‘A Promise Made is a Debt Unpaid’: Nietzsche on the Morality of Commitment and the Commitments of Morality
This article discusses what we can learn about promising and about Nietzsche’s critique of morality from his discussion of sovereign promising in the opening sections of the second essay of On the Genealogy of Morals. It argues that the philosophical focus of GM II: 1–2 is not the nature of promising in the narrow sense of making a pledge to do something for someone else, but the nature of pledging or committing oneself in general. It identifies the root difference between a moral obligation and a Nietzschean account of promissory fidelity. It argues that, in its focus on the difficult questions of what it means and how it is possible to bind oneself to a course of action, the Nietzschean account is philosophically deeper than the moral obligation account. Finally, the article considers misconceptions of revisionist readings of GM II: 1–2.
John Harris and Søren Holm
Abortion is one of those classic problems that has been discussed in all of the major ‘fertile periods’ of practical philosophy, from the flourishing of Greek thought, through the medieval period, in the Renaissance and from the start of modern applied ethics in the 1960s. This article begins with a brief historical overview of the discussion of the ethics of abortion, and then proceeds to a range of questions that have been prominent in the philosophical discussion about abortion since the 1960s. The two main areas of controversy have been how to understand the moral status of the fetus, and whether a right to abortion can be based in the mother's right to autonomy.
This chapter, which examines views about abortion and death, discusses claims about abortion and explains some ways for considering these claims to be true. It analyzes whether abortion causes the death of a fetus and whether bringing death to a fetus greatly harms it, also discussing the relevant issues of nonsentient fetus, intermediate judgment argument, and the unequal harm of death judgment.
Mahmoud F. Fathalla
There is an ethical imperative to take public health action to eliminate the global problem of unsafe abortion. The moral obligation is dictated by the magnitude of the problem, the health inequities and social injustices that result from lack of access to safe abortion, the voices of women calling for action, and an international consensus recognizing unsafe abortion as a global health problem. The availability of public health interventions and the cost savings associated with fewer abortion complications reinforce the obligation to address unsafe abortion. Public health actions include reducing the need for abortion through family planning, providing safe abortion to the full extent of the law, managing abortion complications, and providing post-abortion care. These actions intersect with morality, religion, law, justice, and human rights. The public health community has a collective social and ethical responsibility to stand beside and behind women as they claim their human right to health.
The three major classical accounts of the morality of abortion are all subject to at least one major problem. Can we do better? This article aims to discuss three accounts that purport to be superior to the classical accounts. First, it discusses the future of value argument for the immorality of abortion. It defends the claim that the future of value argument is superior to all three of the classical accounts. It then goes on to discuss Warren's attempt to fix up her personhood account and David Boonin's attempt to fix up Tooley's desire account. Warren claims that her updated version of a personhood account is superior to any potentiality account, such as the future of value account. The article evaluates her claim. Boonin argues that his improved desire view both deals adequately with the apparent counterexamples to Tooley's original account and also is superior to the future of value account. The article evaluates his views as well.
Sheelagh McGuinness and Heather Widdows
If women are to have true equality with men, they must be able to control the number of children they have and the time of childbirth. Access to family planning services, particularly safe contraception and abortion, is key to this control and thus must be understood as basic reproductive rights. To disallow such access effectively bars women from attaining equality with men by denying minimal standards of bodily integrity. These rights must be understood not just in terms of noninterference but also in terms of ensuring an enabling environment to access to these services. International human rights norms are an important empowerment tool and are evolving towards protecting basic reproductive rights, but there is still more to be accomplished. An important threat to basic reproductive rights, which must be resisted, is the Global Gag Rule that prohibits funding to reproductive agencies which offer abortion services.
Anne Drapkin Lyerly, Elana Jaffe, and Margaret Olivia Little
Advancing fair access to evidence-based pregnancy-related services is a critical public health priority. It is widely recognized that there are inequalities in lifesaving interventions. This chapter however addresses issues raised by services whose value or utility are contested. Using illustrative examples of prenatal genetic testing and modes of childbirth, the chapter highlights the ways in which issues of access are complicated by social and cultural ideas about what is valued; discusses contested questions about what is ethically responsible or required of patients, providers, and public health systems in these reproductive health contexts; and addresses areas of needed research and further ethical analysis. It concludes that issues of access in pregnancy-related care must attend both to broad issues of justice and access and to particular ways that pregnancy services are valued, debated, and made available to women who might—or might not—benefit from them.
