Kant's assumption that any person, qua rational being, has guaranteed epistemic access to the moral law as the standard of good action and the capacity to act upon this standard makes autonomy an achievement within the individual agent's power, but this is contrary to a feminist understanding of autonomy as a relational achievement that can be thwarted (...) by the systematic attack on autonomy that occurs within oppressive social conditions. Insofar as Kant's negative duty of self-respect is unable to accommodate the ways immersion in oppressive social environments can warp an individual's understanding of what she is owed and capable of as a moral agent, it perpetuates the cruelty of unjust social systems in the guise of respecting individual autonomy. I conclude by considering Carol Hay's argument that those who are oppressed have an obligation to themselves to resist their own oppression, in order to explore how this limitation in how Kant conceives of the duty to respect the self may reach expression in contemporary ethical theory inspired by Kant. (shrink)

In the Doctrine of Right Kant holds that the classical Ulpian command honeste vive is a juridical duty that has the particular feature of being internal. In this paper I explore the reasons why Kant denies that the duty to be an honorable human being comprises an ethical obligation and conceives it as a juridical duty to oneself. I will argue that, despite the conceptual problems that the systematical incorporation of this type of duty into (...) the doctrine of morals might entail, these reasons are coherent. The fulfillment of the duty honeste vive involves a coercion to the self but at the same time does not necessarily imply the adoption of a moral end. (shrink)

In “On duties to oneself,” Marcus G. Singer argued that, contrary to long established philosophical tradition, there are no duties to oneself. Singer observes that to have a duty is to be accountable to someone for that duty’s fulfillment, and while she to whom a duty is owed may release the person who has the duty from being bound to fulfill it, the latter cannot release herself from the duty. For releasing oneself (...) from a duty is no different from simply opting not to fulfill it, which would make the duty no more than a mere option and rob it of its categorical character. Singer thus argues that (a) A has a duty against herself; (b) if A has a duty against herself, then A is accountable to herself for the duty’s performance; (c) if A has a duty against herself, A can release herself from the duty; and (d) because a person is accountable to the individual owed the duty for its fulfillment, no one can release herself from an obligation, form an inconsistent set. (shrink)

ABSTRACT:Increasingly, global businesses are confronted with the question of complicity in human rights violations committed by abusive host governments. This contribution specifically looks at silent complicity and the way it challenges conventional interpretations of corporate responsibility. Silent complicity implies that corporations have moral obligations that reach beyond the negative realm of doing no harm. Essentially, it implies that corporations have a moral responsibility to help protect human rights by putting pressure on perpetrating host governments involved in human rights abuses. This (...) is a controversial claim, which this contribution proposes to analyze with a view to understanding and determining the underlying conditions that need to be met in order for moral agents to be said to have such responsibilities in the category of the duty to protect human rights. (shrink)

