In this paper, we present and defend an analysis of harm that we call the Negative Influence on Well-Being Account (NIWA). We argue that NIWA has a number of significant advantages compared to its two main rivals, the Counterfactual Comparative Account (CCA) and the Causal Account (CA), and that it also helps explain why those views go wrong. In addition, we defend NIWA against a class of likely objections, and consider its implications for several questions about harm and its role (...) in normative theorizing. (shrink)

A popular view of harming is the causal account (CA), on which harming is causing harm. CA has several attractive features. In particular, it appears well equipped to deal with the most important problems for its main competitor, the counterfactual comparative account (CCA). However, we argue that, despite its advantages, CA is ultimately an unacceptable theory of harming. Indeed, while CA avoids several counterexamples to CCA, it is vulnerable to close variants of some of the problems that beset CCA.

According to the standard version of the counterfactual comparative account of harm, an event is overall harmful for an individual if and only if she would have been on balance better off if it had not occurred. This view faces the “preemption problem.” In the recent literature, there are various ingenious attempts to deal with this problem, some of which involve slight additions to, or modifications of, the counterfactual comparative account. We argue, however, that none of these attempts work, and (...) that the preemption problem continues to haunt the counterfactual comparative account. (shrink)

ABSTRACT Suppose that, for every possible event and person who would exist whether or not the event were to occur, there is a well-being level that the person would occupy if the event were to occur, and a well-being level that the person would occupy if the event were not to occur. Do facts about such connections between events and well-being levels always suffice to determine whether an event would harm or benefit a person? Many seemingly attractive accounts of harm (...) and benefit entail an affirmative answer to this question, including the widely held Counterfactual Comparative Account (CCA). In this paper, however, we argue that all such accounts will be unsuccessful. (shrink)

The counterfactual comparative account of harm faces problems in cases that involve overdetermination and preemption. An influential strategy for dealing with these problems, drawing on a suggestion made by Derek Parfit, is to appeal to _plural harm_—several events _together_ harming someone. We argue that the most well-known version of this strategy, due to Neil Feit, as well as Magnus Jedenheim Edling’s more recent version, is fatally flawed. We also present some general reasons for doubting that the overdetermination and preemption problems (...) for the counterfactual comparative account can be satisfactorily solved by appealing to plural harm. (shrink)

We have argued that the counterfactual comparative account of harm and benefit (CCA) violates the plausible adequacy condition that an act that would harm an agent cannot leave her much better off than an alternative act that would benefit her. In a recent paper in this journal, however, Neil Feit objects that our argument presupposes questionable counterfactual backtracking. He also argues that CCA proponents can justifiably reject the condition by invoking so-called plural harm and benefit. In this reply, we argue (...) that Feit’s lines of criticism are both unsuccessful. (shrink)

According to the “deprivation approach,” a person’s death is bad for her to the extent that it deprives her of goods. This approach faces the Lucretian problem that prenatal non-existence deprives us of goods just as much as death does, but does not seem bad at all. The two most prominent responses to this challenge—one of which is provided by Frederik Kaufman (inspired by Thomas Nagel) and the other by Anthony Brueckner and John Martin Fischer—claim that prenatal non-existence is relevantly (...) different from death. This paper criticizes these responses. (shrink)

In this article I discuss the question of whether a person’s existence can be better (or worse) for him than his non-existence. Recently, Nils Holtug and Melinda A. Roberts have defended an affirmative answer. These defenses, I shall argue, do not succeed. In different ways, Holtug and Roberts have got the metaphysics and axiology wrong. However, I also argue that a person’s existence can after all be better (or worse) for him than his non-existence, though for reasons other than those (...) provided by Holtug and Roberts. (shrink)

