Both left libertarians, who support the redistribution of income and wealth through taxation, and right libertarians, who oppose redistributive taxation, share an important view: that, looming catastrophes aside, the state must never redistribute any part of our body or our person without our consent. Cécile Fabre rejects that view. For her, just as the undeservedly poor have a just claim to money from their fellow citizens in order to lead a minimally flourishing life, the undeservedly ‘medically poor’ have a just (...) claim to help from fellow citizens in order to lead such a life. Such obligatory help may in principle involve even the supply of body parts for transplantation. The state ought to exact such resources from the medically rich whenever doing so would secure the prospect of a minimally flourishing life to the medically poor without denying that prospect to anyone else. Fabre criticizes Ronald Dworkin's belief in ‘a prophylactic line that comes close to making the body inviolate, that is, making body parts not parts of social resources at all’. For her, ‘Duties to help. . . do not stop at material resources: they involve the body. . . in invasive ways’. (shrink)

The Self-Intimation thesis has it that whatever justificatory status a proposition has, i.e., whether or not we are justified in believing it, we are justified in believing that it has that status. The Infallibility thesis has it that whatever justificatory status we are justified in believing that a proposition has, the proposition in fact has that status. Jointly, Self-Intimation and Infallibility imply that the justificatory status of a proposition closely aligns with the justification we have about that justificatory status. Self-Intimation (...) has two noteworthy implications. First, assuming that we never have sufficient justification for a proposition and for its negation, we can derive Infallibility from Self-Intimation. Interestingly, there seems to be no equivalently simple way to derive Self-Intimation from Infallibility. This asymmetry provides reason for thinking that bottom-level justification rather than top-level justification drives the explanation for why the levels of justification align. Second, Self-Intimation suggests a counterintuitive treatment of information concerning what justificatory status a proposition has. It follows from Self-Intimation that we always have justification for the truth about whether a proposition is justified for us, and therefore, that higher-order evidence could change what we should believe on this matter only by misleading us. This permits forming beliefs about whether a proposition is justified for us without regard to higher-order evidence, and thus reveals a reason for thinking that top-level justification is evidentially inert. (shrink)

Advances in artificial intelligence (AI) raise important questions about whether people view moral evaluations by AI systems similarly to human-generated moral evaluations. We conducted a modified Moral Turing Test (m-MTT), inspired by Allen et al. (Exp Theor Artif Intell 352:24–28, 2004) proposal, by asking people to distinguish real human moral evaluations from those made by a popular advanced AI language model: GPT-4. A representative sample of 299 U.S. adults first rated the quality of moral evaluations when blinded to their source. (...) Remarkably, they rated the AI’s moral reasoning as superior in quality to humans’ along almost all dimensions, including virtuousness, intelligence, and trustworthiness, consistent with passing what Allen and colleagues call the comparative MTT. Next, when tasked with identifying the source of each evaluation (human or computer), people performed significantly above chance levels. Although the AI did not pass this test, this was not because of its inferior moral reasoning but, potentially, its perceived superiority, among other possible explanations. The emergence of language models capable of producing moral responses perceived as superior in quality to humans’ raises concerns that people may uncritically accept potentially harmful moral guidance from AI. This possibility highlights the need for safeguards around generative language models in matters of morality. (shrink)

Law, Economics, and Morality examines the possibility of combining economic methodology and deontological morality through explicit and direct incorporation of moral constraints into economic models. Economic analysis of law is a powerful analytical methodology. However, as a purely consequentialist approach, which determines the desirability of acts and rules solely by assessing the goodness of their outcomes, standard cost-benefit analysis is normatively objectionable. Moderate deontology prioritizes such values as autonomy, basic liberties, truth-telling, and promise-keeping over the promotion of good outcomes. It (...) holds that there are constraints on promoting the good. Such constraints may be overridden only if enough good is at stake. While moderate deontology conforms to prevailing moral intuitions and legal doctrines, it is arguably lacking in methodological rigor and precision. Eyal Zamir and Barak Medina argue that the normative flaws of economic analysis can be rectified without relinquishing its methodological advantages and that moral constraints can be formalized so as to make their analysis more rigorous. They discuss various substantive and methodological choices involved in modeling deontological constraints. Zamir and Medina propose to determine the permissibility of any act or rule infringing a deontological constraint by means of mathematical threshold functions. Law, Economics, and Morality presents the general structure of threshold functions, analyzes their elements and addresses possible objections to this proposal. It then illustrates the implementation of constrained CBA in several legal fields, including contract law, freedom of speech, antidiscrimination law, the fight against terrorism, and legal paternalism. (shrink)