This paper argues that economic agents, including corporations, have the duty to further justice, not just a duty merely to comply with laws and do their share. The duty to further justice is the requirement to assist in the establishment of just arrangements when they do not exist in society. The paper is grounded in liberal theory and draws heavily on one liberal theorist, Kant. We show that the duty to further justice must be interpreted as (...) a duty of virtue that is owed. This means that the duty is not enforceable but that violating this duty is still wrong and not merely non-virtuous. Our analysis has consequences for the morality of commercial life. It is often suggested that the morality of the market is a special, restricted morality that is leaner than the morality that agents must acknowledge outside the market. If our analysis is correct, the duty to further justice cannot be exempted from market morality, even if it is agreed that this must be leaner than the morality outside commercial life. Our analysis also has direct consequences for John Ruggie’s view on the responsibilities of businesses. Ruggie has never explicitly acknowledged a duty on the part of business enterprises to further justice. If our analysis is correct, his view is contradictory in that it presupposes the normative validity of free market enterprise yet shrinks from taking into account the conditions of its possibility. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Response to David Carr, “The Significance of Music for the Promotion of Moral and Spiritual Value”Iris M. YobDavid Carr has addressed a question that has been lurking in philosophical literature for centuries and, I might add, in our collective intuition as well: Just what is the connection between music and the moral and spiritual life? And as we have come to expect from his work, he brings a (...) new perspective to this perennial question in his answer. First he traces a line of thinking since Plato about music and the ordering of the soul, he touches on the role of music and the other arts in exploring the complexities of the moral imperative as it is lived out in human lives, and returns at the end to give a new take on the old Platonic idea of ordering of the soul. Just maybe, he suggests, the detachment, however temporary, "from the trials and tribulations that beset us in the day to day rough and tumble of human practical affairs" "in the interests of some more balanced perspective" on spiritual and moral matters "might be easier to achieve in the contemplation and appreciation of great works of 'music alone.'"This conclusion does not lay claim to more than what is perfectly reasonable. Allowing oneself to be immersed in a great work of music or art or architecture or dance may very well provide that distance from every day life where one might [End Page 209] re-center and refocus, refresh and renew one's outlook on the world. Such an engagement with an artwork can interrupt the patterns of thinking and acting that might have become increasingly thoughtless and ego-centric. It can be a re-creation in the true sense of the word. Paul Tillich, one of the great twentieth century religious philosophers, tells of an experience he had during the First World War where he served as a chaplain in the German army. On a brief leave from the front he visited Kaiser Friedrich Museum in Berlin and stood entranced before Botticelli's "Madonna and Child with Singing Angels." The moment was spiritually transformative, he tells us, lifting his spirits beyond the mud and grime of the battlefield to contemplate life and meaning on a different plane altogether. The experience enabled him to return to duty with renewed inner strength and calm.1 I believe this is a rather powerful and compelling example of what Carr is talking about.In coming to his conclusion, Carr is relying on the particularly difficult case of "music alone," that is, music that does not have words, title, or any other kind of representative function. In other words his argument does not depend on any didactic nature or morally or spiritually directive intent of the music. Rather, it is centered on music that ostensibly is not about anything. This is musical sound composed and performed for the appreciation of what it is in itself. And yet, in providing distance from the every day world, according to Carr, it can give expression to "realms of spiritual experience that lie beyond the sensual and empirical." Here we enter the world of the metaphorical and symbolic, what Rudolf Otto would call the "irrational" or "superrational," or the realm of the Holy. While Carr does not state this explicitly I would go so far as to say that this realm of the wordless and sacred is where the spiritual and the moral are grounded and from where they draw their power.Against this background, I would like to ask how does "music alone," in the sense intended by Carr and Peter Kivy from whom he borrowed the term bring about this effect? We are unable now to ask Tillich what it was that gave the Botticelli its impact for him, but it is curious that what it did for him it most likely did not do for all the other soldiers from the front who happened upon it the way he did. Tillich would most likely explain its effect by resorting to his theory of symbols, because after all this painting does have a literal meaning that might very well have inspired him. But... (shrink)

While the ethical use of deception has been discussed in literature, the ethics and acceptability of nursing deception has yet to be studied. The current study examined nurses’ and nursing students’ ratings of the ethics and acceptability of nursing deception. We predicted that nurses and nursing students would rate a truthful vignette as more ethical than a deceptive vignette. We also predicted that participants would rate nursing deception as unethical and unacceptable. A mixed design was used to examine ethics scores (...) as a within-subjects factor and order as a between-groups design factor. A total of 131 nurses and nursing students were recruited from university nursing programs and hospitals in Texas. Participants were provided with a truthful vignette and deceptive vignette and used the Multidimensional Ethics Scale-Revised 1 to rate each vignette. Participants also completed the Lies in Nursing Ethics Questionnaire. The truthful nursing vignette was rated as more ethical than the deceptive vignette. Results indicated that most participants rated nursing deception as unethical, unacceptable, and a violation of the ANA ethical code. Some participants deemed that nursing deception may be acceptable within some cases. Age and years of experience were not related to the perceived ethics and acceptability of nursing deception. Nurses and nursing students believe that using deception with patients is unethical and unacceptable. However, some participants believed that deception may be warranted within some cases. These findings may reflect nurses’ placing the patient at the core of their values and viewing honesty as important for the nurse-patient relationship. Further implications and directions are discussed. (shrink)