A prominent objection to the counterfactual comparative account of harm is that it classifies as harmful some events that are, intuitively, mere failures to benefit. In an attempt to solve this problem, Duncan Purves has recently proposed a novel version of the counterfactual comparative account, which relies on a distinction between making upshots happen and allowing upshots to happen. In this response, we argue that Purves’s account is unsuccessful. It fails in cases where an action makes the subject occupy a (...) high well-being level though one of the available alternatives would have made it even higher. In fact, it fails even in some cases where each of the available alternatives to the action that was actually performed would have made the subject’s well-being level lower. (shrink)

This article explores how ethical agency, as ‘other-oriented’ caring, emerged from feelings of being ‘different’ in a cultural organization by drawing on feminist ethics of care. By analyzing interview material from an ethnographic study, we centralize the relationship between feelings of being ‘different,’ vulnerability and the development of sensibilities, practices and imaginaries of care. We elaborate on how vulnerability serves as a ground for caring with rather than for others, and illustrate how it allowed individuals to challenge both organizational, normative (...) diversity discourses and essentialization of differences. We contribute to the literature on critical diversity management by furthering problematizations of instrumental diversity management from the perspective of care, and to the organizational literature on feminist care ethics by empirically exploring how ethical agency emerges from tensions related to feeling ‘different.’ While previous studies have shown how marginalized individuals use their sense of ‘otherness’ to negotiate, conform to and resist organizational norms, practices and discourses, we provide further insights on how it also can drive concern and care for others, and thus serve as possible ground for ethical change initiatives within organizations. (shrink)

In a recent Utilitas article, Neil Feit argues that every person occupies a well-being level of zero at all times and possible worlds at which she fails to exist. Views like his face the problem of the subject': how can someone have a well-being level in a scenario where she lacks intrinsic properties? Feit argues that this problem can be solved by noting, among other things, that a proposition about a person can be true at a possible world in which (...) neither she nor the proposition exists. In this response, we argue that Feit has not solved the problem of the subject, and also raise various related problems for his approach. (shrink)

Nurses working in correctional and forensic mental health settings face unique challenges in the provision of care to patients within custodial settings. The subjectivities of both patients and nurses are subject to the power relations, discourses and abjection encountered within these practice milieus. Using a poststructuralist approach using the work of Foucault, Kristeva, and Deleuze and Guattari, this paper explores how both patient and nurse subjectivities are produced within the carceral logic of this apparatus of capture. Recognizing that subjectivities are (...) fluid and dynamic, and capable of change, Deleuze and Guattari's concept of deterritorialization will illustrate opportunities for resistance, where nurses can begin to practice outside the dominant carceral logic (and restrictions) of the system. (shrink)

Traditional health sciences (including nursing) paradigms, conceptual models, and theories have relied heavily upon notions of the ‘person’ or ‘patient’ that are deeply rooted in humanistic principles. Our intention here, as a collective academic assemblage, is to question taken‐for‐granted definitions and assumptions of the ‘person’ from a critical posthumanist perspective. To do so, the cinematic works of filmmaker David Cronenberg offer a radical perspective to revisit our understanding of the ‘person’ in nursing and beyond. Cronenberg's work explores bodily transformation and (...) mutation, with the body as a fragile and malleable vessel. Cronenberg's work allows us to interrogate the body in all its complexity, contingency, and hybridity and provides avenues of rupture within current understandings of ‘the person’. Reinventing the definition of what it means to be human, critical posthumanism offers opportunities to both critique humanist theories and build affirmative futurities. Also drawing on the work of Deleuze and Guattari, specifically, their concept of becoming, we propose a critical posthumanist alternative to the conceptualization of the person in the health sciences, that of the becoming‐mutant, so frequently explored in Cronenberg's films. Such a conceptualization permits the inclusion of various technological interventions of the contemporary subject: The postperson. This position offers the health science disciplines a radical reconceptualization of the conceptual and theoretical approaches, extending beyond those trapped within the quagmire of humanistic principles. (shrink)