This chapter examines the role of the virtuous agent in the acquisition of virtue. It rejects the view of the virtuous agent as a direct model for imitation and instead focuses on recent research on the importance of phronesis. Phronesis is understood as a type of moral “know-how”—expertise that is supported by a variety of abilities, from emotional maturity, to self-reflection, to an empathic understanding of what moves others, to an ability to see beyond the surface and understand the complexities of human behavior. If we want to acquire virtue, instead of focusing on the virtuous agent as such, we should be trying to understand the abilities exemplified by his phronesis. As part of this project, the author also considers philosophers who seek inspiration from the empirical sciences to shed light on how phronetic expertise is developed and what relevance this may have for moral education.
Holly Lawford-Smith and William Tuckwell
According to act-consequentialism, only actions that make a difference to an outcome can be morally bad. Yet, there are classes of actions that don’t make a difference, but nevertheless seem to be morally bad. Explaining how such non-difference making actions are morally bad presents a challenge for act-consequentialism: the no-difference challenge. In this chapter we go into detail on what the no-difference challenge is, focusing in particular on act consequentialism. We talk about how different theories of causation affect the no-difference challenge; how the challenge shows up in real-world cases, including voting, global labor injustice, global poverty, and climate change; and we work through a number of the solutions to the challenge that have been offered, arguing that many fail to actually meet it. We defend and extend one solution that does, and we present a further solution of our own.
Alfred R. Mele
What are actions? And how are actions to be explained? These two central questions of the philosophy of action call, respectively, for a theory of the nature of action and a theory of the explanation of actions. Many ordinary explanations of actions are offered in terms of such mental states as beliefs, desires, and intentions, and some also appeal to traits of character and emotions. Traditionally, philosophers have used and refined this vocabulary in producing theories of the explanation of intentional actions. An underlying presupposition is that common-sense explanations expressed in these terms have proved very useful. People understand their own and others' actions well enough to coordinate and sustain complicated, cooperative activities integral to normal human life, and that understanding is expressed largely in a common-sense psychological vocabulary. This article focuses on these issues.
Yishai Cohen and Travis Timmerman
The actualism/possibilism debate in ethics is about whether counterfactuals of freedom concerning what an agent would freely do if she were in certain circumstances even partly determine that agent’s obligations. This debate arose from an argument against the coherence of utilitarianism in the deontic logic literature. In this chapter, we first trace the historical origins of this debate and then examine actualism, possibilism, and securitism through the lens of consequentialism. After examining their respective benefits and drawbacks, we argue that, contrary to what has been assumed, actualism and securitism both succumb to the so-called nonratifiability problem. In making this argument, we develop this problem in detail and argue that it’s a much more serious problem than has been appreciated. We conclude by arguing that an alternative view, hybridism, is independently the most plausible position and best fits with the nature of consequentialism, partly in light of avoiding the nonratifiability problem.
James R. Otteson
The Theory of Moral Sentiments (1759) is Adam Smith's major contribution to ethical thought. Although it underwent six revisions during his lifetime, its primary arguments did not change, and this chapter focuses on those aspects that remain constant, beginning with an overview of Smith's theory followed by a discussion of the main elements of the theory. Smith presents morality as systems of overlapping spontaneous order that arise unintentionally based on continuous interactions, reactions, and responses to feedback. Although the philosopher can discover the relative utility of specific aspects of a community's moral standards, and thus make recommendations or encouragements to increase utility, Smith agrees with Hume that moral distinctions are not derived from reason.
In recent decades, patient advocates have joined scientists in lobbying for research funds from government agencies, nonprofit organizations, and for-profit entities. Advocates also seek to influence decisions about access to unproven interventions, most notably in right-to-try and expanded-access debates. Advocates weigh in on the design and conduct of individual studies, too. Advocates can help make research more responsive to the needs and desires of patients, but they can also contribute to harm in the form of unjust resource allocation, as well as burdens and disappointments for research participants and patients. Ethical analysis of advocacy activities points to guidelines that can maximize the benefits and minimize the harms produced by research advocacy.
Affirmative action is a term used in the USA to depict a set of laws, policies, guidelines, and government-mandated and government-sanctioned administrative practices, including those of private institutions, intended to end and correct the effects of a specific form of discrimination. It seeks to end the effects of discriminatory practices that violate the inherent equality of persons who, because they share certain attributes such as sex or skin colour, have been denied opportunities on the grounds that they are inferior or different. Affirmative action aims to reduce present discrimination against members of targeted groups such as African, Native or Hispanic Americans, women, and the handicapped, and to increase their numbers within certain occupations and professions and at universities and colleges.