ABSTRACT:Increasingly, global businesses are confronted with the question of complicity in human rights violations committed by abusive host governments. This contribution specifically looks at silent complicity and the way it challenges conventional interpretations of corporate responsibility. Silent complicity implies that corporations have moral obligations that reach beyond the negative realm of doing no harm. Essentially, it implies that corporations have a moral responsibility to help protect human rights by putting pressure on perpetrating host governments involved in human rights abuses. This (...) is a controversial claim, which this contribution proposes to analyze with a view to understanding and determining the underlying conditions that need to be met in order for moral agents to be said to have such responsibilities in the category of the duty to protect human rights. (shrink)

A challenge to Kant’s less known duty of self-knowledge comes from his own firm view that it is impossible to know oneself. This paper resolves this problem by considering the duty of self-knowledge as involving the pursuit of knowledge of oneself as one appears in the empirical world. First, I argue that, although Kant places severe restrictions on the possibility of knowing oneself as one is, he admits the possibility of knowing oneself as one (...) appears using methods from empirical anthropology. Second, I show that empirical knowledge of oneself is fairly reliable and is, in fact, considered as morally significant from Kant’s moral anthropological perspective. Taking these points together, I conclude that Kant’s duty of self-knowledge exclusively entails the pursuit of empirical self-knowledge. (shrink)

In this article, the last in the symposium on world poverty and human rights, Pogge replies to his critics Mathias Risse, Alan Patten, Rowan Cruft, Norbert Anwander, and Debra Satz.

Kant claims that persons have a perfect duty to respect themselves. I argue, first, that Kant’s argument for the duty of self-respect commits him to an implausible view of the nature of self-respect: he must hold that failures of self-respect are either deliberate or matter of self-deception. I argue, second, that this problem cannot be solved by understanding failures of self-respect as failures of rationality because such a view is incompatible with human psychology. Surely it is not irrational (...) for people, especially members of oppressed groups, to view themselves as having diminished moral worth. (shrink)

Clinicians have good moral and professional reasons to contribute to pragmatic clinical trials (PCTs). We argue that clinicians have a defeasible duty to participate in this research that takes place in usual care settings and does not involve substantive deviation from their ordinary care practices. However, a variety of countervailing reasons may excuse clinicians from this duty in particular cases. Yet because there is a moral default in favor of participating, clinicians who wish to opt out of this (...) research must justify their refusal. Reasons to refuse include that the trial is badly designed in some way, that the trial activities will violate the clinician’s conscience, or that the trial will impose excessive burdens on the clinician. (shrink)

In some cases, you may release someone from some obligation they have to you. For instance, you may release them from a promise they made to you, or an obligation to repay money they have borrowed from you. But most take it as clear that, if you have an obligation to someone else, you cannot in any way release yourself from that obligation. I shall argue the contrary. The issue is important because one standard problem for the idea of having (...) duties to oneself relies on the impossibility of self-release. The argument is that a duty to oneself would be a duty from which one could release oneself, but that this is an absurdity, and so there can be no duties to oneself. This argument is to be rejected because a duty from which one can release oneself is perfectly possible, and such release occurs quite properly from time to time. (shrink)

This essay develops a Kantian approach to the permissibility of biomedical physical, cognitive, and moral enhancement. Kant holds that human beings have an imperfect duty to promote their physical, cognitive, and moral perfection. While an agent’s individual circumstances may limit the means she may permissibly use to enhance herself, whether biomedically or otherwise, I argue (1) that biomedical means of enhancing oneself are, generally speaking, both permissible and meritorious from a Kantian perspective. Despite often being equally permissible, I (...) also argue (2) that enhancing oneself by more traditional means is, generally speaking, more meritorious (and involves the display of more virtue) than enhancing oneself by biomedical means. Nevertheless, since Kant does not fault agents for acting less meritoriously (or for displaying less virtue) than they otherwise could, I also argue (3) that those who opt for permissible biomedical enhancement over more traditional forms are not blameworthy for doing so. I also consider and reject several objections to these claims, including that biomedical enhancements (1) are too passive to count as actions by the agent who enhances herself, (2) involve a failure of the agent to treat her humanity as an end in itself or to show proper respect for her dignity, (3) might be undertaken on the basis of motives that undermine their permissibility, (4) are likely to exacerbate existing social and economic inequalities in ways that do the same, and (5) in their moral form are incompatible with Kant’s conception of duty and human freedom. (shrink)