Nurses working in outreach capacities frequently encounter disaffiliated or ‘hard to reach’ populations, such as those experiencing homelessness, those who use substances, and those with mental health concerns. Despite best efforts, nurses regularly fail to find meaningful engagement with these populations. Mobilizing the work of Deleuze and Guattari, this paper will critically examine conventional outreach nursing practices as rooted in the royal science of psychiatry, which many ‘survivors’ of psychiatric interventions reject. The field of Mad Studies offers an understanding of (...) patient resistance to outreach nursing interventions. Delueze and Guattari's concepts of packs and sorcerers provide a framework to envision alternative nursing practices as a form of resistance and creativity, where new alliances may be formed outside the coercive confines of traditional practices. In response to patient resistance, outreach nurses themselves must assemble packs and engage in acts of sorcery. (shrink)

Recovery is a model of care in (forensic) mental health settings across Western nations that aims to move past the paternalistic and punitive models of institutional care of the 20th century and toward more patient‐centered approaches. But as we argue in this paper, the recovery‐oriented services that evolved out of the early stages of this liberating movement signaled a shift in nursing practices that cannot be viewed only as improvements. In effect, as “recovery” nursing practices became more established, more codified, (...) and more institutional(ized), a stasis developed. Recovery had been reterritorialized. The purpose of this paper is to examine some of the threads of recovery, from its early days of antipsychiatry activism to its codification into mental health—including forensic mental health—institutions through the lens of poststructuralist philosophers Gilles Deleuze and Felix Guattari. We believe that Deleuze and Guattari's scholarship provides the necessary, albeit uncomfortable, framework for this critical examination. From a conceptualization of recovery as an assemblage, we critically examine how we can go about creating something new, caught in a tension between stasis and change. (shrink)

In a recent article, I criticized Anthony L. Brueckner and John Martin Fischer’s influential argument—appealing to the rationality of our asymmetric attitudes towards past and future pleasures—against the Lucretian claim that death and prenatal non-existence are relevantly similar. Brueckner and Fischer have replied, however, that my critique involves an unjustified shift in temporal perspectives. In this paper, I respond to this charge and also argue that even if it were correct, it would fail to defend Brueckner and Fischer’s proposal against (...) my critique. (shrink)

Derek Parfit famously defends a number of surprising views about "fission." One is that, in such a scenario, it is indeterminate whether I have survived or not. Another is that the fission case shows that it does not matter, in itself, whether I survive or not. Most critics of the first view contend that fission makes me cease to exist. Most opponents of the second view contend that fission does not preserve everything that matters in ordinary survival. In this paper (...) I shall provide a critique that does not rely on either of these contentions. There are other, interrelated reasons to reject Parfit's defense of the two theses. In particular, the availability of the following view creates trouble for Parfit: I determinately survive fission, but it is indeterminate which fission product I am. (shrink)

In a discussion of Parfit's Drops of Water case, Zach Barnett has recently proposed a novel argument against “No Small Improvement”; that is, the claim that a single drop of water cannot affect the magnitude of a thirsty person's suffering. We first show that Barnett's argument can be significantly strengthened, and also that the fundamental idea behind it yields a straightforward argument for the transitivity of equal suffering. We then suggest that defenders of No Small Improvement could reject a Pareto (...) principle that is presupposed in Barnett's argument and our developments of it. However, this does not save No Small Improvement, since there is a convincing argument against this claim that does not presuppose the Pareto principle. (shrink)

This chapter is an opinionated survey of three main views about meaning in life: objectivism, on which a component of a person’s life can contribute meaning to it even if she in no way cares about the component; pure subjectivism, on which the person’s caring about the component in some suitable way is all it takes for the component to contribute meaning to her life; and hybridism, on which whether a component of someone’s life contributes meaning to it depends both (...) on her caring about the component in some suitable way and the objective value of the component. The authors discuss various central challenges that these three views respectively face. Among other things, they provide reasons to think that the challenges for pure subjectivism are less serious than they are ordinarily taken to be, and less serious than those that confront objectivism and hybridism. (shrink)

One increasingly popular approach to personal identity is called ‘animalism.’ Unfortunately, it is unclear just what the doctrine says. In this paper, I criticise several different ways of stating animalism, and put forward one formulation that I find more promising.

