This paper draws attention to a fundamental problem for a version of the tracing strategy defended by a number of theorists in the current literature (Rosen 2004, Fischer and Tognazzini 2009). I argue that versions of the tracing strategy that require reasonable foreseeability are in tension with the view that blameless ignorance excuses. A stronger version of the tracing strategy is consistent with the view that blameless ignorance excuses and is therefore preferable for those tracing theorists who wish to (...) continue maintaining that it does. (shrink)

A growing body of literature has revealed ordinary causal judgement to be sensitive to normative factors, such that a norm-violating agent is regarded more causal than their non-norm-violating counterpart. In this paper, we explore two competing explanations for this phenomenon: the Responsibility View and the Bias View. The Bias View, but not the Responsibility View, predicts features peripheral to the agent’s responsibility to impact causal attributions. In a series of three preregistered experiments (N = 1162), we present new evidence that (...) the Norm Effect arises from such peripheral features, namely from nonpertinent or entirely silly norm violations. Furthermore, we show that this effect cannot be explained by recourse to the agent’s foreknowledge or desire of the outcome, nor by its foreseeability: the Norm Effect arises even when participants judge the norm-violating agent’s doing as equally foreseeable. This, we argue, provides evidence in favour of the Bias View. (shrink)

A defense of the principle of double-effect.

For many years, moral philosophers have been debating the conceptual and moral status of the distinction between intending harm and foreseeing harm. In this paper, after surveying some of the objections to the moral significance of this distinction in general, I focus on the special case of state action, arguing that whatever reasons we have to be suspicious about the distinction's moral significance in general, we have very good reasons to believe it lacks intrinsic moral significance when applied to state (...) action. After arguing for this claim, I pursue in a preliminary way some of its implications. (shrink)

We typically assume that there is a difference between foreseeing an effect of one's voluntary action and intending the effect. Call the view that there is such a difference 'the Ordinary View'. My dissertation is a defense of the Ordinary View against two recent challenges. ;The first challenge to the Ordinary View I call "Holism". The upshot of the holist's position is that we intend all the foreseen effects of our voluntary actions. I begin by considering and arguing against a (...) couple of different versions of holism. ;The second challenge to the Ordinary View is made by Jonathan Bennett. Bennett argues that there is no unproblematic way to mark off effects of action which are intended as a means from effects which are merely foreseen. His conclusion is that the notion 'indended as a means' is incoherent. ;These challenges to the Ordinary View are of interest because they threaten to undermine the Doctrine of Double Effect which claims that whether an agent intends or merely foresees a harmful effect of action sometimes matters to the moral permissibility of performing the action. In response to Bennett, I first examine a view put forth by Warren Quinn. Quinn concedes to Bennett that the distinction between intended versus merely foreseen effects faces serious problems, but attempts to limit the ethical implications of Bennett's challenge by offering a replacement principle for DDE which he believes is not subject to Bennett's objection. I defend Quinn's replacement principle against certain recent attacks in the literature, but point out that Quinn's replacement principle really doesn't escape Bennett's objection. I then return to Bennett's objection and argue that it rests upon two false assumptions. I conclude that the Ordinary View withstands the two challenges. (shrink)

It is shown that the program of naturalizing of epistemology, that is, the program of the whole substitution of epistemology for sciences or for the humanities is not realizable. Naturalized epistemology includes metaphysical (in Kant’s sense: synthetic, speculative, a priori) claims which save its partly autonomous philosophical status. The result presented in the paper does not exclude the naturalizing program. It leads, instead, to a modified, attenuated version of it—such one which permits to open epistemology by transferring it in multi-facet (...) vivid philosophical investigations juxtaposed with science and the humanities. The postulated attenuated version of naturalizing does not result in destroying epistemology as a special philosophical domain of investigations, not substitutable for sciences. (shrink)

