In current American medical practice, autonomy is assumed to be more valuable than human life: if a patient autonomously refuses lifesaving treatment, the doctors are supposed to let him die. In this paper we discuss two values that might be at stake in such clinical contexts. Usually, we hear only of autonomy and best interests. However, here, autonomy is ambiguous between two concepts—concepts that are tied to different values and to different philosophical traditions. In some cases, the two values (that (...) of agency and that of authenticity) entail different outcomes. We argue that the comparative value of these values needs to be assessed. (shrink)

Edited by Hans-Christoph Schmidt am Busch & Christopher Zurn. This volume collects original, cutting-edge essays on the philosophy of recognition by international scholars eminent in the field. By considering the topic of recognition as addressed by both classical and contemporary authors, the volume explores the connections between historical and contemporary recognition research and makes substantive contributions to the further development of contemporary theories of recognition.

Rather, in all the texts of this period Marx tries to mount a compelling critique of the present while altogether avoiding the dilemmas central to philosophy in ...

My topic is a problem with our practice of surrogate decision-making in health care, namely, the problem of the surrogate who is not doing her job—the surrogate who cannot be reached or the surrogate who seems to refuse to understand or to be unable to understand the clinical situation. The analysis raises a question about the surrogate who simply disagrees with the medical team. One might think that such a surrogate is doing her job—the team just doesn't like how she (...) is doing it. My analysis raises the question of whether she should be overridden. In approaching this problem, I focus not on the range of difficulties in practice but on the underlying moral conceptual issue. My concern will be to show that the moral values that underpin patient decision-making are fundamentally different from those that underpin surrogate decision-making. Identifying the distinctions will set parameters for any successful solution to the “Who should decide?” question. A patient has a specific kind of moral right to make her own medical decisions. A surrogate has no analogous moral right to decide for someone else. We want the surrogate to make the decision because we believe that she has a relevant epistemological advantage over anyone else on the scene. If and when she has no such advantage or if she refuses or is unable to use it, then there might not be sufficient reason to let her be the decision-maker. (shrink)

This article starts by examining the appeal to hypothetical consent as used by law and economics writers. I argue that their use of this kind of argument has no moral force whatever. I then briefly examine, through some remarks on Rawls and Scanlon, the conditions under which such an argument would have moral force. Finally, I bring these considerations to bear to criticize the argument of judge Frank Easterbrook's majority opinion in Flamm v. Eberstadt.

In this essay, I raise the question of whether some degree of noncoercive state support for religious conceptions (broadly understood) should be left to the majoritarian branch ofgovernment. I argue that the reason not to do so is that such state support would alienate many citizens. However to take this as a sufficient reason to constrain the majoritarian branch is to accept the thesis that not being alienated from one's polity is a significant part of the human good. Those who (...) would prohibit even a small amount of noncoercive support of religious conceptions must appeal either to pragmatic considerations (the worry that noncoercive will lead to coercive support, i.e., to tyranny) or to a conception of the good that puts great value on the agent's sense of connectedness to the polity. And the latter is something that reasonable citizens in a modern democracy could reasonably reject. (shrink)

Among the tasks of modern political philosophy is to develop a favored conception of the relations among modern citizens, among people who can know little or nothing of one another individually and yet are deeply reciprocally dependent. One might think of this as developing a favored conception of civic friendship. In this essay I sketch two candidate conceptions. The first derives from the Kantian tradition, the second from the 1844 Marx. I present the two conceptions and then describe similarities and (...) differences. My approach is both taxonomic and programmatic. My taxonomic goal is to provide an initial sketch of the conceptual territory. My programmatic goal is to provide reasons to think that the conception derived from Marx is both appealing and feasible. (shrink)

When literary texts are included in a course on moral philosophy they tend to be classical tragedies or existentialist novels: texts filled with major moral transgressions and agonized debates over rights, wrongs, and relativism. Recently, however, the focus of much discussion on literature and moral philosophy has been Henry James’s last novel, The Golden Bowl. This ought to seem surprising. For The Golden Bowl is a quintessential Jamesian novel. Almost nothing happens. In the course of more than five hundred pages (...) there are two marriages, one affair, and a single act of violence, the smashing of the golden bowl. The rest is reflection, nuance, detail: the creation and preservation of a “‘brilliant, perfect surface,’” one “scarcely more meant to be breathed upon, it would seem, than the cheek of royalty.”1 There are no extreme actions or high-flown speculations. The moral issues among the four central characters either go unspoken or are raised expressly to be suppressed, banished from articulation. And what counts as the expression of the moral maturity and insight of the heroine, Maggie Verver, is her extraordinary ability to keep the truth silen00to put it precisely, to lie. If even there was a novel in which the protagonists shied away from moral debate, it is The Golden Bowl.The challenge for the philosophical critic, it seems to me, is to argue that it is just this stress on surface and silence that makes this novel of interest to moral philosophers, that makes it exemplary for how literature can do something philosophically important that philosophy cannot. 1. Henry James, The Golden Bowl , pp. 445, 172; hereafter cited by page number. Daniel Brudney is an assistant professor of philosophy at the University of Chicago. (shrink)

European Journal of Philosophy, EarlyView.

European Journal of Philosophy, EarlyView.

A new kind of argument has been proposed to explain why health-care workers can sometimes refuse to offer a service or treatment. But this new kind of argument must also be evaluated and invoked differently.

