This chapter contains sections titled: The Ancient Practice of Abortion, and Continuing Controversies Universalized Maxims Are Not Retroactive The Formula of Humanity: Appealing to Personhood Thomson and Boonin: The Personhood of the Fetus Does Not Matter The Elements of Personhood: Self‐Consciousness, Humanity, Responsibility An Attempt to Bring Fetuses into Kant's Moral Community: The Appeal to Kind Another Common Strategy: The Argument from Potential Do We Have Indirect Duties to Fetuses? No Fetuses, No Children The Need for a Pragmatic Concept of (...) Personhood The Specter of Infanticide Kant's Appeal to God Problematic Implications of the Appeal to Personhood Our Kantian Heritage: Trouble with Those at the Margins of Personhood. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Who or What is the Preembryo?S.J. Richard A. McCormick (bio)IntroductionAlthough widely used by scientists, the term "preembryo" has raised some suspicions. Histopathologist Michael Jarmulowicz (1990), for example, asserts that the term was adopted by the American Fertility Society (AFS) and the Voluntary Licensing Authority (VLA) in Britain "as an exercise of linguistic engineering to make human embryo research more palatable to the general public."I cannot speak for the (...) VLA, but I can clarify that this was not the motive of the AFS. As a member of the AFS ethics committee that discussed and adopted this terminology, I know that our discussion was not tied to embryo research or moral issues. The term "preembryo" was adopted because the earliest stages of mammalian development primarily involve establishment of the nonembryonic trophoblast, rather than the formation of the embryo. As Clifford Grobstein (1988, p. 61), a distinguished basic scientist who also sat on the AFS committee notes:The scientific rationale for the term preembryo... is its greater accuracy in characterizing the initial phase of mammalian and human development.... The status implications of such a change in terminology were not at issue in the discussion.This is not to say that the moral status of the preembryo is not a concern worthy of independent consideration. It is an important question with significant practical implications, especially in the context of in vitro fertilization. At stake are issues such as: (1) what may be done to preembryos before transfer; (2) whether all preembryos must be transferred; and (3) what may be done to preembryos that are not transferred (Ethics Committee of the American Fertility Society (AFS) 1986, p. 29S). Furthermore, emergency treatment of rape cases may also depend on such a determination. [End Page 1]Cryopreservation, which entails freezing unused preembryos for possible later use, is one example of a procedure that raises issues associated with the moral status of the preembryo. Cryopreservation decreases the number of stimulated egg recovery cycles a woman must undergo and increases flexibility in transfer protocols. But thawing of the preembryos is not a completely benign process; significant numbers of the preembryos die in the process and injury cannot be excluded.In addition, down the road a year or so lies preimplantation genetic diagnosis, now being tested in several centers of reproductive research. This would involve the removal of one or more cells from a preembryo developing in vitro. The DNA from these cells would be studied and then only genetically normal preembryos would be transferred. With the growth in knowledge about single gene defects and the rapid advance of amplification technology, which allows gene visualization, it is not difficult to imagine scientists embarking on a variety of micromanipulations of the preembryo for the sake of gaining knowledge.Not all research with gametes involves preembryos, but clearly some experiments and procedures await resolution of the moral status of the preembryo. I contend in this paper that the moral status—and specifically the controversial issue of personhood—is related to attainment of developmental individuality (being the source of one individual). This contrasts with the view that holds that personhood occurs earlier, at the point of genetic uniqueness. I believe that an embryo that has developed to the point where it can be one individual and one individual only, differs in moral status from a preembryo that has not, even if in many cases we may choose to treat them similarly.The Scientific UnderpinningsTwo things must be kept in mind—and in a sense, in tension—in turning to science for help in assessing the status of the preembryo. First, science is not competent to decide the question of personhood or ensoulment. As the Catholic document, Declaration on Procured Abortion, which I will return to later, notes: "It is a philosophical problem" (Congregation for the Doctrine of the Faith (CDF) 1974, p. 10, endnote 19). On the other hand, another Catholic document, Donum vitae(CDF 1987), notes that the conclusions of science provide a "valuable indication" for reason's deliberations about personhood. We might say that if science cannot decide the question of personhood, neither can it be decided without science.For my review of embryological science... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Who or What is the Preembryo?S.J. Richard A. McCormick (bio)IntroductionAlthough widely used by scientists, the term "preembryo" has raised some suspicions. Histopathologist Michael Jarmulowicz (1990), for example, asserts that the term was adopted by the American Fertility Society (AFS) and the Voluntary Licensing Authority (VLA) in Britain "as an exercise of linguistic engineering to make human embryo research more palatable to the general public."I cannot speak for the (...) VLA, but I can clarify that this was not the motive of the AFS. As a member of the AFS ethics committee that discussed and adopted this terminology, I know that our discussion was not tied to embryo research or moral issues. The term "preembryo" was adopted because the earliest stages of mammalian development primarily involve establishment of the nonembryonic trophoblast, rather than the formation of the embryo. As Clifford Grobstein (1988, p. 61), a distinguished basic scientist who also sat on the AFS committee notes:The scientific rationale for the term preembryo... is its greater accuracy in characterizing the initial phase of mammalian and human development.... The status implications of such a change in terminology were not at issue in the discussion.This is not to say that the moral status of the preembryo is not a concern worthy of independent consideration. It is an important question with significant practical implications, especially in the context of in vitro fertilization. At stake are issues such as: (1) what may be done to preembryos before transfer; (2) whether all preembryos must be transferred; and (3) what may be done to preembryos that are not transferred (Ethics Committee of the American Fertility Society (AFS) 1986, p. 29S). Furthermore, emergency treatment of rape cases may also depend on such a determination. [End Page 1]Cryopreservation, which entails freezing unused preembryos for possible later use, is one example of a procedure that raises issues associated with the moral status of the preembryo. Cryopreservation decreases the number of stimulated egg recovery cycles a woman must undergo and increases flexibility in transfer protocols. But thawing of the preembryos is not a completely benign process; significant numbers of the preembryos die in the process and injury cannot be excluded.In addition, down the road a year or so lies preimplantation genetic diagnosis, now being tested in several centers of reproductive research. This would involve the removal of one or more cells from a preembryo developing in vitro. The DNA from these cells would be studied and then only genetically normal preembryos would be transferred. With the growth in knowledge about single gene defects and the rapid advance of amplification technology, which allows gene visualization, it is not difficult to imagine scientists embarking on a variety of micromanipulations of the preembryo for the sake of gaining knowledge.Not all research with gametes involves preembryos, but clearly some experiments and procedures await resolution of the moral status of the preembryo. I contend in this paper that the moral status—and specifically the controversial issue of personhood—is related to attainment of developmental individuality (being the source of one individual). This contrasts with the view that holds that personhood occurs earlier, at the point of genetic uniqueness. I believe that an embryo that has developed to the point where it can be one individual and one individual only, differs in moral status from a preembryo that has not, even if in many cases we may choose to treat them similarly.The Scientific UnderpinningsTwo things must be kept in mind—and in a sense, in tension—in turning to science for help in assessing the status of the preembryo. First, science is not competent to decide the question of personhood or ensoulment. As the Catholic document, Declaration on Procured Abortion, which I will return to later, notes: "It is a philosophical problem" (Congregation for the Doctrine of the Faith (CDF) 1974, p. 10, endnote 19). On the other hand, another Catholic document, Donum vitae(CDF 1987), notes that the conclusions of science provide a "valuable indication" for reason's deliberations about personhood. We might say that if science cannot decide the question of personhood, neither can it be decided without science.For my review of embryological science... (shrink)

Who or what is morally considerable? That is to say, what merits direct moral consideration—consideration in light of what it is? Mark Bernstein steers a middle course between the extremes he labels “chauvinism” and “deep ecology.” Chauvinists hold that, at most, all human beings are morally considerable. Deep ecologists are either individualists who hold that every living thing is morally considerable or holists who hold that ecosystems but not their constituent parts (...) are considerable in themselves. (shrink)

Who or what is morally considerable? That is to say, what merits direct moral consideration—consideration in light of what it is? Mark Bernstein steers a middle course between the extremes he labels “chauvinism” and “deep ecology.” Chauvinists hold that, at most, all human beings are morally considerable. Deep ecologists are either individualists who hold that every living thing is morally considerable or holists who hold that ecosystems but not their constituent parts (...) are considerable in themselves. (shrink)

An array of pressing but conceptually perplexing questions in ethics---questions concerning group rights, collective responsibility, and the ethics of nationalism---would seem to require for their resolution answers to the no less perplexing questions of what social groups are and what membership in them amounts to. In this dissertation, I offer an analysis of the concept of what I call an 'ethnic identity group' and argue that questions about ethics and ethnicity or nationality are best understood as questions (...) about such groups and their agency. The main argument for the analysis involves showing its usefulness for understanding how group membership might be involved in personal moral identity and individual agency. ;The analysis I offer makes use of Max Weber's idea that the concept of a social group is analyzable in terms of the possibility that certain kinds of social action will be performed. A Weberian analysis of a kind of social group involves a characterization of the types of social action that are possible in relation to groups of that kind. After responding to Margaret Gilbert's arguments against Weberian analyses of social groups and related phenomena, I suggest that one central social concept is that of a group defined in terms of the availability for group members of standing in a particular relation to an idea of the group, where that idea is, more specifically, an idea of a collective agent. This is the concept of an identity group. What distinguishes members of an identity group from nonmembers is the availability for the former of standing to the group in a relation I call 'moral alignment'. Roughly, an individual aligns herself with a group to the extent that she sees the group's agency as an extension of her own. This concept of moral alignment is a development of Aristotle's view that through shared deliberation and action, friends in a perfect friendship become "other selves" for each other. A group member is socially placed so as to have access to the idea that other members may act for her and she for them. If she aligns herself with the group, the group becomes another self for her, and she may act as a member of the group. An ethnic identity group is a collection of individuals, each of whom may align himself with an idea of the group---where that idea is an idea of a particular collective agent, whose collectivity rests on the shared ancestry of the collected individuals---and each of whom may, therefore, act and respond emotionally as a member of the group. (shrink)

This paper deals with the moral issues relevant to medical decisions to terminate the life of a human organism. The expression “termination of life” will be used to cover both (1) active intervention to bring about a state of an Organism that will cause its death, and (2) a failure to intervene in causal processes that will otherwise result in the death of an organism. I shall attempt to distinguish the different cases in which the decision to terminate life is (...) morally justified and to isolate the considerations that are morally relevant to such decisions. -/- Decisions to terminate life: some possibly relevant considerations -/- There are a number of considerations that different people think relevant to medical decisions to terminate life and that are taken into account in actual medical practice. The following questions capture, I hope, the main ones: 1. Can the Organism in question be characterized as a person? 2. If the Organism is not a person, is it at least a potential person; that is such as will develop into a person? 3. If the Organism is a person, does he or she desire his or her own death, and if so is that desire a rational one? 4. If the Organism is a potential person, will this potential person express a rational desire to die once it becomes capable of expressing such a desire? 5. What quality of life will this person enjoy 6. What quality of life will this potential person enjoy? 7. What is the cost of maintaining the life of this person? 8. What is the cost of allowing this potential person to become a person, and then of maintaining his or her life? 9. Are we dealing with an unconscious person whom it is technologically impossible to restore to consciousness? 10. Is the termination of life a matter of active intervention or only a matter of refraining from saving the life of the organism? 11. Are we dealing with the case of “direct” killing or only one of “indirect” killing? 12 Does it require “ extraordinary” or only “ordinary” means to keep the person alive? 13. Is the individual suffering from a fatal illness? There are two ways in which each of these considerations might be relevant to a decision to terminate life. First, it might bear upon the question of whether it is morally permissible to terminate life. Secondly, if termination of life is morally permissible it may be relevant to the question of whether there is any positive reason for terminating life. (shrink)

Despite the importance of engineering and technology in economic, social, and other aspects of our lives what it means to develop as an engineer, and how this is to occur, is not widely discussed. Becoming a Human Engineer explores the moral and ethical challenges of educating engineers through the philosophical lens of personalism, a branch of philosophy that puts the person first, seeing human growth and development as central to good. Building from the philosophy of the 20th century (...) philosopher John Macmurray, this book explores how ethics and education intersect through a continuous cycle of action and reflection. By pulling together disparate and wide-ranging topics across engineering education, several promising areas of future work are identified. Engineering methods and ways of reflection are deeply embedded in engineering education to the extent that they may interfere with becoming a person. A focus on specific knowledges must complement rather than distract from developing the habits of mind necessary for engineers to adapt to a changing world. Providing meaningful experiences and explicitly focusing on developing multiple ways to reflect on these experiences are shown to be critical for the holistic development of engineers as persons. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:A Philosophy of Belonging: Persons, Politics, Cosmos by James GreenawayThomas W. HolmanGREENAWAY, James. A Philosophy of Belonging: Persons, Politics, Cosmos. Notre Dame, Ind.: University of Notre Dame Press, 2023. xii + 326 pp. Cloth, $125.00; paper, $50.00“Belonging” is a common theme in contemporary political discourse, but it has not yet garnered much sustained attention in terms of its philosophical significance. James Greenaway’s new book aims to address this (...) issue by offering an original and penetrating exploration into the philosophical meaning of this difficult and laden term. At the heart of his approach lies the concept of the metaxy. As explained in Plato’s Symposium and expanded by Eric Voegelin, it is a state of being-in-tension between two static states or “poles,” which can represent wisdom and ignorance, need and plenty, transcendence and immanence, eternity and time, and so forth. This becomes the foundation for Greenaway’s “hermeneutic of belonging,” which consists of two forces: “existence-from” and “existence-toward.” Existence-toward is a sort of intentionality, a consciousness of “someone or something with whom I am experiencing some kind of an affinity.” It is the “where” or “with whom” I desire to be. Existence-from is an awareness [End Page 717] of the other that a person carries within him- or herself: persons, communities, places, times that are “so significant that I cannot be who I am without them.” Greenaway argues that belonging in the abstract hinges on the metaxic tension between these two poles, variously conceived depending on the context.The second section of the book examines the different contexts in which existence-from and existence-toward play out within each person: between oneself, other persons, and the cosmos. These constitute the various aspects of what Greenaway calls “presence.” Belonging on this level means each person participates “in the grand, continual emergence of reality in all of its variety.” Presence to myself, to others, and to the cosmos as a whole reflects the metaxic tension of the hermeneutic of belonging.In the final section, Greenaway turns to explaining how belonging works in community. He begins by differentiating between the communion, or “bond and order” of a community, and communitas, the “shoulder-to-shoulder stance” that permeates political existence. Communion is a manifestation of the aforementioned hermeneutic of belonging within and among persons and the cosmos. It is the more fundamental principle of community that reflects the primordial intersubjectivity of Buber’s I–Thou: In some sense, each person is or must be involved in or available (in the sense of Gabriel Marcel’s disponibilité) to the other. Without some sort of grounding in communion, communitas becomes impossible. By contrast, communitas is the jostling, back-and-forth movement associated with the practical discernment and attainment of common political goods that Greenaway conceives, with St. Augustine, as objects of common love. These are sought out, argued about, and even fought over in everyday political life, which is marked by a shared commitment to achieving the goals associated with common political goods. The communitas is centered in the tension of belonging between the more fundamental recognition of each person as a bearer of meaning in the cosmos and the everyday business of collectively discerning and implementing the common good.But communion carries a further meaning. In addition to the more fundamental respect for myself and all others in the community as bearers of presence, it is also an awareness of all possible transcendent perfections of the community as a whole. Greenaway calls this second sense “sacramentality.” Yet this mysterious perfection is not necessarily for the here-and-now. It is, rather, another example of the hermeneutic of belonging where transcendent principles intersect with temporal reality. Thus, every community is sealed with seeming contradictions that, far from being irresolvable paradoxes, illustrate its belonging-in-tension alongside mystery. An example of one such paradox is the ideal of universal humanity: we are aware of the claims placed on us by our shared universal humanity, but we are also necessarily situated within a particular place or country or community. The idea of a universal brotherhood of man reflects one way in which transcendent perfection [End Page... (shrink)

This paper builds on prior critical scholarship on Agriculture 4.0—an umbrella term to reference the utilization of robotics and automation, AI, remote sensing, big data, and the like in agriculture—especially the literature focusing on issues relating to equity and social sustainability. Critical agrifood scholarship has spent considerable energy interrogating who gets what, how decisions get made, and who counts as a “stakeholder” in the context of decision making, questions relating to distributive justice, procedural justice, and representative justice, respectively. (...) Less attention, however, has been paid in this literature to the subject of recognition justice. Recognition justice asks the question, “Who are subjects of justice?” That query, however, is easily to oversimplify. As subjectivity is neither monolithic nor fixed, implied in these discussions are deeper questions having to do with the characteristics of one’s subjectivity that deserve moral recognition. This act of translation, from justice-in-theory to justice-in-practice, also complicates the evaluation of whether Agriculture 4.0 platforms are just, or not. These recognition justice tensions are explored by leveraging qualitative data collected through forty-two face-to-face interviews with individuals on farms located in the US states of Arizona, California, Colorado, New Mexico, and Wyoming who utilize these platforms. The study design intentionally oversampled for persons with disabilities, which highlights another distinguishing characteristic of the paper relative to critical Agriculture 4.0 scholarship. In addition to exposing certain ableist assumptions in these discussions, the sampling technique proved invaluable for interrogating how we think about labor, work, and leisure in agriculture. The paper specifically discusses how Agriculture 4.0, for example, shapes conceptions of what it means to be “able to work,” “willing to work,” “hard working,” etc. (shrink)

As has often been observed, neither the thinkers of antiquity nor those of the Middle Ages exhibited a great theoretical interest in the social value or even the ethical significance of labour. Throughout this long period of history, the labour an individual had to carry out to make a living, and thus under compulsion, was understood more or less solely as a heavy burden. It signified daily toil and the state of personal dependency attaching to a lowly social rank. Consequently, (...) there was no cause to subject it to any kind of moral consideration. Indeed, as Moses Finley reports ‘[n]either in Greek nor Latin was there a word with which to express the general notion of ‘labour’ or the concept of labour as a general social function’. Famously, with the advent of modernity, the very opposite begins to become the case. In this period, in the wake of various intersecting processes of cultural revaluation and economic transformation, labour developed into a positive credential of free existence and a presupposition of social integrity: the Protestant ethic led to a gradual upgrading of the value of labour, because it was interpreted as a sign that one possessed a capacity for inner-worldly asceticism. In the course of the establishment of capitalist economic practices, the liberation of labour from personal dependency in legal terms gave rise to the idea that gainful work could henceforth be proof of a free decision, and it thus provided the precondition of individual independence. And over time, the more the intellectual union between these two revolutions was strengthened, the more it would go on to influence the cultural self-understanding of modern societies in the capitalist west: what was previously the sheer necessity of earning a daily crust was now understood as proof of social emancipation and freedom. Nobody provided a better conceptualisation of this transformed self-conception than Georg Wilhelm Friedrich Hegel, who devoted an entire chapter of his ‘Philosophy of Right’ of 1821 to the emancipatory value of labour; here, he tells us that every member of civil society ‘is somebody’ through ‘his competence’ and his ‘regular income and means of support’, i.e. possesses the social status of a full-fledged citizen, and will find ‘his honour’ in this recognised existence as a professional. (shrink)

