Patients in the United States have been subject to an evergrowing “avalanche” of unwanted medical treatment. This is economically, ethically, and legally wrong. As one advocacy campaign puts it: “Patients should receive the medical treatments they want. Nothing less. Nothing more.” First, unwanted medical treatment constitutes waste (and often fraud or abuse) of scarce healthcare resources. Second, it is a serious violation of patients’ autonomy and self-determination. Third, but for a few rare exceptions, administering unwanted medical treatment contravenes settled legal (...) rules and principles. This “Legal Briefing” describes a central and growing role for the law. Specifically, courts and agencies have increasingly imposed penalties on healthcare providers who deliberately or negligently disregard advance directives and DNR (donot-resuscitate) orders. I group these legal developments into the following five categories: 1. Five Types of Unwanted Medical Treatment2. State and Federal Duties to Follow Advance Directives3. Doctors Hospital of Augusta v. Alicea4. Other Lawsuits for Ignoring Advance Directives5. Administrative Penalties for Ignoring Advance Directives. (shrink)

What makes a person's life meaningful? Thaddeus Metz offers a new answer to an ancient question which has recently returned to the philosophical agenda. He proceeds by examining what, if anything, all the conditions that make a life meaningful have in common. The outcome of this process is a philosophical theory of meaning in life. He starts by evaluating existing theories in terms of the classic triad of the good, the true, and the beautiful. He considers whether meaning in (...) life might be about such principles as fulfilling God's purpose, obtaining reward in an afterlife for having been virtuous, being attracted to what merits attraction, leaving the world a better place, connecting to organic unity, or transcending oneself by connecting to what is extensive. He argues that no extant principle satisfactorily accounts for the three-fold significance of morality, enquiry, and creativity, and that the most promising theory is a fresh one according to which meaning in life is a matter of intelligence contoured toward fundamental conditions of human existence. (shrink)

Definitions of terms that are central to a theoretical understanding of the Royal Government of Bhutan's policy of Gross National Happiness.

Reprint of a mildly revised article that initially appeared in the Journal of Animal Ethics (2017).

Insofar as artificial intelligence is to be used to guide automated systems in their interactions with humans, the dominant view is probably that it would be appropriate to programme them to maximize (expected) utility. According to utilitarianism, which is a characteristically western conception of moral reason, machines should be programmed to do whatever they could in a given circumstance to produce in the long run the highest net balance of what is good for human beings minus what is bad for (...) them. In this essay, I appeal to values that are characteristically African––but that will resonate with those from a variety of moral-philosophical traditions, particularly in the Global South––to cast doubt on a utilitarian approach. Drawing on norms salient in sub-Saharan ethics, I provide four reasons for thinking it would be immoral for automated systems governed by artificial intelligence to maximize utility. In catchphrases, I argue that utilitarianism cannot make adequate sense of the ways that human dignity, group rights, family first, and (surprisingly) self-sacrifice should determine the behaviour of smart machines. (shrink)

A 10,000+ word critical overview of analytic philosophy devoted to life's meaning, with some focus on books and more recent works.

The field of bioethics is replete with applications of moral theories such as utilitarianism and Kantianism. For a given dilemma, even if it is not clear how one of these western philosophical principles of right (and wrong) action would resolve it, one can identify many of the considerations that each would conclude is relevant. The field is, in contrast, largely unaware of an African account of what all right (and wrong) actions have in common and of the sorts of factors (...) that for it are germane to developing a sound response to a given bioethical problem. My aim is to help rectify this deficiency by first spelling out a moral theory grounded in the mores of many sub-Saharan peoples, and then applying it to some major bioethical issues, namely, the point of medical treatment, free and informed consent, standards of care and animal experimentation. For each of these four issues, I compare and contrast the implications of the African moral theory with utilitarianism and Kantianism, my overall purposes being to highlight respects in which the African moral theory is distinct and to demonstrate that the field should take it at least as seriously as it does the Western theories. (shrink)

Online reprint of part of an encyclopedia entry (from the Encyclopaedia of Quality of Life and Well-being Research 2014).