This article examines problems that may arise when addressing liability resulting from the genetic modification of microbes, animals, and plants. More specifically, it evaluates how uncertainties relating to the outcomes of these biotechnological innovations affect—or may affect—the courts' application of the reasonable foreseeability requirement and, hence, liability under the tort of negligence. The article also examines how concern expressed by society about injuries feared to result from these genetically modified products could have an impact on the way the courts (...) assess reasonable foreseeability in this area. (shrink)

Le but de cet article est de contribuer au débat sur la relation entre les pratiques prédictives et l’orthodoxie religieuse, telle qu’elle est exposée dans le Liber introductorius de Michel Scot. Au cœur de ce travail se trouve l’étude de la discussion de l’interprétation des signes inhabituels et des événements inattendus par Michel Scot, à la fois dans le Liber quatuor distinctionum et le Liber particularis. L’analyse de nouvelles preuves textuelles, jusque là passées inaperçues, permettra par ailleurs la réévaluation de (...) la réception de Michel Scot en tant qu’autorité dans le domaine des pratiques prédictives. (shrink)

The distinction between harm that is intended as a means or end, and harm that is merely a foreseen side-effect of one’s action, is widely cited as a significant factor in a variety of ethical contexts. Many use it, for example, to distinguish terrorist acts from certain acts of war that may have similar results as side-effects. Yet Bennett and others have argued that its application is so arbitrary that if it can be used to cast certain harmful actions in (...) a more favorable light, then it can equally be manipulated to do the same for any kind of harmful action. In response, some have tried to block such extensions of the intend/foresee distinction by rejecting its application in cases where the relation between the plainly intended means and the harm is “too close”. This move, however, has been attacked as vague and obscure, and Bennett has argued that all the plausible candidates for explicating the idea of excessive closeness ultimately fail. In this paper, I develop and defend an account of excessive closeness with the aim of rescuing the intend/foresee distinction from such charges of arbitrariness. The account is based on the distinction between merely causal and constitutive relations among states of affairs, and I show both how it escapes Bennett’s objections to other accounts and how it applies to a variety of cases. Finally, I also examine Quinn’s alternative move of shifting the focus of the intend/foresee distinction in an attempt to sidestep the issue of closeness, and argue that it is not ultimately successful. In fact, Quinn’s view has shortcomings that can be resolved only by returning to an appeal to some notion of closeness, underscoring the need for the sort of account I offer. (shrink)

Consequentialists maintain that an act is morally right just in case it produces the best consequences of any available alternative. Because agents are ignorant about some of their acts’ consequences, they cannot be certain about which alternative is best. Kagan contends that it is reasonable to assume that unforeseen good and bad consequences roughly balance out and can be largely disregarded. A statistical argument demonstrates that Kagan’s assumption is almost always false. An act’s foreseeable consequences are an extremely poor indicator (...) of the goodness of its overall consequences. Acting based on foreseeable consequences is barely more reliably good than acting completely at random. (shrink)

What grounds the moral significance of the intend/foresee distinction? To put the question another way, what reason do we have for believing that moral absolutes apply with respect to intended effects, but not foreseeable but unintended (bad) effects? Joseph Boyle has provided an answer that relies on the idea that persons can find themselves in situations of “moral impossibility”—situations in which every available option foreseeably will give rise to bad effects. However, Robert Anderson has put Boyle’s answer into question by (...) arguing, in essence, as follows: the choice to do nothing gives rise to no effects at all; one can always simply choose to do nothing; therefore, it is not the case that situations of moral impossibility obtain. In response, Boyle has argued that Anderson’s conception of the effects of the choice to do nothing is implausible and, further, that the choice to do nothing gives rise to effects just as do other choices. In this essay, I address and extend this debate. (shrink)

