In Chapter 9 of The Practice of Moral Judgment and her later article Making Room for Character, Barbara Herman offers a distinctive response to a familiar set of concerns with the room left for character and personal relationships in Kantian ethics. She begins by acknowledging the shortcomings of her previous response on this issue and by distancing herself from a standard kind of indirect argument for the importance of personal commitments according to which these have moral weight in (...) virtue of their connection with the psychological health of individuals. Agreeing with an imagined critic’s concern that Kantian ethics must do more than merely tolerate motives of connection, she proposes that we adopt a deliberative field account of practical deliberation incorporating a developmental model of desire formation. I argue that, while this is a subtle and interesting account of desire development, it is not one that will satisfy the critic and should not satisfy the Kantian. I claim that the Kantian cannot forgo instrumental arguments for the importance of personal relationships and commitments and that they should not be shy of endorsing these arguments. (shrink)

The aim of this article is to show how intimately connected Beth J. Singer's theory of operative rights is with her understanding of the deliberative process. I thus argue against Cynthia Gayman's effort to set in contrast Singer's theory of rights and Dewey's characteristic emphasis on reflective morality. Since I take the value of Singer's approach to be most evident in its relevance to the abortion debate as an ongoing deliberation, I question whether Mary Magada‐Ward sufficiently appreciates the dialogical (...) and deliberative emphases of Singer's stance. My goal, however, is not so much to argue against either Gayman or Magada‐Ward as it is to argue for taking Singer's position even more seriously than either author does. In particular, I want to highlight the finely nuanced character of Singer's philosophical intervention in the debate regarding abortion, especially stressing certain features that Gayman and Magada‐Ward overlook. (shrink)

Many of us read Peter Singer ’ s work on our obligations to those in desperate need with our students. Famously, Singer argues that we have a moral obligation to give a significant portion of our assets to famine relief. If my own experience is not atypical, it is quite common for students, upon grasping the implications of Singer ’ s argument, to ask whether Singer gives to famine relief. In response it might be tempting to remind students of (...) the ad hominem fallacy of attacking the person advancing an argument rather than the argument itself. In this paper I argue that the “ ad hominem reply ” to students ’ request for information about Singer is misguided. First I show that biographical facts about the person advancing an argument can constitute indirect evidence for the soundness / unsoundness of the argument. Second, I argue that such facts are relevant because they may reveal that one can discard the argument without thereby incurring moral responsibility for failing to act on its conclusion even if the argument is sound. (shrink)

This paper considers the question of whether predictions of wrongdoing are relevant to our moral obligations. After giving an analysis of ‘won’t’ claims (i.e., claims that an agent won’t Φ), the question is separated into two different issues: firstly, whether predictions of wrongdoing affect our objective moral obligations, and secondly, whether self-prediction of wrongdoing can be legitimately used in moral deliberation. I argue for an affirmative answer to both questions, although there are conditions that must be (...) met for self-prediction to be appropriate in deliberation. The discussion illuminates an interesting and significant tension between agency and prediction. (shrink)

This paper considers the question of whether predictions of wrongdoing are relevant to our moral obligations. After giving an analysis of 'won't' claims, the question is separated into two different issues: firstly, whether predictions of wrongdoing affect our objective moral obligations, and secondly, whether self-prediction of wrongdoing can be legitimately used in moral deliberation. I argue for an affirmative answer to both questions, although there are conditions that must be met for self-prediction to be appropriate in (...) deliberation. The discussion illuminates an interesting and significant tension between agency and prediction. (shrink)

This study explores the impact of participation in a series of moral case deliberations (MCD) on the moral craftsmanship (MCS) of Dutch prison staff. Between 2017–2020, ten MCDs per team were implemented in three prisons (i.e., intervention group). In three other prisons (i.e., control group) no MCDs were implemented. We compared the intervention and control group using a self-developed questionnaire, administered before (pre-measurement) and after the series of MCDs (post-measurement). Results After the MCDs, participants scored significantly higher on (...) 7 of the 70 items related to MCS. On some items there were significant impact differences between the various professional disciplines. Discussion Possible explanations for a relatively low impact are discussed. A shorter and validated questionnaire is needed in order to further study the MCS of professionals and the impact of Ethics Support Services (ESS). Conclusions There was a positive development on some elements of MCS after participation in a series of MCDs. (shrink)

My aim in this note is to shed light on ways of interpreting Kant’s Formula of Universal Law (FUL), by looking at relevant similarities and differences between Pauline Kleingeld and Mark Timmons. I identify both their readings as a formal interpretation of Kant’s FUL, in contrast to the substantive interpretations that favor a robust conception of rational agency as a necessary requirement for moral deliberation. I highlight the benefits that arise from Kleingled’s interpretation in showing the immediacy involved (...) in the volitional self-contradiction when universalizing a maxim. Alongside Timmons, I address a question as to whether Kleingeld’s interpretation is completely free from at least a minimal set of assumptions about practical deliberation more broadly, that seem to play a role in generating the volitational self-contradiction she is defending. I close by raising some skeptical worries about the capacity of this kind of contradiction to translate into a moral judgment triggering action. (shrink)

This paper develops themes addressed in an article by Eric Wiland in the Journal of Medical Ethics 2000;26:466–8, where he aims to contribute to the debate concerning the moral status of abortion, and to emphasise the importance of analogies in moral argument. In the present paper I try to secure more firmly a novel understanding of why analogy is an essential component in the attempt to justify moral beliefs. I seek to show how analogical argument both encapsulates (...) and exercises the notions of rationality and imagination and that the construction, development, and comparison of analogies fundamentally underpins ethical argument. In so doing, it enables us to adopt imaginative and ethically illuminating perspectives but in a manner that does not relinquish any claims to intellectual rigour. I present a critique of a brand of “moral particularism” by showing how it cannot, if construed in a certain way, adequately conceive of how we use analogies and imaginary cases in ethics. Although such a particularism is thus impotent with regard to ethical debate, I show that the wider motivation behind particularism that can be extracted is of clear relevance and importance to medical practitioners. (shrink)

