Suppose that you prefer A to B, B to C, and C to A. Your preferences violate Expected Utility Theory by being cyclic. Money-pump arguments offer a way to show that such violations are irrational. Suppose that you start with A. Then you should be willing to trade A for C and then C for B. But then, once you have B, you are offered a trade back to A for a small cost. Since you prefer A to B, you (...) pay the small sum to trade from B to A. But now you have been turned into a money pump. You are back to the alternative you started with but with less money. This Element shows how each of the axioms of Expected Utility Theory can be defended by money-pump arguments of this kind. The Element also defends money-pump arguments from the standard objections to this kind of approach. This title is also available as Open Access on Cambridge Core. (shrink)

Critical-Range Utilitarianism is a variant of Total Utilitarianism which can avoid both the Repugnant Conclusion and the Sadistic Conclusion in population ethics. Yet Standard Critical-Range Utilitarianism entails the Weak Sadistic Conclusion, that is, it entails that each population consisting of lives at a bad well-being level is not worse than some population consisting of lives at a good well-being level. In this paper, I defend a version of Critical-Range Utilitarianism which does not entail the Weak Sadistic Conclusion. This is made (...) possible by a fourth category of absolute value in addition to goodness, badness, and neutrality. (shrink)

One of the principles on how to act under moral uncertainty, My Favourite Theory, says roughly that a morally conscientious agent chooses an option that is permitted by the most credible moral theory. In defence of this principle, we argue that it prescribes consistent choices over time, without relying on intertheoretic comparisons of value, while its main rivals are either plagued by moral analogues of money pumps or in need of a method for making non-arbitrary intertheoretic comparisons. We rebut the (...) arguments that have been levelled against My Favourite Theory and offer some arguments against intertheoretic comparisons of value. (shrink)

According to Longtermism, our acts’ expected influence on the expected value of the world is mainly determined by their effects in the far future. There is, given total utilitarianism, a straightforward argument for Longtermism due to the enormous number of people that might exist in the future, but this argument does not work on person-affecting views. In this paper, we will argue that these views might also lead to Longtermism if Prudential Longtermism is true. Prudential Longtermism holds for a person (...) if and only if our acts’ overall influence on that person’s expected well-being is mainly determined by the acts’ effects in the far future. We argue that (due to a small chance of anti-ageing and uploading) there could be an enormous amount of prudential value for some contemporary person in the far future and that value may be so large that it dominates their overall expectation of lifetime well-being. (shrink)

Background: Nurses who are constantly being exposed to patients’ suffering can lead to compassion fatigue. There is a gap in the latest research regarding nurses’ experiences of compassion fatigue. Little is known about how compassion fatigue affects the nurse as a person, and indications of how it affects the profession are scarce. Aim: The aim of this study was to explore compassion fatigue experienced by nurses and how it affects them as persons and professionals. Research design, participants, and research context: (...) A qualitative explorative approach was used. The data consisted of texts from interviews with seven nurses in various nursing contexts. Content analysis was used. Ethical consideration: Ethical approval was sought and granted from an ethics committee at the university where the researchers were based, and written, informed consent was obtained from all the participants. Findings: Five themes were discovered: Compassion as an empathic gift and compassion fatigue as a result of compassion overload, Compassion fatigue as exhausting the nurse as a professional and private person, Compassion fatigue as a crisis with potentially valuable insights, Compassion fatigue can be handled by self-care and focus on self, and Compassion fatigue is affected by life itself and multifaceted factors. Discussion: Compassion stress and overload can lead to compassion fatigue. Compassion fatigue affects the nurse’s ability to compassion, and the caring is no longer experienced in the same way; the nurses experienced it as being deprived of the gift of compassion. Compassion fatigue implicates a crisis with potentially valuable insights. Conclusion: Compassion fatigue can be symbolized as bruises in the soul, hurtful, but with time it can fade away, although it leaves a sense of caution within the nurse, which can affect the suffering patient. (shrink)

