The concept of medical futility has come to be seen in some quarters as a value-neutral trump card when dealing with issues of power and conflicting values in medicine. I argue that this concept is potentially useful, but only in a social context that provides a normative framework for its use. This social context needs to include a broad consensus about the purpose of medicine and the nature of the physician-patient relationship.

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The gift of life argument, the claim that suicide is immoral because our lives are not ours to dispose of as we are their guardians or stewards, is a persistent theme in debates about the morality of suicide, assisted-suicide, and euthanasia. I argue that this argument suffers from a fatal internal incoherence. The gift can either be interpreted literally or analogically. If it is interpreted literally there are serious problems in understanding who receives the gift. If it is understood analogically (...) the question arises whether the gift is understood to be a finite or everlasting existence. If it is finite then it is hard to see how one can be punished for bringing that existence to an end for one will not be around to be punished. If the existence is infinite it is impossible to see how one can be punished for ending one’s life because one cannot end it. However, there is still ethical mileage to be gained from the description of life as a gift and in the concluding section I indicate one way in which this is so. (shrink)

Supervenience therefore is a concept with little to offer. It lacks conceptual clarity and is unable to explain the dependency relation without relying on it too heavily. Its mechanism of operation is unclear unless a projectivist analysis is used, but serious problems remain with such an account, and, even if it does apply to aesthetic or moral properties, and even secondary properties, we cannot see how it might apply to the chemical and physical world and to the mind/brain problem. Whatever (...) characteristics make it plausible in one realm debar it from the other, and even if it is restricted to the ethical realm we cannot see how supervenience applies to our prudential values, the basic attitudes that orient our moral and aesthetic outlook.This is the second aspect to the “Cheshire Catness” of supervenience; the harder you look at it the more insubstantial it becomes. It fades away into the background, leaving just its smile. But, like any smile, there is more gap than substance, and “supervenience” does nothing to fill that gap. Still the smile lingers, the haunting question of the connection between natural and moral-aesthetic properties. This is an important question and needs to be addressed, but supervenience does not address it. It merely labels it, and, by labelling it confers a spurious air of lucidity without shedding any but the most fractured light. (shrink)

This paper investigates some implications of moral development theory for teaching ethics. A summary of moral development theory, focusing on the work of James Rest, provides the basis for our investigation. We conclude that students in a philosophical ethics course experience greater gains in moral reasoning than a control group. However, the large range of students’ moral development results in discrepancies between their developmental level and the more sophisticated level of reasoning around which philosophy curricula are designed. We explore the (...) implications of this for teaching philosophical ethics and discuss teaching strategies that facilitate growth in moral reasoning. (shrink)

It is usual to interpret Mill's understanding of liberty in terms deriving from his distinction in On Liberty between self-regarding and other-regarding conduct. Granted this distinction and Mill's genuine concern to define and defend it, it remains a relevant question why he attached so much importance to it. This raises a less familiar theme in Mill, namely the inter-connection of self-regarding and other-regarding conduct. An uncommitted reading of the main texts suggests an equivalent value is attached to this. Mill clearly (...) and constantly asserts a close connection between each person's own attempt to improve himself, to cultivate his ‘affections and will’, and the social and political structure in which he acts. Self-regarding virtue and responsible social conduct are interdependent; the quality of each depends upon the quality of the other. A fuller recognition of this and its central place in Mill's revision of Bentham may be of help in examining some of the particular problems raised by recent scholarship on Mill. (shrink)