Together we can achieve things that we could never do on our own. In fact, there are sheer endless opportunities for producing morally desirable outcomes together with others. Unsurprisingly, scholars have been finding the idea of collective moral obligations intriguing. Yet, there is little agreement among scholars on the nature of such obligations and on the extent to which their existence might force us to adjust existing theories of moral obligation. What interests me in this paper is the (...) perspective of the moral deliberating agent who faces a collective action problem, i.e. the type of reasoning she employs when deciding how to act. I hope to show that agents have collective obligations precisely when they are required to employ ‘we-reasoning’, a type of reasoning that differs from I-mode, best response reasoning, as I shall explain below. More precisely, two (or more) individual agents have a collective moral obligation to do x if x is an option for action that is only collectively available (more on that later) and each has sufficient reason to rank x highest out of the options available to them. (shrink)

Despite all the attention given to Kant’s universalizability tests, one crucial aspect of Kant’s thought is often overlooked. Attention to this issue, I will argue, helps us resolve two serious problems for Kant’s ethics. Put briefly, the first problem is this: Kant, despite his stated intent to the contrary, doesn’t seem to use universalization in arguing for duties to oneself, and, anyway, it is not at all clear why duties to oneself should be grounded on a procedure that envisions a (...) world in which everyone wills the contrary of those duties. The second, more global problem is that if we follow Barbara Herman in holding that Kantian ethics can provide a structure for moral deliberation, we need an interpretation of the universalization procedure that unproblematically allows it to generate something like prima facie duties to guide that deliberation; but it is not at all clear that we have such an interpretation. I argue here that if we expand our limited way of thinking about universalization, we can solve the first problem and work towards a solution to the second. We can begin by recalling that Kant’s ‘Law of Nature’ formulation (FLN) of the Categorical Imperative obligates us to ‘act as if the maxim of your action were to become by your will a universal law of nature’ (G, 421). (shrink)

In this article I offer an account of normative thought inspired by Plato's proposal in the Theaetetus that judgement is ‘speech spoken … silently.’ After arguing that force conventionalism is the speech act theory best suited for modeling dialogic inner speech, I close the article by sketching the picture of normative thought that results. Though I defend a particular theory of normative speech elsewhere, the core insights of this article can be used by other theorists as well. The arguments offered (...) here also serve as an important step forward for the more general program of using social speech to better understand thought. (shrink)

Sunstein represents moral heuristics as rigid rules that lead us to jump to moral conclusions, and contrasts them with reflective moral deliberation, which he represents as independent of heuristics and capable of supplanting them. Following John Dewey's psychology of moral judgment, I argue that successful moral deliberation does not supplant moral heuristics but uses them flexibly as inputs to deliberation. Many of the flaws in moral judgment that Sunstein attributes to (...) heuristics reflect instead the limitations of the deliberative context in which people are asked to render judgments. (shrink)

In his graceful philosophical account, Alfred I. Tauber shows why Thoreau still seems so relevant today—more relevant in many respects than he seemed to his contemporaries. Although Thoreau has been skillfully and thoroughly examined as a writer, naturalist, mystic, historian, social thinker, Transcendentalist, and lifelong student, we may find in Tauber's portrait of Thoreau the moralist a characterization that binds all these aspects of his career together. Thoreau was caught at a critical turn in the history of science, between the (...) ebb of Romanticism and the rising tide of positivism. He responded to the challenges posed by the new ideal of objectivity not by rejecting the scientific worldview, but by humanizing it for himself. Tauber portrays Thoreau as a man whose moral vision guided his life's work. Each of Thoreau's projects reflected a self-proclaimed "metaphysical ethics," an articulated program of self-discovery and self-knowing. By writing, by combining precision with poetry in his naturalist pursuits and simplicity with mystical fervor in his daily activity, Thoreau sought to live a life of virtue—one he would characterize as marked by deliberate choice. This unique vision of human agency and responsibility will still seem fresh and contemporary to readers at the start of the twenty-first century. (shrink)

It is widely accepted in psychology and cognitive science that there are two “systems” in the mind: one system is characterized as quick, intuitive, perceptive, and perhaps more primitive, while the other is described as slower, more deliberative, and responsible for our higher-order cognition. I use the term “reflectivism” to capture the view that conscious reflection—in the “System 2” sense—is a necessary feature of good moral judgment and decision-making. This is not to suggest that System 2 must operate alone (...) in forming our moral decisions, but that it plays a normatively ineliminable role. In this paper, I discuss arguments that have been offered in defense of reflectivism. These arguments fit into two broad categories; let us think of them as two sides of a coin. On the first side are arguments about the efficaciousness of conscious reasoning—for example, without conscious deliberation we will make bad moral judgments and decisions. On the other side of the coin are arguments about the centrality of conscious deliberation to normative actions—for example, without conscious deliberation we are no more agential than animals or automatons. Despite their attractiveness, I argue that these arguments do not successfully establish that reflection is a necessary component of good moral judgment and decision-making. If I am right, the idea that good moral judgment and decision-making can result from entirely automatic and subconscious processes gains traction. My goal in this paper is to show that reflectivism fails to include the full range of cases of moral decision-making and that a theory of automaticity may do a better job. I briefly discuss at the end of the paper how an account of successful automatic moral judgment and decision-making might begin to take shape. (shrink)

Background Clinical moral case deliberation consists of the systematic reflection on a concrete moral case␣by health care professionals. This paper presents the study of a 4-year moral deliberation project.Objectives The objectives of this paper are to: (a) describe the practice and the theoretical background of moral deliberation, (b) describe the moral deliberation project, (c) present the outcomes of␣the evaluation of the moral case deliberation sessions, and (d) present the implementation (...) process.Methods The implementation process is both monitored and supported by an interactive responsive evaluation design with: (a) in-depth interviews, (b) Maastricht evaluation questionnaires, (c) evaluation survey, and (d) ethnographic participant observation. In accordance with the theory of responsive evaluation, researchers acted both as evaluators and moderators (i.e. ethicists).Results Both qualitative and quantitative results showed that the moral case deliberations, the role of the ethics facilitator, and the train-the-facilitator program were regarded as useful and were evaluated as (very) positive. Health care professionals reported that they improved their moral competencies (i.e. knowledge, attitude and skills). However, the new trained facilitators lacked a clear organisational structure and felt overburdened with the implementation process. The paper ends with both practical and research suggestions for future moral deliberation projects. (shrink)