A straightforward way to handle moral uncertainty is simply to follow the moral theory in which you have most credence. This approach is known as My Favourite Theory. In this paper, I argue that, in some cases, My Favourite Theory prescribes choices that are, sequentially, worse in expected moral value than the opposite choices according to each moral theory you have any credence in. In addition this, problem generalizes to other approaches that avoid intertheoretic comparisons of value, such as My (...) Favourite Option, the Borda Rule, Variance Normalization, and the Principle of Maximizing Expected Normalized Moral Value. (shrink)

One might think that money pumps directed at agents with cyclic preferences can be avoided by foresight. This view was challenged two decades ago by the discovery of a money pump with foresight, which works against agents who use backward induction. But backward induction implausibly assumes that the agent would act rationally and retain her trust in her future rationality even at choice nodes that could only be reached if she were to act irrationally. This worry does not apply to (...) BI-terminating decision problems, where at each choice node backward induction prescribes a move that terminates further action. For BI-terminating decision problems, it is enough to assume that rationality and trust in rationality are retained at choice nodes reachable by rational moves. The old money pump with foresight was not BI-terminating. In this paper, we present a new money pump with foresight, one that is both BI-terminating and considerably simpler. (shrink)

In this article, I argue that the small-improvement argument fails since some of the comparisons involved in the argument might be indeterminate. I defend this view from two objections by Ruth Chang, namely the argument from phenomenology and the argument from perplexity. There are some other objections to the small-improvement argument that also hinge on claims about indeterminacy. John Broome argues that alleged cases of value incomparability are merely examples of indeterminacy in the betterness relation. The main premise of his (...) argument is the much-discussed collapsing principle. I offer a new counterexample to this principle and argue that Broome's defence of the principle is not cogent. On the other hand, Nicolas Espinoza argues that the small-improvement argument fails as a result of the mere possibility of evaluative indeterminacy. I argue that his objection is unsuccessful. (shrink)

It is natural to assume that every value bearer must be good, bad, or neutral. This paper argues that this assumption is false if value incomparability is possible. More precisely, if value incommensurability is possible, then there is a fourth category of absolute value, in addition to the good, the bad, and the neutral.

In the 1960’s, Lars Bergström and Hector-Neri Castañeda noticed a problem with alternative acts and consequentialism. The source of the problem is that some performable acts are versions of other performable acts and the versions need not have the same consequences as the originals. Therefore, if all performable acts are among the agent’s alternatives, act consequentialism yields deontic paradoxes. A standard response is to restrict the application of act consequentialism to certain relevant alternative sets. Many proposals are based on some (...) variation of maximalism, that is, the view that act consequentialism should only be applied to maximally specific acts. In this paper, I argue that maximalism cannot yield the right prescriptions in some cases where one can either (i) form at once the intention to do an immediate act and form at a later time the intention to do a succeeding act or (ii) form at once the intention to do both acts and where the consequences of (i) and (ii) differ in value. Maximalism also violates normative invariance, that is, the condition that if an act is performable in a situation, then the normative status of the act does not depend on what acts are performed in the situation. Instead of maximalism, I propose that the relevant alternatives should be the exhaustive combinations of acts the agent can jointly perform without performing any other act in the situation. In this way, one avoids the problem of act versions without violating normative invariance. Another advantage is that one can adequately differentiate between possibilities like (i) and (ii). (shrink)

Given reductionism about people, personal persistence must fundamentally consist in some kind of impersonal continuity relation. Typically, these continuity relations can hold from one to many. And, if they can, the analysis of personal persistence must include a non-branching clause to avoid non-transitive identities or multiple occupancy. It is far from obvious, however, what form this clause should take. This paper argues that previous accounts are inadequate and develops a new proposal.

