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)

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)

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)

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)

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)

Time and philosophical fashion have not been kind to hedonism. After flourishing for three centuries or so in its native empiricist habitat, it has latterly all but disappeared from the scene. Does it now merit even passing attention, for other than nostalgic purposes? Like endangered species, discredited ideas do sometimes manage to make a comeback. Is hedonism due for a revival of this sort? Perhaps it is overly optimistic to think that it could ever flourish again in its original form; (...) the evolutionary changes which have rendered the philosophical environment hostile to the classical specimens of the theory are doubtless irreversible. None the less, it is still possible that certain features of the classical view can, and should, be recuperated—like bits of DNA which could contribute to the emergence of new and more robust species. So let us ask ourselves: what is living and what is dead in traditional hedonism? (shrink)

The migration of elder-care workers appears to be a zero-sum game. This naturally offends our sense of justice, especially when the host populations are richer. In this article, I argue that we ought to look beyond the short run. Once we look at the long run, we will see possibilities of non-zero-sum games that are mutually beneficial.

These notes are the result of some work done a year or two ago on the Medicean MS. of Aeneas Tacticus1 in preparation for an edition of that unduly neglected author which I hope will soon see the light. I should not have thought it worth while to publish them separately were it not for two papers, at once laborious and brilliant, read by Mr. A. C. Clark to the Oxford Philological Society on the text of Cicero′s speeches, in May, (...) 1912, and February, 1913. The extreme plausibility with which the reader then explained numberless corruptions, transpositions, etc., in the text of Cicero, by reconstructing the length of line and pagination of the MSS. in their several degrees of descent, led me to think that it might be of some interest to publish the results at which I arrived by working on the same lines with a Greek author. In my case the problem has been a far simpler one, as I only had one MS. to deal with; but as I came to my own conclusions quite independently, before I knew that the method was being applied elsewhere, I give them for what they are worth, only too glad to find myself in such good company. (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)

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.

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)

When medical assistance in dying (MAiD) was legalized in Canada in June 2016, the question of allowing decisionally capable persons to make advance requests in anticipation of later incapacity was reserved for further consideration during the mandatory parliamentary review originally scheduled to begin in June 2020 (but since delayed by COVID-19). In its current form the legislation does not permit such requests, since it stipulates that at the time at which the procedure is to be administered the patient must give (...) “express consent” to receiving it. Since express consent presupposes decisional capacity, this requirement rules out administering MAiD to a patient who has lost capacity. Amendments to the legislation passed by Parliament in March 2021 open the door slightly by allowing advance requests by patients after they have been approved for MAiD, if they fear losing capacity before the procedure can be administered. But this provision would apply only to patients whose natural death was deemed to be “reasonably foreseeable”, and would continue to exclude (a) requests made after diagnosis of a “grievous and irremediable medical condition” but in advance of approval for MAiD, and (b) requests made before such a diagnosis. My aim in this paper is twofold: to explore the ethical and legal issues concerning advance requests for MAiD, and to argue for expanding provision for such requests to include both of these further scenarios. (shrink)

This commentary proposes keeping the bridge locus construct with a revised definition which requires the bridge locus to be dynamic, representation-independent and influenced by top-down processes. The denial of the uniformity of content thesis is equivalent to dualism. The active perception perspective is a valuable one.

Hate speech, understood broadly, is any form of expression intended to arouse hatred or contempt toward members of a particular social group. When university administrators have reason to believe that a planned speaking event on campus may feature hate speech (at least in the eyes of some), how should they respond? In this paper I address this question as it arises for Canadian universities. I argue that, where the regulation of campus speech is concerned, the right course of action for (...) university administrators is nearly always to do absolutely nothing. They will have reason to become actively involved only in order to ensure that a speaking event proceeds safely, or when it threatens to disrupt the functioning of the university, or when it is itself threatened with disruption by protesting groups. In those instances the justification for intervention will be to protect and facilitate speech, not to shut it down. (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)