Lithuania was one of the first states in Europe to approve a comprehensive list of patients’ duties under a special Law on the Rights of Patients of 2010. The approval of the catalogue of patients’ duties at the level of a law is based on the restatement of the principle of equal rights of the parties participating in health care relations, and the prevention of consumerism in these relations. The paper distinguishes between general and special patients’ duties. The general duties (...) include the duty to exercise the patient’s rights in good faith, the ban to abuse them, the duties of cooperation and looking after one’s health, as well as the duty of treatment with due respect. The norms that entrench duties of ethical nature should serve to prevent any inappropriate behaviour of patients in health care institutions. Nevertheless, legal application of these provisions and proving the infringements in practice is likely to be complicated. The special duties include: the duty to familiarise oneself against signature with the internal regulations of the health care institution as presented to him or her, other documents prescribed by the health care institution; the duty to present the documents confirming identity; the duty upon receiving information about the health care services prescribed for him or her to confirm in writing his or her consent or refusal with regard to the provision of such health care services in the cases specified by the law; the duty to provide health care professionals with any information about one’s health, to follow the prescriptions and recommendations of health care professionals, to inform health care professionals about any deviations from the prescriptions or the prescribed treatment regime which he or she has accepted. The legal analysis of the contents of the duties has revealed certain unsubstantial obscurities. The analysis of the provision that enables to take sanctions against the patient infringing their duties has revealed that the health care institution may only terminate provision of health care services to the patient if one of the two alternative conditions is fulfilled. I.e. if a person violates his or her duties and thereby causes danger to their own and other patients’ health and life, or prevents them from receiving high quality health care services. The conclusions show that application of this provision may be problematic: first, due to the juridical technique of the wording of the norm; second – due to complicated substantiating that the patient prevented or prevents other patients from receiving high quality health care services; third – due to the conflict of this provision with the provision of the Law of the Republic of Lithuania on Medical Practice, which provides that a doctor may refuse provision of health care services in cases of real threat to his or her own life; and fourth – the norm does not provide for the right to terminate the provision of services in cases of threat to health and/or life of health care workers (non-specialists). (shrink)

Recent discussions in the just war literature suggest that soldiers have a duty to assume certain risks in order to protect the lives of all innocent civilians. I challenge this principle of risk by arguing that it is justified neither as a principle that guides the conduct of combat soldiers, nor as a principle that guides commanders in the US military. I demonstrate that the principle of risk fails on the first account because it requires soldiers both to violate (...) their strict duty of obedience and loyalty and to exceed their special obligations to protect their fellow comrades, the state, the state's constituents and other protected civilians. I then illustrate that the principle of risk fails on the second account since it conflicts with the commander's primary obligation to protect and promote the welfare and lives of his or her soldiers. I conclude by arguing that we cannot reasonably expect soldiers and commanders to adhere to the principle of risk until there is a radical, institutional-level transformation of militaristic goals, values, strategies, policies, warrior codes and expectations of service members in the US Armed Forces. (shrink)

Sometimes physicians lie to third-party payers in order to grant their patients treatment they would otherwise not receive. This strategy, commonly known as gaming the system, is generally condemned for three reasons. First, it may hurt the patient for the sake of whom gaming was intended. Second, it may hurt other patients. Third, it offends contractual and distributive justice. Hence, gaming is considered to be immoral behavior. This article is an attempt to show that, on the contrary, gaming may sometimes (...) be a physician's duty. Under specific circumstances, gaming may be necessary from the viewpoint of the internal morality of medicine. Moreover, the objections against gaming are examples of what we call the idealistic fallacy, that is, the fallacy of passing judgments in a nonideal world according to ideal standards. Hence, the objections are inconclusive. Gaming is sometimes justified, and may even be required in the name of beneficence. (shrink)

