To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
What purpose can be served by empirically unsubstantiated speculation in ethics? In answering that question, we need to distinguish between the major branches of ethics. In foundational moral philosophy, the use of speculative examples is warranted to the extent that ethical principles and theories are assumed to be applicable even under the extreme circumstances referred to in these examples. Such an assumption is in need of justification, and it cannot just be taken for granted. In applied ethics, the use of unrealistic scenarios is more difficult to justify. It can be positively harmful if it diverts our attention from more urgent issues. Neuroethics is one of the areas of applied ethics where speculative scenarios have taken up much of the attention that could instead have been devoted to problems that are relevant for the treatment and care of patients. Speculative ethics has often been defended with mere possibility arguments that may at first hand seem difficult to refute. It is shown with examples how such claims can be defeated with a combination of science and argumentation analysis.
In their daily clinical work, healthcare professionals generally apply what seems to be a double standard for the responsibility of patients. On the one hand, patients are encouraged to take responsibility for lifestyle changes that can improve their chances of good health. On the other hand, when patients fail to follow such recommendations, they are not held responsible for the failure. This seeming inconsistency is explained in terms of the distinction between task responsibility and blame responsibility. The double standard for responsibility is shown to be epistemologically rational, ethically commendable, and therapeutically advantageous. However, this non-blaming approach to patient responsibility is threatened by proposals to assign lower priority in healthcare to patients who are themselves responsible for their disease. Such responsibility-based priority setting requires that physicians assign blame responsibility to their patients, a practice that would run into conflict with the ethical foundations of the patient–physician relationship. Therefore, such proposals should be rejected.
Occupational exposures of pregnant workers can give rise to foetal damage. Two major types of strategies against detrimental effects on the foetus are described: differentiated protection that reduces only the exposure of pregnant workers (or only of female workers) and unified protection that reduces the exposure of all workers to a level that is sufficiently low to protect against detrimental effects on the foetus. The former strategy is shown to be inefficient, as it does not provide the desired protection. Protection only of pregnant workers is insufficient since protection is needed early in pregnancy when it is not known, and in the case of substances that are accumulated in the woman's body even prior to conception. Protection of all women is also insufficient to protect the foetus since evidence indicates that preconception exposure of the father can also give rise to malformations. Furthermore, differentiated protection that requires more costly protective measures for women tends to aggravate the already prevalent discrimination of women on the labour market. It is therefore concluded that unified protection is the only efficient and non-discriminatory strategy against foetal damage.
In order to shorten queues to healthcare, the Swedish government has introduced a yearly “queue billion” that is paid out to the county councils in proportion to how successful they are in reducing queues. However, only the queues for first visits are covered. Evidence has accumulated that queues for return visits have become longer. This affects the chronically and severely ill. Swedish physicians, and the Swedish Medical Association, have strongly criticized the queue billion and have claimed that it conflicts with medical ethics. Instead they demand that their professional judgments on priority setting and medical urgency be respected. This discussion provides an interesting illustration of some of the limitations of new public management and also more generally of the complicated relationships between medical ethics and public policy.
The outcome set of a belief change operator is the set of outcomes that can be obtained with it. Axiomatic characterizations are reported for the outcome sets of the standard AGM contraction operators and eight types of base-generated contraction. These results throw new light on the properties of some of these operators.
The prescriptive ‘ought’ has both an objective and a subjective interpretation. In the objective sense, what one ought to do depends on what is actually true. In the subjective sense it depends on what one believes to be true. Ordinary usage seems to vacillate between these two interpretations. An example (the indecisive terrorist) is used to show that a subjective ought statement can have a determinate truth-value in situations where the corresponding objective ought statement has no truth-value, not even an unknowable one. Therefore the subjective ought is not definable in terms of the objective ought. However, definability in the other direction is not excluded by this argument.
Three of the bioethical issues recently discussed in Sweden appear to be particularly interesting also to an international audience. A new law allowing restrictive use of preimplantation genetic diagnosis (PGD)/human leukocyte antigen (HLA) (“savior siblings”) has been implemented, a new recommendation for the cessation of life-sustaining treatment has been issued, and the scope of individual responsibility for medical mistakes has been rather thoroughly discussed.
Cost–benefit analysis (CBA) is much more philosophically interesting than has in general been recognized. Since it is the only well-developed form of applied consequentialism, it is a testing-ground for consequentialism and for the counterfactual analysis that it requires. Ten classes of philosophical problems that affect the practical performance of cost–benefit analysis are investigated: topic selection, dependence on the decision perspective, dangers of super synopticism and undue centralization, prediction problems, the indeterminateness of our control over future decisions, the need to exclude certain consequences for moral reasons, bias in the delimitation of consequences, incommensurability of consequences, difficulties in defending the essential requirement of transferability across contexts, and the normatively questionable but equally essential assumption of interpersonal compensability.
Healthcare depends increasingly on advanced medical technology. In
addition, other forms of technology contribute to determine how our lives
are influenced by disease and disability. The extent to which persons with
impaired bodily functions are forced to live their lives differently than
other people depends to a large part on a variety of technologies, from
wheelchairs to computer interfaces, from hearing aids to garage doors.
This wide-ranging influence of technology has important ethical aspects,
but has seldom been discussed in bioethics, the ethics of technology, or
other branches of applied ethics.