Nietzsche is concerned with what he calls ‘affirmation of life’, or ‘saying Yes to life’. This article examines attitudes or processes that Nietzsche describes as ‘affirmation’ or ‘Yes-saying’ (Bejahung, Jasagen). Nietzsche often speaks of something other than an individual as the locus of affirmation. Surveying Nietzsche’s uses from the period of Daybreak onwards, we find Bejahung, Jasagen and cognates with a variety of grammatical subjects, referring to human individuals, cultural products and practices such as art forms and value-systems, and (...) sub-personal items such as instincts and drives. This raises the question how he conceives the attitude or process of ‘Yes-saying’. Taking a distinction made by Ken Gemes, between ‘naïve affirmation’ and ‘reflective affirmation’, the article argues that Nietzsche gives priority to affirmation that is the direct expression of instincts or drives in action. However, many drives or instincts are culturally acquired, for Nietzsche. Dispositions to action, feeling and thought can become drives or instincts through cultural transmission, and operate outside conscious control to influence culture in turn. The notion that a drive ‘in us’ says Yes to life and the notion that a surrounding culture says Yes to life do not conflict but are two sides of the same coin. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Consistently Pro-Life: The Ethics of Bloodshed in Ancient Christianity by Rob Arner, and: Christ at the Checkpoint: Theology in the Service of Justice and Peace ed. by Paul Alexander, and: Becoming Nonviolent Peacemakers: A Virtue Ethic for Catholic Social Teaching and US Policy by Eli Sarasan McCarthyBrian D. BerryReview of Consistently Pro-Life: The Ethics of Bloodshed in Ancient Christianity ROB ARNER Eugene, OR: Pickwick, 2010. 136 pp. (...) $15.56Review of Christ at the Checkpoint: Theology in the Service of Justice and Peace EDITED BY PAUL ALEXANDER Eugene, OR: Pickwick, 2012. 182 pp. $19.80Review of Becoming Nonviolent Peacemakers: A Virtue Ethic for Catholic Social Teaching and US Policy ELI SARASAN MCCARTHY Eugene, OR: Pickwick, 2012. 259 pp. $27.00In Consistently Pro-Life, Rob Arner (who teaches at Chestnut Hill College in Philadelphia) makes the case that Christians should not kill other human beings—regardless of the circumstances. Taking as his point of departure the vigilante killing of abortion doctor George Tiller in Wichita, Kansas, in 2009, he argues not only that abortion is always morally impermissible but so also is [End Page 217] the murder of abortion doctors and the use of the death penalty to punish those who murder them. In addition, he turns to the early church fathers to contend that, prior to Constantine, “without exception, the church strongly condemned the taking of human life in any form whatsoever”—thus rejecting abortion and infanticide, the blood sport of the Roman games, suicide, and killing in war (120). This was because the New Testament witness to Jesus and his death on the cross required early Christians to view “the means as just as important, if not more important, than the ends” (xiii).Arner supplements this deontological argument for Christian pacifism, which he learned from John Howard Yoder, with a brief consideration of the virtue of patience cultivated in the early churches, reflecting the influence of Stanley Hauerwas on his thought. This “cardinal virtue” connoting “longsuffering, forbearance, patient endurance”—as found in Jesus’s teaching in the Sermon on the Mount (Mt 5:38–48)—enabled early Christians to practice non-violent resistance “deferring personal revenge in favor of God’s vindicating justice” (98). If Christians were to adopt this same consistently pro-life ethic today, argues Arner, it would “lead to greater healing and peace in our blood-soaked world” (121). The book closes with three appendices—one of which is a chart of terminology that dehumanizes vulnerable victims, including unborn human beings. Unfortunately, the book does not have an index.Christ at the Checkpoint, edited by Paul Alexander (professor of Christian ethics and public policy at the Palmer Theological Seminary of Eastern University), includes thirteen plenary addresses delivered at a conference on the Arab-Israeli conflict organized by Palestinian Evangelical Christians at Bethlehem Bible College in March 2010. Almost all of the contributors to this volume—including biblical scholars, theologians, ethicists, pastors, activists, and others—criticize the ideology of Christian Zionism and its support of a theology of dispensationalism that, in their view, distorts the scriptures and fosters violence rather than reconciliation between the Israelis and the Palestinians. In his own presentation titled “What Can Pentecostals and Charismatics Do for Peace with Justice in Israel and Palestine?,” Alexander—who describes himself as a former “one-sided” Christian Zionist who later discovered the writings of Yoder and Hauerwas—appeals to Jesus’s teaching in the Sermon on the Mount and urges Pentecostals to create church communities “that cultivate persons of character and conviction, who through habits, practices, and action live out the core of our faith” (69). Along with being faithful to the “greater challenges” of love, mercy, compassion, and forgiveness, he argues that they should publicly declare that Jesus does not want Israel to continue the occupation of Palestine, and they should engage in the “easier tasks” of promoting human rights, lending support to United Nations Resolutions, and working toward a two-state solution (72). “The time has come in human history,” writes Alexander, “for Pentecostals to speak and act prophetically regarding this present injustice … [End Page 218] and to use every nonviolent weapon in our arsenal—stories, preaching... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Leporello's QuestionGarry L. HagbergOne finds in the later philosophical writings of Ludwig Wittgenstein an articulation of the distinctive attitude we bring to the perception of human beings. This attitude, called by Wittgenstein "Eine Einstellung zur Seele," an attitude towards a soul, is irreducible—it cannot be analyzed into any more basic constituent parts—and it is the precondition for our sympathetic and imaginative understanding of others. It serves at the same (...) time as the precondition for human selfhood. Stated succinctly, this unique attitude, marking the contrast between our perception of a human being and our perception of anything else animate or inanimate, is constitutive of who and what we are. And while this irreducible facet of the human situation is expressly articulated in philosophy—that is, it is therein said—it is shown in myriad places and ways. Viewed through the lens of Wittgenstein's fundamental concern with this ineliminable human attitude, Mozart and da Ponte's Don Giovanni reveals considerable insight into the content of humane acknowledgment, and the very concept of selfhood upon which that acknowledgment is based.IIt is just after voicing his aspirations to become a gentleman himself that Leporello, outside the palace of the Commendatore, provides the [End Page 180] interpretive clue to the philosophical significance of the entire opera. Thinking that he hears someone coming, he puts into play within the opening line of Don Giovanni the intertwined themes of concealment, of person-perception, and of the underlying desire for human avoidance that motivates the particular act of concealment in question: "I don't want to be seen, ah, I don't want to be seen, I don't want to be seen, no, no, no, no, no, I don't want to be seen" (p. 86).1 However, the deepest clue to the philosophical significance—and the one that resonates most clearly throughout the opera—is given by Don Giovanni himself and comes in his very first line: "You shall not know who I am" (p. 86). He repeats this morally significant epistemic limit a moment later to secure this limitation on person-perception with an emphatic denial (to Donna Anna): "You scream in vain, you shall not know who I am, no" (p. 86).If we are then to see Don Giovanni as an opera that houses considerable insight—and an instructive object-lesson—about what Wittgenstein and others have discussed as the preconditions of selfhood, of inner human content, that make the distinctive—and as I have discussed elsewhere, instructively irreducible—attitude or stance we take towards other persons so much as possible, we must investigate how the opera serves to frame Giovanni.2 That is, we must comparatively situate him in relation to the other characters, as a person lacking precisely that human content, that interiority, which makes the distinctive and remarkable attitude, the essence of person-perception, possible. But before I proceed with the attempt to sketch the philosophical content to which both Leporello's and Giovanni's first words provide clues, let us consider some preliminary details in the libretto that point out the interpretive direction we will take.As early as the fatal wounding of the Commendatore, a telling contrast emerges. With the Commendatore dying, Leporello exclaims "What a tragedy! What a crime!" and then, having made these morally-engaged judgments, he describes his inner state with "I feel my heart pounding with fear in my breast." Then, in humanly-engaged reaction to the scene, he exclaims with increasing urgency (owing to his moral perception of the magnitude of the profound human loss presently occurring at Giovanni's hand) that he does not know what to say or to do. Showing in his words, his actions, and his felt urgency, his attitude towards the person of the Commendatore, Leporello stands in striking contrast to the humanly disengaged language and posture of Giovanni—a posture or stance that displays only a refusal to acknowledge the [End Page 181] humane loss he is presently causing. Giovanni provides the cold description of a detached eyewitness—one without a trace of imaginative sympathy for the victim—that approximates the outwardly descriptive language of a dehumanized behaviorist: "already... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:61 PROJECTIONISM, REALISM, AND HUME'S MORAL SENSE THEORY* Introduction The character of Hume's moral theory is currently a topic of considerable discussion.1 We find in the recent literature essentially two sorts of interpretation of Hume's theory. On the one side there is the view that, for Hume, the distinction between virtue and vice is reducible to the moral sentiments of approval and disapproval. Associated with this view is (...) the further claim that Hume ascribes to us the belief that virtue and vice exist as the counterparts to these sentiments; and, in addition, that this belief is, for Hume, a mistaken one. For reasons which will become obvious this may be described as the Projectionist account of Hume. On the other side, there is the attempt to represent Hume's moral theory as a form of realism, i.e., a theory according to which there are moral properties belonging to actions, or the agents who perform them, which provide objective correlates of the feelings which those actions, or the agents concerned, induce in us as spectators. Now clearly an important part of what is at stake between these different interpretations is the question of how seriously we should take Hume's own description of this theory as one according to which moral distinctions are derived from a moral sense. It is characteristic of the Projectionist interpretation to suggest that 'sense' is equivalent here to 'sentiment', and, indeed, that Hume's moral sense theory is tantamount to the denial that there is anything in Objects' themselves corresponding to our moral (or aesthetic) sentiments. The Realist interpretation, on the other hand, stresses the importance of Hume's references in 62 the Treatise to a moral (and aesthetic) sense, and the precedent provided in this respect by Hutcheson; and it takes seriously the idea that this sense enables us to become acquainted, via the sentiments involved, with the qualities of virtue and vice. My own interest in these different interpretations concerns their disagreement about the way in which we should understand Hume's notion of a moral sense. I wish to argue against the Projectionist interpretation, and its dismissive treatment of Hume's references to a moral sense, though it is a further question whether the view of Hume which emerges deserves the name of 'Realism'. 1. The Projectionist Interpretation It seems clear that the notion of a moral sense cannot be intended literally, i.e., as though there is a form of moral sense-perception strictly comparable to the modes of perception provided by the external senses. It is, presumably, part of the definition of a sense that it is a faculty whose function depends upon stimulation of an organ or, at least, receptors peculiar to that sense; and, furthermore, in the case of the various external senses there is -- except for the contact sense of touch -- a distinctive medium of perception. For both these reasons moral sense theorists can only be proposing an analogy with the external senses. In Hume's case in particular, however, there appear to be reasons for doubting whether the analogy can be more than superficial. Perhaps the most obvious of these lies with Hume's insistence on the action-guiding character of the distinction between moral good and evil (see e.g., T 437-462). For it seems clear that sense-perceptions g as such can have no direct influence upon our actions. 63 Then there is Hume's denial that morality consists in any matter of fact (T 468; EPM 292). If virtue and vice are to be considered the objects of some form of moral sense-perception their existence presumably does become a matter of fact. Finally, a moral sense theory seems to imply that judgements of virtue and vice are straightforwardly true or false, according to whether or not we perceive veridical Iy; while Hume's own discussion sometimes points to a non-propositional view of moral utterances as the expression of certain feelings or sentiments. These last two points remind us that Hume often appears to deny that values belong as intrinsic properties to the objects evaluated. This is obviously true of the following, much quoted, passage: Take any... (shrink)

The discussion concerning the patenting of academic knowledge is already closed for many people. It has become a type of credo, solemnly intoned at all levels: universities must commercially valorize the knowledge that they generate as extensively as possible.The public means that are reserved for universities can never increase at the same rate as the mounting costs for highly specialized research. So universities, if they want to work at the top level, must increasingly appeal to private resources. Universities are increasingly (...) forced to aim at contract research, sponsorships, commercialised service, the patenting of technical findings, and spin-offs: Cash for knowledge!The pressure for the unfettered commercialisation of academic knowledge does not only come from within the universities. The message also comes from the politicians and those who are committed to economic prosperity. They argue that the commercialisation of intellectual property contributes to new employment because it makes new industrial developments possible and reinforces the competitiveness of ventures. They make it seem that universities form the motor of the knowledge economy.In a country without considerable natural resources and with extremely high personnel costs, innovation is of vital importance. Few convictions are equally as expressly avowed at so many differing forums. The direction of the march seems clear.It was once different. The knowledge that was acquired, deepened, preserved, and transmitted within the universities was not for sale. In fact, its sale could present difficulties because academic knowledge has never answered to the properties of a marketable thing. Use does not deplete knowledge and if you consider it your mission to bring to light knowledge, you do not want to exclude anyone from making use of it.Academic knowledge could thus not be an object of trade, at least so long as nobody was intent on keeping that knowledge secret, and so long as nobody appealed to regulations, whereby one could restrict the legal use of that knowledge. Today neither of these strategies are taboo within academic centres. The patenting of all forms of qualifying knowledge is even encouraged.A patent assumes, on the one hand, that one makes public the knowledge upon which a technique rests, while one, on the other hand, can grant use of that technique exclusively to who one gives a licence, whether or not for a fee. This system is put forth as attractive for all parties. The researchers can keep up with technical details, and the entrepreneur can commercialise the finding. Everyone is happy.Or perhaps not? Are there reasons to be concerned that universities must increasingly submit themselves to the laws of the market? Are there arguments for evaluating academic performance differently than the performance of entrepreneurs? Must one regret that knowledge is commercialised as much as possible?The proponents of the commercial orientation point out that all kinds of new incentives will give a new impetus to the old academic system and will increase the relevance of academic research. They seem to dismiss resistance to the renewal as a nostalgic outpouring of a privileged group that used to have it too good, a group that for too long knew to retreat too safely back into a series of unworldly problems.The opponents of the economically oriented approach fear that the proper character of the academic mission will be lost. They fear that the loss of academic autonomy will make the specific function that a university fulfils within society impossible. In what sense?In our society, there is not one type of sphere, and there is not one valid set of standards, the basis upon which performances are evaluated, functions are judged, or objectives commended. There are strongly divergent spheres and each have their own specific function. The laws that apply in one sphere do not necessarily have authority in another sphere, and the standards that apply in one sort of relationship often have little or no meaning in another relationship.Each sphere recognises its own standards and answers to its own system of exchange for compensation, approval, and recognition. What applies in the sphere of law does not necessarily apply in the sphere of someone’s personal friendships, or is not applicable among family members. What applies in trade does not necessarily apply in the sphere of art.Even more, things go wrong when the autonomy of these spheres is not respected. Within the domain of art, love and friendship, monetary laws are not valid, at least in a healthy situation. That is not to say that the rules that apply within the free market would be wrong or unethical – far from it. It seems self evident that these laws are valid under the condition that they apply in the environment to which they belong, and that one respects these limits.This applies for all spheres. It would be unjust if one would apply the standards of friendship to the spheres of jurisprudence or education. Manifestly, it seems self evident not to define justice as a univocal principle that must be extended with the same consistency in every type of sphere. Rather, it is just to respect the individual character of the normative relationship that applies in the diverse spheres of life, and to prevent one sphere from colonising another.Justice assumes that one prevents the political sphere from stipulating what must be said, or concealed, within the academic sphere. Academics must answer alone to that which is expected of them within the academic sphere. Political pressure may exert no influence on this. Why cannot one say the same about economic pressure?Do we run the risk that the economic sphere will colonise the academic sphere just as the economic sphere previously colonised the sphere of media? What must one imagine in this supposed risk? In what sense should economic laws threaten the academic sphere?In the academic sphere, it is traditional to follow one’s own interests and investigate anything whatsoever without having to ask if this knowledge is useful for something or how the fruits of this research fit within the economic context. The academic search for a better understanding of everything has an unconditional character.The manner in which researchers evaluate the performance of each other seldom has to do with the economic effects that their findings have, but with their reliability, the meticulousness with which they were checked, the scrupulousness with which the sources were collected, and the honesty with which they were communicated. The function of the academic is to collect and refine knowledge, and to bring to light the truth.By doing so, universities offer a type of foot-hold within society. They make it possible that a place exists where one can be obedient to what lets itself appear most truthfully today. Nobody has to fear, at least as long as the autonomy of the academic sphere is respected, that the communication of a particular subject was rhetorically coloured in function of a commercial interest, was applied according to the wishes of the sponsor, was brought into conformity with what was agreed upon by the financiers, or answered to the demands of a patent.It is possible that the influence of the commercial sphere shall be less dramatic than pessimistic academics imagine, but nothing indicates the opposite. Today we are giving a new strategy power, and nobody knows how the magician’s apprentice will bring it off.This forms the context of the questions that we shall try to answer together this number of Ethical Perspectives, and we will restrict our discussion to patents. We are aware that the discussion about patents illuminates just one part of the problems, which have to do with the relation of the worlds of academia and commerce. But there is a reason for confining oneself to an aspect of this problematic relationship. If one were to broaden the scope of inquiry further, one would risk missing the complexity of the subject matter already covered, and be consigned to a far too general and aimless debate.We have brought together a number of specialists, jurists, ethicists, and people with practical experience with the field. They shall introduce us into the problematic, confront us with their points of view, and help to answer our questions: Are there moral limits to the patenting of academic knowledge? Is patenting always the most efficient strategy? Does not perhaps the university sell its soul if it gradually leaves itself subject to the laws of the market?We will begin by asking how in particular a university should proceed with the patenting of knowledge. Modern universities were inspired by the ideals of the Enlightenment, which was characterised by the open distribution of unselfishly pursued knowledge.The privatisation and commercialisation of knowledge would seem to conflict with this traditional vision. Jürgen Mittelstrass and Bart Pattyn provide a theoretical and historical basis for protecting the autonomy of university research from the corrupting aspects of the market economy.But, are there reasons for giving up the traditional outlook? Few or no universities have not chosen to patent discoveries, but how is one to proceed within the framework of the university, once one has obtained patent protection? Can one pursue a policy of using these protected intellectual rights to secure the fruits of knowledge for financially weaker groups, or do circumstances compel the universities to be exclusively driven by market forces?Those are the kinds of questions that Gilles Capart and Geertrui Van Overwalle of the KU Leuven will deal with.Sigrid Sterckx of the university of Ghent will answer the question: can patents be morally justified?Paul Belleflamme of the Université Catholique de Louvan La Neuve writes concerning the economic evidence of patents, and the real effect of incentives. Are there any economic facts that can demonstrate the effectiveness of patenting?Then we give the floor to Christopher May of the University of Lancaster, who looks at the question of how universities have to deal with the global information society. (shrink)