The small-improvement argument is usually considered the most powerful argument against comparability, viz the view that for any two alternatives an agent is rationally required either to prefer one of the alternatives to the other or to be indifferent between them. We argue that while there might be reasons to believe each of the premises in the small-improvement argument, there is a conflict between these reasons. As a result, the reasons do not provide support for believing the conjunction of the (...) premises. Without support for the conjunction of the premises, the small-improvement argument for incomparability fails. (shrink)

Is an outcome where many people are saved and one person dies better than an outcome where the one is saved and the many die? According to the standard utilitarian justification, the former is better because it has a greater sum total of well-being. This justification involves a controversial form of moral aggregation, because it is based on a comparison between aggregates of different people's well-being. Still, an alternative justification—the Argument for Best Outcomes—does not involve moral aggregation. I extend the (...) Argument for Best Outcomes to show that any utilitarian evaluation can be justified without moral aggregation. (shrink)

John Locke’s account of personal identity is usually thought to have been proved false by Thomas Reid’s simple ‘Gallant Officer’ argument. Locke is traditionally interpreted as holding that your having memories of a past person’s thoughts or actions is necessary and sufficient for your being identical to that person. This paper argues that the traditional memory interpretation of Locke’s account is mistaken and defends a memory continuity view according to which a sequence of overlapping memories is necessary and sufficient for (...) personal identity. On this view Locke is not vulnerable to the Gallant Officer argument. (shrink)

Moral obligation and permissibility are usually thought to be interdefinable. Following the pattern of the duality definitions of necessity and possibility, we have that something’s being permissible could be defined as its not being obligatory to not do it. And that something’s being obligatory could be defined as its not being permissible to not do it. In this paper, I argue that neither direction of this alleged interdefinability works. Roughly, the problem is that a claim that some act is obligatory (...) or permissible entails that there is a moral law, whereas a negative claim that some act is not obligatory or not permissible does not. Nevertheless, one direction of the interdefinability can potentially be salvaged. I argue that, if we do not require the conceptual possibility of moral dilemmas, then there is a way to plausibly define obligation in terms of permissibility. I conclude that permissibility is the only feasible deontic primitive. (shrink)

John Rawls argues that the Difference Principle would be chosen by parties trying to advance their individual interests behind the Veil of Ignorance. Behind this veil, the parties do not know who they are and they are unable to assign or estimate probabilities to their turning out to be any particular person in society. Much discussion of Rawls’s argument concerns whether he can plausibly rule out the parties’ having access to probabilities about who they are. Nevertheless, I argue that, even (...) if the parties lacked access to probabilities about who they are in society, they would still reject the Difference Principle. I argue that there are cases where it is still clear to the parties that it is not in any of their individual interests that the Difference Principle is adopted. (shrink)

I show, in words of one block of sound, that, while those whose likes form a loop could stop some wealth pumps if they now did what they would like most based on what they thought they would do next, there are wealth pumps they could not stop in that way.

A standard liberal claim is that freedom of choice is not only instrumentally valuable but also intrinsically valuable, that is, valuable for its own sake. I argue that each one of five conditions is plausible if freedom of choice is intrinsically valuable. Yet there exists a counter-example to the conjunction of these conditions. Hence freedom of choice is not intrinsically valuable.

The aim of the Consequence Argument is to show that, if determinism is true, no one has, or ever had, any choice about anything. In the stock version of the argument, its two premisses state that no one is, or ever was, able to act so that the past would have been different and no one is, or ever was, able to act so that the laws of nature would have been different. This stock version fails, however, because it requires (...) an invalid inference rule. The standard response is to strengthen both premisses by replacing ‘would’ with ‘might’. While this response ensures validity, it weakens the argument, since it strengthens the premisses. I show that we can do better: We can keep the weak reading of one premiss and just strengthen the other. This provides two versions of the Consequence Argument which are stronger than the standard revision. (shrink)

Derek Parfit argues that fission is prudentially better for you than ordinary death. But is having more fission products with good lives prudentially better for you than having just one? In this paper, we argue that it is. We argue that, if your brain is split and the halves are transplanted into two recipients (who both have good lives), then it is prudentially better for you if both transplants succeed than if only one of them does (other things being equal). (...) This upshot rules out, among other things, that the prudential value of standing in the relation that matters in survival to multiple people is equal to their average well-being. (shrink)