Mainstream risk analysis deviates in at least two important respects from the rationality ideal of mainstream economics. First, expected utility maximization is not applied in a consistent way. It is applied to endodoxastic uncertainty, i.e. the uncertainty (or risk) expressed in a risk assessment, but in many cases not to metadoxastic uncertainty, i.e. uncertainty about which of several competing assessments is correct. Instead, a common approach to metadoxastic uncertainty is to only take the most plausible assessment into account. This will typically lead to risk-prone deviations from risk-neutrality. Secondly, risks and benefits for different persons are added to form a total value of risk. Such calculations are used to support the view that one should accept being exposed to a risk if it brings greater benefits for others. This is in stark contrast to modern Paretian welfare economics, that refrains from interindividual comparisons and does not require people to accept a disadvantage because it brings a larger advantage for others.
Sweden is probably one of the most secularized nations in the world.
Therefore religious arguments tend to play a smaller role in the public
bioethical debate than in most other countries. Issues such as abortion,
stem-cell research, and therapeutic cloning have been far less
controversial in Sweden than elsewhere. Instead, other issues have
dominated recent bioethical debates in Sweden, in particular those
concerning privacy and the control over biological information about
This article argues that, contrary to the received view, prioritarianism and egalitarianism are not jointly incompatible theories in normative ethics. By introducing a distinction between weighing and aggregating, the authors show that the seemingly conflicting intuitions underlying prioritarianism and egalitarianism are consistent. The upshot is a combined position, equality-prioritarianism, which takes both prioritarian and egalitarian considerations into account in a technically precise manner. On this view, the moral value of a distribution of well-being is a product of two factors: the sum of all individuals' priority-adjusted well-being, and a measure of the equality of the distribution in question. Some implications of equality-prioritarianism are considered.
Due to modern biochemistry and, in particular, recent developments in
genomics, proteomics, and bioinformatics, human samples (organs,
tissues, cells, genes, etc.) have become the most important raw
materials for advancement in the health sciences. Such material has
been at the center of fundamental biomedical research for a long time.
What is new is its increased usefulness in research with direct
clinical relevance, such as the development of drugs. Because of the
larger commercial involvement in such research, this has also led to
greater economic interests in human biological material and in the
information that can be extracted from it.
Five types of constructions are introduced for non-prioritized belief revision, i.e., belief revision in which the input sentence is not always accepted. These constructions include generalizations of entrenchment-based and sphere-based revision. Axiomatic characterizations are provided, and close interconnections are shown to hold between the different constructions.
The notion of residual obligations can be used as a tool to overcome, at least in part, the conflict between the individual's prima facie right not to be exposed to involuntary risks, and the rights of industries and other large organisations to carry out activities that are associated with risks. A typology of residual obligations is developed, and it is applied in a discussion of the moral obligations of those who impose risks on others. The major types are obligations to compensate, to communicate, to improve, to search for knowledge, and to have an appropriate attitude. It is argued that conscientious compliance with risk-related residual obligations is an essential component of what makes it morally acceptable to expose others to risk.
In the Preface, I pointed out that formal representations of values and norms can be useful both for the clarification of basic philosophical issues and for applications in subjects such as economics, jurisprudence, decision theory, and social choice theory. In this final chapter, some indications will be given of how the results reported in the previous chapters can contribute to these two purposes.
The discussions that a formalized treatment of philosophical subject matter gives rise to can be divided into three categories:
New aspects on issues already discussed in informal philosophy.
Issues not previously discussed in informal philosophy, but with a clear philosophical interest.
Issues that are peculiar to the chosen formalism and have no bearing on philosophical issues that can be expressed without the formalism.
To mention just one example from each of these categories, logical approaches to the classification of legal relations belong to category (1), preference transitivity to category (2), and the necessitation paradoxes in deontic logic to category (3). When assessing the philosophical relevance of a formalized approach, it may be useful to compare how much discussion of types (1) and (2) on the one hand, and (3) on the other, it gives rise to.
It is not difficult to find examples of how results from the previous chapters can be applied to philosophical problems, giving rise to discussions that belong to categories (1) and (2) in the above classification.
In addition to the comparative notions, ‘better’ and ‘of equal value,’ informal discourse on values contains monadic (one-place) value predicates, such as ‘good,’ ‘best,’ ‘very bad,’ ‘fairly good,’ and so on.
We predicate concepts such as goodness not only of complete alternatives but also – and more often – of particular states of affairs. Just like combinative preference relations, monadic predicates will be assumed to refer to states of affairs. They will be inserted into a structure that contains a combinative preference relation, so that their relations to the comparative notions can be studied. Throughout this chapter,≥′ denotes a (weak) combinative preference relation that operates on the union ∪A of some contextually complete alternative set A. As before, >′ and ≡′ are its strict and symmetric parts. The more precise nature of ≥′ will be left open. Monadic predicates such as ‘good’ appear both in decision-guiding contexts where it would seem natural to connect them with a decision-guiding preference relation, and in other contexts in which a ceteris paribus preference relation may be more appropriate.
The standard reading of p>′q, “p is better than q,” implies no commitment whatsoever with respect to the truth values of p and q. If p does not hold in the actual world, then “p would be better than q” is a more accurate paraphrase.