Background: Recent literature on addiction and judgments about the characteristics of agents has focused on the implications of adopting a ‘brain disease’ versus ‘moral weakness’ model of addiction. Typically, such judgments have to do with what capacities an agent has (e.g., the ability to abstain from substance use). Much less work, however, has been conducted on the relationship between addiction and judgments about an agent’s identity, including whether or to what extent an individual is seen as the same (...) person after becoming addicted. Methods: We conducted a series of vignette-based experiments (total N = 3,620) to assess lay attitudes concerning addiction and identity persistence, systematically manipulating key characteristics of agents and their drug of addiction. Conclusions: In Study 1, we found that US participants judged an agent who became addicted to drugs as being closer to ‘a completely different person’ than ‘completely the same person’ as the agent who existed prior to the addiction. In Studies 2-6, we investigated the intuitive basis for this result, finding that lay judgments of altered identity as a consequence of drug use and addiction are driven primarily by perceived negative changes in the moral character of drug users, who are seen as having deviated from their good true selves. (shrink)

The question of age as a factor in ethical decision-making takes two forms. The first form considers age as a factor at the societal, or policy, level, and the second as a factor in determining the capacity of the individual patient to make decisions regarding their own care. This article satisfies itself with a consideration of only the latter question. The issue of whether age is contributing factor in medical decision-making is frequently posited when one considers ethically charged instances of (...) medical decision making at the end of life. Few would argue that the person who has the capacity for decision-making should be denied the ability to exercise that facility and so, it is when a person has lost their ability for making those choices that the question of age as a contributing factor in ethical decision making is raised. The question therefore becomes one of capacity more then age, with age as a useful, but inexact, gauge of that capacity. The inexactitude of age as a surrogate of capacity is a contributing factor to the problem posed in this series of articles. Therefore, to define the relative contribution of age to the capacity for ethical decision-making this article will focus not on the loss of that ability, but rather on the factors that define the realization of that faculty. To do this it will be necessary to define how that faculty is to be to be measured and what are the characteristics of an ethical decision that define it apart from other decisions. Since at the beginning of life, if age is the only variable (adjusting for other co-morbid states) then the issue of surrogacy is a temporary one and is unlike the adult where the presumption is that the person is unlikely to regain decision-making capacity as they slip further into their morbid state. (shrink)

The problem of determinism and free will has occupied the minds of human beings since time immemorial. Philosophers have dwelt on it at great length. The problem is alike for both those who support determinism and those who do not. From one side, it is argued that since all the actions are causally determined, the belief that we are free is an illusion; from the other side, it is argued that since we know that we are free, universal determinism is (...) false. Some others argue for both – truth of determinism as well as that of free will but then the question of morality is left aside. The paper attempts to deal with the problem in the light of Jaina philosophy. It is further aggravated when one takes into account one of the central theme of Jaina philosophy – omniscience. Determinism then becomes a necessary corollary of the doctrine that there is a person who knows everything – past, present and future. But, if determinism is true, how does Jainism account for free will? What would be the Jaina position when one talks of moral obligation / responsibility? Is the Jaina position on determinism absolutistic or non-absolutistic? If it is absolutistic, then how does it affect anekāntavāda? The paper seeks to address these issues with some plausible solutions. (shrink)

Photo by Tingey Injury Law Firm on Unsplash ABSTRACT The coverage of healthcare costs allegedly brought about by people’s own earlier health-adverse behaviors is certainly a matter of justice. However, this raises the following questions: justice for whom? Is it right to take people’s past behaviors into account in determining their access to healthcare? If so, how do we go about taking those behaviors into account? These bioethical questions become even more complex when we consider them in the context of (...) a commitment to publicly funded, universal healthcare coverage. INTRODUCTION Healthcare coverage of lifestyle-related conditions is certainly a matter of justice. However, this raises the following justice-related question: Is it right to consider people’s past behaviors in determining their access to healthcare? If so, the methods of taking those behaviors into account must be fair and justifiable. This bioethical question becomes even more complex when we consider it in the context of a commitment to publicly funded, universal healthcare coverage. This paper takes an old, classic debate, evaluates newer approaches, and offers an argument favoring a combined approach which alters the liberal-egalitarian solution to account for social justice. ANALYSIS I. Causes of Disease If healthcare coverage were universal, irrespective of socioeconomic status and lifestyle, people would contribute to the cost of remedying the lifestyle-induced health problems of others. In the West, lifestyle-related diseases are burdensome.[i] This paper approaches this concern from a western lens that incorporates both a European tradition of “social safety nets” and an American tradition of personal freedoms. By taking such an approach, solutions to the consequences of one’s past behavior burdening others must consider an individual’s personal freedom to choose to act as he or she wishes, with the distributive social and economic equality of the many. The concept of disease caused by lifestyle and diet is proven. Many health conditions include behavioral risk factors. Multi-pack smoking increases the risk of chronic lung disease, while obesity increases the risk of type 2 diabetes. Inattention to high blood pressure, high cholesterol, and a lack of exercise leads to increased risks of coronary artery disease.[ii] While poor lifestyle choices certainly influence these conditions, their causes are multifactorial, and it is difficult to say that any single string of poor choices led to their development. In a scenario where two men excessively eat fast food for 20 years, several discrete factors impact whether any of them might suffer an ischemic-embolic stroke or not. Genetics, circumstances, and activity will also contribute to outcomes. II. Alcohol-Related End-Stage Liver Disease One paper suggests that alcohol-related end-stage liver disease (ARESLD) differs from other multifactorial disorders as alcohol alone causes the disease.[iii] It justifies attributing personal responsibility to patients with ARESLD because the condition develops only after the cumulative effects of large quantities of alcohol consumed from years to decades.[iv] However, the paper undermines its position by admitting that even the susceptibility to becoming an alcoholic has some degree of genetic predisposition.[v] Given the extreme scarcity of donor livers, some patients may be prioritized over others on the transplant waiting list. Since donor livers cannot be given to everyone, transplanting a liver into an alcoholic may result in death for competing candidates whose liver disease was not their fault. All else being equal, if bioethicists avoid claiming moral deficiency or judgment, those with apparently self-inflicted ARESLD will not be deprived of treatment but will have a lower priority for transplant.[vi] In contrast, another position suggests that it is often difficult to define what behaviors are punishable as these are largely personal and value-laden.[vii] Still, people do not support using their own resources to support the consequences of others’ poor choices, no matter how objective.[viii] In democratic societies, one must take into consideration community morals and values.[ix] Even if we were to punish people for their health-adverse behaviors, we could not logistically employ the vigorous and sustained efforts necessary to determine whose actions are morally weak.[x] III. The Liberal-Egalitarian Proposal One past argument proposes a liberal-egalitarian solution to manage personal responsibility for so-called “lifestyle diseases.”[xi] This Rawlsian system combines the European-style “social safety net” commitment to social and economic equality with the American liberal notion of pluralist toleration and personal freedoms. This idealized system aims to hold people responsible for their choices rather than the consequences to mitigate the downside of blaming those who might not be blameworthy. The approach avoids determining the questionable nature of luck and personal responsibility for health outcomes, fairness in the distribution of economic burden, and the intrusiveness required to practically determine who acts in a morally wrong and health-adverse way. The liberal-egalitarian model, a theory of distributive justice, has two facets: the liberal principle that people should be held accountable for their choices and the egalitarian principle that people who make the same choices should have the same outcomes.[xii] This model attempts to fuse responsibility with equity by seeking to reward good behavior and tax bad behavior rather than punish the consequences of the action and navigate who deserves treatment. For instance, the hospital bedside is not the appropriate place to introduce responsibility for one’s health outcomes.[xiii] This appeals to the reality that, at that time, discerning the true causes of disease was not plausible and to humanity in avoiding a heartless and cruel approach. An argument in favor of the liberal-egalitarian model considers its method of implementation. This approach assumes that the healthcare system treats all individuals regardless of their choices or ability to cover costs. The liberal-egalitarian model also assumes that a certain adverse health condition is related, statistically speaking, to the consumption of a certain good and that good can be taxed. As such, it proposes to tax the consumption of that good to finance the collective burden which arises from that good’s consumption rather than require individuals to pay for their own treatment. In the example of ARESLD, the recommended solution would be taxing all alcohol. While a systematic infrastructure is not explicit, there is the implication that a per-unit tax can be imposed on alcohol so the total tax revenue would make up for the additional healthcare costs due to consumption.[xiv] Upholding the principle that all people who make the same choices should face the same costs, all consumers of alcohol would pay the same tax, regardless of factors such as genetic predisposition to alcoholism, lifestyle, or expected cost of treatment. Upholding the principle of individual responsibility, this model does not deny treatment to anyone, neutralizing factors outside that individual’s control by imposing the tax ex-ante. Other people are not burdened by those who consume the good. People who consume alcohol face a burden proportional to the amount consumed. This tax-based implementation is justified so long as the tax is not prohibitively high for the average consumer. Further, the model mitigates concerns over the intrusiveness of ascribing morality to health-adverse behaviors. IV. Moral and Social Arguments Against the Liberal-Egalitarian Position Arguments against the liberal-egalitarian model concerns its many assumptions. First, this model assumes that consumption of such goods is directly related to the health outcome and that these goods can be taxed.[xv] Certain people genetically predisposed to alcoholism would be predisposed to consume more alcohol. The model falls short when applied to scenarios where health outcomes are not consumption-based, such as engaging in unsafe sex or abstaining from healthy lifestyle choices like exercise. Second, some might argue that the liberal-egalitarian model fails to remain neutral. Residual moral judgments tied to consumption choices introduce non-neutrality. Although taxation in free societies is determined by democratic procedures rather than by individuals in the healthcare system, moral and value-based judgments will be implicit in deciding what behaviors are taxable, such as the purchase of cigarettes. Third, the liberal-egalitarian model fails to determine whether one’s behavior is autonomous, as socio-cultural-economic factors may influence it and behavior is more a product of society, peer pressure, or income. Those also may reflect systemic inequalities. Therefore, this model, which rewards, or taxes based solely on decisions, regardless of their consequences and motivations, fails to consider that a person’s decisions may not be completely autonomous. V. Libertarian Arguments Against the Liberal-Egalitarian Model a. State Intrusiveness as Counter to the Liberal-Egalitarian Model Last, there is a libertarian worry that if the state guarantees universal healthcare coverage to all people, the state will have to become highly intrusive and investigate people’s morals.[xvi] At least one-third of all disease burden in North America, Europe, and the Asia-Pacific is attributable to lifestyle measures such as tobacco smoking, alcohol consumption, high cholesterol, and obesity.[xvii] With these various lifestyles, it is not likely to agree on what conduct to tax or condemn.[xviii] The fine-toothed comb required to determine whether each citizen has been engaging in these behaviors would intrude on daily life and personal freedom. Libertarians champion the argument that impractical intrusiveness would result from universal healthcare, and such a degree of intrusiveness would likely be universally unacceptable.[xix] The liberal-egalitarian model mitigates the libertarian worry about state intrusiveness as it does not involve prying into one’s life and choices other than taxing goods. A liberal state should ideally be neutral to how people decide to live their lives. In all, libertarians can rest assured that the liberal-egalitarian tax-based model, through its ex-ante implementation, will require no prying state eyes. States that provide universal healthcare coverage and wish to condemn certain misconduct do not need to become overly intrusive to carry out measures to hold individuals accountable. b. Fairness Another libertarian worry regarding the guarantee of universal healthcare coverage in the context of lifestyle-driven diseases is that the public will be burdened unfairly with covering others’ ill-advised mistakes or bad luck. An ideal system to address this worry would link treatment or payment for treatment with whatever behavior caused that need.[xx] The distribution of burdens should be linked to how different individuals contributed to the creation of those burdens. Applied to health policy, we should ask how the need for a certain treatment arose when determining how to distribute its cost.[xxi] The liberal-egalitarian model aspires to hold individuals responsible for their choices, not for the consequences of such choices. This model significantly mitigates the libertarian worry over unfair burdens for covering other people’s mistakes or social conditions, which lead to those bad outcomes, by ensuring to not burden others with any of the costs for the treatment of people who decide to engage in certain health-adverse behaviors. The aforementioned taxation-based system would only tax those who also engage in the health-adverse behavior through consumption, and that tax directly pays for the necessary collective treatment. As such, those who do not consume the good are not involved with the payment scheme, while those who do consume the good are responsible for payment in a matter proportional to the amount of the good they have consumed. VI. Universal Coverage Taking a step back, one should consider whether these worries regarding the coverage of apparently self-inflicted health conditions in the context of universal healthcare are worthwhile issues. One perspective raises what is called the culturally imagined objection — an idea erroneously held by many that sick people, especially those who are poor and uneducated, bring these illnesses upon themselves due to poor decision-making and irresponsible risk-taking.[xxii] This perspective critiques the uniquely American view that, since individuals are free to choose their lifestyles, they should bear the costs of their lifestyle.[xxiii] Taking this argument further, some (perhaps the strongly libertarian) would say that the poor health status among many individuals is the price individuals must pay for their American way of life and the liberty and freedom to live as they wish. However, people should not completely punish individuals for their health-adverse behaviors because these choices are largely pre-determined by a person’s socioeconomic influences.[xxiv] The outcomes from these allegedly ill-advised behaviors, which largely affect poorer people, are not just poor behavior but rather a public health crisis. Perhaps the state and its people should take collective responsibility and cover the costs of treatment for those health outcomes without question, as a form of public service. Rather than worrying about accountability and taxing bad behavior or intrusiveness into personal decisions, some might argue that people need to collectively take responsibility for reducing the overarching systemic inequalities and covering the associated treatment costs as a measure of public health. VII. Proposed Solution Given the strengths of the liberal-egalitarian model and taking into account libertarian and social justice-oriented objections, an ideal solution for the coverage of lifestyle-related health problems needs to consider the complex relationship between a person’s behaviors and their apparent health outcomes. It must consider how society as a whole passes judgment on behaviors and how to take into account that many health-adverse decisions are not truly autonomous decisions, as various genetic and socioeconomic factors influence them. An ideal solution combines the liberal-egalitarian tax-based model with the social justice concerns of universal coverage. Whatever the cost for the treatment of medical issues resulting in part or entirely from lifestyle and diet, taxes collected from spending associated with the behavior (like the purchase of alcohol, junk food, and cigarettes) ex-ante should fund 50 percent of the cost of treatment, while the universal healthcare taxation scheme should include the other 50 percent. Such a system would provide an incentive to avoid the purchases that can lead to unhealthy consumption and make healthier choices, slightly punish and discourage such purchases through taxation, yet not overly punish people whose outcomes may have more to do with socioeconomic factors and genetics. Adding public responsibility demonstrates acknowledgement that health care is in the public interest and can mitigate public health inequalities. This solution would fuse personal responsibility with the public responsibility of state-sponsored social improvement while ensuring that all people have fair access to necessary treatment, no matter their ability to pay. CONCLUSION The 50-50 system this paper proposes reflects both justice and personal responsibility in covering healthcare costs allegedly brought about by people’s own health-adverse behaviors. By allocating tax revenue from consumption that contributes or even alone causes poor health outcomes, such a system incorporates personal responsibility. By using general tax revenue for health care, such a system would meet the libertarian requirement of providing care without any moral investigation of past behaviors and the social justice consideration of providing health care to those who may have unwittingly ventured into ill-health due to systemic injustice, socioeconomics, or genetics. - [i] Cappelen, A. W. (2005). Responsibility in health care: A liberal egalitarian approach. Journal of Medical Ethics, 31(8), 476–480. https://doi.org/10.1136/jme.2004.010421 [ii] Moss, A. H. (1991). Should alcoholics compete equally for liver transplantation? JAMA: The Journal of the American Medical Association, 265(10), 1295–1298. https://doi.org/10.1001/jama.1991.03460100097032 [iii] Moss, p. 1295-1298. [iv] Moss, p. 1296. [v] Moss, p. 1295-1298. [vi] Moss, p. 1295-1298. [vii] Cohen, C. IS THIS SUPPOSED TO BE COHEN AND BENJAMIN (1991). Alcoholics and liver transplantation. JAMA: The Journal of the American Medical Association, 265(10), 1299–1301. https://doi.org/10.1001/jama.1991.03460100101033 [viii] Cohen, p. 1299-1301. [ix] Moss, p. 1297. [x] Cohen, p. 1300. [xi] Cappelen, p. 478-480. [xii] Cappalen, p. 478-480. [xiii] Cappelen, p.479. [xiv] Cappelen, p. 479. [xv] Cappelen, p. 479 [xvi] Cohen, p. 1301. [xvii] Cappelen, p. 478. [xviii] Cohen, p. 1299-1301. [xix] Cohen, p. 1301. [xx] Cappelen, p. 476-480. [xxi] Cappelen, p. 476-480. [xxii] Kawachi, I. (2005). Why the United States is not number one in Health. Healthy, Wealthy, and Fair, 18–33. https://doi.org/10.1093/acprof:oso/9780195170665.003.0013 [xxiii] Kawachi, p. 18-33. [xxiv] Kawachi, p. 18-33. (shrink)