The current informal practice of pharmacometrics as a combination art and science makes it hard to appreciate the role that informatics can and should play in the future of the discipline and to comprehend the gaps that exist because of its absence. The development of pharmacometric informatics has important implications for expediting decision making and for improving the reliability of decisions made in model-based development. We argue that well-defined informatics for pharmacometrics can lead to much needed improvements in the efficiency, (...) effectiveness, and reliability of the pharmacometrics process. The purpose of this paper is to provide a description of the pervasive yet often poorly appreciated role of informatics in improving the process of data assembly, a critical task in the delivery of pharmacometric analysis results. First, we provide a brief description of the pharmacometric analysis process. Second, we describe the business processes required to create analysis-ready data sets for the pharmacometrician. Third, we describe selected informatic elements required to support the pharmacometrics and data assembly processes. Finally, we offer specific suggestions for performing a systematic analysis of existing challenges as an approach to defi ning the next generation of pharmacometric informatics. (shrink)

I seek to advance enquiry into the point of a public higher education institution by drawing on ideals salient in the sub-Saharan African philosophical tradition. There are relational, and specifically communal, values prominently held by African thinkers that I use to ground a promising rival to the dominant contemporary Western, and especially Anglo-American, accounts of what a university ultimately ought to strive to achieve, which focus mainly on autonomy, truth, and citizenship. My aims are not merely comparative, contrasting an Afro-communal (...) approach with other ones that have been more globally influential, but also substantive. Although the theory of a university’s point that I articulate and defend has an African pedigree, I work to show that it should be taken seriously by a global audience, for plausibly capturing a variety of intuitions and claims that are widely shared. (shrink)

Reprint of an article that initially appeared in _Ethical Theory and Moral Practice_ (2012).

This narrative provides insight into medical education for Black physicians in South Carolina in the 1960s, during the civil rights movement. It also discusses the many rewards and challenges of being a physician of color, describes what has been done to develop programs that benefit minority communities, and argues that more such programs are needed.

Many major historical figures in philosophy have provided an answer to the question of what, if anything, makes life meaningful, although they typically have not put it in these terms. Consider, for instance, Aristotle on the human function, Aquinas on the beatific vision, and Kant on the highest good. While these concepts have some bearing on happiness and morality, they are straightforwardly construed as accounts of which final ends a person ought to realize in order to have a significant existence. (...) Despite the venerable pedigree, it is only in the last 50 years or so that something approaching a distinct field on the meaning of life has been established in analytic philosophy, and it is only in the last 25 years that debate with real depth has appeared. Concomitant with the demise of positivism and of utilitarianism in the post-war era has been the rise of analytical enquiry into non-hedonistic conceptions of value grounded on relatively uncontroversial (but not universally shared) judgments or “intuitions,” including conceptions of meaning in life. Englishspeaking philosophers can be expected to continue to find life's meaning of interest as they increasingly realize that it is a distinct line of enquiry that admits of rational enquiry to no less a degree than more familiar normative categories such as well-being, right action, and distributive justice. (shrink)

In a prior issue of Developing World Bioethics, Cheryl Macpherson and Ruth Macklin critically engaged with an article of mine, where I articulated a moral theory grounded on indigenous values salient in the sub-Saharan region, and then applied it to four major issues in bioethics, comparing and contrasting its implications with those of the dominant Western moral theories, utilitarianism and Kantianism. In response to my essay, Macpherson and Macklin have posed questions about: whether philosophical justifications are something with which bioethicists (...) ought to be concerned; why something counts as ‘African’; how medicine is a moral enterprise; whether an individual right to informed consent is consistent with sub-Saharan values; and when thought experiments help to establish firm conclusions about moral status. These are important issues for the field, and I use this reply to take discussion of them a step or two farther, defending my initial article from Macpherson's and Macklin's critical questions and objections. (shrink)

A collection of several articles on African moral and political philosophy by Thaddeus Metz, translated into French by Emmanuel Fopa, and edited and introduced by Pius Mosima of the University of Bamenda, Cameroon.