Moral case deliberation (MCD) is a specific form of clinical ethics, aiming to stimulate ethical reflection in daily practice in order to improve the quality of care. This article focuses on the implementation of MCD in nursing homes and the questions how and where to organize MCD. The purpose of this study was to evaluate one way of organizing MCD in two Dutch nursing homes. In both of these nursing homes the MCD groups had a heterogeneous composition and (...) were organized apart from existing institutional communication structures. As part of a naturalistic evaluation, systematic observations, interviews and focus groups were completed. The findings indicate that the heterogeneous composition and MCD meetings separate from existing structures have benefits. However, the participants also reported negative experiences. This gives rise to the question whether a mixed MCD group which meets separately is an effective way to embed MCD as an instrument for reflection on moral issues in daily practice. We conclude that there is no single answer to that question. In the end, the two implementation strategies (i.e. within existing communication structures and a mixed MCD group) can be complementary to each other. (shrink)

Arriving at a moral judgment is not a straightforward or linear process in which ethical theories are simply applied to cases. Instead it is a process in which the formulation of the moral problem, the formulation of possible “solutions”, and the ethical judging of these solutions go hand in hand. This messy character of moral problems, however, does not rule out a systematic approach. In this article, we describe a systematic approach to problem solving that does justice (...) to the complex nature of moral problems and ethical judgment: the ethical cycle. Our goal is to provide a structured and disciplined method of addressing moral problems, which helps to guide a sound analysis of these problems. We will illustrate the usefulness of this cycle with an example. Further, we will discuss two general issues in applied ethics in relation to the proposed ethical cycle: the role of ethical theories and the place of individual judgment versus collective deliberation. (shrink)

Bernard Williams questioned whether impartial morality “can allow for the importance of individual character and personal relations in moral experience.” Underlying his position is a distinction between factual and practical deliberation. While factual deliberation is about the world and brings in a standpoint that is impartial, practical deliberation is, he claims, radically first‐personal; it “involves an I that [is] intimately the I of my desires.” While it may be thought that Williams's claim implies an unpalatable Humean (...) subjectivism, the present article argues that this does not follow: That first‐person practical deliberation is directed both by the “I of my desires” and by the world. Drawing on Peter Winch's argument against the universalizability of moral judgments and D. H. Lawrence's Lady Chatterley's Lover, the article argues that practical deliberations involve discovering value in the world, but that what is revealed about the world depends constitutively on the first‐person deliberations and decisions of particular agents. (shrink)

The principle of patient autonomy dominates the contemporary debate over medical ethics. In this examination of the doctor-patient relationship, physician and philosopher Alfred Tauber argues that the idea of patient autonomy -- which was inspired by other rights-based movements of the 1960s -- was an extrapolation from political and social philosophy that fails to ground medicine's moral philosophy. He proposes instead a reconfiguration of personal autonomy and a renewed commitment to an ethics of care. In this formulation, physician beneficence (...) and responsibility become powerful means for supporting the autonomy and dignity of patients. Beneficence, Tauber argues, should not be confused with the medical paternalism that fueled the patient rights movement. Rather, beneficence and responsibility are moral principles that not only are compatible with patient autonomy but strengthen it. Coordinating the rights of patients with the responsibilities of their caregivers will result in a more humane and robust medicine.Tauber examines the historical and philosophical competition between facts and values in medicine. He analyzes the shifting conceptions of personhood underlying the doctor-patient relationship, offers a "topology" of autonomy, from Locke and Kant to Hume and Mill, and explores both philosophical and practical strategies for reconfiguring trust and autonomy. Framing the practicalities of the clinical encounter with moral reflections, Tauber calls for an ethical medicine in which facts and values are integrated and humane values are deliberately included in the program of care. (shrink)

Muslim physicians and Islamic jurists analyze the moral dimensions of biomedicine using different tools and processes. While the deliberations of these two classes of experts involve judgments about the deliverables of the other's respective fields, Islamic jurists and Muslim physicians rarely engage in discussions about the constructs and epistemic frameworks that motivate their analyses. The lack of dialogue creates gaps in knowledge and leads to imprecise guidance. In order to address these discursive and conceptual gaps we describe the sources (...) of knowledge and reasoning employed by Islamic jurists and clinicians to resolve the question of when a patient must seek healthcare. As we examine both the scriptural evidence and legal reasoning of jurists and the types of medical evidence used by clinicians to address the same question, we draw attention to the epistemic frameworks and constructs at play and identify how constructs from one field may sharpen the deliberative exercises of the other. Hence our work advances discourses at the intersection of Islam and medicine and offers building blocks for a comprehensive Islamic framework that fully integrates the deliverables of medical science within the deliberations of Islamic jurists. (shrink)

In James Gouinlock's essay "Dewey's Theory of Moral Deliberation," he argues that Morton White and Charles L. Stevenson's criticisms of John Dewey's ethical theory are based upon fundamental misinterpretations of Dewey's theory of moral deliberation. In this paper, I attempt, in the spirit of Gouinlock's 1978 essay, to widen and enrich the discussion of Dewey's theory of moral deliberation by relating it to a claim of political philosophers and theorists that is recently in vogue, (...) namely, that Dewey's writings contain a nascent theory of deliberative democracy. Deliberative democratic theorists contend that deliberation is the group activity that transforms individual preferences and behavior into mutual understanding, agreement and collective action. If Deweyan democracy is identified with deliberative democracy, do Dewey scholars risk making Dewey's democratic vision a useless relic for theorizing about democracy in the wake of the deliberative turn? The paper is organized into four sections. In the first, I summarize the positions of those scholars defending the view that John Dewey was a proto-deliberative democrat, in effect anticipating the deliberative turn in democratic theory. The second section examines Gouinlock's thesis that despite White and Stevenson's mistaken accounts, Dewey offered a distinctive and insightful way of understanding moral judgment. In the third section, my analysis reveals the political dimension of Dewey's theory of moral deliberation. The fourth and concluding section explores the lesson that my analysis might impart to commentators enamored with the idea that Dewey's vision of democracy is essentially deliberative. (shrink)