In the latter half of the 20th century, Western medicine moved death from the home to the hospital. As a result, the process of dying seems to have lost its spiritual dimension, and become a matter of prolonging material life by means of medical technology. The novel quandaries that arose led in turn to medico-legal regulation. This paper describes the recent regulation of dying in Israel under its Dying Patient Law, 2005. The Law recognizes advance directives in principle, but limits (...) their effect and form through complex medico-legal artifices. It reflects a culture that places high value on both scientific medicine and the sanctity of life as such, and illustrates a medical culture that pitches battle against death. At the same time, the Law constructs the will of the individual in a medico-legal language that is alien to the lay person. The paper suggests an alternative approach to advance care planning that is patient-centred and addresses the psycho-social needs of the individual in terms of her relational autonomy. From this perspective, advance care planning becomes an opportunity to extract the patient from the medical context and allow her to speak about her approaching death with close ones in her own terms of reference. To this end, there is a need for facilitation of an intimate encounter where patients can speak about their concerns with their loved ones. The paper also presents a methodological approach of attentive listening, which can be applied across diverse cultures and circumstances. (shrink)

We examine whether the "evidence of evidence is evidence" principle is true. We distinguish several different versions of the principle and evaluate recent attacks on some of those versions. We argue that, whatever the merits of those attacks, they leave the more important rendition of the principle untouched. That version is, however, also subject to new kinds of counterexamples. We end by suggesting how to formulate a better version of the principle that takes into account those new counterexamples.

Which inequalities in longevity and health among individuals, groups, and nations are unfair? And what priority should health policy attach to narrowing them? These essays by philosophers, economists, epidemiologists, and physicians attempt to determine how health inequalities should be conceptualized, measured, ranked, and evaluated.

Pilcher, Carmel Review of: Earth unites with heaven: An introduction to the liturgical year, by Gerard More, Northcote, VIC: Morning Star, 2014, pp. 75, $12.95.

This preregistered experiment examined two proximate drivers of retributive punishment attitudes: the motivation to make the perpetrator suffer, and understand the wrongfulness of his offense. In a sample of 514 US adults, we presented criminal case summaries that varied the level of suffering (absent vs. present) and understanding (absent vs. present) experienced by the perpetrator and measured punishment judgments and attitudes. Our results demonstrate, as predicted, that participants were more satisfied by the sentence and less punitive when they believed that (...) the perpetrator had suffered from the punishment or that he understood the wrongfulness of his actions. This pattern held across crimes of varying seriousness (theft vs. aggravated robbery) and across two narrative perspectives (participant as victim vs. participant as third party). However, joint evidence of suffering and understanding did not strengthen this effect, contrary to predictions. We discuss the implications of these findings for leading philosophical theories of punishment. (shrink)

The article begins by reconstructing the just distribution of the social bases of self-respect, a principle of justice that is covert in Rawls’s writing. I argue that, for Rawls, justice mandates that each social basis for self-respect be equalized. Curiously, for Rawls, that principle ranks higher than Rawls’s two more famous principles of justice - equal liberty and the difference principle. I then recall Rawls’s well-known confusion between self-respect and another form of self-appraisal, namely, confidence in one’s determinate plans and (...) capacities. Correcting that confusion forces Rawls to accept objectionable and illiberal politics. Surprisingly, a consistent Rawls must endorse absolute economic equality, deny liberty any priority whatsoever, or sponsor still other illiberal political views - evidence of a flaw in the ethical basis of Rawls’s politics. (shrink)

This article argues that, in its standard formulation, luck-egalitarianism is false. In particular, I show that disadvantages that result from perfectly free choice can constitute egalitarian injustice. I also propose a modified formulation of luck-egalitarianism that would withstand my criticism. One merit of the modification is that it helps us to reconcile widespread intuitions about distributive justice with equally widespread intuitions about punitive justice.