Prioritarianism is a variant of utilitarianism. It differs from utilitarianism in that benefiting individuals matters more the worse off these individuals are. On this view, there are two standard ways of handling risky prospects: Ex-Post Prioritarianism adjusts for prioritizing the worse off in final outcomes and then values prospects by the expectation of the sum total of those adjusted values, whereas Ex-Ante Prioritarianism adjusts for prioritizing the worse off on each individual's expectation and then values prospects by the sum total (...) of those adjusted expectations. A standard objection to Ex-Post Prioritarianism is that it violates Ex-Ante Pareto, that is, it prescribes choices that worsen the expectations for everyone. In this article, I argue that Ex-Ante Prioritarianism suffers from much the same problem: it violates a sequential version of Ex-Ante Pareto, that is, it prescribes sequences of choices that worsen the expectations for everyone. (shrink)

Although organizational and situational factors have been found to predict burnout, not everyone employed at the same workplace develops it, suggesting that becoming burnt out is a complex, multifaceted phenomenon. The aim of this study was to elucidate perceptions of conscience, stress of conscience, moral sensitivity, social support and resilience among two groups of health care personnel from the same workplaces, one group on sick leave owing to medically assessed burnout (n = 20) and one group who showed no indications (...) of burnout (n = 20). The results showed that higher levels of stress of conscience, a perception of conscience as a burden, having to deaden one’s conscience in order to keep working in health care and perceiving a lack of support characterized the burnout group. Lower levels of stress of conscience, looking on life with forbearance, a perception of conscience as an asset and perceiving support from organizations and those around them (social support) characterized the non-burnout group. (shrink)

The money-pump argument aims to show that cyclic preferences are irrational. The argument can be based on a number of different exploitation schemes that vary in what needs to be assumed about the agent. The Standard Money Pump works for myopic and naive agents, but not for sophisticated agents who use backward induction. The Upfront Money Pump works for sophisticated agents, but not for myopic or naive agents. In this paper, I present a new money pump, the Universal Money Pump, (...) that works for myopic, naive, and sophisticated agents. Moreover, the Universal Money Pump (just like the Upfront Money Pump) also works for minimally sophisticated agents who need not assume that they will choose rationally at nodes that can only be reached by irrational choices. This enables an argument that rational preferences are acyclic, which is based on weaker assumptions about dynamic rationality than existing money-pump arguments. (shrink)

Derek Parfit’s argument against the platitude that identity is what matters in survival does not work given his intended reading of the platitude, namely, that what matters in survival to some future time is being identical with someone who is alive at that time. I develop Parfit’s argument so that it works against the platitude on this intended reading.

This is the best collection of essays on Rorty’s philosophy that has been published in the last decade. It will be of great interest not only to Rorty specialists but to anyone concerned with the difficulties contemporary analytic philosophy faces in its search for a viable self-understanding. The contributors are Barry Allen, Akeel Bilgrami, Jacques Bouveresse, Robert Brandom, James Conant, Donald Davidson, Daniel Dennett, Jürgen Habermas, John McDowell, Hilary Putnam, Bjørn Ramberg, and Michael Williams. Rorty himself has also written an (...) essay, plus individual and fairly extensive replies to each of his critics. (shrink)

In this paper, I argue against defining either of ‘good’ and ‘better’ in terms of the other. According to definitions of ‘good’ in terms of ‘better’, something is good if and only if it is better than some indifference point. Against this approach, I argue that the indifference point cannot be defined in terms of ‘better’ without ruling out some reasonable axiologies. Against defining ‘better’ in terms of ‘good’, I argue that this approach either cannot allow for the incorruptibility of (...) intrinsic goodness or it breaks down in cases where both of the relata of ‘better’ are bad. (shrink)

Independence is the condition that, if X is preferred to Y, then a lottery between X and Z is preferred to a lottery between Y and Z given the same probability of Z. Is it rationally required that one’s preferences conform to Independence? The main objection to this requirement is that it would rule out the alleged rationality of Allais and Ellsberg Preferences. In this paper, I put forward a sequential dominance argument with fairly weak assumptions for a variant of (...) Independence (called Independence for Constant Prospects), which shows that Allais and Ellsberg Preferences are irrational. Hence this influential objection (that is, the alleged rationality of Allais and Ellsberg Preferences) can be rebutted. I also put forward a number of sequential dominance arguments that various versions of Independence are requirements of rationality. One of these arguments is based on very minimal assumptions, but the arguments for the versions of Independence which are strong enough to serve in the standard axiomatization of Expected Utility Theory need notably stronger assumptions. (shrink)