Moral case deliberation (MCD) is a form of clinical ethics support in which the ethicist as facilitator aims at supporting professionals with a structured moral inquiry into their moral issues from practice. Cases often affect clients, however, their inclusion in MCD is not common. Client participation often raises questions concerning conditions for equal collaboration and good dialogue. Despite these questions, there is little empirical research regarding client participation in clinical ethics support in general and in MCD (...) in particular. This article aims at describing the experiences and processes of two MCD groups with client participation in a mental healthcare institution. A responsive evaluation was conducted examining stakeholders’ issues concerning client participation. Findings demonstrate that participation initially creates uneasiness. As routine builds up and client participants meet certain criteria, both clients and professionals start thinking beyond ‘us-them’ distinctions, and become more equal partners in dialogue. Still, sentiments of distrust and feelings of not being safe may reoccur. Client participation in MCD thus requires continuous reflection and alertness on relational dynamics and the quality of and conditions for dialogue. Participation puts the essentials of MCD (i.e., dialogue) to the test. Yet, the methodology and features of MCD offer an appropriate platform to introduce client participation in healthcare institutions. (shrink)

In this paper, I argue that many recent interpretations of John Dewey's vision of democracy distort that vision by filtering it through the prism of contemporary deliberative democratic theories. An earlier attempt to defend Dewey's theory of moral deliberation is instructive for understanding the nature and function of this filter. In James Gouinlock's essay "Dewey's Theory of Moral Deliberation," he argues that Morton White and Charles L. Stevenson's criticisms of John Dewey's ethical theory are based upon (...) fundamental misinterpretations of Dewey's theory of moral deliberation. In the spirit of Gouinlock's 1978 essay, I show how this historical debate relates to a claim of political philosophers and political theorists that is currently in vogue, namely, that Dewey's writings contain a nascent theory of deliberative democracy. Deliberative democratic theorists contend that deliberation is the group activity that transforms individual preferences and behavior into mutual understanding, agreement, and collective action. Once Dewey's vision of democracy is identified with this theory of deliberative democracy, the strategic question for Deweyans arises: If Deweyan democracy is identified too closely with deliberative democracy, will Dewey scholars risk making Dewey's democratic vision an outmoded approach to theorizing about democracy in the wake of an expired deliberative turn? One way to see our way clear of this strategic question is to remove the deliberative democracy filter and appreciate Dewey's vision of democracy as a unique and free-standing contribution to democratic theory. (shrink)

In Section 1, I rehearse some arguments for the claim that morality should be ``action-guiding'', and try to state the conditions under which a moral theory is in fact action-guiding. I conclude that only agents who are cognitively and conatively ``ideal'' are in general able to use a moral theory as a guide to action. In Sections 2 and 3, I discuss whether moral ``actualism'' implies that morality cannot be action-guiding even for ideal agents. If actualism is (...) true, an ideal agent will know about her own future actions. Since such foreknowledge is often thought to be incompatible with deliberation, and since action-guidance presupposes the possibility of deliberation, there is an apparent difficulty in combining actualism with the requirement of action-guidance. In opposition to an argument by Jan Österberg, I try to show that actualism and action-guidance are in fact compatible. (shrink)

The literature on ethical behavior has called for studies that investigate the interaction between individual and contextual factors. This study examined whether moral identity interacts with ethical culture to predict unethical behavior at work and whether implicit and explicit moral identity affects unethical behavior distinctively. Our sample consisted of 238 participants who took part in an experiment involving an in-basket exercise that measured unethical behavior. Ethical culture was manipulated via a cover letter from a fictitious company’s CEO, and (...) moral identity was measured through a self-report scale and the Implicit Association Test (IAT). Findings indicate that implicit and explicit moral identity were negatively associated with unethical behavior and that organizational culture moderated the relationship between moral identity and unethical behavior. The results have theoretical and practical implications for understanding the interaction of predictors of unethical behavior by combining automatic and deliberate measures of moral identity with ethical culture. (shrink)

Psychiatric patients sometimes ask where to draw the line between who they are – their selves – and their mental illness. This problem is referred to as the self-illness ambiguity in the literature; it has been argued that solving said ambiguity is a crucial part of psychiatric treatment. I distinguish a Realist Solution from a Constructivist one. The former requires finding a supposedly pre-existing border, in the psychiatric patient’s mental life, between that which belongs to the self and that which (...) belongs to the mental illness. I argue that no such border exists, and that attempts to find it might even render the felt ambiguity worse. Instead, any solution must be constructivist; the patient (and others) should deliberate and discuss what to identify with or not. I further argue that psychiatric patients need not see their mental illness as wholly distinct from themselves to avoid ‘identifying with their diagnoses' in a problematic way. Finally, we can excuse problematic behaviour by mentally ill people – in fact, we can do so in a more nuanced and constructive way – while rejecting the view that the mental illness is wholly distinct from the patient’s self. (shrink)

New media and technologies such as social media and online platforms are disrupting the way businesses are run and how society functions. This article advises that scholars consider the morality of new media as an area of investigation. While prior literature has given much attention to how social media provides benefits, how it affects society generally, and how it can be used efficiently, research on the ethical aspects of new media has received relatively less attention. In an age where matters (...) such as violence, hate crimes, fake news, etc. are increasingly pervasive, we need to address the role of online technology in aiding or limiting such negative acts. In this regard, this article uses the canvas of a terror attack that was facilitated by online technology to bring to light pressing social and ethical issues in the use of new media. I draw upon 264 news articles focusing on the 2019 Christchurch terrorist attacks to piece together how the attack was orchestrated and focus on technology-enabled facets of the event. I stir discussion on the ethical aspects of technology with regard to online discrimination and highlight business and other stakeholder responsibilities and challenges as technology continues to evolve and pervade our social lives. (shrink)