Photo by Jonathan Ford on Unsplash ABSTRACT Since 2008, an average of twenty million people per year have been displaced by weather events. Climate migration creates a special setting for a duty to rescue. A duty to rescue is a moral rather than legal duty and imposes on a bystander to take an active role in preventing serious harm to someone else. This paper analyzes the idea of expanding a duty to rescue to climate migration. We address who should have (...) the duty and to whom the duty should extend. The paper discusses ways to define and apply the duty to rescue as well as its limitations, arguing that it may take the form of an ethical duty to prepare. INTRODUCTION Climate migration creates a special setting for a duty to rescue. A duty to rescue is a moral rather than legal duty and imposes on a bystander to take an active role in preventing serious harm to someone else. Examples of circumstances range from person-to-person intimate rescue to saving those in poverty, even in distant parts of the world.[1] Since 2008, an average of twenty million people per year have been displaced by weather events.[2] Circumstances like being thrust from homes under the threat of fire, mudslide, and flooding vary greatly from long-term changes like land becoming too arid for crops or temperatures increasing annually gradually pushing up the number of heat-related deaths, with the area slowly becoming uninhabitable. Imminence in fleeing affects resettling and need for rescue with important implications for how the duty to rescue might apply. This paper reevaluates the ethical framing of the duty to rescue and, while it is arguably a stretch, applies it to climate migration. Climate migration has become common and is expected to increase due to rises in sea level, increases in weather events that make areas uninhabitable, and changes to land that preclude farming or other necessary land uses. We argue that a duty to rescue may help highlight who has moral obligations to whom. Because the problem is so large in scope, we suggest a change in the ethical limits to humans' duty to rescue other humans who are in distress. We imagine an expansion or extension of the duty to rescue to meet some of the basic needs created by climate migration. Yet how it should expand, and how much depend on ethical framing and practical limitations. l. Expanding the Geographical Boundaries Two commonly recognized emergencies, Hurricane Katrina in the case of weather events and the current COVID-19 pandemic, provide a historical and current backdrop to evaluate ethical obligations as more disasters displace people. A significant reassessment of the ethical scope of an obligation to rescue in the case of weather events will be limited by the ability to render aid to those in distress in the case of a planet-wide weather catastrophe. The problems may overwhelm the ability to rescue or the reasonableness of attempting rescue. The extent of the moral obligation borne by humans to other humans in the case of a weather event has been largely defined by its locality and limited geographic influence. Whether we are imagining the scope of ethical obligation in the case of hurricane, flood, tornado, drought, or wildfire events, the perceived ethical obligation is significantly defined by the limited impact of these weather events on people outside the zone of the weather event's direct impact, yet close to that zone. A hurricane affecting New Orleans will not have immediate impact on the residents of California or even those on the northeast coast of the United States until a later time. Wildfires in the Pacific Northwest do not impair the ability of those in the rest of the country to come forward with assistance. But as climate migration crosses international borders, and climate events occur simultaneously in many regions, a more expansive duty to rescue may provide the ethical impulse to help those who live afar or migrate long distances. In this respect, the need for help in the event of widespread climate migration due to global warming is more like a pandemic than a weather event. Its broad impact area diminishes the capability of nearly the entire balance of the human population to help due to those populations' awareness that they will, in short order, have the same need for the same resources, from the same cause. Those living near current flood zones may find their historically safe havens are also a flood zone. Those previously best positioned to rescue may find themselves also needing to relocate. Thus, we may observe the need for new rescuers. ll. The Rule of Rescue The Rule of Rescue as defined by Al Jonsen describes the moral impetus or knee jerk reaction to save identifiable people facing death.[3] A duty to rescue has since been expanded beyond imminent death and beyond the near and identifiable. But there are limitations. For example, by most accounts, the ethical duty tends not to require extreme bodily risk or financial depletion. In comparing Good Samaritans to humanitarians, Scott M. James argues the duty to rescue arises from unique dependence, but the ethical obligation to help strangers through humanitarian aid is of a different nature.[4] The wrongness of failing to help is arguably more egregious when one is in a unique position to help. Like in the tragedy of the commons, where there is no unique positioning, when the global community is called upon to help, each individual in it may feel less obliged to do so. Climate migration falls in between—it requires helping strangers, yet it may move forward without anyone seeing themselves as uniquely positioned to help until those strangers become part of communities, at which time, there may be more moral justification to help a community member in need. Generally, arguments about Good Samaritans hinge on extraordinary acts, praiseworthy because they are acts of compassion, not obligation. Now all US states have Good Samaritan laws[5] which protect helpers from liability for help gone wrong or for a failure to succeed once engaged in an act of rescue. Extraordinary help as a moral good is thus somewhat encouraged through legal protection, but not imposed. Conversely, jobs like firefighting, search and rescue, and emergency medical care tend to oblige employees to take on risks that would be extraordinary if undertaken by the average bystander, yet they are rendered ordinary rescue as part of the job. Three states, Minnesota, Rhode Island, and Vermont have a broad duty to rescue, adding legal considerations to an otherwise moral conundrum. The laws do not require bystanders to take on risk for the sake of rescuing strangers.[6] The moral duty will require looking beyond law, but it is unclear how the moral duty to rescue should be distributed in the case of climate migration. A bare minimum would prevent taking advantage of newcomers, paying sub-minimum wage, and discriminating against them. Yet such a minimum is hardly rescue. lll. An Ethical Rather than Legal Duty The difficulty in defining the duty to rescue as a legal obligation is that it is difficult to determine the extent of risk a rescuer ought to be required to take. The nature of this ethical duty is also arguably tied to the experiences of both the rescuer and the rescued. There are subjective aspects like what someone perceives as a danger that make it difficult to write enforceable laws requiring rescue. It is one thing to expect a rescuer to step into several inches of relatively warm water to lift a person lying face down in a pond and enable them to breathe. It is something altogether different to expect that rescuer to dive into frigid water and attempt to extricate someone trapped in a submerged automobile. As the legal philosopher H.L.A. Hart observed, it is always easier to define application of the core intention of any rule, whether law or ethical norm. It is more difficult to create legal certainty about how the law applies to what he described as “penumbra circumstances”. In the case of a hurricane, it is easier to define what surplus resources are available in areas geographically remote from the impact of the storm and demand, as a moral obligation, that those nearby but outside the area provide assistance. It is more difficult to obligate people, organizations, or governments to supply a quantity of medication or some number of ventilators to an adjacent community when they expect to imminently need them for their own community. In the early stages of climate migration, the ethics of extreme weather event assistance, a common application of the duty to rescue, will be useful and appropriate. The rising sea levels first experienced by island nations in the South Pacific[7] will not render those living in other coastal communities, those with greater available “high ground”, unable to supply resources to those in need. But when sea level rise and climate change affect more communities simultaneously, albeit in varying degree, the task of defining what response is ethically obligatory becomes increasingly complicated. Pinpointing the obligations of those communities which are resource rich to those communities which are resource deprived, and of those partly affected to those more severely affected may become necessary. The limitations of the traditional duty to rescue could expand to meet the needs. lV. Contribution to the Problem Many argue that the duty to rescue may depend on any appropriate claim of those needing rescue. One issue is whether preferential claims among those who can identify the source of the harm should call for a greater duty or whether everyone in need should be approached as like candidates for rescue, shaping the duty as equal across those on the receiving end. As climate change does have human-made causes, there are strong arguments to impose a greater ethical duty on any entity that caused the climate-related problems leading to the mass exodus. While the global north is often implicated in pollution that causes migration, industries like energy, transportation, and agriculture are tied to climate change and associated with significant greenhouse gas emissions.[8] Practices like directing agriculture to less sustainable single crop growth generally made land less farmable. Yet it is difficult to place blame and identify specific causal relationships as most migration is due to many factors. A movement toward greater accountability can be reframed as a greater duty to rescue, a duty to engage in the extraordinary. The fossil fuel industry, for example, should have a larger obligation than the average person. Similarly, some may argue anyone unjustly enriching themselves while contributing to climate change or people who over-consume have an elevated duty to rescue.[9] Climate change lawsuits demonstrate an eagerness to hold governments and corporations accountable, despite difficulty proving causation. V. The Most Vulnerable One ethical dimension of climate migration that remains unexplored is how a duty to rescue applies to vulnerable populations who stand to be left behind or unable to migrate without assistance. Researchers from the Global North working across the Global South are increasingly observing the phenomenon of ethics dumping, where the research ethics of some countries are imposed on research subjects in other countries.[10] In that vein, rescuers should be careful not to impose unwelcome cultural standards or exploit people who are in the process of migrating. There is a gap in discussions reflecting voices that have been left out. The duty to rescue is incomplete without an attempt to understand the ethical experiences of those being rescued. The actual people affected by climate migration who are the least likely to have the means to migrate, or to do so without extreme hardship, should have a voice informing the global community including those in a position to carry out rescue. People who have the means and are young and healthy may easily make decisions to avoid the catastrophic consequences that climate migration brings. However, what about those who are left behind? For example, especially recognizing cultural differences, the homeless community, disabled community, refugees, the elderly community, and women[11] and children may suffer differently and call for more attention. In some parts of the world, human rights are severely constrained. An ethical duty to rescue, with many considerations and variables, may be more justified in the case of those most in need. As climate migration continues and increases significantly, it may be reasonable to ask the local and global community to focus on those least well positioned to migrate successfully. In this context, the use of phenomenology to understand the lived experiences of those migrating, sometimes termed “ethical experiences”, may help flesh out how a duty to rescue takes shape. The discussion of duty and obligation requires an articulation of the ethical experiences (how the local community in need of rescue views the proposed rescue). Then, the obligation to interpret the duty as ‘one shall not’ or ‘one must’ can be focused on the migrants’ needs rather than the rescuers’ feelings of obligation.[12] A revised theory of the duty to rescue taking into account the asymmetrical experiences of communities involved could ensure that the needs of people whose living situations, gender, ethnicity, age, or race impact their ability to even begin the migration process are considered. In this discussion, the rescuing is directed toward communities /collectives of persons migrating, whether at once or across a period of time. Often, the climate migrant may not be in a state to articulate the nature of this event when it happens, given its subjective proximity. Yet, when communities are given the space and opportunity to articulate their shared values, the ethical action of rescue derives its meaningfulness from the community rather than the rescuers. In other words, allowing climate migrants to explain their feelings can add complexity to what some see as a binary receiver-giver (of rescue) dynamic. This is necessary because the concept of vulnerable populations is fraught with problematic assumptions. There have been various definitions and criteria to determine what would constitute vulnerable populations.[13] For example, the United Nations Framework Convention on Climate Change[14] identifies and assesses vulnerable populations. These criteria may be helpful. However, they do not provide the full picture. Rather than identifying categorical criteria of vulnerable populations, engaging with people who are experiencing climate migration and listening to their current experiences and concerns helps determine need. Knowing what people need may prevent the kneejerk reaction to label people who are quite resilient yet have appropriate needs “vulnerable”. Proceeding with caution is important because the duty to rescue has hierarchical underpinnings of "us" and "them." Often when people swoop in to save, there are good and bad consequences of the intervention. We should proceed with caution because often the helper misses the actual needs of those in need. The only way to combat this would be to make sure that people are empowered to inform those agencies that are able to help. In addition to more practical approaches, large scale oral histories could allow those who have migrated already to share their experiences. It would be important to capture the lived experiences of people who are already experiencing the consequences of climate migration or of other migration like that due to political or economic extreme events. These experiences could shape our analysis of whether people in fact wish for rescue. If so, further conversations can determine best actions as well as give important insight into what resources might be necessary to empower people now and in the future. Vl. A Duty to Rescue as a Duty to Prepare If we view Good Samaritans as going above and beyond, then a duty to rescue, something ethically compelled, must bring rescue out of the framework of charity and place it in the context of humanity and obligations. Such a view would also support expanding the geographical reach of the otherwise more proximate duty. The duty may be stronger and take shape in a more workable way if it applies to preparing places expecting to see an influx of people due to climate migration and to helping those most in need. The duty may arise out of expectations of what type of community the place welcoming those migrating due to climate should be—does it want to offer good housing, schooling, and medical care as well as economic opportunity to new people? And if so, at what cost, or with which risks? If the newcomers are viewed as community members rather than strangers, a model of acceptance may lead to better preparation. Some considerations like whether the actions will reasonably help the persons in need of rescue[15] will shape the application of a duty to rescue in the context of climate migration. Similarly, ensuring that people have the chance to articulate their values may help communities support the newcomers. New relationships should not be defined as migrant and rescuer. Voluntariness in participation and not forcing any action deemed rescue would help ensure the human rights of those migrating. In the United States, President Biden issued an executive order addressing impending climate migration steeped in a duty to prepare by making plans for resettlement and to address the impact of climate migration.[16] Vll. At What Risk? As we investigate the ethical obligations to meet even basic needs, we must also ask what level of risk is ethically compelled. There is an extraordinary need to integrate newcomers successfully, but it is difficult to stretch an ethical duty to rescue to require all the prerequisites for successful climate migration. Even defining success would create deep ethical arguments. As observed in almost all migrations, extraordinary charitable acts may be the key to success, while an ethical duty to rescue must try to require the important government and community-based basics and ensuring respect for human rights. That is, the migrating people should be rescued from circumstances that contradict basic human rights. Rather than comparing communities to bystanders, mere places where people will arrive and need to hash out how to find housing, jobs, education, and opportunity, a duty of preparation may be the key to rescue those disenfranchised by migration. There are cultural, personal, physical, psycho-social, and geopolitical issues surrounding how to best help those needing to permanently relocate. Ethics arguments will certainly range from “do nothing”, which may fail people, to “do everything”, which could waste taxpayer money in futile over-preparation while failing to actually help. Communities must avoid planning exclusively for one scenario only to have it not take place. Striking the balance, a duty to rescue as it could apply to climate migration should set goals of societal integration, and providing the basics like education, housing, food, health care, and job opportunity, the precursors to flourishing. Recommending the extraordinary, morally preferred but perhaps not compulsory, when charitable actors are participating, or when wrongdoers are compensating, may be more workable than seeing the duty to rescue as compelling people or local governments to take on significant financial and personal risk for newcomers. While humanitarian ethics supports helping everyone, it is likely that people who resettle in advance of a need to flee will find themselves with more choices and opportunities. Help is warranted for those with more dire needs. Preparing for them may do just that. Vlll. Rescue Prior to Migration and Rescue in the Process of Resettlement The duty to enable the migration in the first-place hints to the inadequacy of a duty to prepare. The traditional duty to rescue perhaps steps in if rescue looks like those geographically just out of harm's way rescuing those in danger. That resembles the traditional moral requirement, or duty to rescue according to the Rule of Rescue. Humanitarian aid typically provided by many institutions makes sense and is in place, although financial support for additional humanitarian aid is always needed. Despite having moved to purportedly more capable communities, migrant communities may be able to develop more egalitarian orders of living. Rather than continually being identified as having been rescued, it is important to make sure people keep or make social ties during and after migration. Immigrants often face social isolation.[17] Small shifts in gestural language also have the potential to welcome people and show they are valued. For instance, some migrants may not like questions like “Where are you from?” and “What brings you here?” as they emphasize differences over fitting in. CONCLUSION The ethical duty to rescue should be expanded to better match those in need of relocation with a welcome environment and the resources needed to achieve success and fully integrate socially and culturally. Expanding a dialogue that includes the voices of people who have recently migrated whether due to violence, poverty, or climate, could properly frame the extent of the duty. If we are to apply the duty of rescue to climate migration, rescuers should avoid labeling people vulnerable, dependent, or needy, although there is reason to focus on those whose needs are the most dire. A soft duty to rescue people during the course of climate migration can come in the form of preparation. People will need help finding housing, education, access to food, and employment. Ultimately, to help them help themselves may be the best goal. While the obligations should be borne differently by people, whether due to a special responsibility, or a special relationship that creates a clearer duty, the global community must prepare for its role in rescuing those displaced by climate events. By helping those displaced at the start of the climate migration process according to a more commonly held notion of the duty to rescue, and by preparing to incorporate newcomers successfully according to an expanded duty to rescue, effectively a duty to prepare, countries that take on climate refugees may find themselves rewarded by the cultural diversity and workplace talents that people bring. A duty to those at a distance is a reasonable expansion of the duty to rescue. But what one ought to do in the global community varies somewhat from the traditional Rule of Rescue. - [1] Singer, P. (1972). Famine, Affluence, and Morality. Philosophy and Public Affairs, 1(3): 229-43. [2] Irfan, U. (2022, March 16). Why We Still Don’t Yet Know How Bad Climate Migration Will Get. Vox. https://www.vox.com/2022/3/16/22960468/ipcc-climate-change-migration-migrant-refugee, citing the International Panel on Climate Change (IPCC) (2022). Sixth Assessment Report, Climate Change 2022, Impacts, Adaptation, and Vulnerability. https://www.ipcc.ch/report/ar6/wg2/ [3] McKie, J., Richardson, J. (2003) The Rule of Rescue. Social Science & Medicine, 56(12): 2407-2419. https://doi.org/10.1016/S0277-9536(02)00244-7. [4] James, S.M. (2007). Good Samaritans, Good Humanitarians. Journal of Applied Philosophy, 24(3):238-254. [5] Overview of Good Samaritan laws. https://worldpopulationreview.com/state-rankings/good-samaritan-law-states [6] Fifield, J. (2017, Sept. 19). Why It’s Hard to Punish ‘Bad Samaritans’. Stateline Blog, Pew Charitable Trusts, https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2017/09/19/why-its-hard-to-punish -bad-samaritans [7] Cassella, C. (2019). There’s a Climate Threat Facing Pacific Islands That’s More Dire Than Losing Land, Science Alert, https://www.sciencealert.com/pacific-islanders-are-in-a-climate-crisis-as-rising-sea-levels-threaten -water; Hassan, H. R., and Cliff, V. (2019). For Small Island Nations, Climate Change is not a Threat. It’s Already Here, World Economic Forum, https://www.weforum.org/agenda/2019/09/island-nations-maldives-climate-change/ [8] For example, Lyons, K. (2019). Australia Coal use is Existential threat to Pacific Islanders, The Guardian. https://www.theguardian.com/world/2019/aug/12/australia-coal-use-is-existential-threat-to-pacific-is lands-says-fiji-pm [9] Cripps, E. (2013). Climate Change and the Moral Agent: Individual Duties in an Interdependent World. Oxford: Oxford University Press. [10] Schroeder, D., Chatfield, K., Singh, M., Chennells, R., and Herissone-Kelly, P.. Ethics Dumping and the Need for a Global Code of Conduct. In Cham. (Ed.)(2019). Equitable Research Partnerships. SpringerBriefs in Research and Innovation Governance. Springer. 2019. https://doi.org/10.1007/978-3-030-15745-6_1 [11] Giudice L.C., Llamas-Clark E.F., DeNicola N., Pandipati, S., Zlatnik, M.G., Decena, D.C.D., Woodruff, T.J., Conry, J.A. (2021). Climate Change, Women’s Health, and the Role of Obstetricians and Gynecologists in Leadership, International J Gynecol Obstet, 155(3), 345-356. 10.1002/ijgo.13958 [12] See Ferrarello, S. and Zapien, N. (2020). Ethical Experience: A Phenomenology, Bloomsbury. (for understanding phenomenological determinants of ethical action). [13] McLeman, R.A., Hunter, L.M., (2010). Migration in the context of vulnerability and adaptation to climate change: insights from analogues. Wiley Interdiscip Rev Clim Change, 1(3): 450-461. [14] Least Developed Countries Expert Group. (2018). Considerations Regarding Vulnerable Groups, Communities and Ecosystems in the Context of the National Adaptation Plans: United Nations Framework Convention on Climate Change. [15] Jecker, N.S. 2013. "The Problem with Rescue Medicine." J Med Philos, 38(1):64-81. [16] White House Report. (February 9, 2021), Executive Order (E.O.) 14013, “Rebuilding and Enhancing Programs to Resettle Refugees and Planning for the Impact of Climate Change on Migration.” (calls on the National Security Advisor to prepare a report on climate change and its impact on migration. “This report marks the first time the U.S. Government is officially reporting on the link between climate change and migration.” https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/27/executive-order-on-tackling -the-climate-crisis-at-home-and-abroad/ [17] Torres, J.M., Casey, J.A. (2017) The centrality of social ties to climate migration and mental health. BMC Public Health, 17: 600. https://doi.org/10.1186/s12889-017-4508-0. (shrink)

