Samuel J. Kerstein develops a new, broadly Kantian account of the ethical issues that arise when a person treats another merely as a means. He explores how Kantian principles on the dignity of persons shed light on pressing issues in modern bioethics, including the distribution of scarce medical resources and the regulation of markets in organs.

The threat of bioterrorism, the emergence of the SARS epidemic, and a recent focus on professionalism among physicians, present a timely opportunity for a review of, and renewed commitment to, physician obligations to care for patients during epidemics. The professional obligation to care for contagious patients is part of a larger "duty to treat," which historically became accepted when 1) a risk of nosocomial infection was perceived, 2) an organized professional body existed to promote the duty, and 3) the public (...) came to rely on the duty. Physicians' responses to epidemics from the Hippocratic era to the present suggests an evolving acceptance of the professional duty to treat contagious patients, reaching a long-held peak between 1847 and the1950's. There has been some professional retrenchment against this duty to treat in the last 40 years but, we argue, conditions favoring acceptance of the duty are met today. A renewed embrace of physicians' duty to treat patients during epidemics, despite conditions of personal risk, might strengthen medicine's relationship with society, improve society's capacity to prepare for threats such as bioterrorism and new epidemics, and contribute to the development of a more robust and meaningful medical professionalism. (shrink)

Philosophical Investigations, Volume 45, Issue 3, Page 320-333, July 2022.

The allocation of scarce health care resources such as flu treatment or organs for transplant presents stark problems of distributive justice. Persad, Wertheimer, and Emanuel have recently proposed a novel system for such allocation. Their “complete lives system” incorporates several principles, including ones that prescribe saving the most lives, preserving the most life-years, and giving priority to persons between 15 and 40 years old. This paper argues that the system lacks adequate moral foundations. Persad and colleagues' defense of giving priority (...) to those between 15 and 40 leaves them open to the charge that they discriminate unfairly against children. Second, the paper contends that the complete lives system fails to provide meaningful practical guidance in central cases, since it contains no method for balancing its principles when they conflict. Finally, the paper proposes a new method for balancing principles of saving the most lives and maximizing life-years. (shrink)

This article probes the voucher program from an ethical perspective. It focuses mainly on an issue of inequity. A disparity exists in US kidney transplantation. Although African-Americans suffer far higher rates of ESRD than whites, African-Americans are much less likely than whites to get a transplant. The article explores the voucher program in light of this disparity. It motivates the view that, at least in the short term, more whites than African-Americans are likely to take advantage of the voucher program. (...) The program is, thus, likely to increase the gap in transplantation rates between the two groups. If this is correct, what impact does it have on the moral acceptability of the program? (shrink)

In recent scholarship, the science and religion debate has been historicized, revealing the novelty of the concepts of science and religion and their complex connections to secularization and the birth of modernity. This article situates this historicist turn in the history of philosophy and its connections to theology and Scripture, showing that the science and religion concept derives from philosophy's earlier tension with theology as it became an academic discipline centered in the medieval, then research university, with the centrality of (...) Scripture changing under the influence of historical criticism. Looking at Thomas Aquinas and Friedrich Schleiermacher on theology and Scripture's connection to science, it offers a new framework for theorizing science and religion as part of the history of philosophy. (shrink)

Out of a concern for keeping suicidal patients alive, some psychotherapists may use hard persuasion or coercion to keep them in treatment. However, more recent evidence-supported interventions have made respect for patient autonomy a cornerstone, showing that the effective interventions that promote the wellbeing of suicidal patients also prioritize respect for patient autonomy. This article details how psychotherapists can incorporate respect for patient autonomy in the effective treatment of suicidal patients by listening to them, explaining treatments to them, involving them (...) in decisions, and inviting evaluations from them on the process and progress of their treatment. It also describes how processes that respect patient autonomy can supplement interventions that directly address some of the drivers of suicide. (shrink)

In this book, I give a topic-based, modular introduction to philosophy. The book has 16 chapters: 7 in theoretical philosophy and 9 in practical philosophy. Each topic is introduced by means of a concrete question; the main positions on this question are then developed and criticized in turn. I try to avoid taking sides; instead, I emphasize that students must think through the issues for themselves.