The field of Islamic bioethics is currently in development as thinkers delineate its normative content, ethical scope and research methods. Some scholars have offered Islamic bioethical frameworks based on the maqāṣid al-Sharīʿah, the higher objectives of Islamic law, to help advance the field. Accordingly, a recent JBI paper by Ibrahim and colleagues describes a method for using the maqāṣid al-Sharīʿah to provide moral end-goals and deliberative mechanisms for an Islamic bioethics. Herein I highlight critical conceptual and practical gaps in (...) the model with the hopes of fostering greater discussion about how maqāṣid al-Sharīʿah frameworks may fit within Islamic bioethics deliberation. (shrink)

I argue against interpretations of Mencius by Liu Xiusheng and Eric Hutton that attempt to make sense of a Mencian account of moral judgment and deliberation in light of the moral particularism of John McDowell. These interpretations read Mencius’s account as relying on a faculty of moral perception, which generates moral judgments by directly perceiving moral facts that are immediately intuited with the help of rudimentary and innate moral inclinations. However, I argue that (...) it is a mistake to identify innate moral inclinations as the foundational source of moral judgments and knowledge. Instead, if we understand that for Mencius an individual’s natural dispositions (xing 性) have a relational element, then the normativity of moral judgments can be seen as stemming from the relationships that constitute the dispositions of each individual. Finally, this essay elaborates on John Dewey's account of moral deliberation as moral imagination, an account which also takes the relational quality of natural dispositions as its starting point, in order to suggest the vital role of imagination for Mencius’s own account of moral deliberation. (shrink)

An important and supposedly impactful form of clinical ethics support is moral case deliberation. Empirical evidence, however, is limited with regard to its actual impact. With this literature review, we aim to investigate the empirical evidence of MCD, thereby a) informing the practice, and b) providing a focus for further research on and development of MCD in healthcare settings. A systematic literature search was conducted in the electronic databases PubMed, CINAHL and Web of Science. Both the data collection (...) and the qualitative data analysis followed a stepwise approach, including continuous peer review and careful documentation of our decisions. The qualitative analysis was supported by ATLAS.ti. Based on a qualitative analysis of 25 empirical papers, we identified four clusters of themes: 1) facilitators and barriers in the preparation and context of MCD, i.e., a safe and open atmosphere created by a facilitator, a concrete case, commitment of participants, a focus on the moral dimension, and a supportive organization; 2) changes that are brought about on a personal and inter-professional level, with regard to professional’s feelings of relief, relatedness and confidence; understanding of the perspectives of colleagues, one’s own perspective and the moral issue at stake; and awareness of the moral dimension of one’s work and awareness of the importance of reflection; 3) changes that are brought about in caring for patients and families; and 4) changes that are brought about on an organizational level. This review shows that MCD brings about changes in practice, mostly for the professional in inter-professional interactions. Most reported changes are considered positive, although challenges, frustrations and absence of change were also reported. Empirical evidence of a concrete impact on the quality of patient care is limited and is mostly based on self-reports. With patient-focused and methodologically sound qualitative research, the practice and the value of MCD in healthcare settings can be better understood, thus making a stronger case for this kind of ethics support. (shrink)

The COVID-19 pandemic put a large burden on many healthcare systems, causing fears about resource scarcity and triage. Several COVID-19 guidelines included age as an explicit factor and practices of both triage and ‘anticipatory triage’ likely limited access to hospital care for elderly patients, especially those in care homes. To ensure the legitimacy of triage guidelines, which affect the public, it is important to engage the public’s moral intuitions. Our study aimed to explore general public views in the UK (...) on the role of age, and related factors like frailty and quality of life, in triage during the COVID-19 pandemic. We held online deliberative workshops with members of the general public. Participants were guided through a deliberative process to maximise eliciting informed and considered preferences. Participants generally accepted the need for triage but strongly rejected ‘fair innings’ and ‘life projects’ principles as justifications for age-based allocation. They were also wary of the ‘maximise life-years’ principle, preferring to maximise the number of lives rather than life years saved. Although they did not arrive at a unified recommendation of one principle, a concern for three core principles and values eventually emerged: equality, efficiency and vulnerability. While these remain difficult to fully respect at once, they captured a considered, multifaceted consensus: utilitarian considerations of efficiency should be tempered with a concern for equality and vulnerability. This ‘triad’ of ethical principles may be a useful structure to guide ethical deliberation as societies negotiate the conflicting ethical demands of triage. (shrink)

The successes of the human genome project and genomics research programs portend great potential to improve upon health and enhance life. As scientific advancements continue, bioethicists and policy makers deliberate over the social and ethical implications of genetic and genomic technologies and information (ggT/I). The application of ggT/I to human reproduction raises conceptual and moral questions about being human and the links between offspring, parents, and society. Given ggT/I’s ability to significantly affect the biological constitution of humans and future (...) human generations thinking through such issues is fundamental to ethical and policy analysis. By means of a systematic literature review and accompanying content analysis, this paper highlights the dominant ethical concerns raised within recent bioethics discourse over the use of ggT/I for human reproduction. Based on these findings it aso offers a framework through which, and demarcates where, religious perspectives can add value to genethics debates and policy deliberation. (shrink)