SUPPORT, a study involving approximately 1,300 premature infants who were randomly assigned to treatment protocols that differed in whether they offered higher or lower levels of oxygen saturation, was purportedly an example of comparative effectiveness research performed in the intensive care unit. However, SUPPORT became highly controversial. One source of controversy involved the proper determination of “reasonably foreseeable risks.” Commentators debated whether randomization to contrasting restrictive strategies that are within existing standard‐of‐care treatments imposed additional “reasonably foreseeable risks” greater than what (...) study participants would have received outside of the research. A second controversial issue had to do with disclosures in informed consent documents. This article explores these issues.We argue that randomization to contrasting restrictive interventions lying at the outer ends of “standard‐of‐care” practices differs in important ways from unrestricted “standard‐of‐care” practices available outside of a proposed study; that research involving such randomization might pose additional “reasonably foreseeable risks” from what occurs in “standard‐of‐care” practices; and that for trials whose study designs are similar to the SUPPORT study, respect for persons requires the disclosure of information about the nature of the experimental procedures and their risks. (shrink)

This paper explores the connection of offshoring and outsourcing to nonconsensual global pharmaceutical trials in low-income countries. After discussing reasons why the topic of nonconsensual offshored clinical trials may be overlooked in bioethics literature, I suggest that when pharmaceutical corporations offshore clinical trials today, nonconsensual experiments are often foreseeable and not simply the result of aberrant ethical conduct by a few individuals. Offshoring of clinical trials is structured so that experiments can be presented as health care in a unique form (...) of outsourcing from the host country to pharmaceutical corporations. Bioethicists’ assessments of the risks and potential benefits of offshore corporate pharmaceutical trials should therefore systematically include not only the hoped for benefits and the risks of the experimental drug but also the risk that subjects will not have consented, as well as the broader international consequences of nonconsensual experimentation. (shrink)

Theoretical defenses of the principle of double effect (pde) due to Quinn, Nagel and Foot are claimed to face severe difficulties. But this leaves those of us who see something in the case-based support for the pde without a way of accounting for our judgments. This article proposes a novel principle it calls the mismatch principle, and argues that the mismatch principle does better than the pde at accounting for our judgments about cases and is also theoretically defensible. However, where (...) the pde makes claims about the permissibility of actions, the mismatch principle makes claims only about the evaluation of agents; and where the pde explains the cases in terms of intending harm, the mismatch principle explains them in terms of a quite different feature of the agent's will. (shrink)

There are a number of cases where, collectively, groups cause harm, and yet no single individual’s contribution to the collective makes any difference to the amount of harm that is caused. For instance, though human activity is collectively causing climate change, my individual greenhouse gas emissions are neither necessary nor sufficient for any harm that results from climate change. Some (e.g., Sinnott-Armstrong) take this to indicate that there is no individual moral obligation to reduce emissions. There is a collective action (...) problem here, to which I offer a solution. My solution rests on an argument for a (sometimes) bare moral difference between intending harm and foreseeing with near certainty that harm will result as an unintended side-effect of one’s action. I conclude that we have a moral obligation to reduce our individual emissions; and, more broadly, an obligation to not participate in many other harmful group activities (e.g., factory-farming). (shrink)

Each month brings new scientific findings that demonstrate the ways in which human activities, from resource extraction to carbon emissions, are doing unprecedented, perhaps irreparable damage to our world. As we hear these climate change reports and their predictions for the future of Earth, many of us feel a sickening sense of _déjà vu_, as though we have already seen the sad outcome to this story. Drawing from recent scholarship that analyzes climate change as a form of “slow violence” that (...) humans are inflicting on the environment, _Climate Trauma_ theorizes that such violence is accompanied by its own psychological condition, what its author terms “Pretraumatic Stress Disorder.” Examining a variety of films that imagine a dystopian future, renowned media scholar E. Ann Kaplan considers how the increasing ubiquity of these works has exacerbated our sense of impending dread. But she also explores ways these films might help us productively engage with our anxieties, giving us a seemingly prophetic glimpse of the terrifying future selves we might still work to avoid becoming. Examining dystopian classics like _Soylent Green _alongside more recent examples like _The Book of Eli_, _Climate Trauma_ also stretches the limits of the genre to include features such as _Blindness_, _The Happening_, _Take Shelter_, and a number of documentaries on climate change. These eclectic texts allow Kaplan to outline the typical blind-spots of the genre, which rarely depicts climate catastrophe from the vantage point of women or minorities. Lucidly synthesizing cutting-edge research in media studies, psychoanalytic theory, and environmental science, _Climate Trauma _provides us with the tools we need to extract something useful from our nightmares of a catastrophic future. (shrink)