Photo by Tingey Injury Law Firm on Unsplash ABSTRACT The coverage of healthcare costs allegedly brought about by people’s own earlier health-adverse behaviors is certainly a matter of justice. However, this raises the following questions: justice for whom? Is it right to take people’s past behaviors into account in determining their access to healthcare? If so, how do we go about taking those behaviors into account? These bioethical questions become even more complex when we consider them in the context of (...) a commitment to publicly funded, universal healthcare coverage. INTRODUCTION Healthcare coverage of lifestyle-related conditions is certainly a matter of justice. However, this raises the following justice-related question: Is it right to consider people’s past behaviors in determining their access to healthcare? If so, the methods of taking those behaviors into account must be fair and justifiable. This bioethical question becomes even more complex when we consider it in the context of a commitment to publicly funded, universal healthcare coverage. This paper takes an old, classic debate, evaluates newer approaches, and offers an argument favoring a combined approach which alters the liberal-egalitarian solution to account for social justice. ANALYSIS l. Causes of Disease If healthcare coverage were universal, irrespective of socioeconomic status and lifestyle, people would contribute to the cost of remedying the lifestyle-induced health problems of others. In the West, lifestyle-related diseases are burdensome.[1] This paper approaches this concern from a western lens that incorporates both a European tradition of “social safety nets” and an American tradition of personal freedoms. By taking such an approach, solutions to the consequences of one’s past behavior burdening others must consider an individual’s personal freedom to choose to act as he or she wishes, with the distributive social and economic equality of the many. The concept of disease caused by lifestyle and diet is proven. Many health conditions include behavioral risk factors. Multi-pack smoking increases the risk of chronic lung disease, while obesity increases the risk of type 2 diabetes. Inattention to high blood pressure, high cholesterol, and a lack of exercise leads to increased risks of coronary artery disease.[2] While poor lifestyle choices certainly influence these conditions, their causes are multifactorial, and it is difficult to say that any single string of poor choices led to their development. In a scenario where two men excessively eat fast food for 20 years, several discrete factors impact whether any of them might suffer an ischemic-embolic stroke or not. Genetics, circumstances, and activity will also contribute to outcomes. ll. Alcohol-Related End-Stage Liver Disease One paper suggests that alcohol-related end-stage liver disease (ARESLD) differs from other multifactorial disorders as alcohol alone causes the disease.[3] It justifies attributing personal responsibility to patients with ARESLD because the condition develops only after the cumulative effects of large quantities of alcohol consumed from years to decades.[4] However, the paper undermines its position by admitting that even the susceptibility to becoming an alcoholic has some degree of genetic predisposition.[5] Given the extreme scarcity of donor livers, some patients may be prioritized over others on the transplant waiting list. Since donor livers cannot be given to everyone, transplanting a liver into an alcoholic may result in death for competing candidates whose liver disease was not their fault. All else being equal, if bioethicists avoid claiming moral deficiency or judgment, those with apparently self-inflicted ARESLD will not be deprived of treatment but will have a lower priority for transplant.[6] In contrast, another position suggests that it is often difficult to define what behaviors are punishable as these are largely personal and value-laden.[7] Still, people do not support using their own resources to support the consequences of others’ poor choices, no matter how objective.[8] In democratic societies, one must take into consideration community morals and values.[9] Even if we were to punish people for their health-adverse behaviors, we could not logistically employ the vigorous and sustained efforts necessary to determine whose actions are morally weak.[10] lll. The Liberal-Egalitarian Proposal One past argument proposes a liberal-egalitarian solution to manage personal responsibility for so-called “lifestyle diseases.”[11] This Rawlsian system combines the European-style “social safety net” commitment to social and economic equality with the American liberal notion of pluralist toleration and personal freedoms. This idealized system aims to hold people responsible for their choices rather than the consequences to mitigate the downside of blaming those who might not be blameworthy. The approach avoids determining the questionable nature of luck and personal responsibility for health outcomes, fairness in the distribution of economic burden, and the intrusiveness required to practically determine who acts in a morally wrong and health-adverse way. The liberal-egalitarian model, a theory of distributive justice, has two facets: the liberal principle that people should be held accountable for their choices and the egalitarian principle that people who make the same choices should have the same outcomes.[12] This model attempts to fuse responsibility with equity by seeking to reward good behavior and tax bad behavior rather than punish the consequences of the action and navigate who deserves treatment. For instance, the hospital bedside is not the appropriate place to introduce responsibility for one’s health outcomes.[13] This appeals to the reality that, at that time, discerning the true causes of disease was not plausible and to humanity in avoiding a heartless and cruel approach. An argument in favor of the liberal-egalitarian model considers its method of implementation. This approach assumes that the healthcare system treats all individuals regardless of their choices or ability to cover costs. The liberal-egalitarian model also assumes that a certain adverse health condition is related, statistically speaking, to the consumption of a certain good and that good can be taxed. As such, it proposes to tax the consumption of that good to finance the collective burden which arises from that good’s consumption rather than require individuals to pay for their own treatment. In the example of ARESLD, the recommended solution would be taxing all alcohol. While a systematic infrastructure is not explicit, there is the implication that a per-unit tax can be imposed on alcohol so the total tax revenue would make up for the additional healthcare costs due to consumption.[14] Upholding the principle that all people who make the same choices should face the same costs, all consumers of alcohol would pay the same tax, regardless of factors such as genetic predisposition to alcoholism, lifestyle, or expected cost of treatment. Upholding the principle of individual responsibility, this model does not deny treatment to anyone, neutralizing factors outside that individual’s control by imposing the tax ex-ante. Other people are not burdened by those who consume the good. People who consume alcohol face a burden proportional to the amount consumed. This tax-based implementation is justified so long as the tax is not prohibitively high for the average consumer. Further, the model mitigates concerns over the intrusiveness of ascribing morality to health-adverse behaviors. lV. Moral and Social Arguments Against the Liberal-Egalitarian Position Arguments against the liberal-egalitarian model concerns its many assumptions. First, this model assumes that consumption of such goods is directly related to the health outcome and that these goods can be taxed.[15] Certain people genetically predisposed to alcoholism would be predisposed to consume more alcohol. The model falls short when applied to scenarios where health outcomes are not consumption-based, such as engaging in unsafe sex or abstaining from healthy lifestyle choices like exercise. Second, some might argue that the liberal-egalitarian model fails to remain neutral. Residual moral judgments tied to consumption choices introduce non-neutrality. Although taxation in free societies is determined by democratic procedures rather than by individuals in the healthcare system, moral and value-based judgments will be implicit in deciding what behaviors are taxable, such as the purchase of cigarettes. Third, the liberal-egalitarian model fails to determine whether one’s behavior is autonomous, as socio-cultural-economic factors may influence it and behavior is more a product of society, peer pressure, or income. Those also may reflect systemic inequalities. Therefore, this model, which rewards, or taxes based solely on decisions, regardless of their consequences and motivations, fails to consider that a person’s decisions may not be completely autonomous. V. Libertarian Arguments Against the Liberal-Egalitarian Model a. State Intrusiveness as Counter to the Liberal-Egalitarian Model Last, there is a libertarian worry that if the state guarantees universal healthcare coverage to all people, the state will have to become highly intrusive and investigate people’s morals.[16] At least one-third of all disease burden in North America, Europe, and the Asia-Pacific is attributable to lifestyle measures such as tobacco smoking, alcohol consumption, high cholesterol, and obesity.[17] With these various lifestyles, it is not likely to agree on what conduct to tax or condemn.[18] The fine-toothed comb required to determine whether each citizen has been engaging in these behaviors would intrude on daily life and personal freedom. Libertarians champion the argument that impractical intrusiveness would result from universal healthcare, and such a degree of intrusiveness would likely be universally unacceptable.[19] The liberal-egalitarian model mitigates the libertarian worry about state intrusiveness as it does not involve prying into one’s life and choices other than taxing goods. A liberal state should ideally be neutral to how people decide to live their lives. In all, libertarians can rest assured that the liberal-egalitarian tax-based model, through its ex-ante implementation, will require no prying state eyes. States that provide universal healthcare coverage and wish to condemn certain misconduct do not need to become overly intrusive to carry out measures to hold individuals accountable. b. Fairness Another libertarian worry regarding the guarantee of universal healthcare coverage in the context of lifestyle-driven diseases is that the public will be burdened unfairly with covering others’ ill-advised mistakes or bad luck. An ideal system to address this worry would link treatment or payment for treatment with whatever behavior caused that need.[20] The distribution of burdens should be linked to how different individuals contributed to the creation of those burdens. Applied to health policy, we should ask how the need for a certain treatment arose when determining how to distribute its cost.[21] The liberal-egalitarian model aspires to hold individuals responsible for their choices, not for the consequences of such choices. This model significantly mitigates the libertarian worry over unfair burdens for covering other people’s mistakes or social conditions, which lead to those bad outcomes, by ensuring to not burden others with any of the costs for the treatment of people who decide to engage in certain health-adverse behaviors. The aforementioned taxation-based system would only tax those who also engage in the health-adverse behavior through consumption, and that tax directly pays for the necessary collective treatment. As such, those who do not consume the good are not involved with the payment scheme, while those who do consume the good are responsible for payment in a matter proportional to the amount of the good they have consumed. Vl. Universal Coverage Taking a step back, one should consider whether these worries regarding the coverage of apparently self-inflicted health conditions in the context of universal healthcare are worthwhile issues. One perspective raises what is called the culturally imagined objection — an idea erroneously held by many that sick people, especially those who are poor and uneducated, bring these illnesses upon themselves due to poor decision-making and irresponsible risk-taking.[22] This perspective critiques the uniquely American view that, since individuals are free to choose their lifestyles, they should bear the costs of their lifestyle.[23] Taking this argument further, some (perhaps the strongly libertarian) would say that the poor health status among many individuals is the price individuals must pay for their American way of life and the liberty and freedom to live as they wish. However, people should not completely punish individuals for their health-adverse behaviors because these choices are largely pre-determined by a person’s socioeconomic influences.[24] The outcomes from these allegedly ill-advised behaviors, which largely affect poorer people, are not just poor behavior but rather a public health crisis. Perhaps the state and its people should take collective responsibility and cover the costs of treatment for those health outcomes without question, as a form of public service. Rather than worrying about accountability and taxing bad behavior or intrusiveness into personal decisions, some might argue that people need to collectively take responsibility for reducing the overarching systemic inequalities and covering the associated treatment costs as a measure of public health. Vll. Proposed Solution Given the strengths of the liberal-egalitarian model and taking into account libertarian and social justice-oriented objections, an ideal solution for the coverage of lifestyle-related health problems needs to consider the complex relationship between a person’s behaviors and their apparent health outcomes. It must consider how society as a whole passes judgment on behaviors and how to take into account that many health-adverse decisions are not truly autonomous decisions, as various genetic and socioeconomic factors influence them. An ideal solution combines the liberal-egalitarian tax-based model with the social justice concerns of universal coverage. Whatever the cost for the treatment of medical issues resulting in part or entirely from lifestyle and diet, taxes collected from spending associated with the behavior (like the purchase of alcohol, junk food, and cigarettes) ex-ante should fund 50 percent of the cost of treatment, while the universal healthcare taxation scheme should include the other 50 percent. Such a system would provide an incentive to avoid the purchases that can lead to unhealthy consumption and make healthier choices, slightly punish and discourage such purchases through taxation, yet not overly punish people whose outcomes may have more to do with socioeconomic factors and genetics. Adding public responsibility demonstrates acknowledgement that health care is in the public interest and can mitigate public health inequalities. This solution would fuse personal responsibility with the public responsibility of state-sponsored social improvement while ensuring that all people have fair access to necessary treatment, no matter their ability to pay. CONCLUSION The 50-50 system this paper proposes reflects both justice and personal responsibility in covering healthcare costs allegedly brought about by people’s own health-adverse behaviors. By allocating tax revenue from consumption that contributes or even alone causes poor health outcomes, such a system incorporates personal responsibility. By using general tax revenue for health care, such a system would meet the libertarian requirement of providing care without any moral investigation of past behaviors and the social justice consideration of providing health care to those who may have unwittingly ventured into ill-health due to systemic injustice, socioeconomics, or genetics. - [1] Cappelen, A. W. (2005). Responsibility in health care: A liberal egalitarian approach. Journal of Medical Ethics, 31(8), 476–480. https://doi.org/10.1136/jme.2004.010421 [2] Moss, A. H. (1991). Should alcoholics compete equally for liver transplantation? JAMA: The Journal of the American Medical Association, 265(10), 1295–1298. https://doi.org/10.1001/jama.1991.03460100097032 [3] Moss, p. 1295-1298. [4] Moss, p. 1296. [5] Moss, p. 1295-1298. [6] Moss, p. 1295-1298. [7] Cohen, C. IS THIS SUPPOSED TO BE COHEN AND BENJAMIN (1991). Alcoholics and liver transplantation. JAMA: The Journal of the American Medical Association, 265(10), 1299–1301. https://doi.org/10.1001/jama.1991.03460100101033 [8] Cohen, p. 1299-1301. [9] Moss, p. 1297. [10] Cohen, p. 1300. [11] Cappelen, p. 478-480. [12] Cappalen, p. 478-480. [13] Cappelen, p.479. [14] Cappelen, p. 479. [15] Cappelen, p. 479 [16] Cohen, p. 1301. [17] Cappelen, p. 478. [18] Cohen, p. 1299-1301. [19] Cohen, p. 1301. [20] Cappelen, p. 476-480. [21] Cappelen, p. 476-480. [22] Kawachi, I. (2005). Why the United States is not number one in Health. Healthy, Wealthy, and Fair, 18–33. https://doi.org/10.1093/acprof:oso/9780195170665.003.0013 [23] Kawachi, p. 18-33. [24] Kawachi, p. 18-33. (shrink)