This thesis explores Aristotle's conception of practical reason through examining his discussion of 'wish [ bou&d12;l hsiv ]' and 'deliberation [ bou&d12;l 3usiv ]'. In chapter 1, which focuses on Aristotle's claim that all wishes are directed at 'acting well [ 3u&d12;pr axi&d12;a ]', I argue that this claim indicates that wish, unlike nonrational desires, involves the agent's reflective endorsement of an initial desirable and thus demonstrates a double aspect structure of human motivation. In chapter 2, which concerns Aristotle's (...) view of the relationship between wish and the nonrational states of the soul, I refute the view that the desiderative drive involved in a wish originates entirely from the nonrational part of the soul. For Aristotle, I argue, both the rational and nonrational parts of the soul are independent sources of motivation, and while the latter presents the initial desirables, it is the former that, using them as basic data, finally determines the object of wish. In chapter 3, which explores Aristotle's distinction between action and production, especially the sense in which the end of action is not 'distinct [ ` 3&d12;t3r on ]' from action itself, I argue that the point of the non-distinctness is that under every purposive action lies the agent's ultimate concern to respond appropriately to the practically relevant features of the given situation. In chapter 4, which concentrates on the relationship between the practically wise person's capacity to find out the best means and his perceptual capacity, I argue that this perceptual capacity concerns the particularity of the given situation, not of the subject of his final practical judgment, and that this capacity essentially concerns what should be done as opposed to what is there. In chapter 5, which is concerned with the practically wise person's knowledge of the end, I defend the view that this knowledge consists in possessing a set of appropriate settled dispositions towards specific objects and concerns, against the view that it consists in a comprehensive, articulate conception of the good life. I also argue that in accepting the first view, we should take the stage where a narrow practical end is set to be already part of the process of practical deliberation. (shrink)

One prominent strand in contemporary moral particularism concerns the claim of "principle abstinence" that we ought not to rely on moral principles in moral judgment because they fail to provide adequate moral guidance. I argue that moral generalists can vindicate this traditional and important action-guiding role for moral principles. My strategy is to argue, first, that, for any conscientious and morally committed agent, the agent's acceptance of (true) moral principles shapes their responsiveness to (...) (right) moral reasons and, second, that if so, then those principles can contribute non-trivially to some reliable strategy for acting well that is available for use in the agent's practical thinking. My defense of these two claims appeals to an account of moral principles as a kind of hedged principles which I defend elsewhere, but my general line of argument should be acceptable to many other forms of generalism as well. I defend the epistemic significance of hedged principles in moral deliberation, and argue that the need for sensitivity to particulars in moral judgment doesn't supplant principles in moral guidance. I finish by arguing that the generalist model of moral guidance developed here isn't undermined by evidence from cognitive science about how we make moral judgments in actual practice, and that it compares favorably to particularism with respect to its capacity to offer adequate moral guidance. (shrink)

Whereas most moral philosophers believe that the facts as to what we’re morally required to do are grounded by the facts about our moral reasons, which in turn are grounded by non-normative facts, I propose that moral requirements are directly grounded by non-normative facts. This isn’t, however, to say that there is no place in the picture for moral reasons. Moral reasons exist, and they’re grounded by moral requirements. Arguing for this picture of the (...) moral sphere requires playing both offense and defense; this article provides the defense. I defend this view against the objections that it must deny that one is generally blameworthy for having violated a moral requirement, that it implies the existence of genuine moral dilemmas, that it runs counter to an obviously true view of how moral deliberation should work, and that it cannot explain why it feels as though figuring about what one is morally required to do often takes the form of thinking about what one’s moral reasons are. (shrink)

The perspectives of the dominant Western ethical theories, have dominated the concepts of autonomy and informed consent for many years. Recently this dominant understanding has been challenged by ethics of care which, although, also emanates from the West presents a more nuanced concept: relational autonomy, which is more faithful to our human experience. By paying particular attention to relational autonomy, particularity and Process approach to ethical deliberations in ethics of care, this paper seeks to construct a concept of informed consent (...) from the perspective of ethics of care which is here called relational autonomy-in-informed consent (RAIC). Thus, providing a broader theoretical basis for informed consent beyond the usual theoretical perspectives that are particularly Western. Care ethics provides such a broader basis because it appeals to a global perspective that encompasses lessons from other cultures, and this will help to enrich the current ideas of bioethics principles of autonomy and informed consent. This objective will be achieved by exploring the ethics of care emphasis on relationships based on a universal experience of caring; and by contrasting its concept of autonomy as relational with the understanding of autonomy in the approaches of the dominant moral theories that reflect rational, individualistic, and rights-oriented autonomy of the American liberalism. (shrink)

BackgroundIn paediatric oncology, healthcare professionals face moral challenges. Clinical ethics support services, such as moral case deliberation, aim to assist them in dealing with these challenges. Yet, healthcare professionals can have different expectations and goals related to clinical ethics support services.MethodsIn this study, the perceptions held by healthcare professionals regarding the importance of possible outcomes of MCDs, prior to implementation of MCDs, were investigated. A multisite, cross-sectional, quantitative study was performed at all six Paediatric Oncology Centres in (...) Sweden. Healthcare professionals answered the Euro-MCD instrument with 26 potential MCD outcomes using a scale from Not important to Very important. Descriptive and comparative statistical analyses were carried out.ResultsAll outcomes were rated high, i.e., between 3.12 and 3.78. More open communication, developing skills to analyse ethically difficult situations, better mutual understanding, and deciding on concrete actions were rated as most important. Understanding of ethical theories and critical examination of policies were rated less important. Most often nursing assistants rated higher and physicians lower than the other professions did. Women and participants without previous experience of MCDs perceived outcomes as more important. There were differences between centres as one centre had significantly higher, and one centre had significantly lower ratings compared to the others.ConclusionIt is clear that healthcare professionals want MCDs to improve teamwork and skills in order to analyse and manage ethically difficult situations. When comparing to previous research about important MCD outcomes, there were similarities in what healthcare professionals consider to be important when handling moral challenges regardless of country and potential differences in healthcare settings and systems, such as paediatric vs. adult care. (shrink)