This paper considers the role of ‘vices of culture’ in Immanuel Kant’s account of radical evil and education. I argue that Kant was keenly aware of a uniquely human tendency to allow a self-centered concern for status to misunderstand or co-opt the language of dignity and equal worth for its own purposes. This tendency lies at the root of the ‘vices of culture’ and ‘aggravated vices’ that Kant describes in the Religion and Doctrine of Virtue, respectively. When it comes to (...) moral education, then, it will be crucial that the developing agent have a clear understanding of the shared dignity of rational agents and the particular duties that are defined, in part, by their tendency to alter status among agents. I argue that the casuistical questions that Kant attaches to these discussions in the Doctrine of Virtue are an example of a pedagogical device that might help pupils to overcome this tendency so closely associated with radical evil. (shrink)

This essay applies to the morality of lying and other deception a sketch of a kind of virtues-based, input-driven, role-centered, patient-focused, ethical theory. Among the questions treated are: What is wrong with lying? Is it always and intrinsically immoral? Can it be correct, as some have vigorously maintained, that lying is morally wrong in some circumstances where other forms of deliberate dissimulation are not? If so, how can that be? And how can it be that lying to someone is immoral (...) when other, harsher ways of treating her are permissible? The essay examines several responses to the first question, and suggests that lying violates morality as an excessive departure from the role-derived virtues of charity and justice: the liar wills another person the evil of false belief precisely in the proposition for which the speaker offers her assurance and takes special responsibility in asserting. So conceived, lying is an especially egregious form of treachery and degrading manipulation of another person. Appeal is then made to the gravity inherent in lying so conceived to suggest ways of answering the other questions which would support the traditional Augustinian claim that lying is inherently impermissible and ineligible in circumstances where other forms of deliberate deception may not be, and even in situations where violent attack may be permissible.At the end, a taxonomy of more and less rigorist positions of lying is offered. A tentative proposal is made that, while consistent with the traditional Augustinian rigorist position that Iving is always immoral, nevertheless has some features that may slightly soften that view’s practical application. The proposed view does this in a way similar to that in which allowing moral dilemmas may soften it, for allowing dilemmas means there may be cases where an act of a type always immoral may still be more eligible than any alternative. However, it is maintained that the view here proposed need not countenance genuine dilemmas. (shrink)