It is often assumed that, except perhaps in a few rare cases, people with addiction can be aptly held responsible for having acquired the condition. In this chapter, I consider the argument that supports this view and draw attention to a number of challenges that can be raised against it. Assuming that early decisions to use drugs were made in possession of normal-range psychological capacities, I consider the key question of whether drug users who later became addicted should have known (...) that addiction was a likely outcome of their decisions to use drugs in a way that makes them blameworthy for their lack of foresight. I focus on three different points of contention surrounding this claim: how likely the outcome to be predicted was, how tolerable risk should be weighed against the expected value of decisions to use, and how reliable the relevant predictive abilities of the average person are. Once we consider in some detail what would have to be true in order for someone to be aptly held responsible for becoming addicted, the prospects for making a convincing case to that effect look, I argue, somewhat more uncertain than they might at first appear. (shrink)

In a familiar moral dilemma faced by physicians who care for the dying, some patients who are within days or hours of death may experience suffering in a degree that cannot be relieved by ordinary levels of analgesia. In such cases, it may sometimes be possible to honor a competent patient's request for pain relief only by giving an injection of narcotics in a dosage so large that the patient's death is thereby hastened. Doctors rightly worry that taking an action (...) likely to result in a patient's death may violate the Hippocratic injunction against the direct killing of anyone in their care. (shrink)

In a familiar moral dilemma faced by physicians who care for the dying, some patients who are within days or hours of death may experience suffering in a degree that cannot be relieved by ordinary levels of analgesia. In such cases, it may sometimes be possible to honor a competent patient's request for pain relief only by giving an injection of narcotics in a dosage so large that the patient's death is thereby hastened. Doctors rightly worry that taking an action (...) likely to result in a patient's death may violate the Hippocratic injunction against the direct killing of anyone in their care. (shrink)

We increasingly rely on AI-related applications (smart technologies) to perform tasks that would be simply impossible by un-aided or un-augmented human intelligence. This is possible because the world is becoming an infosphere increasingly well adapted to AI’s limited capacities. Being able to imagine what adaptive demands this process will place on humanity may help to devise technological solutions that can lower their anthropological costs.

Artificial intelligence research and regulation seek to balance the benefits of innovation against any potential harms and disruption. However, one unintended consequence of the recent surge in AI research is the potential re-orientation of AI technologies to facilitate criminal acts, term in this article AI-Crime. AIC is theoretically feasible thanks to published experiments in automating fraud targeted at social media users, as well as demonstrations of AI-driven manipulation of simulated markets. However, because AIC is still a relatively young and inherently (...) interdisciplinary area—spanning socio-legal studies to formal science—there is little certainty of what an AIC future might look like. This article offers the first systematic, interdisciplinary literature analysis of the foreseeable threats of AIC, providing ethicists, policy-makers, and law enforcement organisations with a synthesis of the current problems, and a possible solution space. (shrink)

For an artificial agent to be morally praiseworthy, its rules for behaviour and the mechanisms for supplying those rules must not be supplied entirely by external humans. Such systems are a substantial departure from current technologies and theory, and are a low prospect. With foreseeable technologies, an artificial agent will carry zero responsibility for its behavior and humans will retain full responsibility.