For the more than a decade, I have advanced an account of what makes persons, animals, and other beings entitled to moral treatment for their own sake that is informed by characteristically African ideas about dignity, a great chain of being, and community. Roughly according to this account, a being has a greater moral status, the more it is capable of communing (as a subject) or of us communing with it (as an object). I have mainly argued that this characteristically (...) African and relational approach to moral status is a better account than salient Western approaches, especially individualist views associated with utilitarianism and Kantianism. Over the years, several commentators have raised criticisms of my approach, including that it objectionably: entails that we may rightly dominate mentally incapacitated human beings; prioritizes mentally incapacitated human beings over animals with similar cognitive abilities without sufficient justification; entails that intelligent aliens lack moral status; cannot make sense of our duties towards the dead; and is unable to account for the standing of species as distinct from their members. In this chapter I provide a comprehensive response to these and related objections, defending the initial account as an attractive way to understand what makes a being matter morally for non-instrumental reasons. (shrink)

One of the central issues in comparative law and political economy is whether the forces of globalization will result in the convergence of public policies across countries. Noting in particular that taxes collected still cover a considerable range across industrialized countries — from a low of 20% of GDP to a high of 50% — some have argued that globalization has not resulted in a loss of tax sovereignty. However, following a review of the evidence, in this Article we conclude (...) that globalization has had significant but subtle effects on tax levels and structures. Moreover, these pressures will make it increasingly difficult for countries to raise revenue to finance new public needs and to structure their tax systems in order to achieve a more socially acceptable distribution of income than what market forces dictate. Tax levels in most countries have remained essentially flat over the past twenty years, but there is a host of reasons for thinking they would have continued to rise were it not for the pressures of globalization. Statutory corporate tax rates have declined dramatically and, although corporate tax revenues have remained robust, this has been due to factors unrelated to deliberate tax policy choices. Personal marginal tax rates have also declined sharply and tax revenues have been increasingly raised by regressive consumption taxes. These trends stem from tax competition brought on by the forces of globalization, not from changing ideas or other political variables. In this Article we conclude that in order to prevent tax competition from completely eroding the ability of countries to fashion their own tax systems, there will have to be considerable cooperation among the major countries and some harmonization of aspects of their tax systems, particularly as they apply to footloose factors of production. (shrink)

The most remarkable characteristic of Pope Benedict XVI’s encyclical Caritas in Veritate is its theologically robust mode of discourse: a pervasive and unapologetically Trinitarian and Christological, substantive argument, based in a robust theological anthropology of person and society as gift, and a peculiarly Platonic and Augustinian rhetorical mode of discourse. Caritas reveals the implicit, hidden, and faulty theological and philosophical commitments of secular reason—which, when used as a medium for the Gospel, can too easily taint the true doctrine the Church (...) attempts to convey with it—proclaiming instead a radically orthodox diagnosis of and prescription for a disenchanted, love-and-truth starved—yet Enlightenment-weary—postmodern world. (shrink)

Originally published in German in 1935, this monograph anticipated solutions to problems of scientific progress, the truth of scientific fact and the role of error in science now associated with the work of Thomas Kuhn and others. Arguing that every scientific concept and theory—including his own—is culturally conditioned, Fleck was appreciably ahead of his time. And as Kuhn observes in his foreword, "Though much has occurred since its publication, it remains a brilliant and largely unexploited resource." "To many scientists just (...) as to many historians and philosophers of science facts are things that simply are the case: they are discovered through properly passive observation of natural reality. To such views Fleck replies that facts are invented, not discovered. Moreover, the appearance of scientific facts as discovered things is itself a social construction, a _made_ thing. A work of transparent brilliance, one of the most significant contributions toward a thoroughly sociological account of scientific knowledge."—Steven Shapin, _Science_. (shrink)

Ariane Lewis offers a comprehensive and expert review of ethical issues raised by brain death in the United Kingdom and how they compare to management of those issues in the United States (Lewis 20...

Ideally, the government of any nation is in a contract with the citizens for protection of life, property and freedom while the citizens are obliged to obey government laws. Moreso, the government is to discharge her duties without discriminating against any person or group. In Nigeria there are economic and administrative policies that discriminate against the Igbo nation resulting in dire consequences. Since economic policies make or mar the wellbeing of citizens especially in business, the need for fairness, equity, and (...) justice in the formulation and execution of policies is unquestionable. The Igbo of South East Nigeria, who are very active in business and entrepreneurship, suffer untold disadvantages and massive economic losses due to the lopsided and discriminatory economic policies churned out by successive Nigerian governments. Here we examine and argue against such policies based on their ethical implications and effects on individual and national development. (shrink)

A 3,500 word overview of 21st century Anglo-American philosophical books devoted to the question of what, if anything, would make life meaningful.