The counterfactual comparative account of harm (cca) faces well-known problems concerning preemption and omission. In a recent article in this journal, Daniel Immerman proposes a novel variant of cca, which he calls the worse than nothing account (wtna). According to Immerman, wtna nicely handles the preemption and omission problems. We seek to show, however, that wtna is not an acceptable account of harm. In particular, while wtna deals better than cca with some cases that involve preemption and omission, it has (...) implausible implications in other similar cases – cases that, moreover, pose no problems for cca. (shrink)

In this paper, we critically examine Molly Gardner’s favored solution to what she calls “the problem of justified harm.” We argue that Gardner’s view is false and that her arguments in support of it are unconvincing. Finally, we briefly suggest an alternative solution to the problem which avoids the difficulties that beset Gardner’s proposal.

In this paper, we give a new argument for the existence of moral luck. The argument is based on a manipulation case in which two agents both lack second-order control over their actions, but one of them has first-order control. Our argument is, we argue, in several respects stronger than standard arguments for moral luck. Five possible objections to the argument are considered, and its general significance for the debate on moral luck is briefly discussed.

Those who endorse the view that death is in some cases bad for the deceased—a view that, as I shall explain, has considerable bearing on many bioethical issues—need to address the following, Epicurean question: When is death bad for the one who dies? The two most popular answers are "before death" (priorism) and "after death" (subsequentism). Part of the support for these two views consists in the idea that a third answer, "at no time" (atemporalism), makes death unsatisfyingly different from (...) other evils. I argue that this objection is mistaken, and that priorism and subsequentism face problems that atemporalism avoids. Moreover, I argue that if it is nonetheless insisted that we must find a time at which my death is bad for me, we can appeal to periods that begin before my death and end after my death. I end with some implications for posthumous harm. (shrink)

Several attractive principles about prudential concern and moral responsibility seem to speak against animalism. I criticize some animalist responses to this kind of problem, and suggest another answer, which has similarites with the most important argument in favor of animalism: the “thinking animal” argument.

A central claim in abortion ethics is what might be called the Harm Claim – the claim that abortion harms the fetus. In this article, we put forward a simple and straightforward reason to reject the Harm Claim. Rather than invoking controversial assumptions about personal identity, or some nonstandard account of harm, as many other critics of the Harm Claim have done, we suggest that the aborted fetus cannot be harmed for the simple reason that it does not occupy any (...) well-being level. (shrink)

John Martin Fischer and Anthony L. Brueckner have argued that a person’s death is, in many cases, bad for him, whereas a person’s prenatal non-existence is not bad for him. Their suggestion relies on the idea that death deprives the person of pleasant experiences that it is rational for him to care about, whereas prenatal non-existence only deprives him of pleasant experiences that it is not rational for him to care about. In two recent articles in The Journal of Ethics, (...) I have objected that it is irrelevant what it is in fact rational for the person to care about. Fischer and Brueckner have replied to my critique. In this paper I respond to their latest pair of replies. (shrink)

Nurses working in forensic psychiatric settings face unique challenges in practice, where they take on a dual role of custody and caring. Patient resistance is widespread within these restrictive settings and can take many forms. Perhaps the most disturbing form of resistance entails a patient's weaponization of their bodily fluids, with nurses as their target. The tendency in assigning motive for this act is to relegate to the psychopathology of the patient. This paper will adopt a poststructuralist perspective to reexamine (...) this phenomenon as an act of resistance through the lens of Kristeva's concept of abjection. Patients confined in these settings have little sense of control, and in resistance may resort to the only thing available: their bodily fluids. By weaponizing the abject, patients actively violate and permeate the physical and psychological boundaries of nurses—the very boundaries considered crucial to safe and professional forensic psychiatric nursing practice. By recognizing this phenomenon as an act of resistance to confinement and loss of control, nurses may reorient their approach to care in forensic psychiatric settings. (shrink)