Artificial Intelligence research and regulation seek to balance the benefits of innovation against any potential harms and disruption. However, one unintended consequence of the recent surge in AI research is the potential re-orientation of AI technologies to facilitate criminal acts, term in this chapter AI-Crime. AIC is theoretically feasible thanks to published experiments in automating fraud targeted at social media users, as well as demonstrations of AI-driven manipulation of simulated markets. However, because AIC is still a relatively young and inherently (...) interdisciplinary area—spanning socio-legal studies to formal science—there is little certainty of what an AIC future might look like. This chapter offers the first systematic, interdisciplinary literature analysis of the foreseeable threats of AIC, providing ethicists, policy-makers, and law enforcement organisations with a synthesis of the current problems, and a possible solution space. (shrink)

The capacity to collect and analyse data is growing exponentially. Referred to as ‘Big Data’, this scientific, social and technological trend has helped create destabilising amounts of information, which can challenge accepted social and ethical norms. Big Data remains a fuzzy idea, emerging across social, scientific, and business contexts sometimes seemingly related only by the gigantic size of the datasets being considered. As is often the case with the cutting edge of scientific and technological progress, understanding of the ethical implications (...) of Big Data lags behind. In order to bridge such a gap, this article systematically and comprehensively analyses academic literature concerning the ethical implications of Big Data, providing a watershed for future ethical investigations and regulations. Particular attention is paid to biomedical Big Data due to the inherent sensitivity of medical information. By means of a meta-analysis of the literature, a thematic narrative is provided to guide ethicists, data scientists, regulators and other stakeholders through what is already known or hypothesised about the ethical risks of this emerging and innovative phenomenon. Five key areas of concern are identified: informed consent, privacy, ownership, epistemology and objectivity, and ‘Big Data Divides’ created between those who have or lack the necessary resources to analyse increasingly large datasets. Critical gaps in the treatment of these themes are identified with suggestions for future research. Six additional areas of concern are then suggested which, although related have not yet attracted extensive debate in the existing literature. It is argued that they will require much closer scrutiny in the immediate future: the dangers of ignoring group-level ethical harms; the importance of epistemology in assessing the ethics of Big Data; the changing nature of fiduciary relationships that become increasingly data saturated; the need to distinguish between ‘academic’ and ‘commercial’ Big Data practices in terms of potential harm to data subjects; future problems with ownership of intellectual property generated from analysis of aggregated datasets; and the difficulty of providing meaningful access rights to individual data subjects that lack necessary resources. Considered together, these eleven themes provide a thorough critical framework to guide ethical assessment and governance of emerging Big Data practices. (shrink)

In this article, responding to assertions that the principle of double effect has no place in legal analysis, I explore the overlap between double effect and negligence analysis. In both, questions of culpability arise in situations where a person acts with no intent to cause harm but where reasonable foreseeability of unintended harm exists. Under both analyses, the determination of whether such conduct is permissible involves a reasonability test that balances that foreseeable harm against the good intended by the (...) actor's conduct. In both, absent a finding that the foreseeable harm is unreasonable in light of that intended good, no liability will be imposed upon the actor. Even conceding, however, such general similarity between double effect and negligence analysis - disagreement over the proper interpretation of the reasonability criterion at play in negligence poses an additional challenge for the attempt to correlate negligence with double effect. Economic efficiency interpretations of negligence, for example, purportedly based on the Learned Hand Formula and the RESTATEMENT (SECOND) OF THE LAW OF TORTS, propose that culpability depends upon a utilitarian balancing of good effects of conduct (utility) versus its harmful foreseeable consequences (magnitude of risk of injury). Based on such an interpretation of negligence, however, contrasts between actors' states of mind, and normative differences between kinds of goods and harms, ultimately fade into the background and become irrelevant as essential conditions for properly assessing liability. This article elaborates and defends the view that double effect analysis lies at the heart of negligence theory. Part I elucidates in more detail the principle of double effect and describes its prima facie operation in negligence analysis. Part II considers and rejects the economic efficiency interpretation that has been offered as a theory of negligence, overcoming the challenge that such an interpretation presents for the effort to locate double effect analysis in the law. Part III illustrates and confirms the overlap between double effect and negligence by consideration of a series of case applications. The Article proposes that the weighing of conflicting values in double effect analysis and negligence is not achieved - as proposed by law and economics theory with respect to negligence - by imposing a consequentialist-utilitarian reduction of all value to a single concept of good and eliminating the relevance of traditional state of mind distinctions between intention and foreseeability. Instead, each mode of analysis recognizes that distinct culpability determinations flow naturally and plausibly from an appreciation of the traditional legal distinctions made between various types of goods and harms, and upon whether such goods and harms come about as result of an actor's intention or mere foreseeability. Keywords: Double effect, negligence, intention, foreseeability, choice, law and economics, utilitarianism, consequentialism, weighing of values. (shrink)