To understand Kantian moral philosophy as it is presented in the Foundations of the Metaphysics of Mo rals it is important to grasp not only Kant's strictly metaphysical exposition but also his analyses of the application of his doctrine to particular cases of everyday morality. At the same time each of the four examples he presents should serve, according to Kant, as a kind of type for a whole class or list of moral norms, a type that visibly represents a (...) recognized class of duties to oneself or others. A careful examination, however, reveals that even the so-called duties to oneself can be represented consistently only as duties to that law-giving power of the moral world that raises the dignity of moral freedom in man above any nonrational nature in the world. Yet, in reality the dignity of humanity is not absolute, for without assuming the existence of a supreme will we cannot have a genuine grounding for these duties in the exact form in which they appear to Kant. This is quite obvious in the first of Kant's four examples, his discussion of suicide from weariness with life. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:141. ON HARRISON'S INTERPRETATION OF TREATISE III ii 1 In Treatise III ii 1, Hume is concerned to argue that justice is an artificial virtue, not a natural one. Commenting on this Section, Jonathan Harrison has pointed out that, on his reading and interpretation, Hume's argument runs into many difficulties. I shall argue in this paper that a more sympathetic reading of Hume will show that his argument is (...) a whole lot more plausible than Harrison takes it to be. Harrison raises many separate points, but instead of taking up these points one by one, I shall concentrate on one that seems to be most serious, and to lie at the heart of his criticism. The point is as follows. Hume's argument, designed to prove that justice is an artificial virtue as opposed to natural, proves too much: '(It) proves that justice is not a virtue at all' (HTJ 6). According to Harrison, Hume's first premise is [1] That actions are not duties unless there is in the mind of man a motive which normally prompts him to perform them, and the second premise is [2] That there is in the mind of man no motive which normally prompts him to perform just actions ( ibid. ) Harrison goes on to argue that we can derive from these two premises the 'embarrassing conclusion' that 'it cannot be a duty to perform just actions,' or that 'justice is not a virtue at all.' If Hume did indeed assert [1] and [2], the embarrassing conclusion would seem to follow. I shall argue that there is more than meets the eye as regards [1], and that Hume does not assert [2], 142. It would appear that in attributing [1] to Hume, Harrison has the following passage in mind: (It) may be establish'd as an undoubted maxim, that no action can be virtuous, or morally good, unless there be in human nature some motive to produce it, distinct from the sense of its morality (T 479). As I interpret this passage, the main point of the maxim is that the virtuousness of an action resides not in the sense of the morality of the action, as this is clearly circular, but in some other motive. This maxim does imply [1] above provided that we take Harrison's 'actions are not duties' to mean 'actions are not virtuous,' and his 'motive' to mean 'motive other than a sense of duty or morality.' In general, however, Harrison's way of rendering the passage above is quite unsatisfactory because it obscures what Hume means by 'duty' and what for Hume renders an action virtuous. To clarify matters, we need to look more closely at Hume's maxim. The first thing to note is that, while it is not clear what Harrison means by 'motive, ' Hume clearly uses the term 'motive' to mean 'passion.' Hume talks about 'the motives that produced' actions (T 477, my emphasis). Given Hume's psychology of actions, it is obvious that Hume is talking about the passions that produced actions. The sense of morality or duty, or the moral sentiment, is itself a passion which is capable of producing actions, and can do so 'without any other motive' (T 479). However, what Hume stresses in the passage above is that it is not the sense of duty that gives an action a good moral character, but some other motive, or passion. Hume is saying that the sense of duty is a derivative passion: an action has to 143, be established as virtuous in the first place for there to be a sense of duty concerning that action, or a sense of its morality; and it has to be so established by some other motive of which the sense of duty can be said to be derivative. Hume spells this out explicitly when he talks about humane actions. Thus, it is the humanity that 'bestows a merit on the actions' (T 478), not a regard to this merit, or a sense of duty concerning the actions, which is 'deriv'd from the antecedent principle of humanity' ( ibid., my emphasis). Now a sense of duty or obligation has to be distinguished from... (shrink)

A "wrongful life" suit is based on the purported tortious liability of a genetic counsellor towards an infant with hereditary defects, with the latter asserting that he or she would not have been born at all if not for the counsellor's negligence. This negligence allegedly lies in the failure on the part of the defendant adequately to advice the parents or to conduct properly the relevant testing and thereby prevent the child's conception or birth. This paper will offer support for (...) the thesis that it would be both feasible and desirable to endorse "wrongful life" compensation actions. The genetic counsellor owed a duty of due professional care to the impaired newborn who now claims that but for the counsellor's negligence, he or she would not have been born at all. The plaintiff's defective life constitutes a compensable injury. A sufficient causal link may exist between the plaintiff's injury and the defendant's breach of duty of due professional care and an appropriate measure of damages can be allocated to the disabled newborn. Sanctioning a "wrongful life" cause of action does not necessarily entail abandoning valuable constraints with regard to abortion and euthanasia. Nor does it inevitably lead to an uncontrolled slide down a "slippery slope". (shrink)

E. H. Carr was one of the most influential theorists of international relations, and his works, notably The Twenty Year's Crisis (1939), are widely read by students of the subject. He is generally regarded as a hard-nosed, right-wing political realist, but Charles Jones' study reveals him as a much more radical figure. By examining the political context in which he wrote, and the ruthless ways in which he sought to persuade his contemporaries in a period of national crisis, this book (...) offers a radical reinterpretation of a major theorist of international relations. (shrink)