The advance of mechanism in science and philosophy in the 17th century created a great interest to machines or automata. Leibniz was no exception - in an early memoir Drôle de pensée he wrote admiringly about a machine that could walk on water, exhibited in Paris. The idea of automatic processing in general had a large role in his thought, as can be seen, for example, in his invention of the binary code and the so-called Calculemus!-model for solving controversies. In (...) metaphysics, the idea of an automata was expressed most clearly in the 1695 article New System of the Nature of Substances and their Communication, and the ensuing correspondence with, among others, Foucher, Bayle, Lamy, Jaquelot and Masham. In the article Leibniz discusses the soul as a spiritual machine in the context of pre-established harmony, arguing that God can "give to a substance at the outset a nature or internal force which could produce in it an orderly way (as in spiritual or formal automaton; but a free one, in the case of a substance which is endowed with a share of reason) everything that is going to happen to it, that is to say, all the appearances or expressions it is going to have, and all without the help of any created thing." The basic idea of Leibniz's spiritual machine is that the soul or entelechy is an autonomous and spontaneous unity, consisting of internal active force and producing its own perceptions (both confused and distinct). It is a self-moving machine, driven by its perceptions and appetites, but it follows (without being conscious of it) a lawful series or programme created by God. The entelechy remains the same despite undergoing an infinite number of changes. To Foucher he explained that each state of the individual substance is a consequence of its preceding one, "as if there were only God and the substance in the world". Despite this, the spiritual machine is related not only to God, but through the pre-established harmony to bodies or natural machines. However, as it is not dependent on them, the spiritual machine is superiot to natural machines. In this paper I concentrate on three moral themes related to the spiritual machine: moral deliberation, moral identity and the goal of moral action. All these themes are more or less implicit in the New System, but are discussed in more detail in the ensuing correspondence after the publication of the article. Finally, the themes are given an extended discussion especially in the second book of New Essays on Human Understanding (1704, published 1765), written partly at the same time as some of the correspondence and unpublished related material. I will first give an overview of Leibniz's position concerning the spiritual machine or automaton in the New System and then go on to explore the three moral themes one by one, as they feature in the subsequent correspondence and in the New Essays. I will show that the three topics are essential to the function of the spiritual machine – to Sophie Charlotte Leibniz wrote: "...let us say that everything in bodies happens mechanically, or in accordance with laws of motion, and that everything in the soul happens morally, or in accordance with perceived good or evil." There are many texts that anticipate the views in the New System (notably the unpublished memoir De Affectibus of 1679) and Leibniz continued to discuss its themes later on (in addition to correpondence, for example, in Theodicy of 1710 and Monadology and Principles of Nature and Grace of 1714). Here I focus on the short-term development of Leibniz's views on the topic (around 1695-1705), but I argue that his basic view of the spiritual machine did not change much after finishing the dialogue with Locke in 1704. (shrink)

I defend a deontological social contract justification of punishment for philosophers who deny free will and moral responsibility (FW/MR). Even if nobody has FW/MR, a criminal justice system is fair to the people it targets if we would consent to it in a version of original position deliberation where we assumed that we would be targeted by the justice system when the veil is raised. Even if we assumed we would be convicted of a crime, we would consent (...) to the imprisonment of violent criminals if prison conditions were better than the state of nature but deterring enough to prevent the state of nature. (shrink)

ABSTRACT:Whether at the executive or the line-management levels, businesspeople face moral decisions that cannot be easily resolved with reference to a shared ethos, whether because of diversity of ethea in the organization or its environment, or because the organization's ethos is inadequate for the problem at hand. These decisions are made more common by the changing norms of a pluralistic business environment, and require collective moral deliberation to be adequately resolved. Discourse ethics ideally characterizes the form of (...) valid collective moral deliberation. I argue that accommodation for the limitations of actual discourse makes discourse ethics, conceived in terms of the rules of practical discourse, practical for realizing improvements in the openness and validity of moral decision-making over states in which these rules are flagrantly violated. These rules have normative implications at the organizational level for the integrity approach to corporate ethics programs, and at the individual level for ethical leadership. (shrink)

J.G. Fichte’s 1798 System of Ethics is seldom read, despite the fact that it remains, after more than two centuries, one of the most original and insightful efforts at a systematic normative ethical theory on Kantian foundations. Part of the reason for its obscurity lies in the perceived implausibility of Fichte’s account of practical deliberation and of the authority of individual conscience. The view typically attributed to Fichte is a conjunction of four claims: that moral deliberation consists (...) entirely in consultation of one’s conscience; that conscience is a faculty that gives immediate epistemic access to substantive moral truths; that conformity with the verdict of conscience is the sole criterion of the moral worth of actions; and that an individual’s conscientious decision is therefore morally incorrigible. This set of views is indeed implausible; but Fichte in fact held none of them. Hegel was the first to attribute them to him and, incredibly, Hegel’s has remained for 200 years the dominant interpretation, even among scholars of Fichte. In this paper I explain how Fichte actually thought about practical deliberation and the role of conscience, and diagnose the sources of appeal of the Hegelian interpretation. (shrink)

No one is responsible for their conduct because free will is an illusion, say some skeptics. Even when it seems that we have several options, we only have one. Hence, says the free will skeptic, we should reform our practices which involve responsibility attributions, such as punishment and blame. How seriously should we take this doctrine? Is it one that we could live by? One thorn in the side of the skeptic concerns deliberation. When we deliberate about what to (...) do—what film to go see, whom to befriend, which doctrine to follow—we must presume that our options are open to us. But then, every time that skeptics deliberate, they presume something which is incompatible with their doctrine, i.e. that they have several options. In a word, skeptics cannot deliberate qua skeptics. Some philosophers have responded that deliberators don’t have to presume that their options are open; they only have to presume that their choice will be efficacious. I argue that this proposal uses resources which, if they are available and successful, can be employed to refute skepticism. The upshot is that free will skeptics are pushing for a doctrine that is either false or in tension with deliberation. (shrink)