This chapter examines three primary public health goals relating to elderly populations: promoting healthy aging (including aging in place), reducing health inequities, and extending life spans. It then considers the ways in which programs or policies to advance population-wide goals are challenged to meet ethical responsibilities to protect older adults from harm, respect their autonomy and dignity, and treat them fairly or justly when resources are limited. Lastly, by looking at a difficult situation commonly faced in hospitals—the discharge of an elderly patient who may not be able to safely return home—the chapter introduces questions about the relationship between public health ethics, clinical ethics, and social justice, and about the future role of public health as a field of inquiry and action.
Stephen G. Post
Of the many topics worthy of discussion regarding older adults and bioethics, two seem to provide an especially pointed opportunity for reflection on our aging society. First, is aging itself something that biomedical researchers should focus on as a deficit to be overcome through eventual anti-aging treatments? While aging may not fall neatly into the disease category, it is clearly the primary susceptibility factor for the innumerable diseases of older adults, and therefore its potential deceleration consistent with the compression of morbidity might constitute a salutary biomedical goal. The aging society is no panacea to those who suffer from a host of chronic illnesses and feel overwhelmed by the burden of years. Second, we must concentrate on the most challenging problematic of our current aging society, assuming that anti-aging technologies will only become available in future decades. One immense problem is the harsh reality of irreversible progressive dementia, which will serve here as an example of the rise of chronic illness, for which age itself is the primary risk factor.
This article explores a number of issues in agriculture and agricultural biotechnology putting a special emphasis within the philosophy of biology which is a fruitful area of study. The ecological impact of agriculture and the potential for humans to make novel contributions to genetic diversity raises questions about biodiversity. Thousands of years of selective breeding and food production using microorganisms in wine, bread, and cheese qualify as agricultural biotechnology. There are various disputes regarding genetically modified food, between products of agricultural biotechnology, and their conventional counterparts. The agricultural revolution also raises many ethical issues including concerns about corporate control, intellectual property rights, and use of traditional biological knowledge. We are on the threshold of the life sciences revolution. Unrevealing these mysteries of science will increase our knowledge and provide understanding of the world around us. Thus, it should lead to a better quality of life.
This chapter examines ethical principles that guide public health intervention to reduce the harms of alcohol and other drugs, including justice-based concerns regarding intervention. While many egalitarian moral theories support public health measures to reduce these harms, and thereby protect individual capability and opportunity, there are opposing arguments to limit public health intervention based on either individual liberty or personal responsibility. The chapter also reviews ethical issues related to prevention, treatment, harm reduction, and decriminalization/legalization. Prevention through education is politically appealing, but is not always evidence-based and can be stigmatizing. Treatment can be highly cost-effective, but some approaches are controversial, such as legally coerced treatment. Harm reduction approaches, such as needle exchange, can reduce many of the negative health consequences of alcohol and drug use, but they require a more direct government role in illicit behaviors. Marijuana legalization is a growing movement in the United States, but it poses complex regulatory challenges.
Calvin C. Baker and Barry Maguire
An ethical theory is alienating if accepting the theory inhibits the agent from fitting participation in some normative ideal, such as some ideal of integrity, friendship, or community. Many normative ideals involve nonconsequentialist behavior of some form or another. If such ideals are normatively authoritative, they constitute counterexamples to consequentialism unless their authority can be explained or explained away. We address a range of attempts to avoid such counterexamples and argue that consequentialism cannot by itself account for the normative authority of all plausible such ideals. At best, consequentialism can find a more modest place in an ethical theory that includes nonconsequentialist principles with their own normative authority.
Holly M. Smith
Consequentialists have long debated (as deontologists should) how to define an agent’s alternatives, given that (a) at any particular time an agent performs numerous “versions” of actions, (b) an agent may perform several independent co-temporal actions, and (c) an agent may perform sequences of actions. We need a robust theory of human action to provide an account of alternatives that avoids previously debated problems. After outlining Alvin Goldman’s action theory (which takes a fine-grained approach to act individuation) and showing that the agent’s alternatives must remain invariant across different normative theories, I address issue (a) by arguing that an alternative for an agent at a time is an entire “act tree” performable by her, rather than any individual act token. I argue further that both tokens and trees must possess moral properties, and I suggest principles governing how these are inherited among trees and tokens. These proposals open a path for future work addressing issues (b) and (c).