The money-pump argument is the standard argument for the acyclicity of rational preferences. The argument purports to show that agents with cyclic preferences are in some possible situations forced to act against their preference. In the usual, diachronic version of the money-pump argument, such agents accept a series of trades that leaves them worse off than before. Two stock objections are (i) that one may get the drift and refuse the trades and (ii) that one may adopt a plan to (...) only accept some of the trades. This article argues that these objections are irrelevant. If the diachronic money-pump argument is cogent, so is a more direct synchronic argument. The upshot is that the standard objections to the diachronic money-pump argument do not affect this simpler synchronic argument. Hence the standard objections to the money-pump argument for acyclicity are irrelevant. (shrink)

Andy Egan argues that neither evidential nor causal decision theory gives the intuitively right recommendation in the cases The Smoking Lesion, The Psychopath Button, and The Three-Option Smoking Lesion. Furthermore, Egan argues that we cannot avoid these problems by any kind of ratificationism. This paper develops a new version of ratificationism that gives the right recommendations. Thus, the new proposal has an advantage over evidential and casual decision theory and standard ratificationist evidential decision theory.

Joshua Gert and Wlodek Rabinowicz have developed frameworks for value relations that are rich enough to allow for non-standard value relations such as parity. Yet their frameworks do not allow for any non-standard preference relations. In this paper, I shall defend a symmetry between values and preferences, namely, that for every value relation, there is a corresponding preference relation, and vice versa. I claim that if the arguments that there are non-standard value relations are cogent, these arguments, mutatis mutandis, also (...) show that there are non-standard preference relations. Hence frameworks of Gert and Rabinowicz's type are either inadequate since there are cogent arguments for both non-standard value and preference relations and these frameworks deny this, or they lack support since the arguments for non-standard value relations are unconvincing. Instead, I propose a simpler framework that allows for both non-standard value and preference relations. (shrink)

In Cavell (1994), the ability to follow and produce Austinian examples of ordinary language use is compared with the faculty of perfect pitch. Exploring this comparison, I clarify a number of central and interrelated aspects of Cavell's philosophy: (1) his way of understanding Wittgenstein's vision of language, and in particular his claim that this vision is "terrifying," (2) the import of Wittgenstein's vision for Cavell's conception of the method of ordinary language philosophy, (3) Cavell's dissatisfaction with Austin, and in particular (...) his claim that Austin is not clear about the nature and possible achievements of his own philosophical procedures, and (4) Cavell's notion that the temptation of skepticism is perennial and incurable. Cavell's reading of Wittgenstein is related to that of John McDowell. Like McDowell, Cavell takes Wittgenstein to be saying that the traditional attempt to justify our practices from an external standpoint is misguided, since such detachment involves losing sight of those conceptual and perceptual capacities in terms of which a practice is understood by its engaged participants. Unlike McDowell, however, Cavell consistently rejects the idea that philosophical clearsightedness can or should free us from that fear of groundlessness which motivates the traditional search for external justification. (shrink)

If ‘F’ is a predicate, then ‘Fer than’ or ‘more F than’ is a corresponding comparative relational predicate. Concerning such comparative relations, John Broome’s Collapsing Principle states that, for any x and y, if it is false that y is Fer than x and not false that x is Fer than y, then it is true that x is Fer than y. Luke Elson has recently put forward two alleged counter-examples to this principle, allegedly showing that it yields contradictions if (...) there are borderline cases. In this paper, I argue that the Collapsing Principle does not rule out borderline cases, but I also argue that it is implausible. (shrink)

The standard argument for the claim that rational preferences are transitive is the pragmatic money-pump argument. However, a money-pump only exploits agents with cyclic strict preferences. In order to pump agents who violate transitivity but without a cycle of strict preferences, one needs to somehow induce such a cycle. Methods for inducing cycles of strict preferences from non-cyclic violations of transitivity have been proposed in the literature, based either on offering the agent small monetary transaction premiums or on multi-dimensional preferences. (...) This paper argues that previous proposals have been flawed and presents a new approach based on the dominance principle. (shrink)

A dialogue, in three parts, on utilitarian vulnerability to exploitation.