Notwithstanding the success of conventional field trials for vaccines against COVID-19, human challenge trials that could obtain more information about these and about other vaccines and further strategies against it are about to start in the UK. One critique of COVID-19 HCTs is their distinct paucity of information on crucial population groups. For safety reasons, these HCTs will exclude candidate participants of advanced age or with comorbidities that worsen COVID-19, yet a vaccine should protect such populations. We turn this cliché (...) on its head. The truth is that either an HCT or a field trial has intrinsic generalisability limitations, that an HCT can expedite protection of high-risk participants even without challenging them with the virus, and that an important route to obtaining results generalisable to high-risk groups under either strategy is facilitated by HCTs. There are no data in this work. (shrink)

Is it ever rational to suspend judgment about whether a particular doxastic attitude of ours is rational? An agent who suspends about whether her attitude is rational has serious doubts that it is. These doubts place a special burden on the agent, namely, to justify maintaining her chosen attitude over others. A dilemma arises. Providing justification for maintaining the chosen attitude would commit the agent to considering the attitude rational—contrary to her suspension on the matter. Alternatively, in the absence of (...) such justification, the attitude would be arbitrary by the agent's own lights, and therefore irrational from the agent's own perspective. So, suspending about whether an attitude of ours is rational does not cohere with considering it rationally preferable to other attitudes, and leads to a more familiar form of epistemic akrasia otherwise. (shrink)

Artificial intelligence surveillance can be used to diagnose individual cases, track the spread of Covid‐19, and help provide care. The use of AI for surveillance purposes (such as detecting new Covid‐19 cases and gathering data from healthy and ill individuals) in a pandemic raises multiple concerns ranging from privacy to discrimination to access to care. Luckily, there exist several frameworks that can help guide stakeholders, especially physicians but also AI developers and public health officials, as they navigate these treacherous shoals. (...) While these frameworks were not explicitly designed for AI surveillance during a pandemic, they can be adapted to help address concerns regarding privacy, human rights, and due process and equality. In a time where the rapid implementation of all tools available is critical to ending a pandemic, physicians, public health officials, and technology companies should understand the criteria for the ethical implementation of AI surveillance. (shrink)

Suppose we learn that we have a poor track record in forming beliefs rationally, or that a brilliant colleague thinks that we believe P irrationally. Does such input require us to revise those beliefs whose rationality is in question? When we gain information suggesting that our beliefs are irrational, we are in one of two general cases. In the first case we made no error, and our beliefs are rational. In that case the input to the contrary is misleading. In (...) the second case we indeed believe irrationally, and our original evidence already requires us to fix our mistake. In that case the input to that effect is normatively superfluous. Thus, we know that information suggesting that our beliefs are irrational is either misleading or superfluous. This, I submit, renders the input incapable of justifying belief revision, despite our not knowing which of the two kinds it is. (shrink)

Pilcher, Carmel Review(s) of: Aboriginal church paintings: Reflecting on our faith, by Eugene Stockton Editor with Terence O'Donnell (Lawson: Blue Mountain Education and Research Trust Publishers, 2010), pp.45, $20.00.

This dissertation is comprised of three parts. The first part is an intellectual historical thesis, regarding the place of Jean Piaget in philosophic thought. In Chapter One I outline the differences between my thesis and Piaget's position on the development of spatial concepts. My second chapter places his theory within the context of congruent accounts from the philosophy of nature, neurophysiology, and philosophy of psychology. Chapter Three situates him in relation to a selection of philosophers in the history of western (...) philosophy, through a metapsychology. ;In Part II I provide a dynamic account of the order of conceptual development, and clarification of the concepts of topological space, projective space, and euclidean or metric space.$\sp1$ In three chapters I outline a systematic analysis of the genetic development of the concepts based on an analysis and critique of Piaget's observations. The emergence of each concept is shown to be a result of the experience of some incongruity between the concept immediately preceding, and experience. The order I outline differs in some specifics from that suggested by Piaget's broad outline, and I explain the differences as they occur. ;The third part of this dissertation is the most tentative. Chapter Nine discusses the kind of testing I will employ when I test the logical order of concepts. There are four kinds of modes which I use to test each concept. This is followed by Chapter Ten, which tests the dynamic development of concepts of space. In this I attempt to confirm those changes in the development of the concepts, as well as Piaget's overall framework, through the use of Piaget's pre-logical modes as well as others I have extracted from the dynamic development of concepts. ftn $\sp1$ I note here that Piaget means, by euclidean geometry, metric geometry. The distinction between geometry with a euclidean and a non-euclidean metric is not crucial for the purpose of this thesis. (shrink)