This is a reply to ‘Defending Wittgenstein’, Piotr Dehnel's critique of my article, ‘Defending Wittgenstein's Remarks on Cantor from Putnam’. I first show that my position is much more in agreement with Felix Mühlhölzer than Dehnel takes it to be, and that his criticism of me is nothing more than a failure to recognize this. I then show how Dehnel incorrectly reads Wittgenstein as rejecting set theory as false. It is an overemphasis on and a much too narrow picture of (...) ‘applicability’ which leads him to this view. Finally, I conclude by rejecting Dehnel's view that Wittgenstein was a finitist about mathematics. (shrink)

In this paper I argue that there would be no obligatory maxims if the only standards for assessing maxims were Kant’s universalizability tests. The paper is divided into five sections. In the first, I clarify my thesis: I define my terms and disambiguate my thesis from other related theses for which one might argue. In the second, I confront the view that says that if a maxim passes the universalizability tests, then there is a positive duty to adopt that maxim; (...) I also confront a close relative of this view. In the third, I confront the view that says that if a maxim does not pass the universalizability tests, then there is a positive duty to adopt the contradictory of that maxim. In the fourth, I confront two variations of the view that says that if a maxim does not pass the universalizability tests and an agent is deliberating about the action in the maxim, then the agent has a positive duty to adopt the contrary of that maxim. In the fifth, I confront the view that says that if an agent has adopted a maxim of ends, then the agent has a positive duty to universalize that end. I then wrap up the paper with some concluding remarks. (shrink)

We routinely observe others’ choices and use them to guide our own. Whose choices influence us more, and why? Prior work has focused on the effect of perceived similarity between two individuals, such as the degree of overlap in past choices or explicitly recognizable group affiliations. In the real world, however, any dyadic relationship is part of a more complex social structure involving multiple social groups that are not directly observable. Here we suggest that human learners go beyond dyadic similarities (...) in choice behaviors or explicit group memberships; they infer the structure of social influence by grouping individuals based on choices, and they use these groups to decide whose choices to follow. We propose a computational model that formalizes this idea, and we test the model predictions in a series of behavioral experiments. In Experiment 1, we reproduce a well-established finding that people's choices are more likely to be influenced by someone whose past choices are more similar to their own past choices, as predicted by our model as well as dyadic similarity models. In Experiments 2–5, we test a set of unique predictions of our model by looking at cases where the degree of choice overlap between individuals is equated, but their choices indicate a latent group structure. We then apply our model to prior empirical results on infants’ understanding of others’ preferences, presenting an alternative account of developmental changes. Finally, we discuss how our model relates to classical findings in the social influence literature and the theoretical implications of our model. Taken together, our findings demonstrate that structure learning is a powerful framework for explaining the influence of social information on decision making in a variety of contexts. (shrink)

In this article, I confront Jessica Flanigan’s recent attempt to show not merely that women have a right to commit prenatal injury, but also that women who act on this right are praiseworthy and should not be criticized for this injury. I show that Flanigan’s arguments do not work, and I establish presumptive grounds against any such right—namely, prenatal injury, by definition, involves intentional or negligent harm and, as such, may be subsumed under a wider class of actions that are (...) presumptively wrong. (shrink)

My goals in this paper are twofold: to outline the refashioning of amateur and professional roles in life science in late Victorian Yorkshire, and to provide a revised historiography of the relationship between amateurs and professionals in this era. Some historical treatments of this relationship assume that amateurs were demoralized by the advances of laboratory science, and so ceased to contribute and were left behind by the autonomous "new biology." Despite this view, I show that many amateurs played a vital (...) part in the construction of a professional academic community in urban Yorkshire, and then continued to collaborate with the laboratory-based biologists. The key to any analysis of the relationship between amateurs and professionals is the great variety of amateur identities and practices in Victorian Yorkshire. The amateur-professional rift fallacy arose because laboratory biologists fashioned an identity in conscious opposition to a particular type of amateur: an ideal that belied an array of cooperative relationships. As naturalists refashioned their roles and identities in light of the changes within academe and without, debates about the practice and place of life science took place as often among amateurs as between professionals and amateurs. (shrink)

In this paper I intend to raise a problem for so-called Frankfurt examples. I begin by describing the examples and what they are used for. Then I describe the problem.