Conflicts of interest are rampant in the American medical community. Today it is not uncommon for doctors to refer patients to clinics or labs in which they have a financial interest (40% of physicians in Florida invest in medical centers); for hospitals to offer incentives to physicians who refer patients (a practice that can lead to unnecessary hospitalization); or for drug companies to provide lucrative give-aways to entice doctors to use their "brand name" drugs (which are much more expensive than (...) generic drugs). In Medicine, Money and Morals, Marc A. Rodwin draws on his own experience as a health lawyer--and his research in health ethics, law, and policy--to reveal how financial conflicts of interest can and do negatively affect the quality of patient care. He shows that the problem has become worse over the last century and provides many actual examples of how doctors' decisions are influenced by financial considerations. We learn how two California physicians, for example, resumed referrals to Pasadena General Hospital only after the hospital started paying $70 per patient (their referrals grew from 14 in one month to 82 in the next). As Rodwin writes, incentives such as this can inhibit a doctor from taking action when a hospital fails to provide proper service, and may also lead to the unnecessary hospitalization of patients. We also learn of a Wyeth-Ayerst Labs promotion in which physicians who started patients on INDERAL (a drug for high blood pressure, angina, and migraines) received 1000 mileage points on American Airlines for each patient (studies show that promotions such as this have a direct effect on a doctor's choice of drug). Rodwin reveals why the medical community has failed to regulate conflicts of interest: peer review has little authority, state licensing boards are usually ignorant of abuses, and the AMA code of ethics has historically been recommended rather than required. He examines what can be learned from the way society has coped with the conflicts of interest of other professionals --lawyers, government officials, and businessmen--all of which are held to higher standards of accountability than doctors. And he recommends that efforts be made to prohibit and regulate certain kinds of activity (such as kickbacks and self-referrals), to monitor and regulate conduct, and to provide penalties for improper conduct. Our failure to face physicians' conflicts of interest has distorted the way medicine is practiced, compromised the loyalty of doctors to patients, and harmed society, the integrity of the medical profession, and patients. For those concerned with the quality of health care or medical ethics, Medicine, Money and Morals is a provocative look into the current health care crisis and a powerful prescription for change. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Aesthetic Experience and Education:Themes and QuestionsDeborah Kerdeman"Being with" music. Attentive responsiveness in teaching. Scholarly learning as engagement with beauty. Three evocative images of aesthetic experience come to light in the essays by Custodero, Hansen, and Neumann. From the musical play of children conducting imaginary orchestras to the vocational aspirations of adults who gaze through telescopes or study paintings at Chicago's Art Institute, aesthetic experience spans a range of (...) activities and ages. No matter the setting or moment, aesthetic experience vitalizes our lives with meaning and joy. Why this is so and what difference this makes for education emerge as overarching concerns in this set of papers. Addressing these issues, the authors articulate a number of commonthemes and reach similar conclusions about the nature and value of aesthetic experience.I want to identify and analyze key ideas that run throughout these essays. Doing so deepens our appreciation of the authors' insights and underscores the importance of the project they undertake. I also want to examine three questions that the essays suggest but do not develop. Exploring these questions, I hope to further enrich our understanding of aesthetic experience and its place in education.First and foremost, aesthetic experience for all three authors integrates multiple ways of knowing and enables individuals to perceive connections that they might otherwise overlook. According to Custodero, aesthetic experience harmonizes imagination, physicality, and "thinking-in-action." [End Page 88] Thinking-in-action, Custodero says, while "critical and consequential," is nonverbal and nonjudgmental — unifying rather than analytic. Synthesizing bodily movement, imagination, and thought, aesthetic experience reveals "surprise relationships between seemingly disparate phenomena." The theme of integration is echoed in Neumann's description of scholarly learning as aesthetic experience. Scholarly learning does not shun feeling or lived experience, Neumann writes. This way of knowing instead is "deeply emotional and personal." Insight fuses with emotion, enabling scholars to "feel the whole picture," as David the astronomer puts it in his interview with Neumann. For Hansen, aesthetic experience connotes heightened perception, a way of being that attends to nuances of gesture that would otherwise remain invisible. "The aesthetic highlights aspects of wonder and of beauty that emerge, spontaneously and unrehearsed," Hansen explains. A form of creativity, aesthetic perception combines with moral and intellectual understanding to fully embrace "the living dynamic gestalt" of teaching and learning.Aesthetic experience thus integrates mind, body, and emotion. Hansen links aesthetic experience to moral judgment as well. Integrating various ways of knowing, aesthetic experience enables individuals to perceive and understand relationships that pulse throughout the social and natural world. Such understanding is pleasurable, the authors agree.Aesthetic experience not only is integrative. It also is interactive. Custodero's musicians interact with instruments, musical scores, and other individuals. Neumann's scholars interact with ideas and scholarly materials. Hansen's preservice teachers interact with works of art, subject matter, students, and one another. Interacting with people and things, individuals become absorbed in what they are doing. "Being with" music is howCustodero puts it. Carmen, the professor of music in Neumann's essay, says that playing music well "is like a complete focus of oneness."Being absorbed in aesthetic interaction does not discount or dissolve the ability to make decisions or direct action. Aesthetic experience rather presumes and promotes "aesthetic agency," to borrow a phrase from Custodero. "To 'be in the moment,'" Custodero writes, "is to encounter the aesthetic — fully engaged in an activity for which one's individual contributions are perceived as vital." Hansen's description of aesthetic perception combines attentiveness and responsiveness in a "dynamic combination of patience, listening, and initiative." Neumann states that scholarly learning is an experience of "deep engrossment." Such engrossment does not extinguish the self, however. In the words of David the astronomer, feeling "the whole picture... is a combination of both what you see, sort of an instinctive or primal thing, and also your knowledge of what, you know, you put together." [End Page 89]The interactive nature of aesthetic experience thus signifies a kind of "agency-in-situ." Aesthetic experience is shaped or directed by the contribution and initiative of individuals. But individuals cannot act in advance of experience or know what to do, unless they are... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:61 PROJECTIONISM, REALISM, AND HUME'S MORAL SENSE THEORY* Introduction The character of Hume's moral theory is currently a topic of considerable discussion.1 We find in the recent literature essentially two sorts of interpretation of Hume's theory. On the one side there is the view that, for Hume, the distinction between virtue and vice is reducible to the moral sentiments of approval and disapproval. Associated with this view is (...) the further claim that Hume ascribes to us the belief that virtue and vice exist as the counterparts to these sentiments; and, in addition, that this belief is, for Hume, a mistaken one. For reasons which will become obvious this may be described as the Projectionist account of Hume. On the other side, there is the attempt to represent Hume's moral theory as a form of realism, i.e., a theory according to which there are moral properties belonging to actions, or the agents who perform them, which provide objective correlates of the feelings which those actions, or the agents concerned, induce in us as spectators. Now clearly an important part of what is at stake between these different interpretations is the question of how seriously we should take Hume's own description of this theory as one according to which moral distinctions are derived from a moral sense. It is characteristic of the Projectionist interpretation to suggest that 'sense' is equivalent here to 'sentiment', and, indeed, that Hume's moral sense theory is tantamount to the denial that there is anything in Objects' themselves corresponding to our moral (or aesthetic) sentiments. The Realist interpretation, on the other hand, stresses the importance of Hume's references in 62 the Treatise to a moral (and aesthetic) sense, and the precedent provided in this respect by Hutcheson; and it takes seriously the idea that this sense enables us to become acquainted, via the sentiments involved, with the qualities of virtue and vice. My own interest in these different interpretations concerns their disagreement about the way in which we should understand Hume's notion of a moral sense. I wish to argue against the Projectionist interpretation, and its dismissive treatment of Hume's references to a moral sense, though it is a further question whether the view of Hume which emerges deserves the name of 'Realism'. 1. The Projectionist Interpretation It seems clear that the notion of a moral sense cannot be intended literally, i.e., as though there is a form of moral sense-perception strictly comparable to the modes of perception provided by the external senses. It is, presumably, part of the definition of a sense that it is a faculty whose function depends upon stimulation of an organ or, at least, receptors peculiar to that sense; and, furthermore, in the case of the various external senses there is -- except for the contact sense of touch -- a distinctive medium of perception. For both these reasons moral sense theorists can only be proposing an analogy with the external senses. In Hume's case in particular, however, there appear to be reasons for doubting whether the analogy can be more than superficial. Perhaps the most obvious of these lies with Hume's insistence on the action-guiding character of the distinction between moral good and evil (see e.g., T 437-462). For it seems clear that sense-perceptions g as such can have no direct influence upon our actions. 63 Then there is Hume's denial that morality consists in any matter of fact (T 468; EPM 292). If virtue and vice are to be considered the objects of some form of moral sense-perception their existence presumably does become a matter of fact. Finally, a moral sense theory seems to imply that judgements of virtue and vice are straightforwardly true or false, according to whether or not we perceive veridical Iy; while Hume's own discussion sometimes points to a non-propositional view of moral utterances as the expression of certain feelings or sentiments. These last two points remind us that Hume often appears to deny that values belong as intrinsic properties to the objects evaluated. This is obviously true of the following, much quoted, passage: Take any... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:72. HAS HUME A THEORY OF SOCIAL JUSTICE? Toward the end of An Enquiry concerning the Principles of Morals, Hume asserts in a footnote that: In short, we must ever distinguish between the necessity of a separation and constancy in men's possession, and the rules, which assign particular objects to particular persons. The first necessity is obvious, strong, and invincible : the latter may depend on a public utility (...) more light and frivolous, on the sentiment of private humanity and aversion to private hardship, on positive laws, on precedents, analogies, and very fine connexions and. turns of the imagination. For one who draws the connection between the ideas of justice and possession as closely as he does, Hume's ambivalence here concerning the rules or principles governing the distribution of objects to be possessed is more than slightly surprising. In fact, for admirers of Hume interested in theories of social (or distributive) justice, his failure to state a preference among these various 'principles of distribution' is downright depressing. Is this all Hume has to say on the subject of how possessions are to be distributed within society? Does it not matter to him what the principles are upon which this distribution is accomplished — as long as it is accomplished? These are the questions with which this essay is concerned, questions which essentially reduce to that of whether Hume has a theoiy of social or distributive justice at all. To be sure;, the amount of space Hume devotes to the discussion of justice would seem to indicate that he is working from a particular theory of social justice, and authors such as Miller, Day, and Ardal ascribe one to him, yet Hume's apparent lack of concern for principles of distribution disputes this ascript- 73. 2 ion. For at the center of all such theories — from Aristotle to Rawls — lies a preference for a certain principle or set of principles which dictates how advantages (goods, wealth, benefits, etc.) should be distributed. In order to evaluate Hume's status as a theorist of social justice, two approaches recommend themselves. First, it is necessary to discover and examine in Hume's major works possible criteria which might dictate how possessions should be distributed in society. Three such criteria will be dealt with here: the principle of utility as Hume construes it, the formal principle of correct application of law, and the principles Hume entitles the laws of nature". If none of these emerge, singly or in combination, as the principle underlying a Humean theory of social justice, a second avenue for analyzing Hume's views of social justice will be explored. Here some of the critical psychological and moral characteristics which Hume attributes to human nature will be examined to determine whether Hume, though he seems to accept no specific principle of distribution, might arrive at a coherent theory of justice in a negative fashion; that is, through rejecting certain criteria of distribution, particularly merit and need. II. The half-heartedness of Hume's commitment to the principle of utility as either a standard of personal morality, a measure of the justness of particular actions, or as 4 an explanatory principle has been frequently documented, and, although the main purpose of this essay is to examine Hume's theory of social rather than personal justice, a few comments on the latter will form a useful preface for the subsequent argument that Hume is equally as luke-warm toward utilitarianism as an adequate basis of social justice. Three considerations indicate Hume's non-utilitarian approach to personal morality. First, unlike all advocates of utilitarianism, Hume is not a consequentialist on matters 74. of personal ethics. That is to say, when Hume speaks of what makes persons or their actions virtuous, he insists that the major criterion for such an evaluation is the motive upon which the agent acts. In the Treatise he states that a virtuous motive is requisite to render an action virtuous ; (T478), and maintains this view in the Enquiry as well. Hume therefore violates the consequentialist stance implicit in the utilitarian construal of personal morality, but just as seriously, is also left rather cold by the later utilitarian contention of Mill... (shrink)

This article is a discussion of Tadeusz Ślipko’s considerations concerning “the origins of human being” or, in other words, his theory of animation. One of the characteristic features of Ślipko’s Thomistic anthropology is an experimental orientation: i.e. using and referring to the data of the sciences as these relate to material, physical and biological reality. As the starting point of his position he adopts the concept of man: being composed of a material substrate, determined in his human form (...) by the immortal soul as the vital principle of his/her existence. In line with this orientation, Ślipko focuses his investigations around the idea of man conceived “as a personal being and the subject of morality as a whole, constituted in what determines his/her proper humanity.” Therefore, asking about the origins—so to say—the initial moment of human substance, Ślipko examines this issue in the context of philosophical assumptions about God as the Creator of the universe, and about man as a self-aware and self-acting being who is the cause of a series of effects. (shrink)

This article is a discussion of Tadeusz Ślipko’s considerations concerning “the origins of human being” or, in other words, his theory of animation. One of the characteristic features of Ślipko’s Thomistic anthropology is an experimental orientation: i.e. using and referring to the data of the sciences as these relate to material, physical and biological reality. As the starting point of his position he adopts the concept of man: being composed of a material substrate, determined in his human form (...) by the immortal soul as the vital principle of his/her existence. In line with this orientation, Ślipko focuses his investigations around the idea of man conceived “as a personal being and the subject of morality as a whole, constituted in what determines his/her proper humanity.” Therefore, asking about the origins—so to say—the initial moment of human substance, Ślipko examines this issue in the context of philosophical assumptions about God as the Creator of the universe, and about man as a self-aware and self-acting being who is the cause of a series of effects. (shrink)

In this highly original book, Jason Hill defends a strong form of moral cosmopolitanism and lays the groundwork for a new view of the self. To achieve a radical cosmopolitan identity, he argues it may be necessary to forget aspects of one's racial and ethnic socialization. The idea of forgetting where one came from demands that morally recreated persons disown parts or even all of their cultures if these cultures are oppressive or denigrate human life. Hill draws on existentialism, (...) developmental psychology, and his own experiences as a Caribbean immigrant to the United States to present a philosophy for the new millennium. (shrink)

This paper addresses the question: Who or what can have a moral status in the sense that we have direct moral duties to them? It argues for a biocentric answer which ascribes inherent moral status value to all individual living organisms. This position must be defended against an anthropocentric position. The argument from marginal cases propounded by Tom Regan and Peter Singer for this purpose is criticised as defective, and a different argument is proposed. The biocentric position developed here (...) is related to that of Albert Schweitzer and Paul F. Taylor, but rejects their assumption of equal inherent value for all living organisms. It argues instead for equal moral status value for moral persons and agents, and gradual moral status value for nonpersons, depending on their degree of similarity with moral persons. Mary Ann Warren's recent book on Moral Status is also discussed. The argument is constructed as a casuistic argument, proceeding by analogical extension from persons to non-persons. The meta-ethical question of its pragmatic validity is discussed. (shrink)

The passionate and staunch defence of logic of the controversial thinker Ibn Ḥazm, Abū Muḥammad ʿAlī b. Aḥmad b. Saʿīd of Córdoba (384-456/994-1064), had lasting consequences in the Islamic world. Indeed, his book Facilitating the Understanding of the Rules of Logic and Introduction Thereto, with Common Expressions and Juristic Examples (Kitāb al-Taqrīb li-ḥadd al-manṭiq wa-l-mudkhal ilayhi bi-l-alfāẓ al-ʿāmmiyya wa-l-amthila al-fiqhiyya), composed in 1025-1029, was well known and discussed during and after his time; and it paved the way for the studies (...) of his compatriots Ibn Bājjah (d. 1138), Ibn Ṭufayl (1185), and Ibn Rushd (1198), who each gave demonstrative reasoning a privileged place within the methods of attaining knowledge. Unfortunately, as too often in the history of science, Ibn Ḥazm’s innovative perspectives and contributions in logic have been overlooked or considered with an attitude of contempt. On the one hand, his work has been seen, at best, as promulgating the benefits of studying Aristotle’s logic, so that his contribution is assessed as more didactical than conceptual. And on the other hand, those who do examine his innovations often consider them to be mistaken. As indicated by Chejne (1984, p. 2) contempt towards the logical work of Ibn Ḥazm was also present in its reception by the Eastern philosophers who accused him of deviating from Aristotelian logic and of dabbling in things beyond his capability. However, a reassessment of his work on logic has since begun, by delving into the ways the thinker of Córdoba studied the links between deontic and modal qualification of propositions. In this context Lameer’s (2013) paper on the logical sources of Ibn Ḥazm is worth mentioning; the author (p. 417, footnote 1) observes that, although, strictly speaking, it was al-Fārābī who first drew the parallelism between deontic and modal concepts, it was Ibn Ḥazm who developed it and worked it out in a more precise manner. A primary aim of this paper is to help fill some of these gaps by stressing the role of the work of Ibn Ḥazm in developing a notion of deontic necessity deeply rooted in legal normativity, and in explicitly discussing the transference between deontic and modal concepts. According to our view; the basic units of Islamic deontic logic are what we might call, indulging in terminological anachronism, heteronomous imperatives. As it turns out, the heteronomy of imperatives within Islamic legal systems contrasts with those of the purely moral realm, which seem to be closer to an autonomous conception of moral law. There it concurs again with Leibniz’s proposal to define obligatory as “what is necessary for a good person to do”. In the present paper, we will focus on the heteronomous imperatives of legal systems rather than on the imperatives of the purely moral realm. In this context, the work of Ibn Ḥazm extends the parallelism between the necessity of events and that of human actions stressed by his predecessors. According to our understanding, Ibn Ḥazm’s parallelism can be rendered explicit formally by means of a conditional (or hypothetical) structure shared by both deontic and modal propositions. Moreover, this structure makes apparent that this parallelism displays an underlying system of “degrees”. Indeed, while in the domain of events, given some conditions, it makes sense to distinguish between an event that is more likely to happen than another. Ibn Ḥazm speaks of near and distant possibility (such as the higher degree of likelihood of rain, given the condensation of clouds in December, and its lower degree, when the condensation occurs in summer); and, in the domain of actions, the Islamic notion of weighting actions determines degrees of virtue (or of legal and moral value). So whereas the degree of virtue of performing a forbidden act as determined by the distribution of sanction and reward is 0, we obtain the same value by pondering the likelihood of an impossible event to take place. Furthermore, as discussed in section II.3.2, the system of values at work in the parallelism can be seen as opening the way to a more direct correspondence. Thus, while in the realm of nature, likelihood of occurrence of an event is dependent upon the conditions specific to the occurrence of that event; while, in the realm of jurisprudence, likelihood of performing an action is dependent upon the distribution of reward and sanction specific to that action (being that, given the choice to perform or not perform a given action, those that will be rewarded are more likely to be performed than those that are not). According to this perspective, the point of the parallelism is that both deontic and modal qualifications measure the degree of an action or event to become actual; that is – indulging once more in anachronism (but this time from the Leibnizian background) – the degree measures how feasible (facile) an action or event may be. This suggests that Ibn Ḥazm’s perspectives already herald the links to probability and possibility explored by Leibniz six centuries later – see for example Leibniz’s (1671, A VI, I, p. 424-26) use of probability in the context of conditional right. Nevertheless, it also shows a crucial difference to the approach developed in the Elementa Jura Naturalis: whereas Leibniz’s studies seek to define what is to be just or virtuous, the logical system of deontic imperatives within Islamic jurisprudence presupposes that what is to be virtuous has already been settled. Determining what is to be virtuous is not achieved by logical reasoning within the system of legal jurisprudence, but by delving into the higher objectives of the Sharīʿa. While developing our point, we will delve into the logical structure of the heteronomous imperatives. This distinguishes our contribution from the existing literature, such as the papers of Chejne (1984), Lameer (2014), and Guerrero (1997, 2010, 2014), which do not provide a logical analysis of the deontic concepts put into work by Ibn Ḥazm. The true antecedent to the present paper is the work of Farid Zidani (2007, 2015), who, so far as we know, was the first to undertake such a task. Some of our own developments and general epistemological thoughts go beyond Ibn Ḥazm’s framework and motivations; mainly those contained in sections II.3.2 and IV. However, according to our view, these reflections suggest that Ibn Ḥazm’s approach has the substance for a broader and deeper exploration of the logic of norms. The paper is structured as follows:I.Ibn Ḥazm’s Logic of Heteronomous Imperatives. After presenting some extracts of the relevant text, we proceed by providing a formal reconstruction of the five forms of deontic modalities. II. A Landmark in the History of the Logical Analysis of Norms. Duties and Modalities. In this section, we study the transferences from deontic to modal necessity and possibility. We briefly compare the deontic system of Islamic Jurisprudence with that of Leibniz.III. Leibniz and Hypothetical Imperatives in Law.IV. Beyond Ibn Ḥazm: Conclusions and the Work Ahead. We will conclude the paper by discussing briefly some conceptual points that distinguish the logic of heteronomous imperatives from contemporary deontic logic. Our final words will discuss deontic-modal parallelism in the context of Ibn Ḥazm’s rejection of reasoning by conjecture and what we call “the internalization of nature.”. (shrink)

In her book Experience Embodied Anik Waldow devotes a chapter to “Locke’s Experimental Persons.” Her chapter aims to show how Locke’s views on persons, personal identity, and moral agency in his Essay concerning Human Understanding build on his esteem-based approach to education that he develops in Some Thoughts concerning Education. After outlining main contributions that Waldow makes in her chapter, I turn to three issues that in my view deserve further consideration. First, I draw attention to the question of how (...) Locke’s esteem-based education can be reconciled with his moral views in the Essay. I propose that the question of how children become persons or moral agents who see their actions bound by divine law is worth examining with more detail. Second, I contrast Waldow’s interpretation of what a Lockean action is with an alternative interpretation and show that this has implications for how we understand the role of consciousness in Locke’s account of persons and personal identity. Third, I take a closer look at Waldow’s view that consciousness has an epistemic function in Locke’s account of persons and personal identity and highlight advantages of also acknowledging a metaphysical function of consciousness. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:In, Out Me, You Mental, Moral Where Do I Begin?Mark D. Rego (bio)I once attended a Buddhist meditation retreat, led by an American meditation teacher. The instructor had studied and practiced is Asia for many years and was well versed in the practices and teachings of Buddhism. Among his opening remarks was something along the line of the following: "One question that is asked on every retreat is, 'if (...) there is no true self, then who is it who has come here to become free of the illusion of a self?' The answer is, I don't know, but we can start anyway."This sense of practicality in the face of unanswerable questions is built into Buddhism, as is the relationship among the particularities of each individual, a process akin to externality, mental well-being, and morality.I raise Buddhism both because of its central interest into the nature of the self (an obviously germane consideration in the papers under discussion) and because of this second feature noted, namely the comfortable integration of individuality, character building, ethical action, and mental well-being (the issue of the true self will, thankfully, have to wait). It is this theme that I raise via the discussion of externality.The commentaries of Talmadge and Graham, unintentionally I think, pull me toward a beguiling observation in my daily practice of psychiatry. Namely, patients commonly report their clinical improvements in terms of how they deal better with others, how they are more thoughtful and even handed (with themselves included), and how they better cope with the demands of their individual lives. In senses both highly individual and highly principled, and in ways both explicit and implicit, when patients feel better they often feel that they are better people (all the kinds of treatment mentioned in my paper equally apply; there is no exclusivity in this result).There is also an interesting consistency in a dual manner in which this is expressed. In one way people report the improved coping, handling, and so on mentioned. In the next breath the same person commonly says, "I feel like myself."The meditation instructor would be pleased; it appears that through a process of becoming aware of and letting go of some form of negativity an individual feels better, acts better, and feels more unified. (As the instructor was psychologically sophisticated, he would not mistake the "like myself" sentiment as a Buddhist heresy. Rather, he would understand it as a reflection of being more at ease with and aware of disparate parts of himself.) And all this without figuring out who the real self is. [End Page 331]I mention these observations about Buddhism and clinical care because when I consider the processes of evaluating, deciding, and forging identity and volition it seems to me that somewhere between the lines the individual is aligning himself with some sense of what is good. The resultant experience of volition and cohesive identity is, often but not always, experienced as good both psychologically and morally.Change, Others, and ValuesIn the two commentaries that follow my paper on Frankfurtian externality and therapeutic change (Rego 2004), Talmadge (2004) and Graham (2004) highlight different aspects of externality and therapeutics. Talmadge, an addiction psychiatrist, expands the theme of volitional change in recovery from addiction. For Talmadge, as for most in the field, the question of when and how an addict has truly committed to change (hitting "rock bottom"? accepting the first of the twelve steps?) is perennially in the air. Such knowledge would be invaluable in guiding addicts along their rocky paths.Although still far short of the mark, Talmadge finds some illustrative guidance in Frankfurt. The shift that takes place within the addict to place him on the road to recovery is not necessarily "rock bottom," or conformity to a program's dictates or a state of new knowledge. Rather, it is a shift in will. By whatever process (and Talmadge is quite aware that there seem to be many paths) the addict has come to care about sobriety in a way he or she did not before. He or she now cares in a way that is part of him or her... (shrink)