The aim of the present study was to describe variations in patient participation in decisions about care planning during the final phase of life for a group of gravely ill patients, and how the different actors’ manner of acting promotes or impedes patient participation. Thirty-seven qualitative research interviews were conducted with relatives of the patients. The patients’ participation in the decisions could be categorized into four variations: self-determination, co-determination, delegation and nonparticipation. The manner in which patients, relatives and caregivers acted (...) differed in the respective variations; this seemed either to promote or to impede the patients’ opportunities of participating in the decision making. The possibility for participation seems to be context dependent and affected by many factors such as the dying patient’s personality, the social network, the availability of different forms of care, cultural values, and the extent to which nurses and other caregivers of the different forms of care can and want to support the wishes of the patients and relatives in the decision-making process. (shrink)

The ‘non-identity problem’ raises a well-known challenge to the person-affecting view, according to which an action can be wrong only if it affects someone for the worse. In a recent article, however, Thomas D. Bontly proposes a novel way to solve the non-identity problem in person-affecting terms. Bontly's argument is based on a contrastive causal account of harm. In this response, we argue that Bontly's argument fails even assuming that the contrastive causal account is correct.

A pure time preference is a preference for something to occur at one point in time rather than another, merely because of when it occurs in time. Such preferences are widely regarded as paradigm examples of irrational preferences. However, Rosemary Lowry and Martin Peterson have recently argued that, for instance, a pure time preference to go to the opera tonight rather than next month may be rationally permissible, even if the amounts of intrinsic value realized in both cases are identical. (...) In this reply, we argue that Lowry and Peterson's argument is unsuccessful. (shrink)

Abstract: The symmetry argument is an objection to the 'deprivation approach'– the account of badness favored by nearly all philosophers who take death to be bad for the one who dies. Frederik Kaufman's recent response to the symmetry argument is a development of Thomas Nagel's suggestion that we could not have come into existence substantially earlier than we in fact did. In this paper, I aim to show that Kaufman's suggestion fails. I also consider several possible modifications of his theory, (...) and argue that they are unsuccessful as well. (shrink)

Daniel Immerman has recently put forward a novel account of harm, the Worse than Nothing Account. We argue that this account faces fatal problems in cases in which an agent performs several simultaneous actions. We also argue that our criticism is considerably more powerful than another one that has recently been advanced.

According to the “deprivation approach,” a person’s death is bad for her to the extent that it deprives her of goods. This approach faces the Lucretian problem that prenatal non-existence deprives us of goods just as much as death does, but does not seem bad at all. The two most prominent responses to this challenge—one of which is provided by Frederik Kaufman and the other by Anthony Brueckner and John Martin Fischer—claim that prenatal non-existence is relevantly different from death. This (...) paper criticizes these responses. (shrink)

In his recent book, Death and the Afterlife, Samuel Scheffler argues that it matters greatly to us that there be other human beings long after our own deaths. In support of this “Afterlife Thesis,” as I call it, he provides a thought experiment—the “doomsday scenario”—in which we learn that, although we ourselves will live a normal life span, 30 days after our death the earth will be completely destroyed. In this paper I question this “doomsday scenario” support for Scheffler’s Afterlife (...) Thesis. In particular, I suggest that Scheffler has underestimated the importance of a good ending. (shrink)

Many philosophers maintain that artworks, such as statues, are constituted by other material objects, such as lumps of marble. I give an argument against this view, an argument which appeals to mereological simples.

This chapter, which examines the argument of Epicurus about the timing problem of death, clarifies the Epicurean challenge and identifies some merits and disadvantages of the various anti-Epicurean views. It also explains the concept of several relevant principles including atemporalism, subsequentism, priorism, concurrentism, and eternalism, arguing that the Epicurean argument and its premises are valid.