The article analyzes the reports of the Club of Rome issued subsequent to its semicentennial celebration. The analysis uncovers the evolutionary trajectory of the Club’s conceptual frameworks, transitioning from the stark alarmism prevalent in the early 1970s to a grounded optimism characteristic of the early 21st century. The majority of its publications, in explicit or implicit form, essentially respond to a question of Hamletian scale that arose within the discussions of the “limits to growth” model: Is it possible, and if (...) so, how, to overcome the antagonism between the continuous growth of the needs of an increasing humanity and the relatively limited natural-resource potential of the biosphere? The analysis introduces an analysis of world development scenarios by 2050, ranging from inertial extrapolation of current trends to radical transformations of global political, socio-economic, and cultural processes. The discourse reflects on the report authors’ contemplations regarding societal adaptability to undergo a “true human revolution,” entailing a fundamental reassessment of established economic models and advancement toward innovative global governance strategies. The paper scrutinizes the assertion that society’s “unlearnability” is one of the key obstacles to the sustainable development of civilization. Significant emphasis is placed on the imperative for a comprehensive transformation encompassing the global educational landscape and the cultivation of a novel (sustainable) mindset, one that appreciates the intricate interplay among economic, environmental, and sociocultural perspectives on the global dynamics of the “humanity – biosphere – civilization” system. Humanity, overcoming the turbulences of contemporary world development, possesses all the prerequisites for a constructive analysis and design of strategic perspectives of the foreseeable future. (shrink)

Warren Quinn suggests a presumption against usefully involving others in foreseeably harmful agency. Frances Kamm offers her Party Case, in which one throws a party only because one expects one’s guests will feel indebted to clean up, to argue that Quinn’s presumption should not apply to all agency undertaken because it will bring about this involvement but only to agency in which this involvement is intended. I offer impermissible and intentional variants of Party Case and consider other cases to argue (...) that the permissibility of usefully involving others depends on their independent rights, rather than whether their involvement is intended. (shrink)

There is, as some public figures have asserted, a real moral difference between creating embryos expressly for medical research and conducting research on embryos that are left over from infertility treatments. To create an embryo intending all along to destroy it is worse. But in the end, it isn't so much worse that we should ban all nonreproductive cloning.

‘AI & Law’ research has been around since the 1970s, even though with shifting emphasis. This is an overview of the contributions of digital technologies, both artificial intelligence and non-AI smart tools, to both the legal professions and the police. For example, we briefly consider text mining and case-automated summarization, tools supporting argumentation, tools concerning sentencing based on the technique of case-based reasoning, the role of abductive reasoning, research into applying AI to legal evidence, tools for fighting crime and tools (...) for identification. (shrink)

This article explores situational determinants and psychological consequences of counterfactual excuse-making - denying responsibility by declaring `I couldn’t have known.’ Participants who were made accountable for a stock investment decision that resulted in an outcome caused by unforeseeable circumstances were particularly likely to generate counterfactual excuses and, as a result, to deny responsibility for the outcome of their choices and minimize their perceptions of control over the decision process. The article discusses the implications of these findings for structuring accountability reporting (...) relationships in business and, more generally, stresses the benefits of counterfactual denials of responsibility for maintaining self-esteem and a desired self-identity. (shrink)