In this issue of JCE, Douglas Diekema argues that the best interest standard (BIS) has been misemployed to serve two materially different functions. On the one hand, clinicians and parents use the BIS to recommend and to make treatment decisions on behalf of children. On the other hand, clinicians and state authorities use the BIS to determine when the government should interfere with parental decision-making authority. Diekema concedes that the BIS is appropriately used to “guide” parents in making medical treatment (...) decisions for their children. But he argues that the BIS is inappropriately used as a “limiting” standard to determine when to override those decisions. Specifically, Diekema contends that the BIS “does not represent the best means for determining when one must turn to the state to limit parental action.” He argues that this limiting function should be served by the harm principle instead of by the BIS.I contend that we should not reassign the BIS’s limiting function to the harm principle. In this article I make two arguments to support my position. First, the BIS has effectively served, and can serve, both guiding and limiting functions. Second, the harm principle would be an inadequate substitute. It cannot serve the limiting function as well as the more robust BIS. (shrink)

For the more than a decade, I have advanced an account of what makes persons, animals, and other beings entitled to moral treatment for their own sake that is informed by characteristically African ideas about dignity, a great chain of being, and community. Roughly according to this account, a being has a greater moral status, the more it is capable of communing (as a subject) or of us communing with it (as an object). I have mainly argued that this characteristically (...) African and relational approach to moral status is a better account than salient Western approaches, especially individualist views associated with utilitarianism and Kantianism. Over the years, several commentators have raised criticisms of my approach, including that it objectionably: entails that we may rightly dominate mentally incapacitated human beings; prioritizes mentally incapacitated human beings over animals with similar cognitive abilities without sufficient justification; entails that intelligent aliens lack moral status; cannot make sense of our duties towards the dead; and is unable to account for the standing of species as distinct from their members. In this chapter I provide a comprehensive response to these and related objections, defending the initial account as an attractive way to understand what makes a being matter morally for non-instrumental reasons. For many animals to have a moral status would have important implications for the practice of agriculture, for instance farming animals for food and expanding crops. (shrink)

One aim of this chapter is to acquaint a reader unfamiliar with African philosophy with some of its more prominent ethical perspectives, especially those pertaining to ubuntu, as they bear on work. However, I undertake this discussion with some sympathy towards these implications, such that another aim is to point out that the prescriptions for the workplace that moral philosophers working in the African tradition have made (or would sensibly make given their more basic commitments) are worth taking seriously regardless (...) of the reader’s background. The vitalist and communalist strains of ethical thought prominent amongst African philosophers are relatively unknown in globally influential discourses, but are revealing in the context of work. Central topics include: what the point of work is; how to distribute jobs; why there might be a right to work; and how to organize the production process. For each question, I emphasize respects in which African ethical thought offers answers that are both different from and plausible relative to what is dominant in English-speaking theory or practice. (shrink)

Reprint of an article that first appeared in Theoretical Medicine and Bioethics (2017).

This article introduces a special issue of Philosophical Papers devoted to the topic of meaning in life. In the paper, I engage with articles by Robert Audi, David Velleman, John Martin Fischer, Laurence Thomas, Berit Brogaard, Barry Smith and Larry James, laying out their central views, criticizing them, and suggesting ways they could be developed.

