If I lead a life of virtue, that may well be good for you. But will it also be good for me? The idea that it will—or even must—is an ancient one, and its appeal runs deep. For if this idea is correct then we can provide everyone with a good reason—arguably the best reason—for being virtuous. However, for all the effort which has been invested in defending the idea, by some of the best minds in the history of philosophy, (...) it remains unproven. Worse, in this skeptical age hardly anyone really believes it. I don't really believe it either, at least not in its strongest forms, but I think that the question is nonetheless worth examining. Even if we cannot show that virtue and self-interest coincide, we can at least measure the breadth of the gap between them. (shrink)

Suppose that the ultimate point of ethics is to make the world a better place. If it is, we must face the question: better in what respect? If the good is prior to the right — that is, if the rationale for all requirements of the right is that they serve to further the good in one way or another — then what is this good? Is there a single fundamental value capable of underlying and unifying all of our moral (...) categories? If so, how might it defeat the claims of rival candidates for this role? If not, is there instead a plurality of basic goods, each irreducible to any of the others? In that case, how do they fit together into a unified picture of the moral life? These are the questions I wish to address, in a necessarily limited way. To many the questions will seem hopelessly old-fashioned or misguided. Some deontologists will wish to reverse my ordering of the good and the right, holding that the right constrains acceptable conceptions of the good. For many contractarians, neither the good nor the right will seem normatively basic, since both are to be derived from a prior conception of rationality. Finally, some theorists will reject the classification of moral theories in terms of their basic normative categories, arguing that the whole foundationalist enterprise in ethics should be abandoned. In the face of these challenges to the priority of the good, and in light of the many current varieties of moral skepticism and relativism, I cannot provide a very convincing justification for raising the questions I intend to discuss. (shrink)

This paper describes the change of emphasis that occurred in the teaching of ethics to small groups of clinical students. Although the original focus of the course was on the analysis of ethical dilemmas associated with individual patients known to the students, it soon became evident that there were, for the students themselves, more fundamental ethical dilemmas in their new role as clinical students. These included worries about how to respond when patients asked questions which their consultants had previously deceived (...) them about, worries about inflicting pain on patients, as with intravenous cannulation, and the role of the medical student in the clinical team. We emphasise the need to explore student experiences as part of the process of ethics teaching. (shrink)

It sometimes happens that a philosopher will develop a view on some topic and then later come to reject it. J. L. Austin was perhaps unique in that he not only rejected a philosophical view of which he himself was the author, he patiently developed the view and then showed it to be ultimately unsatisfactory within the compass of the same work. And he did this not once but three times, in material intended for publication. I am thinking, of course, (...) of his notion of performative utterances: the view that there is a class of utterance, the members of which would on standard grammatical grounds be classed as statements, yet whose proper business is not to state anything but to perform some act. For example, to say ‘I promise to be there’ is to promise to be there, and not to state that one promises nor even to state that one will be there. (shrink)

Moral philosophers agree that welfare matters. But they disagree about what it is, or how much it matters. In this vital new work, Wayne Sumner presents an original theory of welfare, investigating its nature and discussing its importance. He considers and rejects all notable theories of welfare, both objective and subjective, including hedonism and theories founded on desire or preference. His own theory connects welfare closely with happiness or life satisfaction. Reacting against the value pluralism that currently dominates moral philosophy, (...) he advances welfare as the only basic ethical value. He concludes by discussing the implications of this thesis for ethical and political theory. Written in clear, non-technical language, and including a definitive survey of other work in this area, Sumner's book is essential reading for moral philosophers, political theorists, and welfare economists. (shrink)

Ever since medical assistance in dying (MAID) became legal in Canada in 2016, controversy has enveloped the refusal by many faith‐based institutions to allow this service on their premises. In a recent article in this journal, Philip and Joshua Shadd have proposed ‘changing the conversation’ on this issue, reframing it as an exercise not of conscience but of an institutional right of self‐governance. This reframing, they claim, will serve to show how health‐care institutions may be justified in refusing to provide (...) MAID on moral or religious grounds. I argue that it will not make it easier to justify institutional refusal, and is likely to make it harder. (shrink)

In the situations canvassed I have argued that (a) the dominant aim of the utilitarian will be the establishment of a fair procedure, (b) under radical uncertainty cooperation will constitute his best bet, and (c) when he knowsthat all others will cooperate it is still an open question whether he will slack, and if under some conditions he does so he does not then act unfairly. It is wise to bear in mind, however, that an enormous number of possible situations, (...) mostly mixtures of the pure cases, simply have not been considered. It is not inconceivable that in one of them the utilitarian will clearly act unfairly; I am inclined to think not, but the possibility is not entirely ruled out. (shrink)

This paper defends an account of compassion and argues for the centrality of compassion to the proper practice of medicine. The argument proceeds by showing that failures of compassion can lead to poor medical treatment and disastrous outcomes. Several case studies are discussed, exemplifying the difference between compassionate and noncompassionate responses to patients seeking help. Arguments are offered in support of approaching reports of persistent pain with a trusting attitude, rather than distrust or skepticism. The article concludes by suggesting educational (...) improvements to encourage compassion. (shrink)

Hanlester Network v. Shalala ) marks the first test of the application of the Medicare-Medicaid anti-kickback statute to physician self-referral joint ventures. The most recent development in this ongoing litigation was the April 6, 1995 decision of the Ninth Circuit Court of Appeals, holding the Hanlester Network vicariously liable for its marketing vice president's knowing and willful violation of the antikickback statute. The vice president had offered to pay physician-investors in order to induce their referrals of program-related business.The Hanlester Network (...) was a California general partnership comprised of corporations, clinical laboratories, and individual investors. In April 1987, it entered into a management agreement on behalf of the clinical laboratories with SmithKline BioScience Laboratories. (shrink)

As little as a decade ago most moral philosophers still believed that the exercise of their craft did not include defending positions on actual moral problems. More recently they have come to their senses, one happy result being a spate of articles in the last few years on the subject of abortion. These discussions have contributed much toward an understanding of the abortion issue, but for the most part they have not attempted a full analysis of the morality of abortion. (...) Such an analysis is too large a task for a single paper, but a sketch of it will be undertaken here, the details to be filled in elsewhere. (shrink)

In her review of my book Assisted Death: A Study in Ethics and Law, Glenys Williams raises a number of substantive objections to its argument. In this note I reply to those objections.

When Amartya Sen defends his capability theory of well-being he contrasts it with the utility theory advocated by the classical utilitarians, including John Stuart Mill. Yet a closer examination of the two theories reveals that they are much more similar than they appear. Each theory can be interpreted in either a subjective or an objective way. When both are interpreted subjectively the differences between them are slight, and likewise for the objective interpretations. Finally, whatever differences may remain are less important (...) than they might seem, since the two theories are developed by Sen and Mill for different purposes and are in that sense not genuine rivals. (shrink)

In this timely book L.W. Sumner addresses these issues within the wider context of palliative care for patients in the dying process.