In a recent paper, Graf and Komatsu (1994) argued that the process dissociation procedure (Jacoby, 1991) is limited in its ability to separate and measure conscious and unconscious forms of memory and so should be "handIed with caution". Given that the study of unconscious influences has always posed a difficult problem for memory researchers, we agree with the general emphasis on caution. In this paper, we too advocate caution, especially as it applies to the use of indirect tests, assessing Graf (...) and Komatsu’s critique, and using the process dissociation procedure. We address the substantive issues raised by Graf and Komatsu and also point out the errors, both factual and logical, in their paper. Any method proposing to provide separate measures of conscious and unconscious influences requires judicious use and a careful examination of its underlying assumptions. The assumptions underlying the process dissociation framework are supported by a large number of experiments spanning a diverse range of.. (shrink)

This is a retrospective of surrogacy in Israel in the context of medically assisted reproduction. The practice of surrogacy emerged in the 1980s, suggesting a radical view of women as autonomous reproductive agents free from double standards of patriarchy. In 1995 Israel enacted a law that regulated domestic surrogacy for the benefit of infertile married women in accord with orthodox views of halakha. In recent years we see the growth of inter-country practices catering to otherwise ineligible intended parents, and a (...) demand for posthumous male reproduction. Meanwhile, women become objects of intrusive medical procedures and commodities of a global market, more often than not for the benefit of others rather than themselves. Yet the essence of human reproduction remains relational, and calls for care and responsibility. (shrink)

“One man’s ceiling is another man’s floor”Paul SimonThe words of Paul Simon capture the essence of what the courts are called upon to deal with when adjudicating matters of health. Wealthier and healthier neighbors living in the upstairs apartment are, all things being equal, not overly interested in raising the floor of their apartment in order to create more space for those in the apartment below. The floor is tangible, measurable and movable, and thus a subject where science can contribute (...) much. However, where to locate the floor is a matter of values and thus largely in the realm of politics.Resorting to the courts in matters of public policy can be seen as the residual of the inability of the remaining two branches of government, the legislature and the executive, to succeed in allocating resources and regulating the system. When the combination of science and politics falters, enter the judiciary. (shrink)

Next SectionAccess to medicines, vaccination and care in resource-poor settings is threatened by the emigration of physicians and other health workers. In entire regions of the developing world, low physician density exacerbates child and maternal mortality and hinders treatment of HIV/AIDS. This article invites philosophers to help identify ethical and effective responses to medical brain drain. It reviews existing proposals and their limitations. It makes a case that, in resource-poor countries, ’locally relevant medical training’—teaching primarily locally endemic diseases and practice (...) in scarcity conditions, training in rural communities and admitting rural students preferentially—could help improve retention. Locally relevant training would arguably diminish medical brain drain in five ways. It would (i) make graduates less attractive for Western employers, (ii) align graduates’ expectations with actual practice, diminishing ‘burn-out’, (iii) enhance the professional prestige of local practice, (iv) hold rotations in, and recruit applicants from, rural areas, which is known to improve retention there, and (v) create local career development options that attract practitioners to stay. Such educational reform may raise worries about poor-quality care, breach of the freedom of education and occupation, breach of the freedom of movement, unequal distribution of opportunities among students, hypocrisy and resistance from influential actors. We address these worries. (shrink)