Karl Marx did say, “The philosophers have only interpreted the world….the point is to change it.” However, in this short article, I argue that a plain reading of several passages from Marx indicates that an ultimate reason to engage in revolutionary practice is so that more people have the freedom to engage in interpretation such as philosophy. Beyond intending to provide revealing and coherent exegesis in respect to Marx, I argue that it is reasonable for many of us to do (...) some philosophy now, even if doing so will not foster the kind of social change that is admittedly vital. (shrink)

In the first part of the article I show how Descartes employs the sceptical theist strategy as part of his response to the problem of evil in Meditation Four. However, Descartes's use of this strategy seems to raise a serious challenge to his whole project: if Descartes is ignorant of God's purposes, then how can he be sure that God doesn't have some morally sufficient reason for creating him with unreliable clear and distinct perceptions? Drawing on related objections from Mersenne (...) and Hobbes, I show in the second half of the article how Descartes can sidestep this objection. (shrink)

Pullman argues that when it comes to medical aid in dying (MAID), “Canada … has much to learn from California” (Pullman 2023). Canada and California have similar populations: each about 40 million...

In this article we focus on three key precepts shared by Confucianism and the African ethic of Ubuntu: the central value of community, the desirability of ethical partiality, and the idea that we tend to become morally better as we grow older. For each of these broad similarities, there are key differences underlying them, and we discuss those as well as speculate about the reasons for them. Our aim is not to take sides, but we do suggest ways that Ubuntu (...) and Confucianism might have something to learn from each other and perhaps come closer. We hope that our preliminary reflections can inspire further debate and thinking on a theme – dialogues between long-standing and large-scale non-Western traditions – that is bound to increase in importance as non-Western societies play a greater role in the global system and as the search continues for a 'global ethic'. (shrink)

Bester offers powerful arguments for why the harm principle cannot replace the best interest standard (BIS) as a guide for, and limit on, surrogate healthcare decision making (Bester 2018). Since B...

The overwhelming weight of legal authority in the USA and Canada holds that consent is not required for brain death testing. The situation in England and Wales is similar but different. While clinicians in England and Wales may have a prima facie duty to obtain consent, lack of consent has not barred testing. In three recent cases where consent for brain death testing was formally presented to the court, lack of consent was not determinative, and in one case the court (...) questioned whether the clinicians were even required to seek consent from the parents of a child at all. (shrink)

In Revering God, author and scholar Thaddeus Williams bridges the gap between abstract theology and awe-inspired devotion, helping readers better understand God and drawing them into a deeper state of joy and reverence for their Creator.

Syltern and colleagues argue that we should give parents more time to make difficult decisions about life-sustaining treatment at the margins of viability (Syltern et al. 2022). This thesis is appe...

Reprint of an article that first appeared in Synthesis Philosophica (2018).

Given a 21st century context of sophisticated market economies and other Western influences such as Christianity, what similarities and differences are there between characteristic indigenous values of sub-Saharan Africa and China, and how do they continue to influence everyday life in these societies? Establishing that central to both non-Western, indigenous value systems are ideals of harmonious relationships, I compare and contrast traditional African and Chinese conceptions of harmony and analyze a number of respects in which an appeal to this value (...) affects contemporary political, economic and social interaction. (shrink)

This article considers how global ethical matters might be approached differently in the English-speaking literature if values salient in sub-Saharan Africa and East Asia were taken seriously. Specifically, after pointing out how indigenous values in both of these major parts of the world tend to prescribe honouring harmonious relationships, the article brings out what such an approach to morality entails for political power, foreign relations and criminal justice. For each major issue, it suggests that harmony likely has implications that differ (...) from approaches that currently dominate Western thought, namely those of utility, autonomy and capability. Lacking the space to systematically defend harmony as a fundamental value, it nonetheless urges theorists not to neglect it in future work. (shrink)

Terminally ill patients in 10 states plus Washington, D.C. have the right to take prescribed medications to end their lives (medical aid in dying). But otherwise-eligible patients with neuromuscular disabilities (ALS and other illnesses) are excluded if they are physically unable to “self-administer” the medications without assistance. This exclusion is incompatible with disability rights laws that mandate assistance to provide equal access to health care. This contradiction between aid-in-dying laws and disability rights laws can force patients and clinicians into violating (...) one or the other, potentially creating an underclass of patients denied medical care that is available to those with other (less physically disabling) terminal illnesses. The immediacy of this issue is demonstrated by a lawsuit in Federal court filed in August 2021, requesting assistance in self-administration for terminally ill patients with neuromuscular diseases. This paper discusses the background of this conflict, the ethical issues at the heart of the dilemma, and recommends potential remedies. (shrink)