The demand for bodily parts such as organs is increasing, and individuals in certain circumstances are responding by offering parts of their bodies for sale. Is there anything wrong in this? Kant had arguments to suggest that there is, namely that we have duties towards our own bodies, among which is the duty not to sell parts of them. Kant's reasons for holding this view are examined, and found to depend on a notion of what is intrinsically degrading. Rom (...) Harré's recent revision of Kant's argument, in terms of an obligation to preserve the body's organic integrity, is considered. Harré's view does not rule out all acts of selling, but he too ultimately depends on a test of what is intrinsically degrading. Both his view and Kant's are rejected in favour of a view which argues that it does make sense to speak of duties towards our own bodies, grounded in the duty to promote the flourishing of human beings, including ourselves. This provides a reason for opposing the sale of bodily parts, and the current trend towards the market ethic in health care provision. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Literature 27.2 (2003) 284-303 [Access article in PDF] Accidental Art:Tolstoy's Poetics of Unintentionality Michael A. Denner I ART'S ABILITY TO INFECT another with an emotion, the concept that has come to be probably the most readily identified catchphrase in What Is Art? (though it crops up in his earlier writings on art), derives from L. N. Tolstoy's dynamic identity claim about art: we know an artist has (...) created a genuine work of art when he "hands on to others feelings he has lived through, and that others are infected by these feelings and also experience them." 1 "What is art?" is then a taxonomical question, and, according to Tolstoy, art is identifiable from non-art not by some set of external characteristics—the way, say, Aristotle categorized animals in his natural history—rather art is recognizable by its function, by what it does. In this sense art is like a tool: A given thing is art because it performs a certain task, much as one might claim a screwdriver is anything that sets and removes screws, regardless of its external characteristics. Tolstoy, in fact, repeatedly refers to art as "orudie," "a tool," or even "a weapon."It is worth noting from the outset that this metaphor of contagiousness is one of sublimated violence. For its passive "perceiver" (Tolstoy's characteristic term for the consumer of art), art amounts to irresistible, surreptitious emotional manipulation by an external entity. Tolstoy is ever attentive to the underlying meanings of the words he chooses, and I think he means to emphasize the latent, etymological meaning of the zarazit', to infect, the root of which is razit', to strike, a military term that likely resonated with Tolstoy, a war veteran. 2 Etymological arguments aside, Tolstoy makes explicit the psychological violation that goes hand-in-hand [End Page 284] with the experience of a work of art in a diary entry from a period of work on an earlier variant of What Is Art?: "One must hone the artistic work so that it penetrates. To hone a work means to make it perfect artistically, in which case it will pierce through the indifference...." 3 In an earlier version of the essay, Tolstoy offers "hypnotism" as a synonym for infection (p. 53).With its ability to "penetrate" through indifference and colonize, willy-nilly, the other, art accomplishes directly and immediately what no amount of rational argument could accomplish: "Art is differentiated from the activity of rational activity, which demands preparation and a certain sequence of knowledge (so that one cannot learn trigonometry before knowing geometry), by the fact that it acts on people independently of their state of development and education, that the charm of a picture, of sounds, or of forms, infects any man whatever his plane of development" (p. 178).The effect of art does not depend on some graduated, sequential process as it does for rational activity: art's infectiousness is immediate and irresistible. According to What Is Art?, the summum bonum of art's infectiousness, its best use, but notably not its only, is bringing about the Kingdom of God by effecting a change in the psychology of all the individuals who experience it. "Religious art," Tolstoy's supreme category of art, surmounts the (ultimately illusory for Tolstoy) individuality of the perceiver by inducing in him or her an emotional union with the artist and all others who have experienced the work of art, thereby inducting all perceivers into the universal collective of humankind: "In this freeing of our personality from its separation from other people, from its isolation, in this uniting of personality with others, lies the chief characteristic and the great attractive force of art" (p. 228). Art is a sacrament and the artist a priest of sorts.It is often said, even by those who have read the work, that Tolstoy "rejected" art in the last decades of his life, and What Is Art? is often cited as evidence. Granted, much of the book excoriates much of the art of the ages, but one must not... (shrink)