The Levelling-Down Objection is a standard objection to monistic egalitarian theories where equality is the only thing that has intrinsic value. Most egalitarians, however, are value pluralists; they hold that, in addition to equality being intrinsically valuable, the egalitarian currency in which we are equal or unequal is also intrinsically valuable. In this paper, I shall argue that the Levelling-Down Objection still minimizes the weight that the intrinsic badness of inequality could have in the overall intrinsic evaluation of outcomes, given (...) a certain way of measuring the badness of inequality, namely, the Additive Individual-Complaints Measure. (shrink)

How do you make decisions under ignorance? That is, how do you decide when you lack subjective probabilities for some of your options’ possible outcomes? One answer is that you follow the Laplace Rule: you assign an equal probability to each state of nature for which you lack a subjective probability (that is, you use the Principle of Indifference) and then you maximize expected utility. The most influential objection to the Laplace Rule is that it is sensitive to the individuation (...) of states of nature. This sensitivity is problematic because the individuation of states seems arbitrary. In this paper, however, I argue that this objection proves too much. I argue that all plausible rules for decisions under ignorance are sensitive to the individuation of states of nature. (shrink)

Kurt Gödel’s version of the Ontological Proof derives rather than assumes the crucial Possibility Claim: the claim that it is possible that something God-like exists. Gödel’s derivation starts off with a proof of the Possible Instantiation of the Positive: the principle that, if a property is positive, it is possible that there exists something that has that property. I argue that Gödel’s proof of this principle relies on some implausible axiological assumptions but it can be patched so that it only (...) relies on plausible principles. But Gödel’s derivation of the Possibility Claim also needs a substantial axiological assumption, which is still open to doubt. (shrink)

Erik Carlson puts forward a new way of defining monadic value predicates, such as ‘good’, in terms of dyadic value relations, such as ‘better’. Earlier definitions of this kind have the unwanted feature that they rule out some reasonable axiologies by conceptual fiat. Carlson claims that his definitions do not have this drawback. In this paper, I argue that they do.

Any theory that analyses personal identity in terms of phenomenal continuity needs to deal with the ordinary interruptions of our consciousness that it is commonly thought that a person can survive. This is the bridge problem. The present paper offers a novel solution to the bridge problem based on the proposal that dreamless sleep need not interrupt phenomenal continuity. On this solution one can both hold that phenomenal continuity is necessary for personal identity and that persons can survive dreamless sleep.

Moral wrongness comes in degrees. On a consequentialist view of ethics, the wrongness of an act should depend, I argue, in part on how much worse the act's consequences are compared with those of its alternatives and in part on how difficult it is to perform the alternatives with better consequences. I extend act consequentialism to take this into account, and I defend three conditions on consequentialist theories. The first is consequentialist dominance, which says that, if an act has better (...) consequences than some alternative act, then it is not more wrong than the alternative act. The second is consequentialist supervenience, which says that, if two acts have equally good consequences in a situation, then they have the same deontic status in the situation. And the third is consequentialist continuity, which says that, for every act and for any difference in wrongness δ greater than zero, there is an arbitrarily small improvement of the consequences of the act which would, other things being equal, not change the wrongness of that act or any alternative by more than δ. I defend a proposal that satisfies these conditions. (shrink)

These new essays on J. L. Austin's philosophy constitute the first major study of his thought in decades.

According to T. M. Scanlon’s anti-aggregation principle, it is wrong to save a larger number of people from minor harms rather than a smaller number from much more serious harms. This principle is a central part of many influential and anti-utilitarian ethical theories. According to the sequential-dominance principle, one does something wrong if one knowingly performs a sequence of acts whose outcome would be worse for everyone than the outcome of an alternative sequence of acts. The intuitive appeal of the (...) sequential-dominance principle should be obvious; everyone is knowingly made worse off if it is violated. In this paper, I present a number of cases where one is forced to violate either the anti-aggregation principle or the sequential-dominance principle. I show that these principles conflict regardless of whether one accepts a counterfactual or a temporal, worsening view of harm. Moreover, I show that this result holds regardless of how much worse a harm has to be in order to count as a much more serious harm. (shrink)

A compelling requirement on normative theories is that they should be satisfiable, that is, in every possible choice situation with a finite number of alternatives, there should be at least one performable act such that, if one were to perform that act, one would comply with the theory. In this paper, I argue that, given some standard assumptions about free will and counterfactuals, Objective Act Consequentialism violates this requirement.