Even given the final truths of what is right and wrong, good and bad, ethics is not complete. For one may yet ask “Why should I be moral?” Of course, we have no prior assurance that it will be possible to provide a non-moral and justifiable answer to the rational and self-interested person. Nevertheless, I claim that reasons for being moral can be provided even for the rational, self-interested, and remorseless individual who knows he will not be caught. (...) In defending my claim I will draw on empirical data from recent social psychology and game theory. Actual human selves are malleable in a number of ways. I will show that it is rational for the self-interested person to modify selves in such a way that moral actions are increasingly preferred. Specifically, I will argue that it is in one’s rational self-interest to enhance empathy in others and future selves in such a way that for increasing numbers other-injury becomes a component of self-injury, and other-benefit becomes a component of self-benefit. This will allow a linkage to be drawn from rational and self-interested action to moral action. The development of this theory will begin by distinguishing my approach from that of Gauthier, then three interpretations of the “Why be moral?” question will be delineated, next the decision theoretic components of my account will be presented, and finally the role of empathy will be considered in detail. (shrink)

A number of philosophers have recently argued that we should interpret the debate over moral responsibility as a debate over the conditions under which it would be “fair” to blame a person for her attitudes or conduct. What is distinctive about these accounts is that they begin with the stance of the moral judge, rather than that of the agent who is judged, and make attributions of responsibility dependent upon whether it would be fair or appropriate for a moral (...) judge to react to the agent in various (negative) ways. This is problematic, I argue, because our intuitions about whether and when it would be fair to react negatively to another are sensitive to a host of considerations that appear to have little or nothing to do with an agent’s responsibility or culpability for her attitudes or behavior. If this is correct, then theories which make attributions of responsibility dependent upon the appropriateness of our reactions as moral judges will turn out to be fundamentally misguided. (shrink)

One, Mad Hornpipe: Dance as a Tool of Subversion in Brian Friel's Molly Sweeney The plot of Brian Friel's Molly Sweeney oscillates around the theme of perception, blindness and eye-sight recovery. Although visually impaired, the eponymous character is a self-reliant and independent person who is very active, both professionally and socially. What serves as the source of tragedy in the play is the male desire to compensate for Molly's physical disability perceived as a sign of deficiency and oddity that (...) needs to be normalized. Prompted by her husband, Molly decides to undergo a surgery which gives her a chance to regain sight and, thus, become a part of the world of the visually abled. Yet, subsequent to the operation, Molly cannot adapt herself to the new reality and develops a medical condition called blindsight, which leads to her final alienation and confusion.Focusing predominantly on the main character of the play, this paper examines the ways in which Molly Sweeney experiences the surrounding world and seeks satisfaction and self-fulfilment through physical activities, such as swimming or dancing, which she vividly describes in her monologues. It explores the double nature of Molly who, despite her self-sufficiency, capacity for rebellion and a sense of autonomy, seems prone to male manipulation exercised at first by her father, later by her husband Frank and doctor Rice. Her expression of independence becomes particularly conspicuous in the scene of a party organized the night before her surgery when she performs a wild and frantic hornpipe, which serves as a form of momentary upheaval and a visualization of the outburst of extreme emotions. Although the dance is not presented onstage, it has a crucial function in the play, for it serves as its powerful climax, after which Molly experiences gradual deterioration.Interpreted in the context of the history of Irish dance, the mad hornpipe appears replete with meanings and allusions. Traditionally associated with human sexuality and the female element, dance was often treated by the Irish clergy with a great deal of distrust as a source of evil and moral corruption. Consequently, like in the case of the frenzied reel in another famous Frielian play, Dancing at Lughnasa, the limitless and unrestricted performance in the climactic scene of Molly Sweeney may be seen as a tool of subversion and female opposition to the Irish patriarchal order. It is a unique moment in which the protagonist seizes male power and gains full, though very temporary, control over her life. (shrink)

The plot of Brian Friel's Molly Sweeney oscillates around the theme of perception, blindness and eye-sight recovery. Although visually impaired, the eponymous character is a self-reliant and independent person who is very active, both professionally and socially. What serves as the source of tragedy in the play is the male desire to compensate for Molly's physical disability perceived as a sign of deficiency and oddity that needs to be normalized. Prompted by her husband, Molly decides to undergo a surgery (...) which gives her a chance to regain sight and, thus, become a part of the world of the visually abled. Yet, subsequent to the operation, Molly cannot adapt herself to the new reality and develops a medical condition called blindsight, which leads to her final alienation and confusion. Focusing predominantly on the main character of the play, this paper examines the ways in which Molly Sweeney experiences the surrounding world and seeks satisfaction and self-fulfilment through physical activities, such as swimming or dancing, which she vividly describes in her monologues. It explores the double nature of Molly who, despite her self-sufficiency, capacity for rebellion and a sense of autonomy, seems prone to male manipulation exercised at first by her father, later by her husband Frank and doctor Rice. Her expression of independence becomes particularly conspicuous in the scene of a party organized the night before her surgery when she performs a wild and frantic hornpipe, which serves as a form of momentary upheaval and a visualization of the outburst of extreme emotions. Although the dance is not presented onstage, it has a crucial function in the play, for it serves as its powerful climax, after which Molly experiences gradual deterioration. Interpreted in the context of the history of Irish dance, the mad hornpipe appears replete with meanings and allusions. Traditionally associated with human sexuality and the female element, dance was often treated by the Irish clergy with a great deal of distrust as a source of evil and moral corruption. Consequently, like in the case of the frenzied reel in another famous Frielian play, Dancing at Lughnasa, the limitless and unrestricted performance in the climactic scene of Molly Sweeney may be seen as a tool of subversion and female opposition to the Irish patriarchal order. It is a unique moment in which the protagonist seizes male power and gains full, though very temporary, control over her life. (shrink)

The different sorts of virtuous people who display various virtues to a remarkable degree have brought the issue of individualisation of moral character to the forefront. It signals a more personal dimension of character development which is notoriously ignored in the current discourse on character education. The case is made that since in practice, the individualisation of moral character must, by necessity, advance side by side with the cultivation of virtues, a full account of character education needs to give consideration (...) to both concerns. After analysing the specific ways which temperament, social roles, and occupations respectively contribute to the individualisation of moral character, some practical implications are drawn to shed new light on the common practice of the inculcation of virtues. Firstly, since the varieties of moral personality is the norm, it is appropriate to encourage the educated to become virtuous people of different sorts. Secondly, given the influence that temperament may exert on virtue, having good knowledge of each child’s temperament, identifying the specific difficulties possibly confronting him/her accordingly, and then providing more opportunities to strengthen the cultivation of the related virtues are crucial. Thirdly, since children with different temperaments are inclined to identify with different sorts of moral exemplars, it is valuable to present them a great variety of moral models, from which they can choose the kind of virtuous people they would want to emulate. Lastly, since assuming different occupations and social roles is liable to result in various moral characters, character formation cannot be confined to the family or school. Among others, workplaces and communities are also important variables. (shrink)

Some approaches to the assessment of moral intuitions are discussed. The controlled ethical trial isolates a moral issue from confounding factors and thereby clarifies what a person's intuition actually is. Casuistic reasoning from situations, where intuitions are clear, suggests or modifies principles, which can then help to make decisions in situations where intuitions are unclear. When intuitions are defended by a supporting principle, that principle can be tested by finding extreme cases, in which it is counterintuitive to follow the (...) principle. An approach to the resolution of conflict between valid moral principles, specifically the utilitarian and justice principles, is considered. It is argued that even those who justify intuitions by a priori principles are often obliged to modify or support their principles by resort to the consideration of consequences. (shrink)

From the standpoint of disability advocacy, further exploration of the concept of well-being stands to be availing. The notion that “welfarism” about disability, which Julian Savulescu and Guy Kahane debuted, qualifies as helpful is encouraged by their claim that welfarism shares important commitments with that advocacy. As becomes clear when they apply their welfarist frame to procreative decisions, endorsing welfarism would, in fact, sharply undermine it. Savulescu and Kahane's Principle of Procreative Beneficence—which reflects transhumanism, or advocacy of radical bioenhancement— (...) class='Hi'>morally requires parents to choose the child who will, in all probability, have “the best life.” Assuming the emergence of potent biotechnologies, procreative decision-making would be highly standardized, for prospective parents would be morally obliged to maximize select capacities, including intelligence, self-control, and hedonic set-point, in their children. Welfarism, applied to reproduction, is staunchly objectivist about what course is incumbent on decision-makers, giving no credence to first-personal values, aspirations, and experiences. Though this dismissal of individual perspectives applies to everyone, its implications for disability advocacy are especially severe. With that advocacy in view, greater attention to “well-being” should, therefore, be severed from the welfarism of Savulescu and Kahane. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Analogy of Grace: Karl Barth’s Moral Theology by Gerald McKenny, and: Christian Ethics as Witness: Barth’s Ethics for a World at Risk by David HaddorffVictor ThasiahThe Analogy of Grace: Karl Barth’s Moral Theology Gerald McKenny New York: Oxford University Press, 2010. 310 pp. $120.00Christian Ethics as Witness: Barth’s Ethics for a World at Risk David Haddorff Eugene, OR: Cascade Books, 2010. 482 pp. $54.00Karl Barth’s theology remains (...) a resource for Christian ethics. Let me suggest why. Instead of marginalizing or bracketing out consideration of divine agency, Barth presupposes God’s past, present, and future action; God’s inalienable subjectivity and indissoluble over-againstness in relationship (irreducible, for example, to ecclesial action); and God’s ongoing judgment of good and evil, and thus of moral thought and practice. These presuppositions determine the method, structure, content, and purpose of his theology and ethics. His concept of grace consists of God accomplishing the good in our place and on our behalf, a perspective more substantive than supplementary in nature. Finally, his eschatological view of human freedom involves resistance and responsibility—the freedom to resist evil (having been delivered from the determination of evil by grace) and the freedom to witness to God’s action in faith, love, and hope in the world. Barth’s work serves the field of Christian ethics well, burdened as we are by unprecedented global awareness with its challenges and uncertainties.Two new books on Barth’s theology and ethics seek to increase our understanding of his work and engage contemporary Christian moral thought and practice. Gerald McKenny’s The Analogy of Grace is now the indispensable guide to Barth’s ethics. His exposition is comprehensive, critical, and contextual as it relates Barth’s dogmatics to current academic work in Christian ethics and moral philosophy. The tradeoff, however, is that it pays insufficient attention to the ecclesial, cultural, and political contexts for embodying Barth’s ethics. McKenny makes an important contribution to our understanding of Barth’s work. By closely reading primary texts and secondary literature, McKenny shows that many of Barth’s critics and friends continue to misunderstand [End Page 192] him by resolving the unresolvable, airbrushing ambiguities and thus converting Barth’s “strange” ethics into a more conventional moral theory. McKenny argues that it is precisely the strangeness of Barth’s theology—with all its implications—that continues to challenge and contribute constructively to contemporary Christian ethics.What is so strange and significant about Barth’s work? For McKenny, it is Barth’s claim that “God resolves on the good from eternity in the determination of humanity in Jesus Christ to commission and service as active witnesses of God’s glory; fulfills it in time in the incarnation, life, death, resurrection, and ascension of Jesus Christ, who performs this commission and service in place of all of humanity; and summons, empowers, and directs human beings in every time to correspond to this fulfillment in their conduct” (288). Thus, our action should be modeled on God’s action; it should be an analogy of grace. “The telos of God’s grace is realized,” McKenny concludes, “when human beings in their action become the image of God” (208). The Analogy of Grace traces the way Barth develops this ontological and analogical vision as McKenny differentiates Barth’s work from modern theories that presuppose that people are relatively capable of knowing and doing the good.McKenny suggests that there is a possible deficiency in the way Barth’s account of divine agency determines the form and content of his theology and ethics. Barth’s consistent opposition to moral theories that emphasize observable signs of moral progress in either self or society results in the “liability” of the “extraordinarily qualified affirmation he gives to visible human goodness” (223). McKenny asks if Barth “does justice to the work of the Holy Spirit in our lives” and “can make sense of the participation of our action in God’s action or of the way in which the Holy Spirit accomplishes this participation” (223). In other words, Barth’s “extraordinarily qualified affirmation” might neglect the work of the Spirit in... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:What Does It Mean to "Speak Truth to Power"?Christian UhlPolitical Philosophy in Japan: Nishida, the Kyoto School, and Co-Prosperity. By Christopher S. Goto-Jones. London and New York: Routledge, 2005. Pp. 192.Ever since the end of the "Great East Asian War" in Japan a debate has been smoldering over the contamination of philosophy by politics. This debate was sparked by a series of writings through which the "father of (...) Japanese philosophy," Nishida Kitarō (1870-1945), and some thinkers affiliated with him—the so-called Kyoto School—became involved in the politics connected with the war to establish a "Greater East Asia Co-Prosperity Sphere." The debate over Nishida and the Kyoto School has repeatedly been overshadowed by the debate over Heidegger. Aside from the strategic considerations of those engaged in the prosecution of the Kyoto School, one reason for the "Heidegger factor"1 may have something to do with the fact that philosophical parallels can indeed be drawn between Nishida and Heidegger, and that there are also direct links between Nishida and some of his disciples who studied in Germany. Questions concerning Heidegger's political engagement are still explosive, even twenty years after Farias' attempt to prove Heidegger's entanglement with National Socialism. The publication of Emmanuel Faye's book Heidegger—L'introduction du nazisme dans la philosophie has fired up the debate in French philosophical circles.2 And in the debate concerning Nishida and the Kyoto School there is also recent news: the publication of Christopher S. Goto-Jones' ambitious study Political Philosophy in Japan: Nishida, the Kyoto School, and Co Prosperity."Every inquiry," Heidegger says, "is a seeking [Suchen]. Every seeking gets guided beforehand by what is sought for."3 Goto-Jones' inquiry seeks to explain the nature of Nishida's political engagement in the 1930s and 1940s, and his inquiry is guided by the conviction that Nishida should be exonerated from the charges regarding his alleged complicity with a Japanese wartime regime that was at least militarist if not "fascist." However, the declared intention of Goto-Jones' study is not just another exoneration of Nishida. Goto-Jones contends that Nishida, influenced "particularly [by] Kant" (p. 7), has left behind a still relevant political philosophy that, as some other authors have argued,4 is not only not tainted by any form of narrow-minded nationalism but also provides a philosophical framework for a theory of a globalizing, multicentered, intercultural world:Hence, for Nishida, the nation should not be a rigid institutional structure or an artificially... constructed culture, but rather a moral personality formed through the mutual self-determination [End Page 469] determination of its constituents and in a dynamic relationship with other nations. International relations should be characterized by the development of greater levels of unity, as nations creatively interact with each other, producing public goods and increasing the similarities in their personalities, thus decreasing the salience of their national boundaries. In this model, nationalism, like egoism, becomes a nonsense.(p. 134 n)This political model is what Goto-Jones seeks to recover in Nishida, and this recovery is "what is really intended" (Heidegger) by his book.5Nishida's political philosophy needs to be recovered, because it is buried under false accusations and misunderstandings, produced primarily by Nishida's detractors, whose criticism, as Goto-Jones suggests, is in most cases at best based on a rough selection of citations, torn out of the coherence of their original context. Nishida's defenders, on the other hand, have attempted to safeguard the philosopher against the arguments of his critics by simply calling him a "liberal," a seemingly agreeable but in fact rather misleading label. Furthermore, Nishida's defenders have based their arguments only on biographical material, diary entries, letters, and so on. While the apologists "are right to observe a contradiction between... [Nishida's] private condemnation of the regime and his apparent public complicity, this is not in itself enough to conclude that his public writings meant the opposite of what they seem to say" (p. 4).In fact, this conclusion by Nishida's apologists does raise certain questions. Why did Nishida never give vent to his divergent opinions? Should he not rather have remained... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Bad, the Ugly, and the Need for a Position by PsychiatryLloyd A. Wells (bio)Keywordsvice, psychiatric education, psychiatry-law interface, medicalizationSadler’s paper is thought provoking and will resonate with many psychiatrists who deal with the interface of vice and psychiatric syndromes. This interface and the dilemmas it poses are perhaps most discussed by residents, who are dealing with the issue for the first time and who often debate what (...) is “psychiatric” about these cases. Many residents have their own informal systems of classifying vice, often with a divide between the criminal population and those perceived as avoiding work and responsibility. These unofficial classifications are usually judgmental and often pejorative, but the residents rarely get much help from faculty in this area. Indeed, many of the faculty have equally judgmental and pejorative views, which are neither systematized nor subject to systematic analysis.By clarifying the importance of the issue of the vice–mental disorder relationship (VMDR) to psychiatry, Sadler may move this topic to one that receives Socratic discourse in our training programs and serious consideration in the training of psychiatrists rather than an idiosyncratic lumping of these patients into the broad category of “patients I don’t like.”Sadler asks for comments in several categories: historical intractability, goals of psychiatry, taxonomy, implications for the criminal justice system, implications for the law, and ethical/political implications.Issues of historical intractability are long standing. In A Tour of the Whole Island of Great Britain, written in the early eighteenth century, Daniel Defoe (1724–1727) describes many asylums, often with the comment, “as it is a madhouse, so is it also a house of correction.” Some of the great public hospitals of the seventeenth and eighteenth centuries were built at least as much to get antisocial and homeless people off the streets as to provide care for the mentally ill. The moral treatment of France and Great Britain, which added much to the practice of psychiatry, clearly had punitive “treatments” for patients with vice-laden behaviors, and this was very explicit in the American moral model of treatment of the late nineteenth century with its obsessive need to prevent patients from masturbating. In the nineteenth and early twentieth centuries, there was great debate about the inclusion of Pritchard’s “moral insanity”—now sanitized into “personality disorders”—into the psychiatric domain, and Kraepelin referred to this group as “enemies of society.”Sadler next asks us to consider the goals of psychiatry in regard to “a proper VMDR.” He wonders [End Page 43] whether a strict medicalization account can be defended. I think it is clear from a large literature and from clinical experience that it cannot be defended —now. But it may become defensible in this century, which will pose enormous challenges to psychiatry, lawmakers, and the courts (vide infra). A strict moralization model is defended by many in society, including some psychiatrists, but has severe limitations and seems illogical. It is hard to make a case (though juries have done so) that, for example, a very delusional young woman with postpartum psychosis who murders her children because of the belief that far worse things than death will happen to them imminently if they live, fits the moralization approach. The Dahmer case is especially instructive. Although there was enormous “vice” (and perhaps “evil”), it is hard to make a case that a sane man would make temples out of the body parts of victims and would attempt to commune with the dead through them.He wonders whether a “mixed” version of medicalization/moralization can be developed and defended. I would argue for both a mixed approach and a “shared” approach. A middle adolescent with bipolar disorder burned his house to the ground. (Fortunately, he and family members were injured but not killed.) He was wildly manic at the time and set the fire because he wanted to prove that he was immortal and totally impervious to flames. He was delusional, extraordinarily impulsive, and completely without judgment, and it would be extraordinarily difficult to exclude the medical frame in any consideration of the vice involved. The vice, indeed, may be more involved in his decision while euthymic to stop taking... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Reason and Emotion. Essays in Ancient Moral Psychology and Ethical TheoryEve Browning ColeJohn M. Cooper, Reason and Emotion. Essays in Ancient Moral Psychology and Ethical Theory. Princeton: Princeton University Press, 1999. Pp. xiii + 605. Cloth, $75.00.This collection of essays spans 27 years of John Cooper's career as an interpreter of ancient philosophy. Its earliest essay, "The Magna Moralia and Aristotle's Moral Philosophy," already shows Cooper's distinctive approach; (...) he seeks to discover "a simpler and more natural way" (200) to understand the discrepancies between this small treatise and Aristotle's major ethical works than by the comparatively convoluted theory of Dirlmeier. In seeking this simpler and more natural interpretive route, Cooper attends to "the philosophical content of the work" (202), rather than considerations of style and linguistic usage. He concludes with frank discussion of the problems which his interpretation cannot solve; these are dismissed with characteristic exasperation-italics: "... one must not expect to explain everything..." (210). He confines his rougher polemical points to footnotes (Dirlmeier "doesn't even face the question squarely" in note 19, hence he is "wildly off" in note 28). [End Page 430]These characteristics run through all the essays here collected. Only two of the 23 essays are previously unpublished: a reconsideration of Xenophon as a source on Socrates, and a treatment of pleasure and desire in Epicurus. Other essays take up moral problems examined by Socrates, Plato, Aristotle, and several Hellenistic philosophers or schools. A theme running through most if not all the discussions is the desire (shared by the ancient philosophers and by Cooper equally, it would seem) to develop and defend a viable eudaimonism. The relation between human goodness and human happiness must be shown to be one of extremely close affinity, such that the virtuous are also the happy, even in adversity. Thus though no attempt is made to connect the essays into a coherent argument leading to a global thesis about ancient moral philosophy, the book nevertheless contains the ingredients for such an argument and thesis. The book presenting such an argument and thesis could in some ways be both more elegant and more helpful than this collection; it could spend fewer of its pages in arguing against other interpreters over minor differences (the standard journal-article format for our time), more of its pages awakening the texts, eliciting their message, and presenting it in a form useful for guiding life. Perhaps Cooper will write such a book soon.But the present volume will certainly be of interest to scholars and students, who will find in it much to enjoy and ponder. Generally what is striking about Cooper's interpretations is their freshness. He is at his best when dislodging some stale orthodoxy. The essay on Xenophon's Socrates is a case in point. The portrait of Socrates which emerges in Xenophon's Memorabilia is usually taken to be far less accurate than that presented in Plato's earlier dialogues. The Memorabilia seldom appear on the required reading lists of Greek philosophy courses, nor does Xenophon's version of Socrates' approach to moral questions receive even a fraction of the scholarly attention devoted to Plato's early work. Cooper convincingly shows this neglect to rest on a prejudice. The Socrates of Xenophon's portrait addresses a different kind of audience than that of Plato; the difference in the style of questioning and in the topics discussed reflects the historical Socrates' sensitivity to his partners in conversation. He addresses them where they live (so to speak), and this makes him "all the more remarkable a person" (14).Two other strengths run throughout the essays here collected. No matter how intense the exegetical quibble may have become on any given page, Cooper is able to make a sudden soaring flight upward and provide a synoptic view of the broader philosophical terrain, both for any given philosopher and for that philosopher's contemporaries, predecessors, and successors. These flights are sometimes dizzying and often unpredictable, but always refreshing.In addition, Cooper is able to make connections with large issues in contemporary moral philosophy, relating the ancient controversies to their modern versions (John Rawls, Bernard Williams, Leo Strauss... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Morality of Huck FinnCarol FreedmanA familiar refrain is that emotions threaten our capacity for moral judgment because they infringe on our ability to be impartial. Some hold that emotions lead us to serve personal rather than impersonal ends. And most Kantians argue that even when emotions influence us to pursue impartial ends, they still fail to be moral motives. Barbara Herman argues, however, that emotions can play an (...) important role in a Kantian model of moral judgment. 1 But her description of the moral role of emotions ultimately falls short. 2The problems with Herman’s argument are illustrated by a passage from Huckleberry Finn. The passage challenges a common Kantian assumption that any decision motivated by compassion or love is not a case of moral judgment. I contend that there is good reason to interpret Huck’s decision to help his friend Jim as an instance of moral judgment, even though it is also a case of acting from compassion and love. And though Herman’s theory offers a Kantian way of supporting my reading of Huck, her model fails to do justice to Huck’s case. But there is much that we can learn from the way it fails.IHuckleberry Finn is a story “which details some passages in the life of an ignorant village boy... [who has] run away from his persecuting father, and from a persecuting, good widow, who wishes to make a nice, truth-telling, respectable boy of him....” 3 The journey that follows, in which Huck is accompanied by the widow’s runaway slave, Jim, becomes a symbol of a boy’s attempt to grow up, discover his own identity, make his own decisions. In the part of the journey that has come to be known [End Page 102] as Huck’s “crisis of conscience,” we find him trying to decide whether he should help Jim escape from a slaveholder who has just captured him, or whether he should write to Miss Watson to tell her the where-abouts of her slave (pp. 168–69). On the face of it, Huck seems torn between the voices of conscience and temptation. Writing to Miss Watson, as he describes it, is “the right thing and the clean thing.” To do otherwise would just confirm his “wickedness”: “stealing a poor old woman’s nigger,” he says, “who hadn’t ever done me no harm.” But Huck also loves Jim. He says: “I couldn’t seem to strike no places to harden me against him, but only the other kind.” So Huck seems torn between his sense of what’s right and his compassion. When, in exas-peration, he finally decides not to write the letter, but chooses instead “to go to hell,” it sounds like compassion triumphs over conscience. 4But is it necessarily the case that just because Huck acts from compassion that he does not conceive of what he’s doing as right—that he does not engage in moral judgment? I think it is most plausible to say that when Huck finally decides not to turn Jim in, he comes to a more heart-felt conception of what’s right, not that he does what he believes is wrong.Even though Huck describes helping Jim as “stealing,” and sinful, and the sort of thing for which he will “go to hell,” it is not clear that he thinks it is the wrong thing to do. Huck’s deliberation is tied up with thoughts of social condemnation and eternal punishment. He is obsessed with the pain he will endure if he does not write to Miss Watson. His thoughts begin with the pain of social condemnation (“And then think of me! It would get all around, that Huck Finn helped a nigger to get his freedom”); but they quickly turn to the pain of eternal punishment (“And at last, when it hit me all of a sudden that here was the plain hand of Providence slapping me in the face and letting me know my wickedness was being watched all the time from up there in heaven... I most dropped in my tracks I was so scared”). But Huck describes the... (shrink)