In Kant and Modern Political Philosophy, Katrin Flikschuh pursues two main aims. She tries to show that Kant’s theory of Right [Recht] is grounded in Kantian metaphysics. For example, we do not really understand Kant’s thought on property rights and cosmopolitanism unless we have in view its metaphysical underpinnings. Second, Flikschuh attempts to demonstrate the relevance of Kant’s theory of Right, especially as it is presented in Kant’s notoriously difficult Rechtslehre, to contemporary political concerns. In pursuing these aims she brings (...) to bear wide-ranging knowledge of scholarly work on Kant’s political and legal thought. (shrink)

In this article, I explore an important difference between circumstantial luck on the one side and resultant and constitutive luck on the other. In section 1, I argue that, in circumstantial luck, the object of luck and the object of moral judgment are different even though, in resultant and constitutive luck, they are the same. In section 2, I explain that this difference (1) has the potential to undermine the regress argument for moral luck; (2) makes viable the “selective moral (...) luck” argument strategy (affirming some species of moral luck but denying others); and (3) has implications for the heritability of luck. (shrink)

In this paper I defend the traditional interpretations of Kant’s Formula of a Law of Nature from recent attacks leveled by Faviola Rivera-Castro, James Furner, Ido Geiger, Pauline Kleingeld and Sven Nyholm. After a short introduction, the paper is divided into four main sections. In the first, I set out the basics of the three traditional interpretations, the Logical Contradiction Interpretation, the Practical Contradiction Interpretation and the Teleological Contradiction Interpretation. In the second, I examine the work of Geiger, Kleingeld and (...) Nyholm: these three commentators reject the traditional interpretations entirely, but I argue that this rejection is ill-founded. In the third and fourth, I take a detailed look at Furner’s work, work in which he seeks to revise (rather than reject) the traditional interpretations. I argue that, despite his more modest aims, Furner’s revision is also ill-founded. (shrink)

In the Paraplegia Case, we must choose either to preserve the life of a paraplegic for 10 years or that of someone in full health for the same duration. Non-consequentialists reject a benefit-maximising view, which holds that since the person in full health will have a higher quality of life, we ought to save him straightaway. In the Unequal Lifespan Case, we face a choice between saving one person for 5 years in full health and another for 25 years in (...) full health. Frances Kamm has recently unfurled an Equal Respect Argument in an effort to support the position that while we ought to give each person a 50% chance of being saved in the Paraplegia Case, we are morally permitted to save straightaway the person who would live longer in the Unequal Lifespan case. The article tries to show that a Kant-inspired account of the dignity of persons is far more successful than Kamm's argument in supporting this position. The Kant-inspired account owes this success to its conceiving of respect for persons not primarily as respect for their pursuit of what is of value for them, but rather as respect for the value in them. (shrink)

This paper introduces the concept of moral residue to global health, and shows how its presence undermines crucial interventions and research, especially in the global south. Lingering feelings of anxiety, anger, blame or frustration often exist among local populations, where previous interventions or research have left traces of harm and/or exploitation. The existence of such feelings reflects the presence of moral residue, recognizing the moral experiences of epistemic injustices, which in turn undermines critical interventions and research through outright rejection or (...) passive non-compliance among affected populations. While such situations have been variously interpreted and relevant strategies developed to address the issues, little to no consideration is made on the implications of moral residue experiences in global health contexts and how to address them. This paper demonstrates the presence of moral residue in global health and proffers an African ethical approach, a harmony framework, for addressing moral residue issues, as part of a holistic approach towards tackling population health crises without compromising health gains for affected populations in the global south. (shrink)

At the core of Kant's ethics lies the claim that if there is a supreme principle of morality then it cannot be a principle based on utilitarianism or Aristotelian perfectionism or the Ten Commandments. The only viable candidate for such a principle is the categorical imperative. This book is the most detailed investigation of this claim. It constructs a new, criterial reading of Kant's derivation of one version of the categorical imperative: the Formula of Universal Law. This reading shows this (...) derivation to be far more compelling than contemporary philosophers tend to believe. It also reveals a novel approach to deriving another version of the categorical imperative, the Formula of Humanity, a principle widely considered to be the most attractive Kantian candidate for the supreme principle of morality. This book will be important not just for Kant scholars but for a broad swathe of students of philosophy. (shrink)

The allocation of scarce health care resources such as flu treatment or organs for transplant presents stark problems of distributive justice. Persad, Wertheimer, and Emanuel have recently proposed a novel system for such allocation. Their “complete lives system” incorporates several principles, including ones that prescribe saving the most lives, preserving the most life-years, and giving priority to persons between 15 and 40 years old. This paper argues that the system lacks adequate moral foundations. Persad and colleagues' defense of giving priority (...) to those between 15 and 40 leaves them open to the charge that they discriminate unfairly against children. Second, the paper contends that the complete lives system fails to provide meaningful practical guidance in central cases, since it contains no method for balancing its principles when they conflict. Finally, the paper proposes a new method for balancing principles of saving the most lives and maximizing life-years. (shrink)

Many take Kantian ethics to founder when it comes to our duties to animals. In this paper, I advocate a novel approach to this problem. The paper is divided into three sections. In the first, I canvass various passages from Kant in order to set up the problem. In the second, I introduce a novel approach to this problem. In the third, I defend my approach from various objections. By way of preview: I advocate rejecting the premise that nonhuman animals (...) are nonrational. (shrink)

In this article, I argue that Kant’s Categorical Imperative applies to maxim tokens rather than to maxim types. The article has three main parts. In the first, I explain my thesis. In the second, I argue for it. In the third, I argue, further, that, if my thesis is correct, then tokens of different maxim types can have different deontic statuses for different agents.