In a recent article in this journal, Eli Pitcovski puts forward a novel, explanation-based account of harm. We seek to show that Pitcovski’s account, and his arguments in favor of it, can be substantially improved. However, we also argue that, even thus improved, the account faces a dilemma. The dilemma concerns the question of what it takes for an event, E, to explain why a state, P, does not obtain. Does this require that P would have obtained if E had (...) not occurred? Pitcovski’s theory faces problems no matter how one answers that question. (shrink)

The so-called 'Extreme Claim' asserts that reductionism about personal identity leaves each of us with no reason to be specially concerned about his or her own future. Both advocates and opponents of the Extreme Claim, whether of a reductionist or non-reductionist stripe, accept that similar problems do not arise for non-reductionism. In this paper I challenge this widely held assumption.

In a recent article in this journal, John Martin Fischer defends the view that death harms its victim after she dies. More specifically, he develops a “truthmaking” account in order to solve what he calls the Problem of Predication for this view. In this reply, we argue that Fischer’s proposed solution to this problem is unsuccessful.

The counterfactual comparative account of harm has counterintuitive implications in cases involving overdetermination and preemption. A popular strategy for dealing with these problems appeals to plural harm—several events being jointly harmful. Björn Petersson criticizes this strategy on the grounds that it conflicts with a strong intuition that helps to motivate the counterfactual comparative account, namely, that harming someone essentially involves making a difference for the worse for her. In this paper, I argue that Petersson’s argument is unconvincing.

Chris Heathwood has recently put forward a novel and ingenious argument against the view that intrinsic value is analyzable in terms of fitting attitudes. According to Heathwood, this view holds water only if the related but distinct concept of welfare—intrinsic value for a person —can be analyzed in terms of fitting attitudes too. Moreover, he argues against such an analysis of welfare by appealing to the rationality of our bias towards the future. In this paper, I argue that so long (...) as we keep the tenses and the intrinsic/extrinsic distinction right, the fitting-attitudes analysis of welfare can be shown to survive Heathwood’s criticism. (shrink)

Charlotte Unruh has recently put forward a hybrid account of what it is to suffer harm – one that combines comparative and non-comparative elements. We raise two problems for Unruh's account. The first concerns killing and death; the second concerns the causing of temporarily low or high welfare.

In defense of the Deprivation Approach to the badness of death against the Lucretian objection that death is relevantly similar to prenatal nonexistence, John Martin Fischer and Anthony L. Brueckner have suggested that whereas death deprives us of things that it is rational for us to care about, prenatal nonexistence does not. I have argued that this suggestion, even if correct, does not make for a successful defense of the Deprivation Approach against the Lucretian objection. My criticism involved a thought (...) experiment in which a person avoids being tortured. Recently, Taylor Cyr has defended Fischer and Brueckner’s approach, arguing that my thought experiment is incoherent. In this response, I question both the truth and relevance of Cyr’s incoherence claim. (shrink)

If a person’s death is bad for him for the reason that he would have otherwise been intrinsically better off, as the Deprivation Approach says, does it not follow that his prenatal nonexistence is bad for him as well? Recently, it has been suggested that the “A-theory” of time can be used to support a negative answer to this question. In this paper, I raise some problems for this approach.

The 1991 film The Silence of the Lambs tracks the fictional pursuit of an American serial killer by a Federal Bureau of Investigation trainee, via the assistance of another incarcerated serial killer. It features psychologically disturbing themes, such as corpses, the mutilation of skin and monstrous persons. Incidentally, these are all themes regularly encountered by nurses in their day‐to‐day practices, including forensic mental health nurses. Despite regular encounters with these themes and phenomena, nurses continue to find them disturbing and troubling, (...) but, at the same time, clinically fascinating. This paper will mobilize Kristeva's poststructuralist, psychoanalytic concept of abjection to relate the encounters in The Silence of the Lambs to those of nurses, to reconceptualize feelings of both disgust and fascination and to consider how vulnerability may benefit nursing practice. Of particular relevance are the breakdown of skin encountered in nursing practice, encounters with corpses and work with forensic patients considered monstrous. The film provides opportunity for nurses to conceptualize abjection in their own practice and to consider how a reconceptualization of boundaries and vulnerability may prove productive. (shrink)