Distributive theories evaluate distributions of goods based on candidate recipients’ characteristics, e.g. how well off candidates are, how deserving they are, and whether they fare below sufficiency. But such characteristics vary across possible worlds, so distributive theories may differ in terms of the world which for them settles candidates’ characteristics. This paper examines how distributive theories differ in terms of whether candidate recipients’ relevant characteristics are grounded in the possible world that would take place if the distributor does not intervene (...) (call it the “input” world) or if they are grounded in each possible world that the distributor can bring about through different decisions (call each an “output” world). We illustrate the importance of this distinction in relation to one distributive theory, prioritarianism. As we show, both input and output versions of prioritarianism are plausible interpretations of the literature, and there are good reasons to take input prioritarianism seriously. Ultimately, however, we argue that input prioritarianism should be rejected. (shrink)

Reingold and MerikleÕs (1988, 1990) critique of the classic dissociation paradigm identified several issues as inherent problems that severely undermine the utility of this paradigm. Erdelyi (2004) extending his prior analysis (Erdelyi, 1985, 1986) points out several additional factors that may complicate the interpretation of empirically obtained dissociations. The goal of the present manuscript is to further discuss some of these commonly neglected interpretive difficulties. Ó 2003 Elsevier Inc. All rights reserved.

In this article, cluster analysis is used to explore the conflicting results reported when the Defining Issues Test is used to explain moral reasoning ability in business situations. Using a convenience sample, gender, age, work experience, and ethics training were examined to determine their impact on the level of moral reasoning ability as measured by the Defining Issues Test. Using the whole sample, a significant difference was found for average P scores reported for males and females, but no significant differences (...) were found based on age, work experience, and ethics training. However, the sample fell into distinct clusters that identified distinct male and female groupings. While females naturally fell into two distinct high- and low-moral reasoning ability clusters, male clusters were dominated more by work experience and ethics training. Clearly there are other factors mitigating the level of moral reasoning ability for males which require further exploration. The findings suggest that while the P score provides an initial point of comparison, the real benefit to the test is in exploring what is different for males and females in terms of training needs, and the impact of work experience on the moral reasoning ability, and most importantly, how to make ethics training enticing. Recommendations for future research are also discussed. (shrink)

ABSTRACTShould conciliating with disagreeing peers be considered sufficient for reaching rational beliefs? Thomas Kelly argues that when taken this way, Conciliationism lets those who enter into a disagreement with an irrational belief reach a rational belief all too easily. Three kinds of responses defending Conciliationism are found in the literature. One response has it that conciliation is required only of agents who have a rational belief as they enter into a disagreement. This response yields a requirement that no one should (...) follow. If the need to conciliate applies only to already rational agents, then an agent must conciliate only when her peer is the one irrational. A second response views conciliation as merely necessary for having a rational belief. This alone does little to address the central question of what is rational to believe when facing a disagreeing peer. Attempts to develop the response either reduce to the first response, or deem necessary an unnecessary doxastic revision, or imply that rational dilemmas obtain in cases where intuitively there are none. A third response tells us to weigh what our pre-disagreement evidence supports against the evidence from the disagreement itself. This invites epistemic akrasia. (shrink)

Often, a health resource distribution (or, more generally, a health policy) ranks higher than another on one value, say, on promoting total population health; and lower on another, say, on promoting that of the worst off. Then, some opine, there need not be a rational determination as to which of the multiple distributions that partially fulfill both one ought to choose. Sometimes, reason determines only partially, intransitively, or contentiously which of the many “compromises” between these two values is best or (...) most choiceworthy. Norman Daniels, Ruth Chang, Martijn Boot, and Anders Herlitz affirm this opinion, which I shall call “value incommensurability,” “rational underdeterminacy,” or “reasonable disagreement.” To decide between the multiple reasonable compromises on health resource distribution, these philosophers recommend a deliberative democratic process, on two main grounds. First, in such situations, deliberation can produce the determinacy needed for decisionmaking. Second, by treating respectfully and justly even those patients or communities for whom the distributive compromise selected is bad, deliberation shields the legitimacy of that policy. Increasingly, practically-oriented bioethics recommends democratic deliberation even more expansively than these philosophers do—for nearly every decision on health resource distribution and not only when values are incommensurate—on these two grounds and on others. And one could propose a more modest variant on this expansive move as the justification of democratic deliberation. I argue that none of these moves warrants democratic deliberation on health policy. (shrink)