This study explores Kant's accounts of acting from inclination and pursuing happiness. It culminates in two findings. First, Kant fails in his attempt to prove a central tenet of his ethics, namely that there can be no practical law of happiness. Second, Kant's critics have unfairly condemned his account of the role pleasure plays in acting from inclination. Chapter I, devoted to Kant's theory of agency, offers readings of his notions of willing, acting, and acting on a maxim. The chapter (...) rejects the orthodox interpretation of the will as the capacity for choice, arguing that Willkur is actually the capacity to act-on-choice. Chapter II focuses on Kant's account of the role pleasure plays in actions performed from inclination. According to the traditional interpretation, defended by T. H. Green and others, Kant holds that whenever an agent acts from inclination, she has pleasure as her only ultimate end. The chapter offers an alternative to this radically hedonistic reading, arguing that, with equal plausibility but more charity, we may interpret Kant to hold the following: whenever an agent acts from inclination, she has pleasure or the avoidance of displeasure as an ultimate end, but not necessarily as her only one. Chapter III offers a reading of Kant's views on happiness. It argues that his two main conceptions, i.e., his hedonistic and his inclination-based one, are not equivalent. Chapter IV shows that not one of Kant's six arguments for the claim that there can be no practical law of happiness succeeds. Chapter V also begins on a critical note, questioning the plausibility of Kant's conceptions of happiness. It ends by arguing that Kant's account of the role pleasure plays in acting from inclination stands up well to criticisms, including those advanced by Bernard Williams and Phillips Griffiths. With the help of this account, Kant is able to rebut the serious charge that his practical philosophy does not allow for the possibility of genuine friendship. (shrink)

This chapter contains sections titled: I II III IV V VI.

A theoretical structure for multiattribute decision making is presented, based on a dynamical system for interactions in a neural network incorporating affective and rational variables. This enables modeling of problems that elude two prevailing economic decision theories: subjective expected utility theory and prospect theory. The network is unlike some that fit economic data by choosing optimal weights or coefficients within a predetermined mathematical framework. Rather, the framework itself is based on principles used elsewhere to model many other cognitive and behavioral (...) data, in a manner approximating how humans perform behavioral functions. Different, interconnected modules within the network encode (a) attributes of objects among which choices are made, (b) object categories, (c) and goals of the decision maker. An example is utilized to simulate the actual consumer choice between old and new versions of Coca-Cola. Potential applications are also discussed to market decisions involving negotiations between participants, such as international petroleum traders. (shrink)

In reinforcement learning, a decision maker searching for the most rewarding option is often faced with the question: What is the value of an option that has never been tried before? One way to frame this question is as an inductive problem: How can I generalize my previous experience with one set of options to a novel option? We show how hierarchical Bayesian inference can be used to solve this problem, and we describe an equivalence between the Bayesian model and (...) temporal difference learning algorithms that have been proposed as models of RL in humans and animals. According to our view, the search for the best option is guided by abstract knowledge about the relationships between different options in an environment, resulting in greater search efficiency compared to traditional RL algorithms previously applied to human cognition. In two behavioral experiments, we test several predictions of our model, providing evidence that humans learn and exploit structured inductive knowledge to make predictions about novel options. In light of this model, we suggest a new interpretation of dopaminergic responses to novelty. (shrink)

Opponents of commerce in organs sometimes appeal to Kant’s Formula of Humanity to justify their position. Kant implies that anyone who sells an integral part of his body violates this principle and thereby acts wrongly. Although appeals to Kant’s Formula are apt, they are less helpful than they might be because they invoke the necessity of respecting the dignity of ends in themselves without specifying in detail what dignity is or what it means to respect it, and they cite the (...) wrongness of an agent’s treating another merely as a means without clarifying conditions under which this occurs. This paper crystallizes two different approaches to the Formula of Humanity and probes when, according to them, the principle would imply that it is wrong to engage in “live donor” transactions, in which someone chooses to undergo a kidney extraction in exchange for money. (shrink)