Plea bargains are the stock-in-trade of the modern American prosecutor’s office. The basic scenario, wherein a defendant agrees to plea guilty in exchange for a reduced sentence, is familiar to viewers of police procedurals. In an equally famous variation on the theme, the prosecutor requests something more than an admission of guilt: leniency will only be forthcoming if the defendant is willing to cooperate with the prosecutor in securing the conviction of another suspect. In some of these cases, the defendant (...) is a low-level criminal who has information on a high-level malefactor who is of more interest to the police. In others, the defendant and the person she is asked to testify against are of the same criminal rank, but evidentiary weaknesses induce the prosecutor to seek the aid of one suspect in order to convict the other. In this latter version, the classic tactic of film detectives is to offer the bargain to both defendants in the hopes that one will crack and agree to reveal what he knows about the other. The defendants could either be in custody for different crimes or be accomplices in the same offense. -/- The last variation (involving accomplices) is the subject of this Article. I take issue with the prosecutorial tactics in these cases because of the risk they create of punishing the comparatively virtuous person more than the comparatively vicious one for the same acts. As I will argue, it is the less honest person who is more likely to accept the prosecutor’s deal, leading the more honest person, who resisted temptation, to suffer greater penalties. -/- I contend that this scenario offends distributive justice, runs counter to the idea (accepted by some) that a proper goal of the state is the cultivation of good character in the citizenry, and is perverse insofar as a person will suffer more from the prosecutor's dilemma insofar as she is more or less a person of conscience. These negative considerations notwithstanding, I do not call for the abolition of accomplice plea bargaining but argue that the problems I raise should be considered when weighing its pros and cons. -/- This article was published in the company of a strong critical response by Guha Krishnamurthi, whose contribution I greatly appreciate. (shrink)

A theory of basic moral rights ought to aim at telling us who the beings are that have rights and of what those rights consist. It may, however, seek to achieve that goal via an indirect route. In this paper I shall attempt a strategy of indirection. The first stage of the argument is a consideration of why moral theory can allow any place at all to rights. Acknowledging rights can be inconvenient. An otherwise desirable outcome is blocked if (...) the only ways in which it can be attained involve the violation of rights. Why not jettison rights and thereby render these outcomes achievable? The answer that will be suggested trades on it being a deep fact about human beings that they can and do order their lives by reference to long-term commitments and aspirations. In my terminology, they are project pursuers. If people were rational animals all of whose interests were flickering and evanescent, an ethic entirely resting on maximization of impersonal value would be appropriate. But because projects entail commitments to values not subject to trade-offs, the introduction of rights is plausible. That is the first major stage of the argument. The second builds on it and tries to show that the recognition of rights or their equivalent is morally required, that only an ethic in which basic rights are acknowledged can be properly responsive to persons' status as project pursuers. More particularly, is suggested that rights take the form of constraints imposing minimal forbearance on others such that one has reasonable expectations of being able to pursue one's projects amidst a world of other project pursuers. (shrink)

The concepts of 'ethical' and 'socially responsible' investment (SRI) have become increasingly popular in recent years and funds which offer this kind of investment have attracted many individual inve... merstors. The present book addresses the issue of 'How ought one to invest?' by critically engaging with the ideas of the proponents of this movement about what makes 'ethical' investing ethical. The standard suggestion that ethical investing simply consists in refraining from investing in certain 'morally unacceptable companies' is criticised (...) for being both too rigid (often resting on absolute moral rules which lead to an austere conclusion) and too ineffective for individual investors (investors who after all control only a small part of the investment universe). Furthermore, the idea that ethical investing could consist in engaging more actively with the companies one invests in, in order to make them change their ways and become more socially responsible, is criticised for being just as ineffective for individual investors. Some more radical alternatives are elaborated on and defended - for instance, the suggestion that investors should make as much money from their investments as possible and then donate the proceeds to socially worthwhile charities. From similar suggestions, the common idea that there is no conflict between morality and profitability, or that genuinely ethical investing can be just as profitable as mainstream investing, is criticised for being too naïve. Making a difference may indeed require personal sacrifice of investors, but it is argued that the needs of the possible recipients of philanthropy are morally more important than the luxury of investment returns. (shrink)

The paper is a defense of the thesis that there are situations in which morally virtuous persons who are epistemic peers may disagree about what to do without either person being rationally required to change his or her judgment (a version of the Steadfast position in the epistemology of disagreement debate). The argument is based in part on similarities between decisions of virtuous agents and other practical decisions such as a baseball manager’s decision to change pitchers during (...) a game. In both cases, the role and responsibilities of the person making the decision and the complexities of the decision favor the Steadfast position. At the end of the paper, the argument for this position is compared with discussions of traditional arguments against moral objectivity that are based onmoral disagreements, and it is suggested that they involve rather different considerations. (shrink)

This book addresses the topic of the explicit and implicit commitments about persons as a kind in the literature on personal identity and draws out their political implications. I claim that the political implications of a metaphysical account can serve as a test on its veracity in cases in which the object-kind under analysis is itself constitutively normative, as the kind person might be, or in those cases in which counting as a member of the kind in question confers a (...) certain normative status upon those that do so count, which the kind person certainly satisfies. I argue that metaphysical accounts of personal identity often contain certain mistaken background assumptions concerning personhood, often due to a failure to recognize that being a person is environmentally dependent. -/- Because being a person is environmentally dependent, but this is not often noted, let alone incorporated into our theories of persons, although there are exceptions, a closer look at those theories is required if we are to have a just society. In fact, it is a bit surprising that this is the current situation, since the claim that certain members of society are oppressed due to being denied full personhood and its attendant rights has been the basis of several social movements: first-wave feminism, anti-slavery movements, and civil rights movements generally. Historically, these resistance movements aimed at claiming that, unlike how they were treated, they did in fact meet the requirements for personhood that those in more privileged sectors did and should therefore enjoy the same rights as the more privileged. -/- While I agree with the justification for these movements -- that the injustice driving them is that of the denial of the rights of persons -- I advocate for moving away from the idea that the only appropriate response is to count those who make such claims as being members that meet the dominant conception of personhood. Instead, I want to highlight the fact that if being a person is an environmentally dependent fact, theories of the nature of persons must recognize this or risk reflecting and perpetuating the current status quo. -/- For these reasons, those in need of recognition of their rights as persons should not only resist the failure of having them granted but should also question the current understanding of the concept itself, since the very notion may be riddled with normative assumptions typical only of those with certain kinds of privilege. That is, fighting for recognition as persons, without also resisting and questioning the source and objectivity of our current concept of personhood, risks failing to truly challenge the currently unfair social structure in any deep way. -/- There is a risk, however, with taking such a stance -- that it will be fallaciously inferred that there is no fair concept of persons at all to which are owed rights. But this does not follow from the stance I take. All that follows is that we must recognize our fallibility in offering metaphysical theories, particularly when the concept under investigation is normatively sensitive and environmentally dependent in the way that the kind person seems to be. -/- Theories concerning the metaphysics of persons, then, must address the fact that those with privilege not only have more power to assert their rights as persons, but they are also the source of most received views of the concept itself. It is possible, therefore, that our current metaphysical theories may be mis-describing the objective nature of personhood as a kind for politically biased reasons. -/- I argue that one of the particularly pernicious assumptions frequently made is that to be a person is to be a certain kind of psychologically integrated being. This is an ideal we seem to hold dear, since we tend to pathologize the failure to achieve it. I claim, however, that this thesis about persons as integrated is exactly the kind of idea that fails the environmental dependence test, since this state of integration is often only readily had by those who have a certain amount of control over their external environment, which many of us do not enjoy. For those who are not members of the dominant group, a strongly integrated self is sometimes simply not on the horizon, since being subject to the vicissitudes of the external environment often leads to conflict, fragmentation, or disintegration. Having inadequate power over one's own circumstances tends to produce what we might call “fractured selves,” selves that face a multitude of environmental forces, many times thrusting contradictory norms, roles, and traits, upon those subjected to them. -/- The fact that the failure to achieve integration is in fact pathologized makes the integration thesis seriously questionable, since it creates a situation in which those most in need of being conferred the normative status of being a person will fail to get such recognition, and in fact, possibly labelled as "defective" in some way or other. This is unjust for many reasons, at least one of which is that it relies on morally irrelevant facts to determine a person's normative status. -/- The previous issues raise the question of whether the aim of a giving a metaphysical account of persons ought to be understood descriptively or prescriptively, since current metaphysical accounts would fail to count many individuals as persons. However, taking metaphysical accounts as a prescriptive is highly controversial. I doubt that most of those offering explicit metaphysical theories of persons would agree that they are engaged in any kind of prescriptive project. Some psychologists and psychiatrists perhaps may take themselves to be determining whether a person is "healthy" by our current understanding of what it is to be a person, but the idea of having a healthy psychology sufficient for being a fully competent person is vastly different from having a healthy physical body, which does seem to have a more objective basis, although even this is questioned in disability studies. -/- The strong integration thesis, then, as now applied, clearly raises political issues, and has potential negative consequences for many beings that we typically do think of as persons. The integration thesis then needs to be replaced with a more adequately descriptive metaphysical theory or revised in a way so that it avoids these negative political consequences. -/- I see two paths open: (1) maintain the integration thesis as an ideal, and grant those who fail to meet it a temporary kind of normative status equal to that of being a person and push for substantive equal opportunity to achieve integration; or (2) reject the ideal altogether and offer a different account of the nature of being a person that counts so-called "fractured selves" as persons. -/- I believe that path (2) is preferable to path (1) for several reasons. First, it requires no condescension or paternalistic attitudes towards those who fail to be fully integrated; second, it expresses intellectual humility in accepting that standards that appear objective are often, in reality, biased and should not be universally applied; and third, it is more realistic in that it does not assume that there is an infinite amount of resources, and therefore harbors no illusions that equalizing power structures will allow everyone to enjoy the same amount and kind of power currently held by the dominant classes. -/- My own metaphysical account of what matters for survival to persons over time advocates for the idea that persons ought to be understood as constituted not only by internal psychological relations, but also by their relations to their surrounding environments, and this includes relations to inanimate objects. This view, I argue, can accommodate fractured selves as full persons, allowing for various psychological configurations to count as persons. It is also an improvement on views that do happen to recognize the environmental influence on persons -- social constitution views. The reason is that these views argue that persons just are what their environmental social surroundings dictate, which also has potentially negative political consequences, since it threatens to bind persons so closely to socio-cultural contexts that it closes off the possibility of resistance to them. However, because the view I endorse, makes persons environmentally dependent not only on their socio-cultural context, but on the whole of their environment, this makes persons partly independent of socio-cultural contexts, allowing them room to question them, which as noted, I believe they should be. (shrink)