This paper contains a discussion of striking similarities between influential philosophical concepts of the past and the approaches currently employed in selected areas of computer science. In particular, works of the Pythagoreans, Plato, Abelard, Ash’arites, Malebranche and Berkeley are presented and contrasted with such computer science ideas as digital computers, object-oriented programming, the modelling of an object’s actions and causality in virtual environments, and 3D graphics rendering. The intention of this paper is to provoke the computer science community to go (...) off the beaten path in order to find inspiration for the development of new approaches in software engineering. (shrink)

How can we manage knowledge, human and intellectual resources, cognitive and behavioral dynamics at their best within the corporations? The main challenge is to use the missing knowledge, often incomplete and contradictory, owned by a single man and globally not available to anyone.

Extant research has shown that ordinary causal judgments are sensitive to normative factors. For instance, agents who violate a norm are standardly deemed more causal than norm-conforming agents in identical situations. In this paper, we explore two competing explanations for the Norm Effect: the Responsibility View and the Bias View. According to the former, the Norm Effect arises because ordinary causal judgment is intimately intertwined with moral responsibility. According to the alternative view, the Norm Effect is the result of a (...) blame-driven bias. In a series of five preregistered experiments (N = 2688), we present evidence that predominantly favours the Bias View. In particular, and against predictions made by the Responsibility View, we show that participants deem agents who violate nonpertinent or silly norms – norms that do not relate to the outcome at hand – as more causal, and that this effect cannot be explained in terms of plausible mediators such as the agent’s foreknowledge and desire, or the foreseeability of harm. We close with a discussion regarding the implications of these findings, in as regards the just assessment of proximate cause in the law. (shrink)

Can a competent individual refuse care in order to make their natural death reasonably foreseeable in order to qualify for medical assistance in dying (MAiD)? Consider a competent patient with left-side paralysis following a right brain stroke who is not expected to die for many years; normally his cause of death would not be predictable. However, he refuses regular turning, so his physician can predict that pressure ulcers will develop, leading to infection for which he will refuse treatment and consequently (...) die. Is he now eligible for MAiD? Consider a competent patient with spinal stenosis (a non-fatal condition) who refuses food (but not liquids in order not to lose capacity from dehydration). Consequently, her physician can predict death from starvation. Is she now eligible for MAiD? Answering these questions requires that we answer three sub-questions: 1) do competent patients have the right to refuse care?; 2) do healthcare providers have a duty to respect such refusals?; and 3) are deaths resulting from refusals of care natural for the purposes of determining whether a patient is eligible for MAiD? If a competent patient has the right to refuse some particular care, and healthcare providers have a duty to respect that refusal, and if the death that would result from the refusal of that care is natural, then that refusal of care is a legal pathway to MAiD. However, if the competent patient does not have the right to refuse some particular care, or if healthcare providers do not have a duty to respect that refusal, or if the death that would result from the refusal of that care is not natural, then that refusal of care is not a legal pathway to MAiD. In this paper, we explore this complex legal terrain with the most profound of ethical implications – access to MAiD. (shrink)

In the first part of this article, I raisequestions about Dworkin''s theory of theintrinsic value of life and about the adequacyof his proposal to understand abortion in termsof different ways of valuing life. In thesecond part of the article, I consider hisargument in ``The Philosophers'' Brief on AssistedSuicide'''', which claims that the distinctionbetween killing and letting die is morallyirrelevant, the distinction between intendingand foreseeing death can be morally relevantbut is not always so. I argue that thekilling/letting die distinction can be (...) relevantin the context of assisted suicide, but alsoshow when it is not. Then I consider why theintention/foresight distinction can be morallyirrelevant and conclude by presenting analternative argument for physician-assistedsuicide. (shrink)