W. V. Quine wished to restrict the interests that matter to those of actual people. Actual-Population Utilitarianism is a version of utilitarianism where, following Quine, only the interests of actual people matter. It is well known that ethical theories of this kind, which depend on what is actual, typically lead to normative variance. In this paper, I put forward a new objection to Actual-Population Utilitarianism. I present a case in which Actual-Population Utilitarianism prescribes choices that are worse for everyone whose (...) interests matter than the opposite choices. Moreover, I put forward a case in which total and average versions of Actual-Population Utilitarianism prescribe choices that are worse than the opposite choice for everyone (full stop). This objection also applies if the Actual-Population Restriction is combined with non-utilitarian views, given some minimal assumptions. (shrink)

According to Act Consequentialism, an act is right if and only if its outcome is not worse than the outcome of any alternative to that act. This view, however, leads to deontic paradoxes if the alternatives to an act are all other acts that can be done in the situation. A typical response is to only apply this rightness criterion to maximally specific acts and to take the alternatives to a maximally specific act to be the other maximally specific acts (...) that can be done in the situation. (This view can then be supplanted by a separate account for the rightness of acts that are not maximally specific.) This paper defends a rival view, Binary Act Consequentialism, where, for any voluntary act, that act is right if and only if its outcome is not worse than the outcome of not doing that act. Binary Act Consequentialism, which dates back to Jeremy Bentham, has few supporters. A number of seemingly powerful objections have been considered fatal. In this paper, I rebut these objections and put forward a positive argument for the view. (shrink)

Patient dignity in involuntary psychiatric hospital care is a complex yet central phenomenon. Research is needed on the concept of dignity’s specific contextual attributes since nurses are responsible for providing dignified care in psychiatric care. The aim was to describe nurses’ experiences of violation of patient dignity in clinical caring situations in involuntary psychiatric hospital care. A qualitative design with a hermeneutic approach was used to analyze and interpret data collected from group interviews. Findings reveal seven tentative themes of nurses’ (...) experiences of violations of patient dignity: patients not taken seriously, patients ignored, patients uncovered and exposed, patients physically violated, patients becoming the victims of others’ superiority, patients being betrayed, and patients being predefined. Understanding the contextual experiences of nurses can shed light on the care of patients in involuntary psychiatric hospital care. (shrink)

Background: It is of importance to understand and communicate caring ethics as a ground for qualitative caring environments. Research is needed on nursing attributes that are visible in nursing leadership since it may give bases for reflections related to the patterns of specific contexts. Aim: The aim of this study was to illuminate the meaning of crucial attributes in nursing leadership toward an ethical care of patients in psychiatric in-patient settings. Research design: The design of the study was descriptive and (...) qualitative with a phenomenological hermeneutical approach. Participants and research context: The study comprised focus group interviews with nurses working in indoor psychiatric care who participated after giving informed consent. Ethical considerations: Since the topic and informants are not labeled as sensitive and subject to ethical approval, it is not covered by the ethics committee’s aim and purpose according to Swedish law. However, careful procedures have been followed according to ethics expressed in the Declaration of Helsinki. Findings: When identifying the thematic structures, analysis resulted in three major themes: To supply, including the following aspects: to supply evidence, to supply common space, and to supply good structures; To support, including the following aspects: to be a role model, to show appreciation and care, and to harbor; To shield, including the following aspects: to advocate, to emit non-tolerance of unethical behavior, and to reprove. Discussion: Leadership is challenging for nurses and plays an important role in ethical qualitative care. These findings should not be understood as a description about nurse manager’s role, which probably has different attributes and more focus on an organizational level. Conclusion: Making the understanding about crucial attributes explicit, the nurse may receive confirmation and recognition of crucial attributes for ethical care in order to move toward an ethical care. (shrink)