Let’s start with three cases of refusal of treatment.[A] 24-year old graduate student is brought to the emergency room by a friend. Previously in good health, he is complaining of a severe headache and stiff neck. Physical examination shows a somnolent patient without focal neurologic signs but with a temperature of 39.5 degrees centigrade and nuchal rigidity. Examination of spinal fluid reveals cloudy fluid with a white blood cell count of 2000; Gram stain of the fluid shows many Gram-positive diplococcic. (...) A diagnosis of bacterial meningitis is reached, and administration of antibiotics is recommended.... When [the patient] was told his diagnosis and that he would be admitted to the hospital for treatment... (shrink)

Communitarians have long criticized John Rawls′ theory of justice as fairness. In this paper I sketch a picture of communal relationships and use it to examine the nature of community in Rawls′ theory. In the first section I extract a picture of communal relationships from Karl Marx′s work of 1844; in the second section I argue for this picture′s distinctiveness; finally, I look at a shift in the nature of Rawlsian community between A Theory of Justice and Rawls′ later book, (...) Political Liberalism. I argue that a picture structurally similar to that in Marx is exhibited by the well-ordered society of A Theory of Justice, although not by that of Political Liberalism. The communitarian charge – the charge that Rawls′ view is at odds with an emphasis on community – turns out to be justified, but not with respect to A Theory of Justice, the standard communitarian target. (shrink)

argue that there are two forms of perfectionism in John Stuart Mill's work, two ideals of the person. One, the self-development ideal, is found in On Liberty. The other, the strong identification ideal, is tied to Mill's advocacy of a 'religion of humanity' and is found in Utilitarianism, 'Utility of Religion', and other texts. My first concern is to show that Mill's work contains this latter ideal. Next, I situate the strong identification ideal historically. Finally, I ask whether both ideals (...) could be substantially realized in a single life. The ideals are not logically incompatible. Their incompatibility will be one or another form of practical incompatibility. Most importantly, any form of perfectionism concerns the kind of person to be: it involves a distinctive habit of mind. The fundamental tension between the Millian ideals concerns the difficulty of combining their different habits of mind. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Nostromo and Negative LongingDaniel BrudneyWhat, as the upshot of this exhibition of human motive and attitude, do we feel Conrad himself to endorse? What are his positives? It is easier to say what he rejects or criticizes.—F. R. Leavis, The Great Tradition1IWriters, playwrights, filmmakers have often seen their work as political. In this essay I discuss one way in which a narrative might be political. My proof text will (...) be Joseph Conrad's novel Nostromo.2Let's start by noting several ways in which a narrative might criticize the present.(1). It highlights a shortcoming, say, an injustice, of the present.(2). It shows the possibility of a different and better society, usually inhabited by people with a different and better psychology.(3). It shows nothing positive, and yet it elicits a desire for a radically different and radically better future, that is, for something very different from the present.The first option divides into:(1a) The narrative shows a particular injustice, the sort of thing that concrete institutional change might eliminate or ameliorate. There are plenty of examples of (1a): Uncle Tom's Cabin, The Jungle, the movie Dirty Pretty Things. We could debate how far particular instances are propaganda, journalism, or "literature," and what difference these categories might make. Here, I merely note that narrative is capable of pointing to, making palpable, evoking outrage at, this or that particular injustice. Narrative will rarely tell us the best way to fix the injustice ("There ought to be a law" merely begins that conversation), but it can convince us that a particular injustice exists and needs to be addressed. [End Page 369](1b) The narrative shows what is wrong with something more general: a pervasive social institution, such as the market, imperialism (of one or another kind), some general pattern of social feeling and conduct. Many classic works do this, such as Middlemarch and Madame Bovary. Of course, precisely because such works criticize large and pervasive phenomena, they usually do not point to any specific solution. They say, "This (something fairly general) is bad."When we move to narratives that try to present better worlds, things get more complicated. We can see the issue by noting a distinction in (2) and between (2) and (3). With (2a), we are in the realm of what John Rawls calls a "realistic utopia."3 This is supposed to be (i) sufficiently specifiable, in terms of, say, principles of distribution, a conception of the person, and a conception of justification; that is, in terms of several central organizing ideas. It is also supposed to be (ii) sufficiently realistic in terms of the moral psychology needed for its instantiation. Rawls often talks of full compliance in his well-ordered society, but for that society to be sufficiently realistic, the psychology of its citizens must merely be a sufficiently real possibility in the sufficiently near future to generate sufficient compliance to make for sufficient stability.Call a realistic utopia realizably realistic if (I) the better angels of our nature upon which it calls are sufficiently like our actual nature to be plausible in the relatively near term, and (II) it does not require too often the instantiation of those better angels. The contrast is to (2b), a realistic utopia that is unrealizably realistic because although it satisfies (I) it does not satisfy (II): it is too dependent on the more or less constant instantiation of those better angels. It assumes that "can implies will" even though in real life the inference often fails.4 Still, such a society remains "realistic" since it is possible for us always to instantiate those better angels.With (3), condition (i) is not satisfied. The issue is not that we cannot or that we believe human beings will not realize something specifiable in terms of institutions and citizen psychology. It is that we have only a vague and primarily negative understanding of what we want. It is substantially (perhaps entirely) a political via negativa. And so (ii) cannot be known to be satisfied.The distinction between (2a) (and maybe also [2b]) on the one hand, and (3) on the other, tracks two ways... (shrink)