Animal welfare is a concept that plays a role within both our moral deliberations and the relevant areas of science. The study of animal welfare has impacts on decisions made by legislators, producers and consumers with regards to housing and treatment of animals. Our ethical deliberations in these domains need to consider our impact on animals, and the study of animal welfare provides the information that allows us to make informed decisions. This thesis focusses on taking a philosophical perspective (...) to answer the question of how we can measure the welfare of animals. Animal welfare science is an applied area of biology, aimed at measuring animal welfare. Although philosophy of animal ethics is common, philosophy focussing on animal welfare science is rare. Despite this lack, there are definitely many ways in which philosophical methods can be used to analyse the methodologies and concepts used in this science. One of the aims of the work in this thesis is to remedy this lack of attention in animal welfare. Animal welfare science is a strong emerging discipline, but there is the need for conceptual and methodological clarity and sophistication in this science if it is to play the relevant informative role for our practical and ethical decision-making. There is thus is a strong role here for philosophical analysis for this purpose. The central aim of this thesis is to provide an account of how we can measure subjective animal welfare, addressing some of the potential problems that may arise in this particular scientific endeavour. The two questions I will be answering are: what is animal welfare, and how do we measure it? Part One of the thesis looks at the subjective concept of animal welfare and its applications. In it, I argue for a subjective welfare view - that animal welfare should be understood as the subjective experience of individuals over their lifetimes - and look at how the subjective welfare concept informs our ethical decision-making in two different cases in applied animal ethics. Part Two of the thesis looks more closely at the scientific role of welfare. Understanding welfare subjectively creates unique measurement problems, due to the necessarily private nature of mental states and here I address a few of these problems, including whether subjective experience is measurable, how we might validate indicators of hidden target variables such as welfare, how we can make welfare comparisons between individual animals and how we might compare or integrate the different types of experience that make up welfare. I end with a discussion of the implications of all these problems and solutions for the practice of welfare science, and indicate useful future directions for research. (shrink)

Human deliberation is a complicated and a difficult process. When forming moral judgement, various reasons inclinate the agent without necessitating him or her and the final result is more or less a compromise between these different spurs for action. Choosing right requires clear mind, good habits and strength of will. However, by a kind of self-manipulation moral development is possible. In my presentation, I shall discuss the forming of moral judgement in the intellect, consider the role (...) of the passions in deliberation and discuss how moral self-improvement takes place according to Leibniz in Nouveaux essais and Animadversiones in partem generalem Principiorum Cartesianorum. (shrink)

It is commonly thought that moral rules and principles, such as ‘Keep your promises,’ ‘Respect autonomy,’ and ‘Distribute goods according to need ,’ should play an essential role in our moral deliberation. Particularists have challenged this view by arguing that principled guidance leads us to engage in worse decision making because principled guidance is too rigid and it leads individuals to neglect or distort relevant details. However, when we examine empirical literature on the use of rules and (...) principles in other domains, we find that people can learn to use rules discriminately and that rule-based models tend to outperform even expert judgment. I argue that this evidence poses a problem for the moral particularist. If the particularist claims that we should not rely on decision-making rules when making practical decisions and it turns out that these rules help us make better decisions, then the particularists’ prescriptive account is deficient. However, if the particularist claims that we should rely on practical decision-making rules but not on moral rules, she needs to explain how practical rules are different from moral rules and why we should rely on the former but not the latter. (shrink)

My aim in this essay is to explore the implications of the fact that even our most deeply held moral beliefs have been profoundly affected by our upbringing and experience—that if any of us had had a sufficiently different upbringing and set of experiences, he almost certainly would now have a very different set of moral beliefs and very different habits of moral judgment. This fact, together with the associated proliferation of incompatible moral doctrines, is sometimes (...) invoked in support of liberal policies of toleration and restraint, but the relevance of these considerations to individual moral deliberation has received less attention. In Sections II through V, I shall argue that this combination of contingency and controversy poses a serious challenge to the authority of our moral judgments. In Section VI, I shall explore a promising way of responding to this challenge. (shrink)

Most contemporary deliberative democrats contend that deliberation is the group activity that transforms individual preferences and behavior into mutual understanding, agreement and collective action. A critical mass of these deliberative theorists also claims that John Dewey’s writings contain a nascent theory of deliberative democracy. Unfortunately, very few of them have noted the similarities between Dewey and Robert Goodin’s theories of deliberation, as well as the surprising contrast between their modeling of deliberation as a mixed monological-dialogical process and (...) the prevalent view expressed in the deliberative democracy literature, viz., that deliberation is predominantly a dialogical process. Both Dewey and Goodin have advanced theories of deliberation which emphasize the value of internal, monological or individual deliberative procedures, though not to the exclusion of external, dialogical and group deliberation. In this paper I argue that deliberative theorists bent on appropriating Dewey’s theory of moral deliberation for political purposes should first consider Goodin’s account of ‘deliberation within’ as a satisfactory if not superior proxy, an account of deliberation which has the identical virtues of Dewey’s theory— imaginative rehearsal, weighing of alternatives and role-taking—with the addition of one more, namely, that it operates specifically within the domain of the political. (shrink)

In this article I confront Jürgen Habermas' deliberative model of democracy with Claude Lefort's analysis of democracy as a regime in which the locus of power remains an empty place. This confrontation reveals several structural similarities between the two authors and explains how the proceduralization of popular sovereignty provides a discourse-theoretical interpretation of the empty place of power. At the same time, Lefort's insistence on the open-ended nature of the democratic struggle also points towards an unresolved tension at the core (...) of Habermas' model between the cognitive nature of deliberation on the one hand and the freedom of moral and political agents on the other. A proper solution of this tension requires a full appreciation of the ineliminable gap between actual and ideal deliberation. Because actual deliberation can never result in an ideal consensus, the actual exercise of democratic power should be understood as an unavoidable interruption of deliberation. Key Words: consensus • deliberation • democracy • empty place of power • Jürgen Habermas • Claude Lefort. (shrink)

This article considers the sort of diversity in perspective appropriate for a presidential commission on bioethics, and by implication, high-level governmental commissions on ethics more generally. It takes as its point of comparison the respective reports on human cloning produced by the National Bioethics Advisory Commission, appointed by President Bill Clinton, and George W. Bush's President's Council on Bioethics, under the leadership of its original chair, Leon Kass. I argue that the Clinton Commission Report exemplifies forensic diversity (the type of (...) diversity between contesting parties in a legal case), while the Kass Council Report exemplifies academic diversity (the diversity found in a medieval disputatio). Drawing upon Thomas Aquinas, I argue that the type of diversity most appropriate for such advisory bodies is deliberative diversity, which facilitates the President's process of taking counsel. After considering their respective charges, I suggest that neither the Clinton Commission nor the Kass Council possessed an adequate degree of deliberative diversity for their respective tasks. (shrink)